I am writing about teachers who promote ADHD . . .

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I am a school psychologist. I have encountered a serious problem in the public schools. The presence of this problem is confirmed and supported by parents, and other school psychologists.

Teachers and other school employees are telling parents that their children have ADHD. These same people are telling parents that their children need medicine (even specifying the medicine by name). These same teachers are directly requesting that the children’s dosages of medicine by increased. Some are threatening parents, saying that they will be guilty of neglect if they do not get medicine for their child. Some are saying, "If you don't put your child on medicine, we will put him in a special education class with students who have behavior problems."

Pretty gruesome, huh?

Wrightslaw Replies

I am aware of these problems. Some school districts deal with this problem by implementing a "gag order" where teachers are forbidden from talking to parents about their suspicions that a child may have ADHD or LD. Of course, this creates more problems and mistrust of school staff by parents.

I think we need to do a better job of training and supervising teachers. As you know, people in most professions go through internships where they have a lengthy period of supervision. Teachers are often dumped in classrooms where they must sink or swim.

Many teachers feel isolated and powerless. Perhaps "becoming an expert" is a way to counter these feelings. I’ve heard many teachers complain that school psychologists don't understand their work or what it's like to deal with classroom problems. Sometimes, they perceive school psychologists as living in an ivory tower.

Maybe you can find a way to provide some training for these teachers – this would also benefit the kids.

Recently, there was an article in the Associated Press about over-diagnosing children with ADHD.

Researchers studied 30,000 children in two Virginia school districts By fifth grade, nearly 20% of all white male children were on medication for ADD/ADHD. In this case, the people who seemed to be over-diagnosing children were doctors, not teachers. Maybe this study is a good way to start the education process.

Good luck!

Pam Wright
 

ADHD Overdiagnosis
Thursday, September 02, 1999

[By Sonja Barisic of the Associated Press.]

Doctors may be over-diagnosing some groups of children with attention deficit-hyperactivity disorder and over-prescribing drugs to treat the condition, according to a new study published today.

Researchers examined about 30,000 grade-school children in two districts in southeastern Virginia and found that pupils took drugs for ADHD in school at two to three times the expected rate, according to the study in the American Journal of Public Health.

ADHD is characterized by impulsive behavior and difficulty in paying attention and keeping still. About 90 percent of patients take Ritalin, a mild central nervous system stimulant believed to calm hyperactivity by helping the brain disregard distracting stimuli.

ADHD has been estimated to affect 3 percent to 5 percent of school-age children nationwide, with less than 3 percent actually receiving medication, said Gretchen LeFever, a pediatric psychologist and lead author of the study.

By comparison, her research found that 8 percent to 10 percent of children in second through fifth grades routinely took ADHD medication in school during the 1995-96 school year.

Disputes Need for Prescriptions

"It's hard to believe this many children have the specific brain-related problem called ADHD," said LeFever, assistant professor of pediatrics and psychiatry at the Center for Pediatric Research. The center is a joint program of Eastern Virginia Medical School and Children's Hospital of The King's Daughters.

LeFever said there probably are regions across the country with similar trends, indicating more research is needed.

"That's a very high rate of ADHD, by anyone's estimate," said psychologist Nadine M. Lambert of the University of California at Berkeley, a longtime ADHD researcher who was not involved in the current study.

In the study, researchers reviewed records of pupils enrolled in the second through fifth grades in Portsmouth and Virginia Beach. They chose those two cities because they were the most diverse in southeastern Virginia, LeFever said. Portsmouth is a small, urban, poor, mostly black district while Virginia Beach is a larger, wealthy and mostly white.

Most Common for White Boys

Researchers also found that ADHD medication was used by three times as many boys as girls and twice as many whites as blacks. Use of the medication increased as children aged. By the fifth grade, 19 percent to 20 percent of white boys received ADHD drugs.

Dr. Louis H. McCormick, a faculty member in the family medicine department at Louisiana State University medical school, said the study confirms what he has long suspected in his own 20-year practice, that kids are being over-diagnosed with ADHD.

The problem is that other conditions, such as anxiety or depression, can mimic the symptoms of ADHD, said McCormick, a family doctor in Franklin, La., who has given seminars on ADHD. He also is a member of the American Academy of Family Physicians. "We don't have a blood test to evaluate ADHD. ADHD is an educated guess," McCormick said. "...

You need better data from all 50 states to really get a handle on the prevalence."