One Diagnosis or Many?
The epidemic proportions of the ADD diagnosis are gaining widespread attention from parents, educators, physicians, and other healthcare providers. Many people are seriously questioning the possibility of overdiagnosis. This issue was raised in an informative cover article in Newsweek magazine. "ADHD has become America's No. l childhood psychiatric disorder....
Since 1990, Dr. Daniel Safer of Johns Hopkins University School
of Medicine calculates, the number of kids taking Ritalin has
grown two and a half times. Among today's 38 million children
at the ages of five to fourteen, he reports, 1.3 million take
it regularly. Sales of the drug last year alone topped $350 million.
This is, beyond question, an American phenomenon. The rate of
Ritalin use in the United States is at least five times higher
than in the rest of the world, according to federal studies."
The article continues, "For
all the success they've had in treating ADHD, many doctors are
convinced that Ritalin is overprescribed." Dr. Peter S. Jensen,
chief of the Child and Adolescent Disorders Research Branch of
the National Institutes of Mental Health is quoted: "I fear
that ADHD is suffering from the 'disease of the month' syndrome."
Dr. Bruce Epstein, a St. Petersburg, Florida, pediatrician, reports
that parents of normal children have asked him to prescribe Ritalin
just to improve their children's grades. "When I won't give
it to them, they switch doctors."
We applaud Dr. Thomas Armstrong's
warning about the current overdiagnosis of ADD in his book The
Myth of the ADD Child. We have seen a number of children who
were high-spirited, extremely imaginative, and so precocious that
their parents were unable to keep up with their ceaseless questions
and insatiable intellectual appetites. We have also met children
who were overamped, but performed just fine in school. Many of
these children have been diagnosed with ADD, even though we feel
they fall more into the category of unusual, remarkable, or gifted
children. Some youngsters are the victims of rigid, overly strict
teachers whose highly structured classroom environments simply
do not pace their temperaments and learning styles. Or they have
excessively rule-bound parents who do not extend to their children
the freedom that they need to thrive and expand their creative
We have also seen a large number
of children whose behaviors are very disruptive and disturbing
through no fault of teachers. No one can expect a teacher in a
classroom of forty active children to cope happily with the statistical average
of 10 percent (four children) in her class with ADD. The amount
of extra attention, discipline, and time just trying to keep these
children and those around them safe is more than many teachers
Can we, however, lump all of these
children together under one diagnostic category? Can a child who
lashes out at his family, peers, and teachers in a violent, destructive
manner and has no interest in his schoolwork fit into the same
diagnostic group as a sweet, gregarious child who simply cannot
pay attention in class? Conventional medicine would say that,
based on their scores on standardized ADD tests, both children
could indeed have ADD. Homeopathy would say that these are two
distinct children whose problems and temperaments are as different
as night and day. A homeopath would prescribe very different medicines
for the two children, rather than giving them both stimulants.