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Headline: Pearson’s Quotient® ADHD Test Shown to Detect “ADHD Fakers”, October 1, 2013 link - http://www.pearsoned.com/
This is the way it is touted on pearson's website. The headline itself sounds harsh, negative, even accusatory and adversarial. The tone of the article is the same.
Anyone attending the U.S. Psychiatric and Mental Health Congress 2013 in Las Vegas, NV today (October 1, 2013) or tomorrow, as mentioned in the article? Have thoughts to share?
Quote
Pearson, the world’s leading learning company, announced today that the company will present a poster on... ability to detect individuals attempting to fake attention deficit hyperactivity disorder (ADHD). ... detect those attempting to portray themselves as having ADHD to fraudulently obtain controlled substances. ... individuals have a number of incentives for feigning ADHD deficits. ... proven able to simulate... childhood symptoms as well ...
While it is wise to avoid any potential overuse and abuse of controlled substances which may be used to treat ADHD, many have become aware of the possible misdiagnosis and dual diagnoses among the gifted, thanks to SENG (www.sengifted.org) which has presented information framed in a loving, supportive, liberating, and eye-opening context.
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?
I don't think anyone can have a strong opinion about ADHD and medicating or not medicating unless they actually have a kid with the disorder and see the effects. I don't know what the situation is with HowlerKarma, but I have run into a shocking number of judgmental people who know next to nothing about ADHD, have not lived with it, but still have an opinion about medicating vs. not medicating. I have a kid with ADHD. It is immediately and obviously apparent when she is or is not on medication. When she isn't, her ability to focus her thoughts and stay on task is at about the same level as it was when she was 4 (she is now almost 8)--she hasn't matured one bit in that area. I am hoping that when she hits adolescence, maybe whatever part of her brain is misfiring will "catch up" or "mature" or whatever the appropriate term might be. But until then, there is simply no way she can learn or work towards her potential. Even here at home with no distractions, if she is not medicated and I have her try to learn math facts on the computer she dissolves into tears. But she is, for the most part, fine when she is medicated. What does it do to a child's self-esteem to not be able to perform certain mental tasks that other people take for granted? So it would be a punishment and a crime (IMO) to deny her something that so clearly helps her. I don't see any major "inappropriate demands". I think it's completely reasonable to expect an 8 year old to stay in their seat for 20-30 min. at a time rather than turn somersaults across the classroom or sprint down the hallway, to draw a picture, write a few sentences, and learn basic math facts. Without medication, I'm not sure if DD would do much of anything in school except get extremely annoyed at every other student that makes the slightest noise. Maybe there are inappropriate demands placed on kindergartners expected to sit still in their chair and cut and write. And there is still a lot of maturity happening at age 5. But most kindergartners are too young to be diagnosed anyway.
It irks me that people without ADHD abuse these substances and use them just so they can stay awake and study for a test, when there are people with an actual brain disorder. And every month I have to go in and get a paper prescription for DD and run around (or call) trying to track down the drug that she needs. If there was actually a way to easily detect the "fakers" that would make it easier for those who do actually have the disorder. I wish there was a simple brain scan or blood test that said "yes" or "no"--then maybe I wouldn't have to argue with everyone about whether this is a) a real disorder and b) whether I'm harming my child by medicating.
Okay--I think Pearson is to be viewed with some skepticism here given their potential motives. But I do think this is a real problem. In particular, high school and college students fake ADHD to obtain and resell the meds. We need better diagnostic tools...though I also agree that the system is to blame for some (many?) ADHD misdiagnoses.
My "situation" (as you put it) is that I got an advanced degree investigating the changes in midbrain neurochemistry initiated by the administration of a variety of drugs of abuse. So I do know that what I'm saying is factually correct with respect to the molecular neuroscience at work behind the pharmacology. I also have a basis for my opinion which is neither personal nor anecdotal.
I'm not suggesting-- at all-- that it's "abusive" to medicate children who clearly require intervention. That's not my place, and I truly-- in spite of many parents' (understandable) defensiveness on the subject-- don't judge those parents who DO opt to medicate children so that they are functional while they are children. I agree that waiting it out isn't always an option. I find many of those situations to be heartbreaking-- but I definitely don't think that it's bad parenting or anything else but biological misfortune at work. I don't really judge parenting (in general) on the basis of child behaviors unless I've seen enough examples of poor management/coping to warrant concern.
What I am saying is that there is not an "undo" on medicating with any of the drugs that treat ADHD/ADD. They really do cause permanent regulatory changes in the reward and learning centers in the brain. Does this set up kids who have been medicated to be dependent upon those same drugs as adults? I'd consider that (professionally) to be a distinct possibility, based on what I know.
