Neal Boortz: "ADD does not exist!"

[Iamme]

To some of you, I'm sure that you have heard other say the same thing. Neal said it on his radio show yesterday, and has stated this before.

He believes Attention Deficit Disorder and ADHD (more of the same) have to do with kids upbringing, their environment...NOT from a DISEASE, per say. He believes the drug companies are making this a disease to sell more drugs, like Ritalin.

I too have figured that hyper kids are just that. They are healthy and energetic. Some more than others. They want to be into everything at once.

You have any thoughts on this?

[BillHoyt]

Originally posted by Iamme
To some of you, I'm sure that you have heard other say the same thing. Neal said it on his radio show yesterday, and has stated this before.

He believes Attention Deficit Disorder and ADHD (more of the same) have to do with kids upbringing, their environment...NOT from a DISEASE, per say. He believes the drug companies are making this a disease to sell more drugs, like Ritalin.

I too have figured that hyper kids are just that. They are healthy and energetic. Some more than others. They want to be into everything at once.

You have any thoughts on this?

Boortz is a radio commentator. He stated his opinion. Big whoop. Your name has one too many 'm's in it. Go away.

[Bronze Dog]

I don't know anything about ADD or ADHD, but with all the coverage of it out there, it wouldn't surprise me if there's also a lot of misdiagnosis going on (and legitimate, improved diagnosis going on as well). Kids, by their nature, tend to be energetic and unfocused, at least in my experience, so I can see how some people would jump to conclusions.

Here's a rolled up newspaper in case anyone with more concrete knowledge would like to pound some sense into me. *hands it over*

[BracesForImpact]

I think your radio personality is throwing out the baby with the bathwater. While I agree that there is over diagnosis of the problem, simply saying the problem does not exist doesn't seem to be warranted.

I'll skip my anecdotal evidence, and throw some links at ya about some recent findings...

Here (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2026955&dopt=Citation) is a Pub-Med article on the Corpus Callosum morphology and ADD patients. This article states in part "While all MRI scans were judged to be clinically normal, morphometric analysis revealed that, compared to nondisabled controls, ADHD children had a smaller corpus callosum, particularly in the region of the genu and splenium, and in the area just anterior to the splenium. Interhemispheric fibers in these regions interconnect the left and right frontal, occipital, parietal, and posterior temporal regions. These results suggest that subtle differences may exist in the brains of children with ADHD and that deviations in normal corticogenesis may underlie the behavioral manifestations of this disorder."

Here (http://www.med.harvard.edu/publications/On_The_Brain/Volume5/Number1/ADD.html) is a Harvard article on the subject.

To summarize, I think it's a legitimate medical condition, although I do believe it's over diagnosed and I don't think that medication is necessarily called for in each case.

[ungoliant]

there may be some evidence that it is a legitimate medical problem, but is its cause genetic or environmental? to me, that is the most pressing question, other than how to treat it.

[headscratcher4]

I think Boortz makes some good points... hey those are pretty flowers over ther! When will it be time for lunch?

Is that a new dress you are wearing?

This whole Iraq thing has me very concerned.

Puppies! There are puppies just outside!

Sorry for the derail..back to the adults.

[Eos of the Eons]

Most people don't have the chance to actually compare an ADHD kid to a non-ADHD/ADD child. There is no way to misdiagnose these kids if a proper diagnosis has taken place. In Alberta a kid has to be observed for six months before a diagnosis can be given. These observations take place in a variety of settings by a variety of professionals.

Most people are totally ignorant as to the process and have no business spouting their mouths off until they go and see what is really done. This includes brainless maroons like that bore, Boortz.

[TobiasTheViking]

Everyone, take to heart what Eos of the Eons said.

I was going to make a post about this, but.. I fail to see the point now.

The important facts concerning this issue is already on the table.

[c4ts]

This whole "ADD does not exist" thing started out as a Scientology recruitment scam anyway...

[hgc]

For parents and teachers who have to deal with kids who frankly can't function in educational, and sometimes social, settings due to whatever ADD is, the old cop-out that children are energetic must be pretty f*cking aggravating. Children who can't get educated have a much lower chance of functioning in society as adults. That's a problem worth taking seriously.

[casebro]

This post brings up some questions:

How does the Corpus Callosum concept apply to the other thread about the differing brain geometry amoungst men vs women? Does ADD have a sexual preference? Are younger boys more scatterbrained until they grow up enough to concentrate on sex? Maybe all men have ADD, just poll women? Or does sexual arousal temporarily improve Corpus Callosum connections amoung women, thereby allowing a longer sexual attention span than among men?

Hey, but none of my girlfriends ever complained about the size of my Corpus Callosum ....or is that the wrong corpus? damn, my attention span is shorter than my Corpus Callosum.

[stamenflicker]

ADD does not exist, at least "really" exist. It exists because we have created a human scale to represent human behavior nominally. There is no "point of demarcation" at which ADD begins to exist, or ceases to exist within the human specimen, unlike other "real" diseases. When one has cancer, one can see it and observe its progress and existence via microscope, tissue samples, etc. etc.

ADD is not a disease, it is a social construction. Like genocide, it can only exist when certain vectors of a sociological niche form a space for it... one of those vectors being the very psychologists and drug companies who profit from it.

When we begin to deal with unobservable "diseases" we open the door for all kinds of politcal evil covered in law, and we create the opportunity for the violation of human rights in the name of controlling that "disease." One hundred years from now, society will be appalled by the slavery we projected upon on children because we as adults were in fact the ones screwed up.

Consider: For every 1 crime committed against adults in this country, there are 3 times as many crimes committed against children. For every 1 crime against adults that goes unpunished, there are 10 times as many unpunished crimes against children.

The disorders of children, save perhaps schizophrenia in older teens and mental retardation, is almost always 99% of the time the result of adult projection. Trust me on this one.

Flick

[RandFan]

Originally posted by Eos of the Eons
Most people don't have the chance to actually compare an ADHD kid to a non-ADHD/ADD child. There is no way to misdiagnose these kids if a proper diagnosis has taken place. In Alberta a kid has to be observed for six months before a diagnosis can be given. These observations take place in a variety of settings by a variety of professionals.

Most people are totally ignorant as to the process and have no business spouting their mouths off until they go and see what is really done. This includes brainless maroons like that bore, Boortz. Thank you.

It's possible that we medicate kids too often and that doctors might be too willing to make such a diagnosis but the problems are real.

[RandFan]

Originally posted by stamenflicker
Trust me on this one.

Flick Thank you but no. I'm curious, why do you think we should trust you on this one? Why do different children respond differently even though they are raised by the same parents? Have you ever had to work with a child so diagnosed?

FWIW, I have no problem with people being skeptical of labeling such disorders. There is good evidence that such disorders can be the result of suggestion. But there is evidence that children suffer disorders beyond schizophrenia. But don't ask me to just "trust you". Not a very good hallmark of skepticism or critical thinking. I've worked with children with severe, chronic symptoms and they are not so easily dismissed by circling your ear with your indexed finger.

[stamenflicker]

Randfan,

I've worked with children with severe, chronic symptoms and they are not so easily dismissed by circling your ear with your indexed finger.

I wouldn't presume to, but that did make me chuckle. As to why you should trust me, I was stoking a response, like a hot poker on a glowing log. I'm not going to detail my experience with this population because it is extensive, crossing psychological and educational lines.

So we observe phenomenon in children that is behaviorally out of line with social expectation.... no doubt our observation is real. However, to say that the subject being observed is "disordered" or "diseased" crosses the boundary of logic. Again, the observation is many times a real one, but the diagnosis based on that observation is "Pie in the Sky."

Sure the diagnosis is a "real" something, but a "real" what? It is a real social construction, nothing more. In a world where everyone's favorite color is supposed to be blue, then all those who favor green have a disorder.

The problem here, unlike say diabetes or cancer, is that you can't draw blood or examine the problem via any material means. There is no cut, scrape, gash, or severed artery by which one can assume injury. Instead, the injury is in the social world in which the child operates. The injury is ours, not his/her. Expectation is x, subject doesn't meet expectation, therefore subject is disordered. Fill in the blank.

The problem with this mentality is many fold:

1) It removes power/freedom from the individual and places it in law and social institutions. ((ex. He can't sit still, therefore we need to drug him to make him "better;" or worse, "he is spending all his money on manic episodes, therefore we need to take away his rights to his money; or worse still lets just institutionalize the guy))

2) It displaces personal responsibility. ((ex. Johnny would never hit his playmates, it was his condition.))

3) It sets the stage for any number of things to become one of these "etheral disorders." Until recently homosexuality was a disorder in the DSM, who is to say it won't be again given the current religious/political climate? ((ex. Susie is a lesbian, she needs this pill to fix her condition))

4) It is policed by itself, in that the very people creating conditions and disorders are the group benefiting from them. This is no different from the Catholic church instituting a policy of "Indulgences" in the Middle Ages. ((ex. Little Timmy is suffering from acute bi-polar, but I believe with a year of intensive counseling with me, we can get him where he needs to be.))

5) It diverts attention from the real illness in society-- adults. As I mentioned above, ADD is as real as genocide is real, in that it is socially constructed. The problem with genocide (as recently witnessed in the Sudan discussion) is that there is no real method for identifying it. Does genocide begin after 10,000 deaths? 100,000? or maybe 1/4 million? It is not as if genocide has a formula: x/t < 100,000, where x is the number of deaths and t is the time in days through which these deaths occur. Finally, genocide has a political / social element: ex. Phillip Morris isn't going to get called up on genocide charges no matter how many people tobacco kills.

So while we are busy passing laws in the UN to curb genocide (I liken this to giving a kid a pill), people going on killing each other anyway. Saadam was a perfect example with a 1/4 million deaths per year in his country, 8 UN resolutions, and no reduction in the elusive "genocide" category, because what he was doing wasn't harsh enough to be considered genocide... why? Because no one really knows what it is apart from the social conditions and constructions that surround it.

Meanwhile, back at home, we suddenly realize that 1/3 of our population is suffering from ADD and all of it since the 1960's. Rather than look at the social conditions, the vectors of this niche that allowed us to create this category of disorder, we label it or name it, believing somehow that this leads us to be able to control it. Instead of fixing the social vectors, we drug the children, or worse, we kick them out of school and begin the road of institutionalization for them.

Anyway I'm rambling. I strongly suggest those interested in the topic consider, Thomas Szasz "Insanity, its scope and consequences;" Ian Hacking's "Mad Travelers;" and CS Lewis "The Abolition of Man" as a few good reads to begin thinking outside the mainstream on the subject.

Enjoy your posts RandFan.... hope this didn't sound like a rant. I'm having fun with the topic.

Flick

[luchog]

Originally posted by RandFan
Thank you.

It's possible that we medicate kids too often and that doctors might be too willing to make such a diagnosis but the problems are real.
There is some belief that the increase in ADD/ADHD is in large part how kids are raised as well. During their developmental years, they're innundated with short-term stimuli, predominantly television, and thus don't develop the longer attention spans; which is reflected in brain development.

