Society’s Duty to Consider Alternative Therapy when Facing the Symptoms of Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder in Children

Lee Ann Molinaro

ISS 4935

Dr. R. Johns

April 25, 2012

In 2010, the number of children aged three to seventeen diagnosed with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) reached 5.2 million (Bloom, Cohan & Freeman, 2010). Nine out of every ten children diagnosed with ADD or ADHD are treated with harmful prescription medications that result in devastating long-term side effects. The other ten percent are treated by alternative means that are safe and are non-prescription based, such as behavioral modification therapy (Sleator & Pelham, 2010). ADD and ADHD are disorders that affect the focus, attention and overall behavior in a child. If the symptoms of these disorders are ignored, they can be detrimental to the child’s success and will only worsen as the child matures. It is the duty of caregivers to provide their children with the most beneficial method of treatment to ensure that they will have a healthy and successful future.

Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are medically defined disorders and the research herein will provide evidence based medical data to describe the disorders and explain their diagnosis, prognosis and treatment. ADD and ADHD classifications and standards will be outlined using medical dictionaries along with the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) which is the customary classification of mental disorders used by medical professionals in the United States and put forth by the American Psychiatric Association. The DSM-IV is used in many ways by clinicians and researchers because it provides current public health statistics and up to date diagnosis criterion used by qualified medical professionals.

I will also include a comprehensive qualitative analysis of the opinions and knowledge of several medical professionals and scholars who are educated on the topic. The conclusions that I will draw are based on the knowledge gained from professionals who have a great understanding on the subject at hand. All the research for this paper has been gained by a review of secondary literature which will provide a well-rounded and objective examination of the social issue in question.

Although ADD and ADHD are true medical disorders, the diagnosis, and in particular the treatment, of these disorders are causing more and more controversy every day. Research shows that children are diagnosed with ADD and ADHD when they do not truly have a disorder. This unfortunately results in an improper diagnosis and consequently unneeded treatment. It has become apparent that the required diagnosis criterion over the years has become negligent. With this negligence there has been a rise in children receiving treatment with harmful prescription medications. These medications are harmful but they are effective for those who have ADD and ADHD.

Unfortunately, the medication effects are also extremely beneficial to authority figures that have trouble tolerating children’s behavior that has been mistaken for ADD and ADHD. In other words, it is easier for adults to give children a pill that will adjust their behavior than it is for authority figures to work on the behavioral issues present through other means. All in all, medication treatment methods are warranted although not needed simply because they are easier. Undoubtedly, this sort of negligence on behalf of adults will not go unnoticed and it is not surprising that there is controversy. Throughout this paper a history of ADD and ADHD and the problematic present day matters that society faces because of the above-mentioned carelessness of society will be discussed.

As previously mentioned, ninety percent of children diagnosed with ADD and ADHD are being treated by the means of prescription medication (Sleator & Pelham, 2011). This fact demonstrates that the majority of society’s caregivers are condoning the quickest method of treatment for their children and yet also choosing a method that is not the safest or the most beneficial. Studies have shown that alternative methods such as behavioral modification are more beneficial to the future health of children. Medications used to treat ADD and ADHD do not cure the disorders (Purtie, Hattie & Carroll, 2002). “Medication does not make up for skills that children have never mastered nor does it address learning problems” (Powell, Welch, Ezell, Klein, Smith, 2003). These medications simply mask the symptoms by altering the stimulants in the brain that effect behavior.

Alternative methods of treatment like behavioral modification are not as quick as prescription medications; however, this type of intervention is far more beneficial to the child. Behavioral modification employs tools that allow children to work through their behavioral problems and find healthy solutions. This type of treatment involves steady therapy and must include all authority figures in the child’s life. This treatment gives children a chance to fix their behavior before they are immediately labeled with a disorder like ADD or ADHD and treated with hazardous medicine. Caregivers should implement safe and effective methods first and foremost to treat symptoms before any diagnosis or medication is given.

Before delving any further into the preventative measures, the diagnosis and the treatment of ADD and ADHD it is imperative to review the details of these disorders and the reasons behind why millions of children are diagnosed. ADD is a neurological syndrome, usually in childhood, characterized by a persistent pattern of impulsiveness, and a short attention span that interferes with academic, occupational and social performances (American Heritage Medical Dictionary, 2007). ADHD is a neurological disorder similar to ADD that unveils excessive movement, irritability, immaturity and inability to concentrate or control impulses (American Heritage Medical Dictionary, 2007). ADD and ADHD (AD/HD) are ultimately one in the same disorder because the root cause of the problem is neurological and involves an attention insufficiency. The difference is that children with ADHD as opposed to ADD demonstrate more hyperactivity along with their inability to sustain their attention. Most medical research tends to group both ADD and ADHD (AD/HD) together due to the similarity of their characteristics and also because the diagnosis criteria is the same. From here forth, ADD and ADHD will be discussed together for purposes of research and analysis.

