Ugh.
Well, given what I've personally seen with Pearson's much-touted (or is that "self-aggrandized") testing supremacy...
I don't buy it. There's no bright line here between "normal" and "impaired."
Well, I also don't buy that ANY behavioral 'evaluation' is ever going to be completely capable of teasing this one apart, but that's probably my own biases talking.
I'm also firmly of the belief that much of what IS diagnosed as AD(H)D in this country and many others is asynchrony which is temporary, and that pharmacology is applying a
permanent solution to what is inherently not really even a major LIMITATION in the right circumstances for those children...
Because sure, one can look (with fMRI and PET) at ADULTS who have persistent executive deficits and tell them from nt controls, but the picture is WAY less clear when you look at "mild" impairment, or in immature subjects. Bottom line is that administering stimulants to immature brains may well leave them
dependent for a lifetime. That's one facet of the pharmacology there that most clinicians simply do not grasp. It's certainly true in rats, though; if you chronically administer (even short term) stimulants that impact the biogenic amine transport system, there is PERMANENT re-regulation in that system's transporter expression, kinetics, and in receptors. Permanent as in those brains are conditioned to respond more robustly to those stimulants (regardless of mode of administration) and to exist in an altered state at baseline.
There's also the pesky fact that it's a myth that stimulants don't have the same effect on everyone's neurochemistry. If that were true, then coffee in the morning would only be helpful for about 20% of the population, at MOST. Clearly not so. There's a reason why these are "study drugs" and frankly, with respect to testing, they are
performance enhancing drugs. Just like steroids or growth hormone, there is a place for them in legitimate medical treatment... but there is also GROSS misuse.
It makes me
very angry that childhood institutions have become so inflexible about actually giving more than lip service to (neuro)diversity that such measures seem to be the only real solutions for many parents when faced with kids whose executive function development is behind the curve of "average and above" agemates.
I don't think that pathologizing not-quite-in-the-box development is the answer, in other words-- but I'm
so not on board with Pearson's apparent tactic of victim-blaming, either.
Parents aren't DECIDING to label their kids because they're too lazy or negligent to do anything better for them. Sheesh. Most kids who are medicated are simply reaching the endpoint of
years of struggling to find another way to cope with
inappropriate demands.Maybe the
system IS the problem here, and not the solution, eh?