[Bronze Dog]

Originally posted by luchog
There is some belief that the increase in ADD/ADHD is in large part how kids are raised as well. During their developmental years, they're innundated with short-term stimuli, predominantly television, and thus don't develop the longer attention spans; which is reflected in brain development.
Heard one possible explanation for an alleged correlation some people draw between television and ADD: Reverse causation: ADD causes television viewing, not the other way around.

That rolled-up newspaper from my first post in this thread is still available if anyone needs it.

[Eos of the Eons]

Ugh. Children with ADD and ADHD have observable and very real disorders.

It's the spectrum disorders like Autism and Tourette's that are harder to nail down if the symptoms are not as severe. You can have a Tourettes child with just a few tics, and not much else. Or, You can have a Tourettes child with ADHD, learning disabilities, and OCD.

You can have children in the same family, one with ADHD and the other a bookworm that is completely the opposite of his brother (like with my children). They are parented the same, but are completely different children.

DSM-IV Criteria for ADHD
I. Either A or B:

Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level:

(http://www.cdc.gov/ncbddd/adhd/symptom.htm)

Let me tell you about impulsivity! And distractibility! And omigosh, the hyperness!! And boy, does he lose stuff. I'm talking to the extreme. I'm talking about a kid that literally climbed walls, that used a grocery store as a jungle gym. My other kids can be told "stop that" and they behave. My oldest just seems to forget, he is just him. He is from another planet! It's taken a lot, but he's come a long way. He still drives me crazy in the car at 13 years old playing with everything (radio, seat settings, temperature controls) while I'm driving, but he doesn't get irate when I tell him to stop. He stops for a few minutes and starts on something else (maybe he'll start dancing in his seat to the music, so that the whole vehicle sways). He just has to be moving constantly! And making noise. And talking and talking and talking. And yelling at his brother & sister for doing anything that he might do (make noise, move the seat). Man, does that kid have double standards!! Trust me, it's okay for HIM to make noise, but Ed forbid if a sibling does! It bugs him!

Displaces personal responsibility??? NO. That is one of the main focusses of his treatment. He takes personal responsiblility for his actions much better now because of this trained intervention. His anger levels are self controlled now because of it. It was like moving a mountain, but he's improved so much. These kids need these interventions before they become adults. I can't stress that enough. The whole purpose of diagnosing these kids is to help him for these reasons.

Fixing social Vectors?? I'm doing nothing different with my other children. The younger son does copy some of his older brother's behaviors, but with letting the teachers know of his brother's disorder they know not to allow my younger son to think he can use some excuse to misbehave. He tried it, but didn't get away with it. My younger son made a complete turnaround once we took him to the psychologist and came back to the school with a clean bill of mental health. He has taken personal accountability for his actions, and without meds, because he doesn't need them. It's funny what a kid will try! He couldn't get away with it at home, and didn't try it. He had the teachers wondering for a few months there though! Sheesh. The teachers were complaining that my quiet kid (at home) was noisy! It was because he was getting away with it by copying his brother's tics! Tics are involuntary, you could tell this kid was doing it on purpose. He didn't bother faking any noise tics for the doctor. The teachers started a chart for him at school, and he smartened up.

So I guess we fixed a social "vector"?? Thing is, you can't do that with a child who actually has ADHD/ADD. They aren't doing it consciously.

So you can't have a kid just "act up" and get a diagnosis of ADHD or ADD. The professionals know the difference. There are behaviour disorders, and there are ADD/ADHD. You need different types of interventions depending on the case.

I remember boys in my classes when I was a kid. They didn't get the label "ADD" or "ADHD", they got the label "BAD KID". This didn't help them at all, and some are now in jail, and I know 2 that are dead, one by suicide. Society used to just punish these kids the moment they entered school. Now these kids get the help they need to transition much better to adulthood.

stamenflicker, your posts scare me. It would put my child at risk instead of getting him the helps that have made him as successful as he is now. He will be 14 in Oct. He has a part time job at a gas station where he earns tips and gets praises from his boss (unlike his "normal" friend, who keeps getting dragged into the office for lipping off customers). A customer is rude to my son, and my son shows enough self control to just let it go. A few years ago he would have keyed the guy's car, or punched him (he used to hit me). He can put his energy to good use on the job. If he's not washing windshields or pumping gas, he's cleaning up the place. He loses his house keys, but remembers to put his shirt in the wash. There are more good points to praise him for now. His tics? They are annoying to those who have no idea why he makes weird noises. More people are learning, becoming aware though, and find it interesting instead of annoying.

So you can say we're just creating a problem. From my perspective we are finally doing something to make this world fit these kids (instead of making the kids fit the world we created) before they become adults who are sick of being punished for just being themselves. Change the school system so that kids with a lot of energy have more hands on educations instead of sitting in a chair all day long. Give them meds if they help, they have helped my son (he would actually tolerate a light touch after taking the meds, and he finally let me hug him). He was never some drugged zombie, he was still hyper. He could tolerate a classroom setting though.

I don't think there is enough awareness. I would encourage stamenflicker to actually go and research the actual kids involved here. No politics, only kids that are now able to grow up and not be angry at the world for labelling them "bad".

[stamenflicker]

Eon,

I realize that this topic impacts people personally. Perhaps it is best to just leave the issue at the door, shake hands and wish each other well.

That said, for the record, I don't hold much esteem for the DSM in any version. It is more a book of magic to me than science.

So I guess we fixed a social "vector"?? Thing is, you can't do that with a child who actually has ADHD/ADD.

If you mean "we" to mean our culture, then yes. If you mean "we" to mean you as parents, probably not.

The professionals know the difference.

I know many of these professionals. I've worked with them closely. I'm married to one too. Psychology is an art, not a science. Given this, one must only decide to what degree he/she allows the artist to speak. Artists try to paint a picture of reality, but their pictures aren't real in the same sense of the landscape they paint.

I remember boys in my classes when I was a kid. They didn't get the label "ADD" or "ADHD", they got the label "BAD KID". This didn't help them at all, and some are now in jail, and I know 2 that are dead, one by suicide. Society used to just punish these kids the moment they entered school. Now these kids get the help they need to transition much better to adulthood.

Again, its about naming and naming is about control. It is less about fixing these issues and more about making them.

I wonder how it is that now, with our "improved" powers of scientific and pyschological observation, juvenile crime has increased 15 fold?

I wonder how it is that now, with our "improved" powers of scientific and pyschological observation, juvenile suicide has quadrupled?

We aren't making these problems you speak of go away with current pyschological theory... in fact, an argument can be made that we're making them worse. I have neither the time nor the energy at the moment to outline how that may be true, I can only point you to the above readings.

stamenflicker, your posts scare me. It would put my child at risk instead of getting him the helps that have made him as successful as he is now.

Well, I'm not going to make it personal. I'm glad your child is doing well. I sincerely hope his progress does nothign but improve.

I would encourage stamenflicker to actually go and research the actual kids involved here.

I have many years of education and counseling experience. I know them intimately... and sure, drugs work to balance out emotional and mental states. All kinds of drugs work, some prescribed, and others like the one curled up in my fingers right this moment getting sipped through a 12 oz. can.

Flick

[Ryokan]

There's this (http://adhdfraud.com/) website that claims ADHD is a fraud.

[RandFan]

Originally posted by luchog
There is some belief that the increase in ADD/ADHD is in large part how kids are raised as well. During their developmental years, they're innundated with short-term stimuli, predominantly television, and thus don't develop the longer attention spans; which is reflected in brain development. I think the increase in ADD/ADHD is also due in part to mass media and shows like Oprah Winfrey and Jerry Springer.

[Bronze Dog]

Originally posted by RandFan
I think the increase in ADD/ADHD is also due in part to mass media and shows like Oprah Winfrey and Jerry Springer.
Possibly adding fuel to that fire: Unscrupulous quacks (and maybe otherwise legitimate doctors) hoping to make a quick buck off the hysteria.

[RandFan]

Originally posted by stamenflicker
Enjoy your posts RandFan.... hope this didn't sound like a rant. I'm having fun with the topic.

Flick No, that is fine. I'm perfectly fine with skepticism. I fancy myself a skeptic so no problems. It is very healthy. Eos beat me to the punch. At the moment there is no blood test for autism. Yet it is real and thinking that an autistic is simply counter to social norms is rather silly.

So we observe phenomenon in children that is behaviorally out of line with social expectation.... no doubt our observation is real. However, to say that the subject being observed is "disordered" or "diseased" crosses the boundary of logic. I don't think this follows nor have you made a case that it does.

As to the rest of your post. You make some valid points but I would only agree with some of them and even then conditionally. Yes, you raise potential problems but then many treatments come with side effects or negative aspects. You seem to want to throw the baby out with the bath water (sorry for the metaphor I'll try hard not to mix them and keept them to a minimum). ADD and ADHD is arguably diagnosed too often and I would agree the desire to treat children with chemicals is a bit too knee jerk.

As to a comparison to genocide I don't buy it at all. I don't agree with your conclusions that we are creating all of these problems and I doubt that you can document this. Though I would be happy to consider the research.

[RandFan]

Originally posted by stamenflicker
I know many of these professionals. I've worked with them closely. I'm married to one too. Psychology is an art, not a science. Given this, one must only decide to what degree he/she allows the artist to speak. Artists try to paint a picture of reality, but their pictures aren't real in the same sense of the landscape they paint. Forgive me Flick but I'm confused. If we are talking about treatment of ADD/ADHD via medicine then we are talking the realm of psychiatry and not psychology.

I'm not sure your statistics prove what you think they prove. I would be a bit more careful to make such casual assumptions about rise in crime and therapy. Further I think you need to demonstrate this rise in crime and the associated demographics. You have a long way to go before you can so easily make that leap.

[RandFan]

Originally posted by Ryokan
There's this (http://adhdfraud.com/) website that claims ADHD is a fraud. And Wikipedia (http://en.wikipedia.org/wiki/ADHD) takes a neutral POV and details both sides of the argument.

[stamenflicker]

RandFan,

At the moment there is no blood test for autism. Yet it is real and thinking that an autistic is simply counter to social norms is rather silly.

There are exceptions. I mentioned schizophrenia as one, I'd chalk autism up as another, having met only one Terets you might get me to agree to that one. As two the hundreds of conditions in the DSM, nah.

As to a comparison to genocide I don't buy it at all. I don't agree with your conclusions that we are creating all of these problems and I doubt that you can document this. Though I would be happy to consider the research.

I'm open to say maybe we haven't created them... but if they didn't come from us, where did they come from? Consider Fugue States 100 years ago, or hysteria 150 years ago... all "diagnosis" of human behavior that appeared for a while and disappeared. Once diagnosed the further diagnosis of these "conditions" skyrocketed amonst the population.

Now in 2005, no one gets diagnosed with Fugue-- no person that I'm aware of in probably 50 years. The same is true for hysteria. So again, if we aren't creating these conditions, we need to explain who or what is, and we need to explain how an illness of the brain can exist, but then not exist. Cancer doesn't appear and disappear, but certain mental "conditions" do.

