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Why is ADHD a Controversy

ADHD has a become a controversial topic: some experts believe the condition isn't adequately recognised and so many children are not being diagnosed, others claim parents are pushing too hard to get their children a label and it's overdiagnosed.

So what are the problems?

Diagnosis

There's no physical test (such as a blood test) for ADHD.
No single cause has been established.
There's no standardised method of assessment - it's down to the clinician whether he uses written tests or makes a judgement based on what you and the teachers tell him. What one expert would classify as ADHD, another might not.
Other problems can cause behaviour similar to ADHD, such as hearing problems, dyslexia, family problems, anxiety and depression.
ADHD can exist with other conditions. There are overlapping areas with conditions such as language difficulties, dyspraxia, Aspergers Syndrome and other autistic spectrum disorders - although some experts don't believe this.
All children have problems with self-control to some extent - where do you draw the line between normal and difficult behaviour?
Our modern lifestyle with greater use of technology means we're used to getting information very quickly and in bite-size pieces. Some experts feel children have a shorter attention span due to this modern lifestyle, rather than because of a medical condition.

ADHD (Attention-Deficit Hyperactivity Disorder) is not like the measles or a broken leg. It does not have clear physical symptoms. In fact, it is a kind of umbrella term. Let's look first at how the "experts" diagnose and treat ADHD and then we'll look at some alternatives to mainstream treatments.

Diagnosis of ADHD is based on behavioral criteria listed in a reference book called the Diagnostic and Statistical Manual of Mental Disorders, DSM for short. There are three patterns of behavior that might indicate ADHD, "inattention", "hyperactivity" and "impulsivity." According to the DSM, signs of inattention include becoming easily distracted by irrelevant sights and sounds, failing to pay attention to details and making careless mistakes, rarely following instructions carefully and completely, and losing or forgetting things like toys, pencils, books or tools needed for a task. The signs of hyperactivity and impulsivity listed are feeling restless, often fidgeting with hands or feet or squirming, leaving a seat in a situation where sitting or quiet behavior is expected, blurting our answers before hearing the whole question and having difficulty waiting in line or for a turn.

You might recognize some of these "symptoms" in yourself. Most people blurt out, bounce from one task to another, or are disorganized or forgetful once in a while. ADHD is diagnosed when this behavior is excessive or long-term. The identification of those symptoms in a child is accomplished by having adults close to him rate his behavior on a scale. The diagnosis, in other words, is based on the adults' personal perceptions. One adult might chuckle and say, "My, you're full of it today," or "Do you have ants in your pants?," or "What are you daydreaming about?" Another adult might respond to the same behavior with disapproval and control. By the way, ADHD is diagnosed ten times more often in boys than in girls. "He's all boy," has given way to medicating the active, exuberant child.

The diagnosis ADHD is controversial, because no single cause can be found and the diagnostic tools are subjective. Medicating children "diagnosed" with ADHD is also controversial. The medicine is not a cure; it has side effects; it's long-term benefit is limited.

In my opinion it is very important to rule out other possible causes for ADHD "symptoms," before adopting the mainstream treatment. Work with the whole person and not just a bunch of symptoms. Seek out a sympathetic pediatrician as an ally and explore all the possibilities. As you explore the alternative causes, you might find The Holistic Pediatrician, by Kathi J. Kemper, M.D., M.P.H. a useful guidebook. She explores ADHD in chapter 21 of her book.

Are there physical problems that might lead to your child's behavior? Poor sleeping at night due to sinus infection, asthma, large adenoids or tonsils can lead to ADHD behaviors. Thyroid problems, high lead levels, undetectable petit mal seizures and hearing or visual impairments can also lead to acting out in frustration. A word to the wise, vision is more than eyesight. When looking into possible visual impairments seek out a behavioral optometrist. A child might have 20/20 eyesight and be seeing double, have trouble focusing or tracking. Consider any special dietary needs. Identify any food allergies or intolerances.

Are there emotional considerations? A kinesthetic learner in a controlled environment will be disruptive. Classroom management techniques that lead a child to feel like a failure might cause him to fight back by breaking the rules. Differences in personality and energy-level are not easily accommodated in a group situation. The byproducts of being misunderstood, anger, frustration, insecurity, depression or anxiety, can lead to non-compliance. If your child has been in a stressful situation at school or is a delayed learner, homeschooling may bring an end to last-year's behavior without medical intervention. Inattentiveness and boredom may give way to effortless attention to activities the child enjoys. You can highlight those interests in your personalized homeschool curriculum.

While you can benefit from consulting doctors and other health care professionals, the final decision about what to do belongs to you and your child. Trust yourself and him to discover what is best through time and experience.