SimplyBrainy » ADD/ADHD: symptoms in search of a diagnosis

ADD/ADHD: symptoms in search of a diagnosis

(2009 Update)

“Why did they give him Ritalin for diabetes?”
(Mother of a hyperactive child later diagnosed with subclinical diabetes after years of drug treatment.) 1 (p. 5)

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Attention Deficit (with/without) Hyperactivity Disorder – ADD/ADHD – is getting a lot of media attention these days, ever since the `80’s and `90’s. Newspapers, magazines and books (presently almost 3,000 of those on Amazon.com) attest to the dramatic lack of understanding about the topic, by the sheer volume of the literature. Just about everybody has their strongly-felt opinion as to just what causes it and whether it’s even real at all. Drugs are NOT the answer, though they have short-term benefits. Sobering as it is, a new study (May, 2009) on an 8-year follow-up on drug management of ADHD showed that “The MTA participants fared worse than the local normative comparison group on 91% of the variables tested,” and, “…after treatment, children with combined-type ADHD exhibit significant impairment in adolescence.”5 The problem was only whitewashed.

Think about this: the single largest problem with them is that attention deficits and hyperactivity are not properly considered “disorders” any more than headaches, coughs or skin spots are “disorders”. You wouldn’t think much of a physician who merely pushed aspirin, cough drops, and calamine lotion at you when you took your child in for diagnosis of their chronic headaches, cough, or skin eruption, would you? When they have headaches, you need to know whether the child has sinusitis, allergies, a necrotic infection—or worse—or if they merely have vision problems. When they have a cough, you need to know whether the child has bronchitis, pneumonia, tuberculosis – or worse – or a simple upper respiratory infection that needs no specific medication. I don’t need to go on, do I? Headaches, coughs, and skin eruptions are symptoms, not disorders. It is the same with attention deficits and with hyperactivity. There still is no physiological test for ADD/ADHD.

One author, Thom Hartmann, does a good job of describing ADHD as a normal variation of primitive human behavior, calling the children who behave this way the “hunters” of yore in today’s “farmer’s” world.2 He builds a logical case for these personality types that we call ADD/ADHD being those once-upon-a-time hunters.

In a his book, The Hyperactivity Hoax,1 the late neuropsychiatrist Dr. Sydney Walker, former director of the Southern California Neuropsychiatric Institute, courageously and accurately challenges his medical brothers and sisters with the observation they have fallen into the “Emperor’s New Clothes” trap of diagnosis by chemicals. They have been herded into that position by health maintenance and insurance companies, pharmaceutical companies, public pressure for brand-name cures, and the illusion that they are doing good just because the symptoms decline. (Actually, a number of reports have indicated that Ritalin affects non-ADD/ADHD people, as well.) They have understandably bought into the deceit that ADD/ADHD are actually disorders instead of recognizing them for the symptoms that they are – just like headaches, coughs and skin eruptions.

Parents and professionals should have their suspicions aroused by the very way the alleged disorders are diagnosed. Dr. Walker points to the problem of “diagnosis by DSM” (the Diagnostic and Statistical Manual for Mental Disorders, now in its 4th edition), which he portrays as far too political a guide, not enough a science-based one. Diseases are regularly voted in and out and are reclassified by the conventional wisdom of the day, not by solid research, he says. In the older DSM-III, a child had to have 8 of 14 behaviors to qualify as ADD. The newer DSM-IV lists 18 behaviors, broken into two sub-lists of 9 each and the child has to have at least 6 from either sub-list to be classified as either ADD or ADHD. The problem is that the DSM-III has only 6 clearly different behaviors. The other eight are rewordings of the six. The same is true of the DSM-IV, with only THREE symptoms of the nine being distinctly different in each sub-list. Is it any wonder that any child with suspicious behavior comes away as being “diagnosed” with ADD or ADHD? The newest checklists given to parents and teachers now includes such universal childhood behaviors as “sassy” and “wants to run things” which would translate into adult character-istics of independence and assertiveness and would hardly be chemically addressed to subdue them.

Dr. Michael Valentine, West Virginia’s late director of their school psychology program, was quoted as saying, “(Hyperactivity is) one of the biggest frauds ever perpetrated on the educational system, on parents, on their children. Every medical person involved should be held accountable for it, ethically.”1 (p. 5) These strong statements by Walker and Valentine and others,3,4 all speak to the illusion of hyperactivity being a disease. Walker goes on to state, “It’s a hoax, perpetrated by doctors who have no idea what’s really wrong with these children.” Ultimately, this is a sober indictment less of the doctors than of the training and information with which they’ve been provided and the pharmaceutical industry conditions that make such diagnostic sloppiness acceptable.

Walker goes on in depth to explain the great number of conditions that can result in attention deficits and hyperactivity. They follow in the general categories of:

  • Physical problems – thyroid problems, glucose metabolic problems, anemias, immune disorders, parasitic invasions, poisonings, genetic diseases, head injuries, and many others.
  • Nutritional problems – dietary anomalies, vitamin deficiencies, mineral deficiencies, others.
  • Emotional problems – family stress and dysfunctions, inter- and intra-personal conflicts, academic performance anxieties, teacher conflicts, seasonal affective disorder, depression, and others.
  • Sensory problems – visual function problems, auditory problems (especially sub-clinical problems), hyper-reactive crowding sensibility (visual and auditory, both), hyper- or hypo-esthesia, others.
  • Perceptual problems – visual-motor, auditory-motor, tactual-visual, auditory-visual, gross and fine motor problems and the ability to integrate all these: they frequently contribute to learning disabilities and leave a child confused and unable to conceptualize what is going on, what is being communicated. Semantic-pragmatic problems (difficulty translating words into the proper actions) may stem from severe dysperception.

Until these five areas are ruled in or ruled out, the use of strong chemical interventions is not only unscientific, but may in fact mask these problems and make the overall problem worse by discouraging the child and family through lack of progress. The conclusion that ADD/ADHD is a primary problem is not justified until all the conditions that result in attentional deficit and hyperactivity behaviors as secondary symptoms are ruled out. However, there is an art to doing this that isn’t widely found in the professions unless the concerned parent questions the diagnostician closely about them.

The following tests are needed:

  • Behavioral vision studies need to be performed, with a secondary focus on related perceptual skills;
  • A complete psychometric battery, with attention devoted also to projective and affective issues; and,
  • A complete physical that centers on appropriate blood and physically functional studies as noted above.

These tests are completely justified prior to instituting the potentially dangerous pharmacological interventions. With this information at hand, a truly informed decision can be made that will serve the school, the family, and most importantly, the child. One authority, commenting on these children, said, “All in all, they’re pretty neat kids!” I say, “Absolutely!”

REFERENCES

1. Walker, Sydney III, The Hyperactivity Hoax, St. Martin’s Press, New York, 1998.
2. Hartmann, Thom; Attention Deficit Disorder: a different perception, 2nd Ed. Underwood, Grass Valley 1997
3. Block, Mary Ann, No More Ritalin, Kensington Books, New York, 1996.
4. Haber, Julian, ADHD, the Great Misdiagnosis, Taylor Trade Publishing, Dallas, TX, 2000.
5. Molina BS, et al. The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. J Am Acad Child Adolesc Psychiatry. 2009 May;48(5):461-2

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