Attention deficit disorder can be hard for parents
A report in today's newspaper says that children with attention deficit disorder (ADHD) can't switch off the default mode network (DMN) in their brains, the daydreaming function. Stimulant drugs such as methylphenidate may help to switch off this DMN, turn down the volume, as it were, and enable the ADHD sufferer to focus on a task.

These findings are interesting, but they do not address the question of why so many children are suffering from the condition in the first place. We've reached a point where plenty of us know a child personally who's being medicated to improve his or her behavior. Half a million prescriptions for Ritalin - one version of methylphenidate - are filled every year. That is worrying in itself of course, the dosing-up of so many young children with drugs that alter their behavior. But even more alarming is just to think of the changes in society that are creating disturbed children in such numbers. Especially, it is staggering to contemplate the casual neglect and abandonment of children that occurs.

Basically, what's happening is that some people carelessly have children, don't look after them properly and then someone else - the state, the care system - takes over. The process of abandonment combined with lack of love and maltreatment is actually altering the young brains of these children - causing brain damage, really. That's how you get disorders like ADHD: the odd behaviors point to something having changed in the chemistry of the brain, perhaps even in its structure.

Yes, of course, many other factors - both environmental and genetic - cause behavioral disorders and mental illness in children. Devoted and loyal parents may have a child who suffers from ADHD. But the widespread neglect of children that I'm talking about, the non-existent families, the absent fathers - these are phenomena that have flourished in parallel at the same time as conditions such as ADHD. So I feel a hunch that the two are linked (OK, not in all cases - but in some). And, what's more, we adults can do something about how children are brought up: it's not a mystery or something beyond our control like genetics.

Consider this case. Friends of ours adopted a child from a troubled background. I'll call him James. To adopt him they had to go through a screening process lasting about two years. James, who was about two and half when they adopted him, had lived with violence for most of his short life. That's to say, the foster carers who looked after him - some of them - used to fight: the authorities do not think they were violent to James. Counselors involved in the adoption process told the prospective parents that the toddler had suffered trauma as a result of witnessing violent behavior among adults.

When James was four or five, his parents sent him to a local primary school which made excellent provision for pupils with special educational needs. At first, James found it difficult to settle down at school. His bad behavior disrupted the class. At home he could be shockingly abusive towards his parents. He erupted in rages and spat at his mother. At times she would be on the point of despair, thinking: how can we go on like this? And then we would hear that James was making improvements, settling down and benefiting from the conselling that had been provided free of charge by the local authority where James was born (the funding for which has since dried up). Above all, he was responding to the unconditional love that he received from his parents. It is important to note that despite all the trials James's parents love him very much. He has shown himself to be a delightful boy who can be funny, clever and sensitive to the feelings of other people. Often he is racked with guilt over his extreme behavior, and will beg his mother for reassurance.

But his progress has many ups and downs, and this week we heard the latest installment. He is now six and his behavior both at home and at school has deteriorated. His violent outbursts so alarmed the school that they assigned him an adult to keep an eye on him during lessons. He was unable to concentrate on tasks. Every morning his mother gave the school a report on his behavior the night before, so they could prepare. When he was alone with his mother and father, he would verbally abuse them. He would throw objects, bite, and wet the bed on purpose. On two occasions he rammed cotton wool so far into his ear canal that he had to have the obstruction taken out under general anesthetic. He also forced a dried pea up his nose. All this misbehaviour makes him incredibly hard to deal with, and, understandably, it shatters his parents' morale.

Experts diagnosed Oppositional defiant disorder (ODD). In layman's terms you could summarize James's behavior as a desperate and disruptive craving for attention. As his mother says: "The worst punishment I could ever give him is to ignore him for two minutes. He hates being ignored." A few days ago, James's mother administered his first dose of methylphenidate, a cortical stimulant that's sold under such brand names as Ritalin and Equasym.

She described what happened. To begin with, James was a model child - compliant and pleasant, he showed how "good" a boy he had the potential to be. But after about the third hour on the drug he changed. He become drastically speeded up - what you'd expect from someone on speed. He blurted out words rapid-fire, ran about and generally acted out. His parents could not calm him and when bedtime arrived he could not sleep. If anything, the after-effects of the medicine - it sounds like "rebound hyperactivity" - were worse than the defiant misbehavior the drug was intended to treat. They went back to the psychiatrist, who said this reaction was rare and prescribed a different formulation of the drug. James's mother and father are now waiting anxiously for the weekend, when they will try out the new medicine.

There are times when they feel like throwing in the towel but they never do. James's mother often says she can see no future and fears the boy has only prison to look forward to. They must also realize that they are his only chance of a happy outcome, and that every day they care for him must in a tiny way be undoing the harm inflicted in his first two years of life.

The trouble is, when the damage has happened in the earliest years of development, it can be nearly impossible to undo. And it ripples outward to affect most of the people the individual comes into contact with, one way or another. So one has to wonder what the long-term consequences are, for all our lives, of these social trends - where parents have children without taking responsibility for looking after them, and then the care services, saintly adoptive parents and prisons try to cope with distressed and angry children as they grow up. Medicating children for ADHD is all very well, but it's doing nothing to treat the cause.

Comment: According to research Drugs for ADHD 'is not the answer'. For more information about how the use of hyperactivity drugs has soared and the serious health effects associated with treating children with amphetamine drugs such as Aderrall (detroamphetamine) and Ritalin (methylphenidate) read the following articles:

The Over-Prescribing of Psychoactive Drugs to Children: A Scourge of Our Times

New Warning for Attention Deficit Drugs

ADHD Drugs: Hallucinations Not Uncommon

Stimulants for ADHD Shown to Cause Sudden Death in Children

Do ADHD Drugs Take a Toll on the Brain?

ADHD - Another Dangerous over Hyped Drug

From the article:
Spending on ADHD drugs soared from $759 million in 2000 to $3.1 billion in 2004, according to IMS Health, a pharmaceutical information and consulting firm. The United States uses approximately 90% of the world's Ritalin. The International Narcotics Control Board (INCB), an agency of the World Health Organization, deplored that "10 to 12 percent of all boys between the ages 6 and 14 in the United States have been diagnosed as having ADD and are being treated with Ritalin." With 53 million children enrolled in school, probably more than 5 million are now taking stimulant drugs. The number of children on these drugs has continued to escalate. A recent study in Virginia indicated that up to 20% of white boys in the fifth grade were receiving stimulant drugs.
While the author makes an important point about the altering of the young brains of children as a result of emotional stress such as 'feelings of abandonment combined with lack of love and maltreatment is actually - causing brain damage'. There are alternatives to drugging children, for more information about how diet can be an effective alternative to drug therapy read the following articles:

How to Stop the Epidemic of Attention Deficit Disorder

From the article:
There is an effective alternative to drug therapy: Nutrition.

A body of scientific research supports the importance of nutritional factors in ADHD. I have treated hundreds of children with ADHD over the past thirty years. Almost all have improved without the need for drug therapy.


Over 50% of children with ADHD crave sweets, often at the expense of nutritious food. About 70 percent of children who crave sweets have much more control over their behavior when their food is low in added sugar.
A Better Prescription for Generation Rx

About the author

Andrew M Brown is a writer who specializes in mental health and in the influence of addiction and substance abuse on culture.