Beyond that, we need to explain why this is a US phenonmenon, not a global one. If 90% of all the Ritalin in the world is consumed by Americans, well I think that's pretty telling. And it tells much more than the reality that we can afford it, when other affluent nations consume 1/4 the amount per capita.

15% of our nation's boys ages 8-14 have been prescribed Ritalin. Something else is going on here, and its not the magical birth of a new "disorder." It is adult projection, in Freudian terms.

There are many other ways to make the case, but those materials are out there for anyone interested.

You seem to want to throw the baby out with the bath water

Or maybe I'm saying there really is no baby in the bathwater.

I'm not sure your statistics prove what you think they prove. I would be a bit more careful to make such casual assumptions about rise in crime and therapy.

Well I mentioned it only as a possiblity. What is a fact is that in spite of the efforts of this wayward science we call psychology / psychiatry, children are getting worse not better. Sure there are success stories, but I liken them to a person putting their finger in a dike to hold back water. At what point do you find a "scientist" willing to hike up stream and see where all this water is coming from? Especially when they can profit greatly from teaching people finger plugging techniques.

If we are talking about treatment of ADD/ADHD via medicine then we are talking the realm of psychiatry and not psychology.

Depends on your State, but sure. Drug companies have pushed in the last two years to allow psychologists the ability to prescribe Ritalin and other drugs... wonder why.

Even so, its more damning because psychiatrists with their medical training should know better than to be assuming leisons on the brains of our youth. I've talked with many of these folks. Their opinion is that it must be a "real" disease because drugs work on it... well torture works too (so does beer or pot), but that doesn't make the product anything other than a manipulation of the real human condition.

Rather than try to understand what it is that makes a child anxious, or noisy, or depressed, society would rather drug the alpha-males and artists (and some others) right out of the pack... I just have a serious problem with that. I realize it is a radical position.

Flick

[RandFan]

Originally posted by stamenflicker
Or maybe I'm saying there really is no baby in the bathwater. And maybe there isn't but then why should we treat schizophrenics or autistics different? Maybe they are normal and we are the ones with problems.

I really don't understand your point. We observe a behavior and you say the behavior itself is not important. Yet you agree that "some" behaviors are worthy of drawing conclusions.

I have already agreed that there very well could be many instances that are misdiagnosed.

Your point that this isn't a global problem is not proven. Again, I agree that the degree of the problem is not represented but then I don't agree that there really are all of the ADD ADHD cases. That is not at all my point.

What is a fact is that in spite of the efforts of this wayward science we call psychology / psychiatry, children are getting worse not better. Again, this is not proven. You are making unsubstantiated claims. Please tell us your basis for this and not just the questions you posed earlier. By all means be skeptical of ADD ADHD but understand I am very skeptical of your claim.

Rather than try to understand what it is that makes a child anxious, or noisy, or depressed, society would rather drug the alpha-males and artists (and some others) right out of the pack... I just have a serious problem with that. I realize it is a radical position. And again, maybe we just need to understand Autistics and Schizophrenics.

I agree with you to a point but find it rather premature to just dismiss ADD ADHD. Hell, let's just dismiss Autism and Schizophrenia, why not?

[Kiless]

My god.

All this and just after I did a post-grad unit on behavioural management, with assignments on (as far as I can see, despite Stamenflicker's statements) the very real cases of ADHD and Autism! As an educator (secondary - have taught for seven years and currently doing a Masters of Education in Special Needs education and a Masters of Education in Critical Thinking) and as a person who has a family member that was diagnosed as autistic... well, I'm going to have to ask for clarification on the following points:

1) How is psychology an 'art' not a 'science'?

2) Why do you consider the DSM as 'a book of magic, not science'?

3) Your statement:
"15% of our nation's boys ages 8-14 have been prescribed Ritalin. Something else is going on here, and its not the magical birth of a new "disorder." It is adult projection, in Freudian terms.

There are many other ways to make the case, but those materials are out there for anyone interested."

Where?

4) "Even so, its more damning because psychiatrists with their medical training should know better than to be assuming leisons on the brains of our youth. I've talked with many of these folks. Their opinion is that it must be a "real" disease because drugs work on it... well torture works too (so does beer or pot), but that doesn't make the product anything other than a manipulation of the real human condition."

Who and in what circumstances did you speak to these 'folks'?

Sorry - despite your statement: "I'm not going to detail my experience with this population because it is extensive, crossing psychological and educational lines"... I think you're going to have to... :)


5) 'Well I mentioned it only as a possiblity. What is a fact is that in spite of the efforts of this wayward science we call psychology / psychiatry, children are getting worse not better. Sure there are success stories, but I liken them to a person putting their finger in a dike to hold back water. At what point do you find a "scientist" willing to hike up stream and see where all this water is coming from? Especially when they can profit greatly from teaching people finger plugging techniques.'

I'm a little lost with that paragraph - have you failed to find professionals who analyse ADHD or autism correctly (and what constitutes as "correct", in your experience, exactly?) and how exactly are people profiting from mental health related drug promotion as opposed to being just helped?

6) "I wonder how it is that now, with our "improved" powers of scientific and pyschological observation, juvenile crime has increased 15 fold?

I wonder how it is that now, with our "improved" powers of scientific and pyschological observation, juvenile suicide has quadrupled?

We aren't making these problems you speak of go away with current pyschological theory... in fact, an argument can be made that we're making them worse. I have neither the time nor the energy at the moment to outline how that may be true, I can only point you to the above readings."

I wasn't sure if there were meant to be hyperlinks for the two opening sentences above; they were underlined... and thus when you say 'I can only point you to the above readings' I was wondering if you meant to link to 'readings' when you did this.... and what those 'readings' were?

Because you're citing stats when you do this, but you're not giving any foundation for them - unless there are links missing?

7) "I know many of these professionals. I've worked with them closely. I'm married to one too."

Could you clarify what you mean by 'professional'? Professional as in... medical doctors? A PhD? In what, exactly? I guess I'm repeating the 'what's your experience' question again! :)

8) "Consider: For every 1 crime committed against adults in this country, there are 3 times as many crimes committed against children. For every 1 crime against adults that goes unpunished, there are 10 times as many unpunished crimes against children.

The disorders of children, save perhaps schizophrenia in older teens and mental retardation, is almost always 99% of the time the result of adult projection."

Where do you get these figures from? Are you saying that schizophrenia in older teens and mental retardation are the only genuine disorders afflicting children?

9) This had me at a loss - why are you citing the following books as authorities on the subect of... is it ADHD? Or just mental health in general? Sorry, I got a little lost here.

Thomas Szasz "Insanity, its scope and consequences;" Ian Hacking's "Mad Travelers;" and CS Lewis "The Abolition of Man" as a few good reads to begin thinking outside the mainstream on the subject.

And why are they 'outside the mainstream' and 'a good read' on these subjects? Perhaps someone else out there can help with this too, because I'm only familiar with Lewis' works... is there a certain thematic similarity between them all? I will find out for myself immediately, of course - this intrigues me.


"Trust me on this one"? I think more information is needed. :( In fact, it is demanded - as there's a lot here I'm seriously questioning, just like the others.

Edited to clarify a few errant quote marks.

[stamenflicker]

Randfan,

I really don't understand your point. We observe a behavior and you say the behavior itself is not important. Yet you agree that "some" behaviors are worthy of drawing conclusions.

Because these are nuerological conditions that explain more than just a personality or behavior trend. They often accompany a wide variety of other bodily functions which include motor skills, (such as tics), reflexs (such as pupils responding to light, etc.)... and they extend beyond personality and behavior alone covering "medical" conditions which if noted in an otherwise healthy person would give cause for alarm.

Again, this is not proven. You are making unsubstantiated claims. Please tell us your basis for this and not just the questions you posed earlier. By all means be skeptical of ADD ADHD but understand I am very skeptical of your claim.

Well this is for Kilness too then, and this was just a "brief" ten minute search:

Ineffectiveness of prescription drugs:
http://www.ahrp.org/infomail/05/06/09.php
http://www.nlm.nih.gov/medlineplus/news/fullstory_26464.html

US Crime rates:

http://www.disastercenter.com/crime/uscrime.htm

England suicide rates timeline:
http://bjp.rcpsych.org/cgi/content/full/176/1/64/FIG1

Australia suicide chart:
https://www.mja.com.au/public/issues/171_3_020899/cantor/cantor.html#fig1-8

US suicide chart:
http://www.cdc.gov/nchs/data/hus/hus04trend.pdf#046

You can see the spike in both suicide and violence capped off in the mid 90's, but even at the cap the rates are 300-400% higher than in 1960. I'm still looking for a cooresponding chart in the per capita increase of counseling professions, I'm certain its close. Not to say for certain that one has caused the other, but rather to demonstrate that the net effect is near zero.

Kilness,

I've not the time to address everything in your post, but I appreciate your questions. I again refer you to books that probably were not introduced to you in your studies. I believe they'll help a lot, and I'd begin with philosopher Ian Hacking's books: Mad Travellers (on Fugue states) and Rewriting the Soul (on multiple personality disorder), both of which were psychological "crazes" that waxed and weaned (sp.?). Then I'd move to Szasz, "Insanity its Scope and Consequences" or maybe a handful of other books I could recommend.

Who and in what circumstances did you speak to these 'folks'?

I'm shouldn't have to bother with my experiences, because they are irrelevant, just read the ADD consensus statement and see it for yourself:

http://consensus.nih.gov/1998/1998AttentionDeficitHyperactivityDisorder110html.h tm

have you failed to find professionals who analyse ADHD or autism correctly (and what constitutes as "correct", in your experience, exactly?)

I've not spoken much of autism, its not my area. As to a "correct" diagnosis, I don't believe in one. There is only the behavior to consider in issues involving behavior or personality, not a magical disorder which we name and thereby feel better by naming it.


Flick

[Kiless]

The name is : Kiless. :)

"Well this is for Kilness too then, and this was just a "brief" ten minute search"

Feel free to do more and post it later, because I don't see an answer in what you have given to me... but I can wait! :)

New questions:

1) Where is the correlation? I don't see any between 'ineffectiveness of prescription drugs' and 'crime rates'. So far it's stats and more stats...

2) "I've not the time to address everything in your post, but I appreciate your questions. I again refer you to books that probably were not introduced to you in your studies. I believe they'll help a lot, and I'd begin with philosopher Ian Hacking's books: Mad Travellers (on Fugue states) and Rewriting the Soul (on multiple personality disorder), both of which were psychological "crazes" that waxed and weaned (sp.?). Then I'd move to Szasz, "Insanity its Scope and Consequences" or maybe a handful of other books I could recommend.'

Well, when you do have time, feel free to do more because I'd like to know:

- What made these 'psychological "crazes"' wane, as you put it?
- What was the challenge against them and why do you consider such challenges (if that is the correct term) wrong?

And as you said - other books you'd recommend? Feel free to take time to cite, I'm a busy person too and I understand!

And yeah, there were a lot of questions... but they should be addressed.