Maybe that's a price that parents feel okay paying, and maybe some of them don't KNOW that this is a thing they are choosing. Clinicians sure sell AD(H)D meds as harmless-- and they most certainly are not. THAT is my axe to grind on this subject. Nothing more and nothing less. I personally feel increasingly convinced that general practitioners probably ought not be prescribing drugs with this kind of addiction liability. But that's me.
My larger question is still-- WHO SAYS that "normal" 8yo children are capable of sitting still for 30 minutes? WHO SAYS-- and how do they actually know this is true? Maybe some kids just need a radically different kind of childhood than seems within reach for most families now...
Large motor breaks in primary school settings really have shifted dramatically over the past 40 years. Not all children can meet those expectations now, and I don't think that all of them have pathology as a reason why they can't. Why are so many more BOYS seemingly incapable of meeting "typical" expectations now? Used to be, it was girls who couldn't-- because they were not as aggressive by nature (or perhaps nurture) and schools were set up to favor that more aggressive/assertive, physical style. Times have changed.
I definitely think that ADH(H)D is real, and I wish that it WERE clear during childhood which of them SHOULD (versus should not) get medication. Some kids can have behavior which is truly extreme. In those kids, yes-- it is WAY clear that they are not anywhere near the center of the distribution. I just think that it is a distribution-- so not so clear where to draw the line at "dysfunction."
I actually agree with you on most points, blackcat. I'm sorry that your experiences with others judging your parenting have left you expecting judgment from others. My apologies if my post was unclear.
PEARSON has NO business addressing the issue. PEARSON is a CORPORATION making money encouraging stuffing every child into the same box....pushing them down the road to the next grade stop and stuffing them into the next box. PEARSON needs to be STOPPED!!
Gosh, I wonder what Pearson's motivation was here? Anyone want to bet on whether or not they're offering this at cost? Or at least at a reasonable fee?
(I'd bet no, but that's me. I'd also bet that their tool is no better than anything else at ferreting out those determined to "fake" symptoms.)
I personally feel increasingly convinced that general practitioners probably ought not be prescribing drugs with this kind of addiction liability. But that's me.
I'll take that a step further and suggest, from my professional that specialists in psychiatry feel similarly. GPs operate best as a referral pathway to specialists.
Naturally, the idea of a test taking administrator condescending to suggest it is somehow an authority on AD(H)D--logically, a CHECK against psychiatrists and neurologists--is reprehensible at best, and potentially criminally negligent. Any bets when the first lawsuit will surface? I give the franchise a quarter before it implodes.
I hear what you're saying and would be interested in seeing research studies about these permanent brain changes that you're mentioning. But even if that's true, what is a parent to do, other than feel horrible? If I sent DD to school without meds, I think there's a strong possibility she would not pass the third grade, not to mention she would have the teacher "on her case" literally all day (doing what to her self esteem?). Even if we got her a 504, there would still be penalities. Instead of the focus being on her learning, it would be on her behavior and ability to get things done. She would not only not be doing any work, she would be a disciplinary problem. She may very well be one of those kids who just "gives up" and drops out of school in high school--a strong risk factor for kids with ADHD. But as it stands now, with her meds, she's at the top of her class, the teacher loves her, she's a star student. It's that dramatic. On the day that I sent her in without her patch (because I ran out), and only 1 ritalin pill, she started to decline at 10:30 AM. After that, she got no work done and spent half the day poking the kid who sits next to her. When I picked her up, all the teacher could do was drop exhausted into her seat, sigh and shake her head and say "meds." If meds just helped a kid minimally (or there were severe side effects), then I think parents would have reason to question it more. There are definitely pros and cons to weigh but I think sometimes people are so strongly anti-med, fearing that their child will be permanently damaged, that they fail to see how their child is damaged by NOT being medicated. One of my friends has a 6 year old who is gifted but has ADHD. The mother refuses to try medication. But the child needs a para for most of the school day just to keep him from running around yanking cords out of the wall or pushing down other children. He is constantly in trouble. Part of it IS the system, if a teacher has 25 other children to deal with and the only solution is to plop an unruly distracted ADHD kid into a timeout chair, but there has to be a balance and kids need to be able to sit still, do a reasonable amount of work, and listen long enough to learn. There also should be better ways to diagnose a kid and differentiate between those who are just active and immature (the stereotypical unruly boy) and those who do truly have ADHD.
The eye-tracking test that is being hyped for fake detection is one such non-subjective measure for attention. Fairly interesting reading: http://www.quotient-adhd.com/
Has anyone used cognitive behavioral therapy in coordination with drug interventions?
