Gifted Issues Discussion homepage Forums Twice Exceptional Pearson presentation TODAY: outing ADHD fakers

Those adults that I know who have truly severe AD(H)D, though-- they COULD have trouble with routine daily tasks if they are unmedicated.

Would you trust such a person to-- pick up a child's prescription from the pharmacy (assuming that it was URGENTLY needed, I mean)?

Probably not-- you'd scaffold reminders, or maybe ask someone else to do those critical tasks. NO WAY could that person do my household's grocery shopping, because that IS such a critical task.

So different kinds of disability produce different impacts on the tasks associated with daily life-- but that doesn't make the impairment "less" on some magical scale of disability. After all, someone who has a chronic medical condition and drives a cab in a large city is far more impaired by AD(H)D than a creative artist who lives off the grid and on their own, and does not drive.

It's hard, because many hidden disabilities require an answer of "yes, probably the person could be reasonably independent...as long as nothing unexpected goes WRONG..."

I have been following this thread with interest and felt compelled to add a couple of thoughts.

First, in response to the idea that ADHD stimulant meds are addictive, all but one of the recent longitudinal studies based on human subjects (would insert link here but can't get full screen reply to work) actually indicate that these meds are effect-neutral or might even offer slight protection from addiction. People with ADHD are more likely to develop addiction with or without medication than an NT population. However, studies that compare ADHD medicated and unmedicated groups over time have found use of stimulant meds to have no effect or sometimes a positive effect.

These studies theorize that stimulant medication actually brings the low dopamine production and transport in the ADHD brain closer to "normal" levels. Unlike drugs of abuse, ADHD meds are low dose and usually slow release so that the dopamine rush of drug abuse does not occur. The scientists hypothesize that medicated kids might be less likely to self-medicate their brains with drugs of abuse if they are properly medicated. Also, ADHD people on medication have better impulse control, fewer behavior problems and higher self-esteem, all of which help them avoid drug abuse.

My admittedly limited, nonscientist understanding of the effect of stimulant drug abuse on the brain is that the repeated dopamine rush of drug abuse causes the brain to produce more dopamine receptors. These extra receptors then must have a regular diet of dopamine that the body can't produce. At that point the person has developed a physical addiction to the drug and feels sick without it. I know what I have just described is not perfectly scientifically accurate but is how it has been explained at a recent conference on the neuroscience of addiction that I attended.

I have read that the rat studies on the effects of stimulants on the brain use amounts of meds that are large multiples of the treatment dose that would be given to a human for ADHD. The rats also don't have ADHD presumably. I would be very cautious about extrapolating such studies to humans.

The reason why I feel compelled to add my sadly superficial and bowdlerized summary above is the ongoing, unrelenting explicit and implicit societal messages faced by parents that we are harming our ADHD kids by medicating them. Almost all of the studies specific to ADHD populations don't support that.

My DS12 has ADHD. His manifestation of ADHD is not nearly as behaviorally severe as some kids I have read on this thread. However, he could not function academically at school without the medication. Worse, he would be a social outcast as well. His impulsiveness, continual overtalking and trying to answer every question, inability to follow rules or pick up the unwritten rules that govern kids' interactions . . . all of these things made him a complete outcast in kindergarten. When he is medicated he is much better but still struggles with impulse control. He has no real friends but he is not ostracized like he was in kindergarten.

ADHD is not simply an issue of wiggling too much in your seat. I expect that those parents who chimed about this never meant to imply such a thing. However, when several people write in that our classrooms are too restrictive (and this is true!) and this leads to more false ADHD diagnoses, it makes me feel that the people who are writing don't understand the full spectrum and impact of ADHD outside of sitting still in a seat. It profoundly affects every aspect of your child's life. The academic impact is actually just a small part of it. There is also occasional crazy emotional dysregulation, constant low-grade anxiety, hyperfocus on undesirable activities, impact on family dynamics, unhappiness at being "different" . . . I could just go on and on. Every day is a struggle, honestly.