Qualifications, again, are a necessity in this matter. I do suggest you address this, because you're just claiming authority and not backing it up!

I'd like to refer to your link to the NIH report now:

1) It's a 1998 report... got anything more recent? :)

2) QUOTE 'Although an independent diagnostic test for ADHD does not exist, there is evidence supporting the validity of the disorder.'
Sure, they then go on with 'further research is needed' and I'd agree with that... but this isn't supporting your case so far... they're saying it's VALID!!

3) QUOTE: 'Because of the lack of consistent improvement beyond the core symptoms and the paucity of long-term studies (beyond 14 months), there is a need for longer term studies with drugs and behavioral modalities and their combination. Although trials are under way, conclusive recommendations concerning treatment for the long term cannot be made presently.'
(my emphasis)

Again, not supporting your case...!

4)QUOTE: "These problems point to the need for improved assessment, treatment, and followup of patients with ADHD. A more consistent set of diagnostic procedures and practice guidelines is of utmost importance. Furthermore, the lack of insurance coverage preventing the appropriate diagnosis and treatment of ADHD and the lack of integration with educational services are substantial barriers and represent considerable long-term costs for society."

(I'd agree with that - it's tough on everyone. And improvement should always be a goal.)

"Finally, after years of clinical research and experience with ADHD, our knowledge about the cause or causes of ADHD remains largely speculative. Consequently, we have no documented strategies for the prevention of ADHD."

Okay... but how does this support your case? What about the treatment? I shall read further, certainly...


*******

I'm out of time at the moment, but I'll continue reading it... at the moment, stamenflicker - this isn't doing anything for you.

I'd suggest you start finding sections from it that do support what you're saying, because so far it's a link with no benefit to your argument whatsoever!

I've got my study notes at home - I'll refer to them when I get there as the basis for my statements on the matter, where I'll cite at length because I'll have more time. :)

[Mercutio]

Flick, as soon as I read your first post, I knew it would not be long until Szaz was mentioned. :D

Strange thing is, the two battling sides here do each have their points, and are not (as they might think) mutually exclusive.

Of course the diagnoses, and even the disorders, are a social construction, in the sense that (with or without a specific blood test for it) we define a syndrome by a collection of symptoms, and given the inevitable variability among population members, the definitions of these diseases must be flexible. The DSM gives a list of symptoms, and any two individuals with ADD may exhibit vastly different manifestations of those symptoms. (Some, though not all, Behavior Modification therapists, as a response to this, advocate an avoidance of labels of any sort whatsoever, relying on a functional analysis of the behaviors to guide treatment. Others, pragmatically, note the usefulness of a system of labels, if only to facilitate third-party payment....)

But...so what? The same can be said for almost any illness! (And we need not limit ourselves to "mental illness", either; relying on symptoms for a diagnosis means that we will have both "false alarms" and "misses" for many diagnostic categories.) I am reminded of a Saturday Night Live sketch for a simple blood test (4 vials, if I am not mistaken, then a 2-hour wait while the test works) to determine if you have a headache. "Headaches" are socially constructed, too, but that does not mean there is not some real thing there for us to construct our social concept around!

It has been a few years since I looked at the behavioral literature on ADD/ADHD, but at the time I did last look, there was remarkable benefit (remember, these were published case studies--but there is certainly a case to be made that there is a bias in publication toward publishing positive results) to treatments which were based on the assumption that environmental control would be sufficient to reduce symptoms. To my thinking, this is a good thing, whether or not the drug treatments work. I don't think we should remove arrows from our quill based on prejudice toward the theoretical stance of the particular intervention.

For myself...I think there is definitely something there. But I also think that we overuse the label, and that can have harmful effects. (At least one study found that volunteers helping a child with homework gave up--or allowed the child to give up--more quickly when the child was labeled ADD. I am at home now, so I don't have the citation in front of me.) And I smile just a bit at my friend Eos's comment "[t]here is no way to misdiagnose these kids if a proper diagnosis has taken place." Are these kids scotsmen in disguise?

I am not at all opposed to medication for ADD/ADHD. In fact, based (inordinately) on the experience of one student of mine who was diagnosed as ADHD only after she was already in college, and who finally tried meds after avoiding them for at least 2 years after diagnosis, I am quite in favor of appropriate use of meds. They can make a world of difference. But recall that environmental treatments (behavior modification, typically) work even when the disorder has an organic cause. (Here, because I am more familiar with the literature, I point to the Cordelia de Lange and the Lesch-Nyhan syndromes, where severe self-injurious behavior results from an amino acid deficiency. Even though there is a specific organic disorder here, behavior modification is a successful treatment.)

[stamenflicker]

Kiless,

The name is : Kiless.

My apologies.

1) Where is the correlation? I don't see any between 'ineffectiveness of prescription drugs' and 'crime rates'. So far it's stats and more stats...

Look I'm the first one in the room to agree with Mark Twain, that "figures lie and liars figure." So, you make what you want of the numbers, and I'm fine with just knowing my assumption is a better one. Why should I not put the reverse to you and ask what coorelation can you show between the presence of prescription drugs and crime or suicide reduction? My point was that on its best day, psychology and psychiatry can only claim a minimal benefit in helping people with just about any social problem-- depression, suicide, crime-- you pick the stat and then you take your library card and do the research, I've little interest in that I've seen enough and read enough to conclude. The net effect (by that I mean on society itself, ie. total amount of counseling hours per capita over time /// verses /// total increase of crime, suicide, prescription meds) is at best zero, and at worse, well taking us the wrong direction. If you don't want to accept that, I'm no worse for wear.

- What made these 'psychological "crazes"' wane, as you put it?

The invisible pink unicorn? Or a change in a social vector that created the mythological disease? Who can know.... look at both of Hacking's books, they are excellent and in my estimation no one in the helping professions can afford to not read them, so I encourage you to check them out as time allows.

And as you said - other books you'd recommend? Feel free to take time to cite, I'm a busy person too and I understand!

I'll try to work you up a list this weekend. Maybe my top ten on this subject?

1) It's a 1998 report... got anything more recent?

I'm sure I could find something, althuogh most stats run anywhere from 3-5 years behind in my experience. But of what use? Even if rates have declined since 1998, they in no way have come close to a 300% decrease.

Sure, they then go on with 'further research is needed' and I'd agree with that... but this isn't supporting your case so far... they're saying it's VALID!!

And maybe further research is needed to demonstrate that all gays have bad wiring? Of course its valid to them, they are the very ones who profit from it, as well as recommend the drugs, drug treatments, drug types, and drug rehabs (methadone). Have you seen the statitics showing the correlation between Ritalin use and later drug use? I will try to find those for you. Again, look at the list of people who say its valid... do they have anything at all it common?

there is a need for longer term studies with drugs and behavioral modalities and their combination.

More magical talk from the forest fairies. It doesn't work. They're just trying to find a way to make the numbers more real by changing the variables.

I'm out of time at the moment, but I'll continue reading it... at the moment, stamenflicker - this isn't doing anything for you.

Quite the contrary friend, its done it for me. It's just not doing anything for you.

Let me give you a final analogy to express my views:

If Ford cars or Chevy trucks demonstrated an overall 300-400% increase in mechanical problems from 1960-2000, who in their right mind would think the solution was hiring more mechanics to repair them?

Flick

[stamenflicker]

Merc,

I don't think we should remove arrows from our quill based on prejudice toward the theoretical stance of the particular intervention.

I agree we never take an arrow from the quill, but shouldn't we pick a sharper one? And what if our diagnosis themselves are generating the conditions? I'm sure you probably don't think that's possible, but there is evidence to at least suggest the possibility-- and this possibility is true for everything from child abuse to genocide to SIDS to nuclear terrorism. It's the core of the genuine skeptic to question what is socially constructed, how is it constructed via mass media; and if it is perchance real what elements of it feed a deeper seated (and more controllable) social construction by those in power.

Flick

[Mercutio]

Originally posted by stamenflicker
Merc,



I agree we never take an arrow from the quill, but shouldn't we pick a sharper one? And what if our diagnosis themselves are generating the conditions? I'm sure you probably don't think that's possible, but there is evidence to at least suggest the possibility-- and this possibility is true for everything from child abuse to genocide to SIDS to nuclear terrorism. It's the core of the genuine skeptic to question what is socially constructed, how is it constructed via mass media; and if it is perchance real what elements of it feed a deeper seated (and more controllable) social construction by those in power.

Flick Of course there is a large literature on the effect of diagnostic labels on how we treat the individuals so labeled. I thought I had mentioned that in my first post--if I did, it got lost. I am merely saying that the two sides arguing in this thread are not mutually exclusive. An effect of labeling does not eliminate the possibility of an organic cause, nor vice versa. Supporting one position is not an attack on the other, nor does attacking one position support the other.

One of my colleagues was involved in the "daycare debate", and noticed that it differed from country to country. In the US, the question was "is daycare bad for kids?", whereas in Italy, the question was "given that daycare is needed, how can we make it the best thing for kids?" We tend to take an adversarial stance when examining problems in the US (or maybe it just seems that way to me), when perhaps we should simply be trying to see, no matter what the theoretical underpinnings, how we can best help those with ADD/ADHD.

[Kiless]

LOL - just as an aside, I realise now that I've come across you before, stamenflicker... where you misspelt my name in exactly the same fashion, which was why I never found your response. When I search for people's responses to my posts, I use the correct spelling for my name! :)

I quite liked your summation about Flew, back then - '...he is more likely through reason and logic to say, "I'm right, you are wrong and here is why I think so."

And that, ironically, is what I'm about to do here. :)
Hope I don't make any spelling errors - it's 11.16pm.

Originally posted by stamenflicker
Look I'm the first one in the room to agree with Mark Twain, that "figures lie and liars figure." So, you make what you want of the numbers, and I'm fine with just knowing my assumption is a better one.

What a terrible thing to say! Is this the skeptics board? :( And then you do virtually the same again here:

Originally posted by stamenflicker
I've little interest in that I've seen enough and read enough to conclude.

and

Originally posted by stamenflicker
If you don't want to accept that, I'm no worse for wear.

Oh, my husband would like to state that he believes he came up with the 'IPU' phrase which apparently has become the latest JREF 'meme'... although I'm of the opinion he's rather horrified by your reasoning in your posts too, but I don't think he'll contribute here... anyway, that's rather irrelevant:

Originally posted by stamenflicker
The invisible pink unicorn? Or a change in a social vector that created the mythological disease? Who can know.... look at both of Hacking's books, they are excellent and in my estimation no one in the helping professions can afford to not read them, so I encourage you to check them out as time allows.

Sure, I will. But I have my doubts. Serious ones. But then, I doubt Mercutio as well (no blurry photo of his messy faculty desk or irritating habit of saying 'I am right' makes him totally convincing, IMHO, so I continue to read his posts to see what he argues and have read two books he has cited) and although I make an effort to understand where he's coming from, I don't see why I can't do the same for anyone else... but so far, your posts give me absolutely nothing beyond what appears to be unfounded 'conspiracy-theory' atttudes towards the drug manufacturing industry and the medical profession!

