I've heard a lot of talk outside the counseling profession recently about ADHD. ADHD stands for Attention Deficit/Hyperactivity Disorder. It is most commonly known as hyperactivity. ADHD is a physiological condition in which an individual has difficulty maintaining attention on a task, is often loud and aggressive, and usually has problems in school (both social and academic). ADHD is most commonly treated through behavioral modification, contextual modification, and medication.
I have been a little discouraged by the way the popular press has been addressing ADHD recently. Reporters have commented that drugs are the easy fix for ADHD symptoms when the behaviors may instead be symptoms of other problems and they have either implied or stated directly that the condition does not even exist.
Concerning these allegations, I have a couple of suggestions. First, I have seen some amazing changes both in adults and children who are taking medication for ADHD. It works. Often, even if medication is not the best long-term solution, it helps a child or adult focus attention long enough to get other problems in order. Hyperactive children are a challenge for parents. Once the child is on medication and the child's behavior stabilizes, other more effective and long-term interventions are more easily applied.
On the other hand, I believe that some of these reports are correct. I think ADHD is over diagnosed and medication is sometimes prescribed unnecessarily. Because the medication works, it is very easy to terminate other clinical treatment upon receipt of a prescription. It is also easy to misdiagnose other disorders (such as oppositional defiance disorder or even attachment disorders due to abuse) as ADHD. Because the medication does, in fact, change behavior, the real problems are never adequately addressed. Teachers, pediatricians, and others who work with children, are often too quick to make such a diagnosis when they may not be qualified to do so.
I am not a physician and cannot ethically make any suggestions to patients concerning the medication their children are taking. However, what I often find with the children in my practice is that after a period of behavioral modification, they no longer need the same level of medication (if any at all). At this point, I suggest to the parent that a discussion with the pediatrician concerning medication might be helpful. Several of my client's parents have (in consultation with their pediatricians) chosen to reduce or eliminate medication. With behavioral intervention, many of these children have maintained or even improved their behavior after withdrawal of medication.
There are three reasons one would want to eliminate medication. First, if it is an inappropriate prescription, the child certainly should not be taking the medication. Second, if the individual comes to believe that he/she cannot function without it, medication can lead to unnecessary dependence on the medication for maintenance of behavior. Finally, medication often develops within a person a victim mentality; the idea that one does not have any control. This is never true. Even those children who need Cylert or Ritilan have some control over their behavior. Supposing that the medicine should do all the work is irresponsible.
ADHD is a real disorder that, when left untreated, can leave a child frustrated, failing in school, and a frustration at home. However, the dramatic rise in the diagnosis of ADHD gives me cause to reflect on the accuracy of such diagnoses. If you are the parent of a child who you suspect has ADHD, I encourage you to have your child tested by a clinician who specializes in cognitive testing. It is more expensive than taking your pediatrician's word for it, but you may save yourself some trouble in the future. If your child is currently diagnosed as ADHD and this diagnosis did not come from a qualified clinician, I encourage you to have your child reexamined. This, of course, does not mean that the diagnosis was incorrect, but there is too much at risk not to be sure.