I read this board every day and know that none of you are judging or condemning any of the rest of us. You all seem like nice, interesting, thoughtful people. However, ADHD diagnoses have been so consistently judged and minimized that when I read about a more flexible classroom leading to less ADHD diagnosis it feels like you are saying that some parents of ADHD kids are complicit in expecting too much of their kids. Maybe there are such parents. I just haven't met any.

I remember when DS started 5th grade, his teacher told me with a sigh during the first week that three ADHD kids were trying no meds this year in her class. She said "It's just not working but they are going to have to figure it out." This is a teacher that freely allowed kids to move around and sit on the floor to work, gave quizzes using a transponder system, used Google docs for turning in papers to minimize lost papers-she GOT it. She had a flexible classroom. But all those kids were back on their meds by October. ADHD kids and their parents who really need medication don't want to medicate but really have no choice no matter what the classroom is like.

I've been doing a bit of reading on the web and have discovered that Dr. Daniel Amen has received a fair bit of criticism from organizations like Quackwatch and Science Based Medicine. Here's a summary of criticisms.

Also, the National Institute of Mental Health describes SPECT scans for ADHD as not ready for prime time:


If I was investigating ADHD and my child, I would exercise extreme caution with SPECT scans and doctors who have been heavily criticized. As in, I would do a ton of reading with a skeptical eye and probably consult people with very good reputations in the field and absolutely nothing to gain financially from the scans.

And on another note, I can confirm with others who have written that there is truly a tsunami of stimulant abuse for academic purposes amongst college kids. This probably goes hand-in-hand with the purposeful resume padding rampant among competitive college bound high school kids. It's all about the grade/activity on the piece of paper, not about your actual interests and passions or learning to think, explore the world of ideas and start to grow into the adult you want to be. Sad.

The point being that the government may check for consistency between data held by various agencies and the ACS responses for each particular family member.


Use of the word trolley in this context is not typical "American" English, therefore I will ask whether you are in the US and have completed or may become subject to the American Community Survey (ACS) of the Census Bureau?

Agreed.

I don't think environment causes ADHD (sorry that isn't what I meant) I just meant that for kids who have issues the environment must be harder to manage nowadays. My brother would have fed on it and probably become even more hyper, I simply could not have functioned very well in todays classrooms (although there are certain improvements that would be better for my anxiety methods). I also think the amount of time we spent outside must have meant parenting was easier. And I had a SAHM so unlike me she wasn't trying to do housework while the kids weed watching TV.

Right-- the lifestyle that many 40+ yo adults recall from childhood was FAR more accessible then than it is now for most segments of the SES.

NOW, a "kinder, gentler" and more low-key approach is often just completely out of reach financially for parents who require two incomes. But childcare requirements and all the accoutrements of that lifestyle come as a package deal with all sorts of other influences that those parents might well choose differently-- if they COULD, that is.

Similarly, not all parents have the means for private schooling, or quiet, safe neighborhoods.

My ADHD DD actually drew a diagram on a whiteboard this morning indicating her ideal seat arrangement so that "distracting" kids are not surrounding her. She says that she can't get people to stop talking and humming, esp. the boys (although there are a few distracting girls as well). Even in third grade, the teacher has the desks arranged in clusters so there is always someone 6 inches away (usually on both sides) and directly across facing her. I asked DD if they are even allowed to talk to each other and she said "just at morning break". But of course all the kids talk and make noises anyway, so she can't get away. Why in the world arrange desks this way if they not supposed to be talking to each other? Teachers should be aware that most classrooms are going to have at least 1-2 ADHD children, so why set it up for them to fail?
They probably don't have room to set the class up any other way, with 26 kids in the tiny classroom that was probably designed for about 18. Sigh.

Thank you. Your entire post was helpful to me and you said it much better than I could have.