This lumping psychology/psychiatry habit bewilders me too... but perhaps that's addressed in an earlier question I made, in regards to the 'art' comment you make that appears to apply to both.

But yes - top ten stamenflicker booklist would be good. I might only manage the first five though, mind, but only due to limited access. I have three university libraries within easy driving distance; at least one should provide me with several of the texts you will be / are citing. CS Lewis texts out here seems to mostly appear in the fiction section, I note... Whatever happened to the Screwtape Letters, did they ever reprint that? Anyway, I'll try.

Originally posted by stamenflicker
And maybe further research is needed to demonstrate that all gays have bad wiring?

Interesting analogy... and not a very good one. Why? Because at least in studying ADHD (quoting Merc here) - 'we should... be trying to see, no matter what the theoretical underpinnings, how we can best help those with ADD/ADHD.' I see no such 'help' required for those people who are homosexual. Maybe we disagree on that point? Maybe another thread is required for that.

Ah, here's the 'conspiracy theory' part I mentioned:

Originally posted by stamenflicker
Of course its valid to them, they are the very ones who profit from it, as well as recommend the drugs, drug treatments, drug types, and drug rehabs (methadone). Have you seen the statitics showing the correlation between Ritalin use and later drug use? I will try to find those for you. Again, look at the list of people who say its valid... do they have anything at all it common?

Yes, I'd like to see the correlation. I'd like to see more evidence for many of my earlier unanswered questions. I have the time to wait, so that's okay. :)

'List of people and things in common'... they're all stakeholders?

No - I need more. In fact, I'd say anyone reading this thread deserves more to consider your arguments valid.

Originally posted by stamenflicker
More magical talk from the forest fairies. It doesn't work. They're just trying to find a way to make the numbers more real by changing the variables.

This is.... so absurd... sorry, I just can't comment on it without becoming insulting, I fear! :) I might have to come back to it after some sleep and clarify, if needed.

Originally posted by stamenflicker
Quite the contrary friend, its done it for me. It's just not doing anything for you.

*Snorfle* - sorry, but I just thought of half a dozen analogies, none of which are appropriate but all are rather filthy in construct... let's just say... you've got to work beyond self-pleasure? :) Particularly with such an important topic! Imagine if I did this for the variety of other threads on the JREF board! How flamed would I be? Guts for garters, I'd imagine...

Originally posted by stamenflicker
Let me give you a final analogy to express my views:

If Ford cars or Chevy trucks demonstrated an overall 300-400% increase in mechanical problems from 1960-2000, who in their right mind would think the solution was hiring more mechanics to repair them?

Hell, man, I'd say at least a professional mechanic has a bloomin' IDEA about what they could contribute to the fault and certainly give proper feedback to the manufacturer?

You a 'mechanic' by trade, BTW? Because so far I'm seeing nothing that convinces me in the slightest.

Maybe your booklist will help. But so far, you're doing little but harm your own cause.

Really - please answer some of the earlier questions? This ivory tower thing is getting dull and I think I may just bow out with a 'doesn't answer questions, has nothing worthwhile to contribute overall, not worth wasting effort on' conclusion. :(

And I hate that. Especially when you just learned to spell my name right and all.... ;)

[dogguy]

Originally posted by stamenflicker
Trust me on this one.

Flick

Having read this post from the beginning, including all of your somewhat rambling posts, I see no reason to place any trust whatsoever in your opinion. You claim to have some level of expertise on this topic but decline to detail what that may be. Your misspelling of Tourettes (as Terrets) in one post does not instill a lot of confidence in your background education on this topic. You blithely state that you are "having fun" with this topic which is, frankly, an insult to those of us who have to cope full time with a child who cannot function in school and social situations due to an inability to apply proper attention at crucial times. There is no room for "fun" when the current and future mental and emotional stability of your child is at stake.

Our daughter was born to a woman who was addicted to heroin and drank heavily throughout her pregnancy. Our daughter's diagnosis of Fetal Alcohol Syndrome and Neonatal Abstinence Syndrome (FAS/NAS) is a fact. With your claimed extensive backgound on this topic you no doubt know that the brain damage connected to FAS is often physically observable and measurable and is in no way a social construction. She was in hospital for 7 weeks following her birth on a reduced morphine protocol to wean her off the heroin that she became addicted to in-utero. Among the recognized symptoms of such children are measurably higher levels of activity compared to a baseline of unaffected children, and markedly shorter attention spans. These symptoms are easily observable in our daughter - the analogy of a hummingbird flitting around our house is quite appropriate.

The effects of these symptoms, or disorders, in our daughter are serious and they are real. Un-treated, they could have serious effects on her and us personally, and could be to the detriment of society in general. She has difficulty making and keeping friends because of her "flighty" nature. Other children think she is not interested in them or their activities because of her tendecy to become distracted. She does not learn as quickly as her peers in school due to her inability to concemtrate. If a young child is ignored and left behind by her peers due to these disabilities, she is likely to become a "social outcast" as an adult complete with the potential costs to society from depression, welfare ,crime, drug use, prison and suicide. We are not prepared to sit back and let this happen based on your assurances of "trust me, her problems do not really exist".

We are fortunate to have good supports in place for our daughter through government programs, access to qualified and knowledgeable medical professionals, and an extensive supportive and understanding family. We are by no means "hung-up" on labels and acronyms (such as ADD or ADHD) but if a label is what we need to get suitable help for our daughter, then we are all for them! FWIW, we have so far avoided using any drugs in our therapies, with the exception of low dose melatonin to help her sleep at night, but we recognise that this might be a necessary course of treatment in the future and are not averse to drug therapy if and when it becomes necessary.

Unless you have something positive to contribute towards enabling our FAS, NAS, ADD, ADHD daughter to become a happy child and a contributing member of society I suggest you stop insulting us with your biased and unfounded opinions. Go have your "fun" at someone else's expense.

[Kiless]

Dougguy, thanks for your input. I'm not a parent myself but as a teacher who works with students that range across the spectrum of abilities, I have quite a lot of sympathy for what many families have to deal with. 'Fun' isn't the right word, no... Having a kid overall is fun, yes, but there's many things that aren't a joking matter and this is one of them. Hope my attitude in these posts haven't rubbed you up the wrong way either; I know I'm becoming more incredulous with every post and that's when I start getting daft and dirty with my rebuttals. :(

[dogguy]

Hi, Kiless,
I have no problem with any of your posts in this thread. you have made some good points and appear to me to have a much better understanding of the topic than stamenflicker. My objection to stamenflicker is that he/she appears to view this as a purely academic debate for his/her own somewhat uninfomed personal entertainment, and not as a real problem that people have to deal with on a daily basis. As far as I am concerned stamenfilcker and Iamme can take their acronyms and their uninformed opinions and "stick em where the sun don't shine". The important thing is that there is a credible body of research that provides recognition of my daughter's problem and therapies that provide considerable assistance to help her live as normal a life as possible. It is just a nuisance that in addition to helping our daughter live with her limitations, it is also necessary to try and educate the ignorant people who try to tell us that her problems do not exist
As you no doubt realize, we went into this adoption with our eyes wide open. With my wife's pediatric nursing background and the training and resources avalable to us as foster parents we were (almost) fully prepared to deal with our daughter's problems and we are convinced that we are the right people to raise her and help her. It is, in fact, a LOT of fun having her around. She is a cheerful and bright child who is very intelligent in so many ways. We love her dearly and have never for one moment regretted adopting her.

[athon]

I can't believe I've totally overlooked this thread. Must be my new glasses...or absence of them...or something.

Kiless and Merc, you've addressed Flick's comments rather nicely. I don't want to be covering any ground already argued here, and so while I've had a brief read through the posts I might be repeating what's already been said. I think I see what Flick is trying to get at, and where the concept falls down.

ASD and it's associated conditions are very real. To refrain from classifying a set of behaviours takes away tools society can utilise to assist people who might otherwise find difficulty in accessing the rights we all take for granted. Indeed, while such tools are often abused, it's a greater abuse to simply wipe away a set of parameters because some people don't see how they can be distinguished as a disease in their own right.

Firstly, some definitions. Disease in this case is any set of conditions which impedes the normal functioning of an organism. I'll set 'normal' here as the expectations post-industrial society has for any one of its community members.

We do all exist on a scale of variation. ASD (Autistic Spectrum Disorders, which covers - amongst other things - developmental disorders such as ADD and ADHD) is an example of a spectrum of behaviour which makes it difficult for an individual to socially interact in ways we find simple. It is as much a variation as a person's tendency to cry more in soppy movies; it has genetic foundations influenced by environmental conditioning. We could classify a whole range of variations as we have done with ASD. However, the usefulness of doing this then has to be questioned.

How to diagnose such a condition is tricky, of course. Unlike a bacterial infection, there is no proof positive we can utilise to say a person can be classified as being influenced by such biological conditions. Surveys and questionairres have their faults and personal opinion relies on subjective observations. But agian this does not discount the fact that there exists a set of biologically-influenced behaviours common to a large number of individuals.

The question of how we should address this is a seperate matter. Drugs, changing environments, education... all have pro's and con's, and I'd be happy to share my opinion on each.

However it's simply ignorance of classification to suggest that conditions classified within ASD do not exist as they are simply human traits.

Athon

[NeilC]

There are a fair few psychiatrists and educators etc who don't believe that ADD and ADHD are discrete biological diseases but merely a function of a somewhat arbirary definition and diagnoses. Certainly people are successfully treated using exactly the same methods as used on simply badly behaved kids.

It is rather odd how it seemed to crop up in the USA - a country with a culture of MTV and videogames, no exercise and a me-me-me philosophy. And then it spread to the most US influenced European countries first. And odd that so many people seem to have it at a time when juvenille behaviour is at it's worst. Convenient that it removes responsibility from a generation of parents who don't want any.

People who have kids diagnosed with ADD really want to believe it too so are highly insulted by any suggestion it's not biological.

If it isn't a real, discrete disease then it would have been invented anyway IMO.

I am not convinced by the evidence that it is a specific disease.

It's like depression. Nobody makes bad decisions or tries to hold together conflicting beliefs. They are not slothful or misanthropic - they are CHEMICALLY depressed. Hey, we can prove it because they have less serotonin. Well, prove it if we ignore any question of cause and effect .

[dogguy]

Originally posted by Splossy
There are a fair few psychiatrists and educators etc who don't believe that ADD and ADHD are discrete biological diseases but merely a function of a somewhat arbirary definition and diagnoses. Certainly people are successfully treated using exactly the same methods as used on simply badly behaved kids.

It is rather odd how it seemed to crop up in the USA - a country with a culture of MTV and videogames, no exercise and a me-me-me philosophy. And then it spread to the most US influenced European countries first. And odd that so many people seem to have it at a time when juvenille behaviour is at it's worst. Convenient that it removes responsibility from a generation of parents who don't want any.

People who have kids diagnosed with ADD really want to believe it too so are highly insulted by any suggestion it's not biological.

If it isn't a real, discrete disease then it would have been invented anyway IMO.

