Maintaining Focus: Key Issues in ADHD Today
Every day thousands of American youth are treated for Attention Deficit Hyperactivity Disorder (ADHD), whether they take a pill or receive therapy from a psychiatrist, or a combination of the two. The merits of the different methods of treatment have been hotly debated for many years with out any decisive conclusions being reached. Some researchers claim that prescribing Ritalin to youth to control their ADHD has more harmful results than helpful. Other researchers support the use of Ritalin on the basis that it is the only effective method of treatment. There is a third method of treatment supported by researchers, that a multi-faceted approach should be used, involving a moderated use of Ritalin and other aspects from current treatment methods. Before treatment is examined in great depth, however, the methods of diagnosing ADHD should be looked at in detail. Admittedly the diagnosis of ADHD has come a long way since 1902 when it was diagnosed by British physicians George Still and Alfred Tredgold as a being a result of brain damage, current methods of diagnosis need to be studied and revised as necessary (Barkley Attention 3.) The rate of children being diagnosed with ADHD has increased 260% between 1990 and 1995 (Babcockand Byrne143.) This has some researchers wondering if ADHD is notbeingover diagnosed by school councilors and parents.
The entirety of ADHD needs to be researched in much greater depth before any definitive conclusions can be reached about anything relating to it, from diagnosis to treatment. This paper will address a few of the major issues involved, specifically those mentioned above.
True diagnosis of ADHD need to be reserved for people most qualified to make them. Most of the diagnosis of ADHD are not made by expert professionals in the field of mental health. In fact the majority of diagnosis are made by school councilors and parents who are not mental health experts (Hall andGushee 295), or by a pediatrician over the phone with out ever seeing the patient (Baldwin and Cooper598.) This kind of diagnosis process can lead to misdiagnosis which can in turn lead to more serious things including health risks depending on the treatment prescribed because of the false diagnosis. Diagnosing achild or adolescent with ADHD is a major life changing event and should be left to the people most qualified to make such an assessment, the mental health experts.
Qualified experts, properly trained to correctly diagnose ADHD, need to be more available to parents, teachers and school councilors. Since most school councilors are not mental health experts and do not have access to one readily available to them, the majority of diagnosis of ADHD aremade by unqualified people (HallandGushee 295.) If access to amental health expert were more prevalent, the school councilors, or teachers, or parents, could consult with that expert to better help the child in question. Such a pairing of school councilors and mental health experts would also assist in treating achild with ADHD by allowing greater amounts of feed back from an expert trained to deal withADHD (Hall and Gushee296.) The availability of mental health experts would help across the board in all aspects of ADHD and they shouldbe more accessible to those who are closes to a child that has or is suspected to have ADHD.
The causes of ADHD need to be investigated and pinpointed to aid in both the diagnosis and treatment of ADHD. This would allow psychologists to more accurately diagnose someone with ADHD andnot some other mental heath issue or learning disability. Determining the cause of ADHD would also aid inthe treatment of the disorder by allowing the treatment to be targeted specifically to the cause. Some proposed causes of ADHD include neurological imbalances, heredity, pre and post natal care issues,and toxic influences on the body (Brown195.) Other, less scientifically supported causes include parent-child relationships, family issues and upbringing (HallandGushee 298.) The second set of causes would include things like abuse of any kind as a child, family disfunctionality, and neglect to name a few. With out knowing the exact cause of ADHD, any kind of treatment given is a shot in the dark and its success is in question.
The most common treatment for ADHD is the prescription of Ritalin. Ritalin is a dangerous drug and should not be used to treat children with ADHD. We teach our children that they should avoid drugs such as speed (methanphetamine) yet we use a similar drug as the mainstay of our treatment regimen for ADHD. Ritalin is a member ofthe amphetamine family, the same as methanpheatmine, which are addictive and potentially harmful both psychologically and physically (BaldwinandCooper598.) The mental heath community needs to finda method of treatment that does not put the children in jeopardy of so many possible harms. Ritalin, however dangerous to use, is an effective way to control the symptoms of ADHD. In studies performed, pure medication of ADHD patients had an equal or greater effect thana pure behavioral approach to treatment (Barkley”Commentary”595.) The reason for this is that the drug is controlling them,like narcotics control those addicted to them. While Ritalin isan effective method of controlling the symptoms of ADHD, the risks involved in using this drug on children and adolescents far outweighs the potential gains.
Perhaps the best way to treat ADHD isthrough a multi-faceted approach. The most effective treatments are those that include both a medication aspect and a psychological therapy aspect (Barkley”Commentary”598.) Psychological therapy for ADHD is very diverse; it ranges from one on one sessions with councilors for the patient with ADHD all the way to family therapy sessions and even to parental training (Barkley”Commentary”596.) The range of the misuse of drugs for control purposes concerns many of today’s researchers (BaldwinandCooper599.) However in the proper dosage, it can help focus the patient, allowing for other kinds of treatment to be more effective which leads to the phasing out and eventual elimination of the use of the drug (BaldwinandCooper599.) This kind of treatment would lead to a faster and better adjusted ascent to normal behavior patterns and a much easier life for all involved.
More research needs to be done on the subject of ADHD. The research should start with investigating the causes of the disorder. The next step in researching ADHD should be in to the key diagnostic factors that would allow doctors and psychiatrists to more accurately identify and diagnose ADHD. The final phase of research needs to be focused on the treatment of those individuals diagnosed with ADHD so that they can have the greatest amount of help, with the least amount of risk posed to their physical and psychological health. Even though great strides have been made since ADHD was first identified around the turn of the last century, there are still many left to make in the race with Attention Deficit Hyperactivity Disorder.
Works Cited
Babcock, Quinton, and Tom Byrne. “Student Perceptions of Methylphenidate Abuse at a Public Liberal Arts College.” The Journal of American College Health. 49 (Nov. 2000) 143-145
Baldwin, Steve, and Paul Cooper. “How should ADHD be treated?” The Psychologist. 13 (Dec. 2000) 598-602
Barkley, Russel A. “Commentary on the Multi-modal Treatment Study of Children with ADHD.” Journal of Abnormal Child Psychology. 28(2000) 595-599
Barkley, Russel A. Attention-Deficit Hyperactivity Disorder: A hand book for Diagnosis and Treatment. New York, The Guilford Press.1998.
Brown, Michael B. “Diagnosis and Treatment of Children and Adolescents With Attention-Deficit/Hyperactivity Disorder.” Journal of Counseling and Development. 78 (Spring 2000) 195-203
Hall, Alex S., and Arlinn G. Gushee. “Diagnosis and Treatment with Attention Deficit Hyperactive Youth: Mental Health Consultation with School Counselors.” Journal of Mental Health Counseling. 22(Oct. 2000) 295-306
