The notion of categorising the behaviour of young children as either “normal” or not confounds most parents, while the idea that their child needs to be given a psychoactive drug at a young age horrifies even the bravest moms and dads.
As if those factors aren’t enough to make one feel inadequate and hopeless, when parents are then met with the barrage of negative perceptions and misinformation about Attention-Deficit/Hyperactivity Disorder (ADHD), it makes an already intimidating situation that much harder to cope with. The best way to combat ignorance and negativity is to enlighten one’s self, thus I’ve listed a few common ADHD myths and the facts needed to dispel them.
Myth #1 – ADHD is an excuse for children to be naughty and parents to be lazy
To many people, ADHD is a cultural construct with a foundation laid by poor family values, the product of capitalism and the moral decay of society. One might hear remarks such as “we didn’t have any of this ADHD nonsense when I was growing up, just children that needed a good smack”. The implication being that children lacking self-control and affecting poor behaviour are simply naughty and have not been disciplined appropriately by their parents.
Although the nomenclature for ADHD as it is known today was only devised in 1994, this condition characterised by poor attention and over activity was actually identified by Dr George Still in 1902. The criteria for diagnosis have changed many times over the decades given the lack of knowledge on the condition, thus it is likely that many adults actually had or still have ADHD that was not diagnosed in childhood. The high heritability of the disorder also means that it is likely that parents of children with ADHD also have the disorder or symptoms of it.
ADHD is diagnosed at a behavioural level, but advances in biological research have aided understanding of the condition through the development of neuro-imaging techniques, genetic associations and neuro-cognitive theories. This research largely points towards ADHD being associated with dysfunction in the levels of chemical messengers (neurotransmitters) in parts of the brain involved in cognition. The neurotransmitters most commonly implicated are dopamine and noradrenalin.
Myth #2 – Children outgrow their ADHD
Many people consider ADHD as a developmental condition which is confined to childhood. A primary contributor to this school of thought is the fact that levels of hyperactivity, an externalising symptom, tend to decrease with age. However, ADHD has been described in adult populations from as early as the 1970s and the condition is officially recognised and classified in adults in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders(DSM).
During adolescence and adulthood, impairment due to impulsivity and/or inattention becomes more apparent, leading to dysfunction in the carrying out of everyday tasks and social relations. The ratio of men to women with the disorder also tends to decrease as more women find themselves unable to cope with the effects of poor attention and impulsive decision making, leading them to seek medical assistance with the eventuality of a later life ADHD diagnosis.
However, not all children retain ADHD into adolescence and adulthood. The worldwide prevalence of ADHD in children and adolescents is estimated to be approximately 5.29%, whereas estimates in adult populations are thought to be between 2% and 4%.
Myth #3 – ADHD is a school problem
Whether it’s due to the problems caused by ADHD becoming more apparent at school going age or because school introduces a whole new domain in which a child can feel significantly impaired, many people tend to think of ADHD as a condition which only affects a child’s scholastic ambitions. Sadly, this is not the case. Many a parent of child with ADHD will tell you of the woes accompanying the organisation of play dates and knock that it takes on a child’s self-esteem.
Social relationships do not come easily to the ADHD child, this aspect is one that is assessed when the diagnosis is made. Their impulsive nature makes them that much more likely to speak before thinking, to be explosive in their actions (and reactions) and to have difficultly in reading cues for socially acceptable behaviour (probably because they were more interested in the picture of the animal on the other child’s T-shirt than listening to what s/he was saying).
It’s not just limited to interactions with peers. One might find greater family discord with an ADHD child, which can be due to a number of causes. A lack of patience and understanding between parent and child (and siblings) may lead to tempers flaring, frustration due to tasks not being done on time, aggression from a child who feels that s/he is being treated unfairly or unduly put upon – these scenarios create tension in a family and demonstrate how an ADHD diagnosis cannot be put into a little box with a neat label which is marked “school problem”.
Myth #4 – ADHD is caused by artificial food additives
The effect of food on behaviour has been explored from as early as the 1920s, but it was popularised in the 1970s by Feingold following reports of an improvement in the behaviour of at least 50% of learning impaired children “treated” with his Kaiser-Permanente (K-P) diet. This diet eliminated foods containing salicylate and additives such as artificial colourants and flavours. Follow-up studies on this, however, failed to find definitive proof of the correlation and much criticism was levelled against Feingold for his methodological flaws. Despite scientifically sound research disproving Feingold’s theories, principles from his original diet plan persist today, which, although not harmful, could compromise a child’s wellbeing through scientifically validated management such as behavioural therapy and, where indicated, pharmaceutical therapy being withheld. However, it should be noted that a small percentage of individuals, not necessarily affected by ADHD, do show sensitivity to certain additives and should avoid products containing these substances.
Myth #5 – Drugs used for ADHD are addictive
The pharmacokinetic properties of methylphenidate (Ritalin®) are similar to that of addictive substances such as cocaine and methamphetamine, but numerous studies have concluded that tablet or capsule formulations of methylphenidate do not confer addiction. In particular, investigations into this potential problem concluded that there is very little evidence that methylphenidate is abused by the patients it is prescribed for, while some studies have even suggested that children treated with methylphenidate from a young age may be protected from developing substance addiction later in life. That being stated, chemical adulteration of the immediate-release tablet dosage form into one with more immediate central nervous system delivery can result in this drug being used for illicit purposes. Thus is it very important that this drug, like all medications, is stored according to safety instructions, with precaution taken to ensure it is not misplaced or stolen. Controlled-release dosage forms such as Concerta® and Ritalin LA® are safer options for patients where abuse potential is of concern. - Judith Regnart
Author Bio:
Judith is a wife, pharmacist, part-time PhD student, bellydancer and mother to three furry children. Although she hopes to start her own family in the near future, in the mean time she devotes her faculties to researching aspects of ADHD in the hope of positively contributing to understanding of the disorder. She has real life experience with her late-life ADHD diagnosed husband who is living proof that a difficult childhood of undiagnosed ADHD can be overcome and can be very rewarding creatively as evidenced by his photography business, www.nikregnart.com.
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