I am not convinced by the evidence that it is a specific disease.

It's like depression. Nobody makes bad decisions or tries to hold together conflicting beliefs. They are not slothful or misanthropic - they are CHEMICALLY depressed. Hey, we can prove it because they have less serotonin. Well, prove it if we ignore any question of cause and effect .

I have read this post several times but I cannot seem to grasp your point. Care to summarize for me?

[athon]

Originally posted by Splossy
There are a fair few psychiatrists and educators etc who don't believe that ADD and ADHD are discrete biological diseases but merely a function of a somewhat arbirary definition and diagnoses. Certainly people are successfully treated using exactly the same methods as used on simply badly behaved kids.

First of all, welcome to the forum. Always happy to have more people at this party.

The question here is 'can we distinguish between a learned behaviour pattern and a significant underlying biological influence?' The answer is yes, we can.

Of course we are all subject to underlying biological influences. All emotions, compulsions, tendencies etc. have some sort of a neurological and/or endocrinological influence. How we deal with these in terms of behaviour varies with the environment in which we learn. So I'm not surprised that learned behaviour and behaviour that is highly influenced by 'ASD' biology could both be remedied with identical methods, such as changing environments or by teaching coping skills.

It is rather odd how it seemed to crop up in the USA - a country with a culture of MTV and videogames, no exercise and a me-me-me philosophy. And then it spread to the most US influenced European countries first. And odd that so many people seem to have it at a time when juvenille behaviour is at it's worst. Convenient that it removes responsibility from a generation of parents who don't want any.

Hmm, a bit of the 'glory age' rose-coloured glasses approach, I'm afraid. Juvenile behaviour is not necessarily any worse than before. I agree that there are comparitively different problems now, and that some cycles of behaviour might have continued, but kids are no worse now than they were before. I challenge you to support your case to contrary.

We are now a society more aware. However, awareness has a cost; we have access to more information now than ever before, and that information may or may not be good. People lack the skills to be able to discern the relevance or the value of what they are being told. Therefore, what was once a 'bad child' now is seen as being an 'ASD' child. A hundred years ago, the understanding that biology influenced behaviour on a variety of levels was basic in the least.

The thing is, what do we do with the information? I agree that a lot of people use it as an excuse. These people do not understand the significance of biologically influenced behaviour, that as humans we have the option to adapt and take responsibility.

People who have kids diagnosed with ADD really want to believe it too so are highly insulted by any suggestion it's not biological.

If it isn't a real, discrete disease then it would have been invented anyway IMO.

I'm not sure I understand what you mean. Can you clarify?

I am not convinced by the evidence that it is a specific disease.

It's like depression. Nobody makes bad decisions or tries to hold together conflicting beliefs. They are not slothful or misanthropic - they are CHEMICALLY depressed. Hey, we can prove it because they have less serotonin. Well, prove it if we ignore any question of cause and effect .

Hmm, again I'm a little lost. Are you saying that a variation in biochemistry can't be considered a disease?

See my definition of disease in my above post. Indeed, the problem is not with this definition, but with how to define 'normal'. All things we see as 'diseases' are simply variances in function. What's one man's genetic disease is another man's genetic trait. Change the environment, and the disease becomes something of an advantage (see sickle cell anaemia vs. malaria). Bacteria can be seen in a similar fashion (salmonella is actually normal GI microflora in fish and foul).

Our issue lies with our understanding of what constitutes a disease. True, we can't see it in a simple 'black and white' picture. But dimissing it because it doesn't fit is even more foolish.

Athon

[dogguy]

Athon,
You appear to have understood a lot of what I did not understand in Splossy's post Your responses have made Splossy's comments somewhat clearer to me - thanks. I would still be interested in a clarification from Splossy

[Eos of the Eons]

Okay,

We have ADHD/ADD associated with:
ASD
Tourette's Syndrome
FAS


And some people would deny that there is some underlying physical cause? These kids undeniably have different brains from the "norm".

Not all kids with any of the above diagnoses have ADD/ADHD, so it is then the parenting??

Not all kids with ADHD/ADD have any of the above diagnoses, so blame parenting? If it were just the parenting, then the drugs that actuallly help these kids would have no effect.

These are very complicated cases. Ritalin actually makes my son's other problems and his ADHD symptoms worse. He doesn't have just ADHD, he has Tourettes. You can't use the same interventions as you would for those with "just" ADHD/ADD. My son was not able to take anything to help with his ADHD symptoms. He does take an antipsychotic (very low dose, a low dose would not help with other disorders that are helped by antipsychotics) and an antidepressant. This is a normal course of action for those with Tourettes.

We learned parenting techniques to address his specific needs and worked with the schools for strategies to address what he needed to get the most out of a school setting. There was never anything chemically given to address my son's hyperness or tics. The meds may have helped him be that much less distractible (and evened out some moods) they certainly brought him "down to earth" so that he could focus more on what was being said to him. They just gave that "edge" needed to help the rest of interventions sink in and help him out. We still had a very hyper aggressive and prone to anger kid, but less so. It was like getting a fire under control so it could be directed.

Kids I've seen that get Ritalin aren't turned into zombies. One boy's mother wanted to take him off the meds on weekends and holidays, but the boy wanted to take them 100% of the time because he finally started to make some friends. Things didn't "bug" him so much. He could stand to read a book. He liked feeling in control.

I've yet to see a careless case where a child is zombified. If the kid is zombified, then maybe the dose needs to be looked at, or maybe the kid doesn't even have ADD. I'd like to see these zombified kids!!

I would like to ask those people out there that would blame parenting...what kind of parenting makes a kid get ADHD/ADD?? If it IS parenting, then why don't all the siblings then turn out the same?


Truth is, only 3 - 5 % of the population has ADD. We aren't seeing high numbers of misdiagnosed children carelessly chucked on medications. This is a myth.


ADHD was first described in 1902. Ritalin has been in use since 1955.
http://www.holysmoke.org/cos/ritalin.htm


There is a big stink NOW about this now rather old news? Why? Is it because so many kids are zombified? Is it because parents are just looking for a "quick fix"?? NO.

I would look at who's making these ridiculous claims and why. Humour me.


ADHD occurs in 3-5% of school age children. ADHD must begin before the age of seven and it can continue into adulthood. ADHD runs in families with about 25% of biological parents also having this medical condition.
http://www.aacap.org/publications/factsfam/noattent.htm

There is no epidemic, and this isn't a "new" diagnosis. Parenting can either help or exacerbate it. Parenting won't cause it. From the time my child was a toddler I tried various techniques to try to help him. It wasn't until he was "labelled" that I could access better services. These "labels" are a tool, not an excuse.

Help parents, don't don't dismiss or blame them. It takes a village.


research has shown some differences between the brain functioning of individuals with AD/HD and that of normal subjects. Individuals with brain injury to the frontal lobes of the brain may show attention problems similar to those of AD/HD adults.

A study done at NIMH showed that boys with AD/HD had a smaller prefrontal cortex, (part of the brain just behind the eyes and forehead) caudate nucleus and globus pallidus. The latter two structures are located deeper in the brain. Xavier Castellanos, M.D. compared the prefrontal cortex to the brain’s steering wheel with the caudate nucleus and the globus pallidus as the accelerator and the brakes. (2) These size differences are just averages. One cannot use a brain scan to diagnose AD/HD.

Other differences in brain activity and function have been found. It is believed that the transmission of dopamine and norepinephrine in the circuits between the frontal cortex and deeper brain structures play an important role in AD/HD.

http://www.baltimorepsych.com/Stimulants.htm

We're talking ADD, not Tourettes, so I'm trying to focus on that. The ignorance spills over to other disorders like Tourettes, ASD, and FAS where there is a hyper & distractible child though. Awareness for all these children would be a help.

For ADD though, I would encourage more awareness. It's the most talked about for some darn reason.

[Beth]

Originally posted by athon
Hmm, again I'm a little lost. Are you saying that a variation in biochemistry can't be considered a disease?

What I took Splossy to mean by "It's like depression. Nobody makes bad decisions or tries to hold together conflicting beliefs. They are not slothful or misanthropic - they are CHEMICALLY depressed. Hey, we can prove it because they have less serotonin. Well, prove it if we ignore any question of cause and effect ." is that the change in neurochemistry might be considered an effect of what we call "depression" not a cause of it.

This is a legimate question in regards to the cause/treatment of mental illnesses. There does appear to be a tendancy to presume that if a consistent difference in found in brains of affected individuals that the difference is the cause of rather than the effect of the illness.

Personally I suspect that it might well be a result of a bad feedback cycle. Being depressed (having some imbalance of neurochemicals) leads to behaviors (ie.e sitting around moping, feeling bad about yourself, etc.)which lead to being more depressed (further imbalance in neurochemicals) which leads to further depressed behaviors, etc.

I don't know, I'm no expert, but it seems reasonable and plausible to me. If true, it would imply that either medication (changing the brain chemistry and thus affecting behavior) or behavor modification (changing behavior and thus modifing the brain chemistry) should work to improve the condition. This seems to be the case for at least some forms of depression.

Beth

[athon]

Originally posted by Beth
What I took Splossy to mean by "It's like depression. Nobody makes bad decisions or tries to hold together conflicting beliefs. They are not slothful or misanthropic - they are CHEMICALLY depressed. Hey, we can prove it because they have less serotonin. Well, prove it if we ignore any question of cause and effect ." is that the change in neurochemistry might be considered an effect of what we call "depression" not a cause of it.

Ok. I'll comment on this view of it, keeping in mind the fact that Splossy hasn't verified whether this was what was meant.

I agree that a correlation does not indicate cause and effect. However, in relation to studies in the field of neurochemistry, we can fairly safely conclude that a number of biochemicals have an influence on behaviour. Cortisol, for example, is released as an effect of stress. By artificially adding cortisol, the effects of a stressed situation can be replicated.

Depression is similar. Serotonin blockers (one of the neurotransmitters involved) can be administered to replicate depressive states. My knowledge in this area is limited (slept through a lot of my neurophys' lectures...hehe), so I'd have to look up exact examples.

This is a legimate question in regards to the cause/treatment of mental illnesses. There does appear to be a tendancy to presume that if a consistent difference in found in brains of affected individuals that the difference is the cause of rather than the effect of the illness.

It's often a safe assumption to make initially, but does need to be supported by additional evidence. The problem faced in pharmacological research is more to do with the knock on effects of these chemicals, rather than sorting whether they are directly responsible.

Personally I suspect that it might well be a result of a bad feedback cycle. Being depressed (having some imbalance of neurochemicals) leads to behaviors (ie.e sitting around moping, feeling bad about yourself, etc.)which lead to being more depressed (further imbalance in neurochemicals) which leads to further depressed behaviors, etc.

You base this on what, exactly? I have a vague sense that you are almost insinuating some sort of metaphysical origin to the original feeling. For example, in a given situation, your brain will respond to a stimulus or a range of stimuli through producing various neurotransmitters in localised areas. Severe clinical depression (which is what we are talking about, and is defined as recurrent bouts of depression that last for long periods of time, nominally about two weeks), is not 'normal' behaviour. It appears that people who suffer this have - for whatever reason - a bias in those chemicals normally responsible for such behaviour.

