Dear Dr. Fournier:
I have read a number of your articles, and I think the idea you have presented in the past that children who have ADD or ADHD are somehow misdiagnosed or can be dealt with without medication is against everything I have read elsewhere. My son has ADD and the medication he takes helps his symptoms.
Amanda
Harrisburg, PA
Dear Amanda:
My mail often includes chastising letters from those who place great-almost sole- confidence on the label ADD/ADHD and on medication for Attention Deficit Disorder.
ASSESSMENT
Easily Distracted. Difficulty listening, focusing or concentrating and following directions. Inconsistent school performance. Disorganized. Poor study skills. Cannot work independently
Frankly, I could make a case that one or more items on this list applies to all of the people some of the time just as much as it characterizes some of the people all of the time.
That does not mean that all suffer from ADD. It does mean that all of us have different ways of coping with the day-to-day demands of our environment.
But at school, within the confines of a rather rigid environment, children are expected to gather knowledge at a certain pace and in a certain way. Beat out your own path-march to a different drummer- and you are in trouble.
The definitions of ADD and ADHD are smack at the interface of medicine and education. Although the above list addresses learning behavior, the “solution” is solely a medical prescription. I believe medication without an educational prescription is inadequate.
WHAT TO DO
When a child has a medical problem, you take him or her to the doctor and discuss the symptoms: fever, indigestion, and a rash. Yet even having all three symptoms does not allow the diagnosis of a particular disease. The physician must consider numerous diagnoses before settling on one. What could look like an allergy could turn out to be a viral or bacterial infection, or a metabolic disturbance.
When a child has a learning problem, too many adults jump to a medical diagnosis that lumps a group of behaviors together under one particular medicinal heading. A medical diagnosis implies that a disease has been identified, which places the child at the center of the problem as though he or she were entirely to blame. Yet, ADD/ADHD are not diseases, but clusters of behaviors whose root causes do not necessarily lie within the individual exhibiting them. Symptoms point to possible diagnoses, yet with ADD/ADHD the symptoms too often are perceived to point to only one possible diagnosis. If you review the list above, the child could have a receptive language disorder, or even a sound discrimination disorder. Until all other possibilities are eliminated, a parent should not accept the medicating of their children with a potentially addictive drug.
All too often, when a child is identified as “spaced out,” or “inattentive,” and this judgment may cascade into a description of how the child lacks focus, cannot follow directions, and is seldom on task, which is the result from the one-size-fits-all conclusion of ADD. If a child is inattentive, the characteristics of inattentiveness are not additional symptoms. An instructor cannot expect someone who is not paying attention to follow instructions. One goes hand in hand with the other.
Certainly, ADD/ADHD occurs in some of the people, some of the time. But ADD/ADHD is not the answer to all children’s learning problems all of the time. As such, I will continue to give parents and teachers non-chemical prescriptions in the form of learning strategies to help children learn to cope with the changing demands of their learning environment long before I recommend medication of any sort.
CONTACT DR. FOURNIER
