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Bringing ADHD out of the shadows

Having grown up with a younger brother with attention-deficit/hyperactivity disorder, there wasn’t much question as to which side I’d be on when attending last week’s “Fact or Fiction: ADHD in America” summit in Washington, D.C.

New York Times columnist Judith Warner, author of “We’ve Got Issues: Children and Parents in the Age of Medication,” thought she knew what side of the debate she’d be on, too, when she began researching for the book more than six years ago.

“The feeling that these disorders came out of nowhere, so they must be bogus —  I was fully within the mainstream on this, as was much of journalism for the last 15 years,” said Warner in an interview before the event. “I chose doctors [to interview] because I thought they backed up my point of view. They didn’t.”

So there she sat — not truly an advocate but certainly a convert — on a panel of experts trumpeting the need for more awareness in society about what ADHD is and what it is not. An apt comparison was how a majority of conditions 30 or 40 years ago merely fell into the broad brushstroke of “retardation” on the part of society, whereas now ADHD is often written off as bad parenting, an overactive child or simply someone with no self-control.

Michele Novotni, a counselor with a PhD who raised a son with a severe case of ADHD, said learning how to help those with the disorder succeed takes a re-learning of how to help them learn. She shared a story of how, needing to gain cooperation from her son for just a short period of time so she could make an appointment, she promised to buy him a much-desired toy.

“He just looked at me and said, ‘Mom don’t bother,'” Novotni said, going on to explain that her son knew he couldn’t do it — even at the age of 5. Two years later, when asking what he heard when she talked to him, her son told her he picked up all the noise we’d normally tune-out out as background noise on the same intensity, making staying focused on just one thing for an extended period of time next to impossible. “Very few things are auto-pilot for people with ADHD.”

Most of the panel supported the combination of medication and behavior therapy to help those with ADHD not just cope with the disorder, but function in a productive manner. Katherine Schantz, who runs the Lab School of Washington and Baltimore Lab School, which caters exclusively to students with learning disabilities such as ADHD and dyslexia, said that testing for students with ADHD and other learning disorders should be done at a young age to ensure they aren’t lost to years of teaching from an ineffective model.

The Lab School uses a variety of techniques, such as visualization, breaking tasks into small, manageable chunks and allowing them to “pre-game” how to tackle an assignment, which allows the brains of the students to better process the information being taught to them.

“We’re also doing a better job working with the kids to reduce the shame part,” Schantz said. “The guilt and shame people feel [about the disorder] cannot be minimized.”

That carries over into adult life, making psychologist and ADHD expert Ari Tuckman flabbergasted when he hears of insurance companies that won’t cover ADHD medication beyond the age of 18.

“Folks with ADHD struggle across every aspect of their life,” he said. “It’s not just things like GPA in high school. They are more likely to be divorced, fired, have unplanned pregnancies, higher car accident rates and lower credit scores. This is serious stuff.”

An estimated 5 percent of the population suffers from ADHD, but much of it still goes undertreated or completely untreated. Novotni’s father wasn’t diagnosed with ADHD until late in life, after decades of struggling to keep a job and working at tasks well below his intellect.

“When you look at the economic impact of untreated or undertreated ADHD, it’s huge … in terms of success in high school, in academics and in the workplace beyond,” Tuckman said. “There is not a simple solution. People are complicated and so we need to think about this in a complex sort of way.”

Part of the multifaceted approach to aiding those with the disorder starts with the public school system, which Schantz said has not done a good job of training teachers how to help students with learning disorders succeed. She worries, as well, that the federal push to improve test scores has too many educators teaching students how to take tests, rather than helping them learn in the best manner possible.

On a larger scale, Warner said, keeping those with ADHD from falling to the fringes of society will take a concerted effort to create a mindset change on the part of the public.

“I think the news media has played a hugely negative role,” she said. “We desperately need more government research, as there is enormous skepticism about current research.”

For more from the panelists at the event, go to KevinMD.com to view video interviews with each of the participants.