There's no great cause and effect confusion here.

I don't know, I'm no expert, but it seems reasonable and plausible to me. If true, it would imply that either medication (changing the brain chemistry and thus affecting behavior) or behavor modification (changing behavior and thus modifing the brain chemistry) should work to improve the condition. This seems to be the case for at least some forms of depression.

Beth

Thanks for the opinion. Having had a rather personal experience with clinical depression, my opinion is that modifying behaviour and environment is preferential to using drugs for long term benefit. However, I can also see the benefit to short term use of pharmaceuticals for some people.

Athon

[Beth]

Originally posted by athon
I agree that a correlation does not indicate cause and effect. However, in relation to studies in the field of neurochemistry, we can fairly safely conclude that a number of biochemicals have an influence on behaviour.

I don't think there's any disagreement on that. :) Certain chemicals can certainly affect behavior.

You base this on what, exactly? Personal experiences and things I've learned from diverse and mostly forgotten sources. I can never remember where I read some snippit or who wrote it. You may ignore my opinion if you like, it's not an area of expertise for me. This is just my current best assessment. It's also likely to change as I learn more.
I have a vague sense that you are almost insinuating some sort of metaphysical origin to the original feeling. For example, in a given situation, your brain will respond to a stimulus or a range of stimuli through producing various neurotransmitters in localised areas. Severe clinical depression (which is what we are talking about, and is defined as recurrent bouts of depression that last for long periods of time, nominally about two weeks), is not 'normal' behaviour. It appears that people who suffer this have - for whatever reason - a bias in those chemicals normally responsible for such behaviour. There's no great cause and effect confusion here.

No, nothing metaphysical being insinuated. And I don't know that I would term the cause and effect relationship confused, but I don't think it's as well understood as many people assume it to be. People have experiences and react to them. In addition they have certain genetic predispositions in the form of biases in brain chemicals as you put it. But people also make choices in how they respond to various situations and those choices can create environmental situations that can then either help them change their current situation or become more entrenched in it. I don't think this is an area of clear cause and effect channels, but rather a meshing of environmental and physical factors combined with personal choices.

Thanks for the opinion. Having had a rather personal experience with clinical depression, my opinion is that modifying behaviour and environment is preferential to using drugs for long term benefit. However, I can also see the benefit to short term use of pharmaceuticals for some people.


We are in complete agreement here!

Beth

[Z]

Well, all I can offer is anecdotal evidence - first hand.

I was - and still am - ADHD. I actually have real, documented problems staying focused for any length of time. I forget things on a regular basis, and bore easily.

Like right now - in order to post logically and sanely on JREF, I am using my browser (Opera), downloading videos, listening to music, playing Spider Solitaire, and enjoying a pipe. Oh, and drinking coffee, watching the kids, and digesting a yummy dinner of Rotini.

My third son - the six year old - has a form of ADD. The doctors have been extremely reluctant to pin a label on it, as his behavior is unusual, even for ADD children. Medication was not advised; instead, his diet is carefully monitored (he has specific and documented sensitivity to various food dyes), and his behavior is carefully controlled. He is homeschooled, in part because his abilities are so unbalanced; he's technically a first-grader, but doing third grade math and second grade language arts, while struggling with music.

My other children are all fairly normal, so far. Not one exhibits the same ADD-related behavior that he does.

He wasn't raised on television; we don't have cable, there are no broadcast channels here, and no satellite. He's limited to one or two movies per day, which he also rarely bothers with. We have no Playstation or Gamecubes, Gameboys, or other game systems. He does have a computer, on which is loaded educational software like Reader Rabbit, and a few games - Hot Wheels and Lego titles, mostly - which he also rarely plays.

I've heard people claim his behavior is the result of too much short-attention-span entertainment, like TV or games. They are much taken aback when I tell them these things do not exist in our home.

No, I'd have to stand by the theory that ADD is, in some cases, an actual genetic problem. No other hypothesis fits with the observable data in my son's case, nor in mine.

That being said, I do think that it's over-diagnosed and used way too often as an excuse for rotten behavior. My son doesn't get away with anything because of ADD. He's disciplined regularly for being too wild, for misbehaving, for not doing his work. Rarely a day goes by when he doesn't spend at least an hour, total, in time-out, isn't grounded from something, and hasn't been lectured at least three times.

On the plus side, his siblings are learning to behave by example. They don't want what he goes through! lol

[NeilC]

What I meant was:

1. Cause and effect are difficult to deal with in brain chemistry. What might appear to be the cause of a problem can be the symptom. Depression is a good example. People are told they have a chemical depression because they have low serotonin levels but in many cases that might be a symptom of their depression which is actually caused by their life.

2. Many medical folk argue that once you define an entity such as ADD you will start to find people with it. You are grouping symptoms and labelling them. It is possible that you are doing this somewhat arbitarily. It's like saying that a cold is defined not in terms of it's viral cause but it's symptoms - you will catch a lot of people with hayfever using that diagnostic process. Obviously it's a lot more complicated than that with ADD.

On the news today was a report from a world expert in Dyslexia who states that after decades of research he cannot even be confident that it actually exists as a discrete brain disorder. Check it out: http://news.bbc.co.uk/1/hi/education/4205932.stm - as you will see from dyslexia NGOs - there is a violent reaction to any such question being raised.

Similar things happened with schizophrenia - little was known of the actual cause and the term was really nothing more than a description of symptoms. This has been looked into and now lots of people who would previously have been told they are schizophrenic are not.

3. My point about parents was this - many of them want to believe there is a simple biological cause for their child's problems. So diagnoses are accepted readily and an army of people are formed all backing up the concept. This makes rational discussion on the subject difficult.

4. My point about how it arose in the USA was this: The USA is famous for it's overdose of media requiring little or attention. Their children spend a hell of a lot of time in front of MTV and vid games etc. These have been shown tpotentially lower people's ability to concentrate and cause behavioural problems, as have poor diet and lack of exercise - all these things are problems on the rise. Some researchers believe that THESE are the reasons for the symptoms.

I also find it odd how the disease seems to have exploded in the USA but is totally unknown in other countries. There are explanations for this but it makes me suspicious that the way of life and tendency to medicalise everything might be important in this issue.

Sorry it wasn't clear before. More sorry it if isn't now! :-)

A couple of quotes from people involved in the US health system who make similar points, but probably better than I do:

"Tom DeWeese of the American Policy Center contends that Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are "frauds. There is no scientific evidence whatsoever to prove either exists. Yet today," he notes, "almost seven million children have been diagnosed as having ADD or ADHD. And most have been placed on a behavior-altering drug called Ritalin, which is supposed to be the miracle answer to a nonexistent problem...... DeWeese emphasizes that "there has never been issued a single peer-reviewed scientific paper officially claiming to prove that ADD or ADHD exists"

"Interview with California neurologist Fred A. Baughman Jr:

Interviewer: You've spent 35 years in private practice as an adult and child neurologist, diagnosing real diseases. What spurred your interest in the ADHD diagnosis?

Baughman: Through the 1970s and 1980s the ADHD "epidemic" began to impact all of us, and the numbers of children being referred to me were increasing dramatically. I'd examine these kids to determine whether they did or did not have real diseases. After giving them thorough examinations, doing such tests as I deemed were necessary, I couldn't find anything wrong with them.

I was becoming more and more aware that something was afoot from the tone with which the diagnoses were being made in schools and by psychiatrists who were part of the school team. And never mind that I could find no scientific basis for the diagnosis. But here were pediatricians and school psychiatrists practicing mental health in ways that did not make sense. Principals and teachers would threaten that if I didn't diagnose ADHD they'd find someone who would. As a neurologist, I'm in the business of diagnosing real diseases, so this attitude on the part of people who should know better was very disturbing."



I am suggesting that the case for it's existence as a genuine disease is far from being proven. So I am currently skeptical about it.

[athon]

Originally posted by Splossy
What I meant was:

1. Cause and effect are difficult to deal with in brain chemistry. What might appear to be the cause of a problem can be the symptom. Depression is a good example. People are told they have a chemical depression because they have low serotonin levels but in many cases that might be a symptom of their depression which is actually caused by their life.

Thanks for the clarification.

I think the problem lies in your definition of 'depression'. Depression, in common vernacular, is simply when we feel a sense of sadness resulting from a particular event that extends for a small period of time. Clinical depression is divided into three categories; mild, moderate and severe. Mild depression is what everybody gets from time to time, and is denoted by the fact that it rarely lasts longer than a day or two and is typically linked with a particular event or environment.

Moderate lasts up to a week and is typically recurrent. It may or may not be related to a particular event, but environment will often be the cause. Severe depression is persistent, lasts up to and beyond two weeks at a time and is not necessarily related to an event or circumstance.

While I understand your 'cause and effect' query, I might be able to help clarify it a bit. Behaviour within an environment can indeed often be the stimulus, especially in mild and moderate cases of depression. However, it is considered a normal response for people to lose this sense of depression once they are removed from the stimulus. The rate at which this is lost varies, but for some the continued depressed state impacts their normal functioning. The sensation itself is caused by the variance in biochemistry, which may have either been brought on by a behaviour or by an original increase in the neurochemicals to begin with. In addition, other blockers and neurotransmitters responsible for returning the body to a 'normal' state (homeostatic mechanisms) are often inadequate in people suffering from depression. Therefore, the problem is less the cause of the depression itself, and more the persistance of it.

2. Many medical folk argue that once you define an entity such as ADD you will start to find people with it. You are grouping symptoms and labelling them. It is possible that you are doing this somewhat arbitarily. It's like saying that a cold is defined not in terms of it's viral cause but it's symptoms - you will catch a lot of people with hayfever using that diagnostic process. Obviously it's a lot more complicated than that with ADD.

Be careful about the vague appeal to authority. If you specifically state 'people say' you might want to back it up with some sort of evidence.

ASD at this point has few non-behavioural markers, making it hard to test in a lab. This makes it extremely difficult to diagnose and does rely heavily on speculative observation of a subject. But look at it this way;

ASD is defined by a set of behaviours. I'm a teacher and have a great diversity of learning abilities and social behaviours in my class. I find it useful to be able to predict to a certain extent how my class will interact, what activities I should set for them and where I should aim the lesson. For instance, should I have a few large, focussed activities or many small, fast-paced ones? If I am aware of students who have ADD or Aspergers or mild Autism, to give them additional assistance it's like knowing if a child comes from another country and speaks little English, or if a child is gifted, or if a child has diabetes and needs to be monitored for BSL.

I guess it's a bit like saying 'this child is scratching; you say it's chicken pox, I say it's only hives'. Concerning some applications of ASD diagnosis, it doesn't matter: the child is evidentally itchy and needs assistance.

As for the root cause (and using again the above analogy), dismissing a disease simply because it's hard to distinguish borderlines of behaviour is like saying 'there's no such thing as chicken pox because it looks a lot like hives'.