According to the DSM IV, to diagnose AD/HD, the symptoms such as inattention, hyperactivity and impulsivity must be present for at least six months and also be displayed before a child is seven years old. Inattention is demonstrated when a child is not able to give close attention to details, makes careless mistakes, has difficulty sustaining attention in playful activities, is unable to follow through with instructions, has difficulty organizing tasks, avoids tasks that require mental effort, frequently loses items needed for scheduled tasks, is distracted by extraneous factors or is forgetful in daily activities. Hyperactivity can be determined when a child frequently fidgets in his or her seat, frequently leaves his or her seat when asked to stay, runs or climbs excessively in inappropriate situations, has difficulty playing in activities quietly, tends to be “on the go” or “driven by a motor” or talks excessively. Impulsivity is determined when a child frequently blurts out answers to questions before the question is completed, has a difficulty waiting his or her turn or habitually interrupts others. (American Psychiatric Association, 2000)

In general a child’s caretaker first observes the symptoms of AD/HD yet it is normal for a teacher or another unattached authority figure to mention when the symptoms start to become troublesome. When this occurs, a caretaker usually seeks the help of a medical professional to assess if there is a problem in need of an intervention. Medical professionals that are qualified to give a diagnosis for AD/HD are pediatricians, neurological physicians, psychologists, psychiatrists and in some cases clinical social workers (Guevara & Stein, 2001). As previously stated it is required, as outlined by the DSM IV, to observe the symptoms of inattention, hyperactivity or impulsivity for at least six months before a diagnosis occurs and to see the prolonged symptoms before the age of seven. Clearly, a standard visit to one of the qualified professionals does not provide any ability to observe a child for six months and may occur after the child is seven years of age. Therefore, medical professionals are accepting the observation by the child’s authority figures to make the decision that a diagnosis is in order. Along with the six month observation reported by the caretakers the medical professionals are using several types of Attention Tests that have been created to also point out symptoms of AD/HD. (National Institute of Mental Health, 2009). However, after review of several studies, these tests do not prove to have any true validity to them which concludes that there is extreme difficulty in assessing behavior by the means of a test. Behavior is circumstantial and not something that can be summed up from a set of questions or by a single doctor’s visit. Ultimately, for a true diagnosis to occur, a thorough investigation of a child’s behavioral history is necessary.

In the past twenty years, the percentage of children diagnosed with AD/HD has dramatically increased by about 500% (Center for Disease Control and Prevention (CDC), 2010). Dr. Lawrence Greenberg is a child pediatrician and child psychologist who also created one of the Attention Tests called The Tests of Variables of Attention (TOVA). Dr. Greenberg states one reason as to why the diagnosis rates are increasing is because society has become more aware of AD/HD. He claims that any symptoms of AD/HD, even if the symptoms are temporary, results in a diagnosis of a child to have AD/HD even when they do not actually have a disorder. Dr. Greenberg verifies that the problem of over-diagnosing children with AD/HD has been a result of society’s eagerness to control children’s behavior and get any problematic behavior treated as quickly as possible. (Greenberg, Shaughnessy, Martin & Rivera, 1999)

Jaak Panksepp, another child psychologist, claims that society has become intolerant to children’s behaviors and that the behaviors that used to be considered playful are now being seen as disruptive (Panksepp, 1998). The 5.2 million children that are diagnosed with AD/HD represent a 500% increase since 1990. We can now conclude that this rise is due to society’s expectancy for children to behave in a certain manner. Although this may not have been the intention, society has evolved to expect a certain type of human order that pressures children to act more mature than ever before. Behaviors that were once considered just ordinary childlike behaviors are now considered to be bothersome and annoying and must be a result of a disorder like AD/HD. Subsequently, society has latched on to the medicines that change children’s behaviors instead of just allowing kids to be kids.

Symptoms of AD/HD are symptoms that all human beings experience, especially children. The reason that the diagnosis criterion has a six month observation guideline is because the symptoms are relatively common, especially in children (National Institute of Mental Health, 2009). Therefore, to consider these symptoms worthy of a diagnosis they would need to be present for an extended period of time. A child’s diet, health, exercise, family, and social circumstances can severely affect how he or she will behave on any given day, thus to diagnose a child with AD/HD for showing symptoms of hyperactivity, inattention or impulsivity you must take a look at all factors affecting the child’s life. A six month observation is vital to ensure that these symptoms are not just circumstantial and they are truly a real cognitive problem which is affecting their behavior. It has become apparent that the diagnosis criterion is being overlooked and a majority of the children diagnosed with AD/HD are diagnosed improperly and even worse are now being treated.

As the rate of children diagnosed with AD/HD has increased, so has the rate of treatment for these disorders. The most common form of treatment for children with AD/HD is prescription medications like Adderall or Ritalin. Adderall, commonly used for children with ADD is a combination of dextroamphetamine and amphetamine. The combination of these two drugs can produce severe side effects such as nervousness, restlessness, difficulty sleeping, shaking, headache, dry mouth, stomach pain, nausea, vomiting, diarrhea, constipation, decreased appetite, weight loss, heart attack, stroke and death. Ritalin commonly used in children with ADHD is a similar drug that contains methylphenidate. The side effects from using this drug include nervousness, difficulty sleeping, dizziness, nausea, vomiting, decreased appetite, stomach pain, diarrhea, heartburn, dry mouth, headache, muscle tightness, uncontrollable movements, restlessness, numbness in hands and feet, painful menstruation, heart attack, stroke and death. (US National Library of Medicine, 2011).

A study conducted in 1995 by Hedges, Frederick, Reimherr, Rogers, Strong and Wender found that the severe side-effects of AD/HD medications occurred in 39% of AD/HD patients. The most common side effects reported were fatigue, confusion and dizziness. Many of these patients had trouble staying on the medication. This study also found that 50% of patients experienced nausea and 17% experienced “lowered energy, gas, diarrhea, insomnia, tremor, muscular tension or teeth grinding”. Although these medications are meant to sustain focus, the negative side effects have had adverse effects on “fine motor skills, weight, appetite, blood pressure, heart rate, and sleep”. (Purdie, Hattie & Carroll, 2002)