On the news today was a report from a world expert in Dyslexia who states that after decades of research he cannot even be confident that it actually exists as a discrete brain disorder. Check it out: http://news.bbc.co.uk/1/hi/education/4205932.stm - as you will see from dyslexia NGOs - there is a violent reaction to any such question being raised.

Of course there'd be a reaction, because stupid people interpret such things as 'there's no obvious, single cause, therefore it doesn't exist'. Dyslexic behaviour is very real. Tying it to a discrete, single neurological variation might well be difficult to do. However dyslexic people have a variation in behaviour that is consistent between individuals. The application is that I, as a teacher, would like to be able to anticipate this behaviour and offer assistance.

Similar things happened with schizophrenia - little was known of the actual cause and the term was really nothing more than a description of symptoms. This has been looked into and now lots of people who would previously have been told they are schizophrenic are not.

What is your point exactly? That as diagnostic analysis becomes more refined, we can distinguish behaviours into categories with more precision? Of course. Or that as diagnostic analysis becomes more refined, we're going to find that some people just don't exhibit the behaviours that led to the original conclusion?

Autism used to be just that; a single disorder called autism denoted by extreme disfunctional behaviour. Now it has been extended into a family of similar behaviours called 'Autism Spectrum Disorder'. Thus categories change accoriding to our understanding. I'm sure most of my behaviours could be classified into conditions (or traits) which are in part learned and in part biological, which are similar to a number of people. But classifying these has little benefit for others to anticipate my behaviour; none of my 'conditions' are disorders or diseases, as they do not impede my normal functioning.

3. My point about parents was this - many of them want to believe there is a simple biological cause for their child's problems. So diagnoses are accepted readily and an army of people are formed all backing up the concept. This makes rational discussion on the subject difficult.

It does make it difficult to discuss, but this is a problem with education of people and not with the diagnostic field itself. I've got kids who often say 'it's not my fault, I've got ADD'. Again, this is a fault with understanding how to deal with the diagnosis and not with the diagnosis itself.

One day we might refine ASD diagnostics and find that a lot of children who are labelled ASD don't share a certain characteristic (e.g. a chemical basis), and that it is more of a learned behaviour. Their behaviour still exists, only now we have classified it better as technology advances.

4. My point about how it arose in the USA was this: The USA is famous for it's overdose of media requiring little or attention. Their children spend a hell of a lot of time in front of MTV and vid games etc. These have been shown tpotentially lower people's ability to concentrate and cause behavioural problems, as have poor diet and lack of exercise - all these things are problems on the rise. Some researchers believe that THESE are the reasons for the symptoms.

Indeed, a few researchers have argued alternative causes. And these should be taken seriously. But be mindful of what you're arguing there. I'm all for looking for root causes of ASD, and at no point did I say it had to be genetic. Environmental causes might be significant to the disorder. And there is evidence that additives in various foods alter developmental behaviour, not to mention the environment a child is raised it will of course do the same.

But again, how does this dismiss the existence of ASD?

I also find it odd how the disease seems to have exploded in the USA but is totally unknown in other countries. There are explanations for this but it makes me suspicious that the way of life and tendency to medicalise everything might be important in this issue.

Please, support this argument. I've lived and taught in both the UK and Australia, and the incidence of ASD has increased in both. This is nominally because of refined diagnostic methods and changes to classification schemes, and increased awareness in the public, so before children who exhibited a set of behaviours were simply 'bad'. Now, the subjective label has been exchanged for one that attempts to be objective. Yes, the child misbehaves, but why? And more importantly, how can this be addressed?

Sorry it wasn't clear before. More sorry it if isn't now! :-)

Much. Thank you.

A couple of quotes from people involved in the US health system who make similar points, but probably better than I do:

Being skeptical is a good thing, but be mindful of how you're defining your terms so the issue doesn't get confused.

Athon

[Kiless]

Bugger. Athon beat me to the punch, but his response is better than what I was formulating anyway.

Certainly this statement:
"I also find it odd how the disease seems to have exploded in the USA but is totally unknown in other countries. There are explanations for this but it makes me suspicious that the way of life and tendency to medicalise everything might be important in this issue."
... has already been rebutted - you have a Canadian and two Australians (both teachers, one who has been working for some time in the UK) who have experienced this 'totally unknown' condition and have expressed such in this thread. :) Certainly, I've undergone PD and done a unit for my studies that focused on it as a part of basic teacher training.

[NeilC]

I must say I don't see how any of that assuages the concern that this might merely be an artificial construct created by a combination of over zealous psychologists immersed in their own culture, attention-damaging youth behaviour, some bad parenting, a desire to medicalise and remove personal responsibility plus some drugs company influence.

It might be a useful label to some but I see little real evidence that it has a single cause or even an exact and reliable symtomology. I can also see how such medicalisation could be a disasterous thing for many people.

You ask how does this negate the existence of ADHD. How can anyone negate the existence of an arbitary definition? The question is how useful and is that label and what does it actually mean.

If I am right, then saying someone "has" ADHD is somewhat lacking in meaning. You might also say that they have trouble concentrating, or are badly behaved or any number of other things.

I might label people who get angry a lot as having Anger Control Disorder (ACD). Some can be treated with tranquilisers. This supposedly proves there is a chemical reason for their behaviour. People with angry kids can now tell people their kids are not nasty but have ACD. They can't control it - it's a disease. And when we start applying this definition to the nation we find that we have been ignoring millions of other kids with this disease. They all need treatment. It rings bells with adults too - NOW they know why they kept hitting people when growing up.

Why not go the whole hog and create labels for all human behaviour? I might have a medical reason for my laziness and abrutness socially?

[athon]

Originally posted by Splossy
I must say I don't see how any of that assuages the concern that this might merely be an artificial construct created by a combination of over zealous psychologists immersed in their own culture, attention-damaging youth behaviour, some bad parenting, a desire to medicalise and remove personal responsibility plus some drugs company influence.

You still don't understand the nature of what you're arguing, it seems.

What is the point of diagnosing a condition? If you have a range of symptoms that disrupt your normal functioning, you want the symptoms to abate, true? If you're sick, you want to know what is causing it in relation to a possible remedy or a treatment. That is no different here.

A range of behaviours are exhibited by a number of individuals that disrupts their normal functioning, and this set of behaviours are commonly seen together. We can classify them together under a term; thereby when somebody says 'they have X', the behaviours are described within.

You seem to be indicating that these behaviours are not necessarily influenced by an underlying set of physical differences, that they are simply learned behaviours a large percentage of us all exhibit from time to time, except sometimes a little more extreme. But in itself, that dismisses responsibility. It benefits us to know why these behaviours are being exhibited, why they vary, why are they sometimes more extreme, why does conventional behavioural management not work, and how we can deal with that.

Please, forget this idea that it is about diagnosing a person and then leaving it at that. It is not; it is about addressing underlying causes and diminishing the disfunctional behaviour through a range of different means.

In addition to this, we've already pointed out that behaviours classified by ASD are indeed influenced by circumstances outside of mere 'bad parenting' or social constructs.

It might be a useful label to some but I see little real evidence that it has a single cause or even an exact and reliable symtomology. I can also see how such medicalisation could be a disasterous thing for many people.

No offence, but how well read up on this issue are you?

Behaviour complicates diagnosis; the 'symptoms' don't equal the behaviour, but rather they are the underlying influences on the behaviour itself. Different people who have ASD behave differently with regards to the symptoms; ask Zaaydragon, I'm sure he can explain this better than me. So underlying 'symptoms' are difficult to describe, at least in a sense we are used to. Again it does not mean they don't exist.

Medication for any condition will vary in effect depending on numerous factors, and I doubt you would argue that something like cardiac disease or leukaemia or even HIV are not diseases. yet with each of these, some drug regiments are ineffective due to numerous factors.

And, of course, I've already admitted that ASD might actually have a whole lot of different causes, each creating similar symptoms. As technology advances, it will again be divided into different categories. For example, perhaps a common behaviour is found in people who all have an enzyme missing in thier nervous system. These might then be termed 'a-enzyme A ASD', to distinguish them from 'Learned Behaviour ASD'...

It's an example of how we endeavour to understand behviour, not sweep it under the carpet because it's 'just a variation on normal'.

You ask how does this negate the existence of ADHD. How can anyone negate the existence of an arbitary definition? The question is how useful and is that label and what does it actually mean.

Ok. Firstly, the definition is not arbitrary. It refers to a set of behaviours an individual exhibits under variable circumstances. The defining points between 'ASD' and 'non-ASD' have more to do with our human need for precise definition, not to do with biology. Nature has no written definitions.

I'll give you another example; where is the exact defining line between 'heart disease' and 'not heart disease'?

Secondly, I've already explained how I find the label useful as a teacher. Zaayrdragon could probably give you a better idea of how it is useful as a parent. And its diagnostic relevance I have also addressed. Reread my above posts.

If I am right, then saying someone "has" ADHD is somewhat lacking in meaning. You might also say that they have trouble concentrating, or are badly behaved or any number of other things.

Collectively, under certain circumstances, these behaviours can be classified under ASD. How is this complicated for you?

I might label people who get angry a lot as having Anger Control Disorder (ACD). Some can be treated with tranquilisers.

Indeed, you might. Is this ACD behaviour exhibited by a number of individuals under similar circumstances? Does it indicate a possible, underlying influence? Is this influence disrupting normal functioning? There are such conditions as this, you know, so I think you inadvertanlty added support to a contrary argument.

This supposedly proves there is a chemical reason for their behaviour. People with angry kids can now tell people their kids are not nasty but have ACD. They can't control it - it's a disease.

Here is the crux of your misunderstanding. 'Can't control it' is the construct, not the diagnosis.

Indeed, they probably do have a biased chemical influence that varies within the population. Knowing they find it harder than most will help devise techniques, alternative environments, strategies etc. that can help this child.

Or do you just say 'face it, you're an angry kid, suffer it...'?

And when we start applying this definition to the nation we find that we have been ignoring millions of other kids with this disease. They all need treatment. It rings bells with adults too - NOW they know why they kept hitting people when growing up.

Perhaps. We are all influenced by our biochemistry. For instance, I have a rather above average ability to sit for long periods of time, concentrating on the one thing. Anti-ADD, you could say. It's a condition I have, you could say. I can change this behaviour, and it can be effected by the environment. But it's influenced by my genetics as well.

It's not a disease because it does not effect my normal functioning to any great extent. So it's hardly going to be addressed as a medical issue.

Why not go the whole hog and create labels for all human behaviour?

We could. But how much of that would be useful?

I might have a medical reason for my laziness and abrutness socially?

No. You probably have an underlying chemical influence on that, modified by education and environment. If it is so severe that standard education (by parents, system or society) cannot remedy it, and it affects your day to day living, then perhaps it might attract medical interest and need to be addressed.

Athon

[Z]

Part of the other problem is that the labels 'ADD', 'ADHD', 'ASD', etc. cover a wide range of different problems, each with its own causes, symptoms, and potential treatments. It's a fallacy