Friday, November 18, 2005

Does the Absence of Fathers Cause ADHD?

In a controversial new book, Destructive Trends in Mental Health: The Well-Intentioned Path to Harm, the authors point out a study that showed ADHD (Attention Deficit Hyperactivity Disorder) might be related to a lack of a positive father figure. Rogers Wright and Nicholas Cummings, two liberal psychologists who were prominent leaders within the American Psychological Association, have seen first hand how the organization has omitted important research when it did not fit in with their liberal dogma.

In a study described in the book, kids with ADHD were paired with male therapists due to a noted absence of fathers in this child/adolecent population. The kids were given behavioral treatment with the therapists and special attention was paid to developing a positive attachment to the male figure. At the end of the treatment, only 11% of the boys and 2% of the girls had to remain on medication. The authors of this sudy suggested that social forces may be major contributors to ADHD. Among these social forces are: "the absence of positive father role models; the presence of a revolving door for negative male role models brought into the home; poor parenting; the need for order in the classroom when teachers are severely curtailed in meting out discipline; and a declining appreciation in our culture of what constitutes normal boy behavior." This study was never given much attention by the mental health community as the "solutions" were not politically correct at they emphasized the deficit of a male role model.

I wonder how this lack of positive role models and declining appreciation for normal boy behavior plays out with the shortage of male teachers in the classroom. Could male children be taking Ritalin as a substitute for their absence?

77 Comments:

Anonymous Anonymous said...

My daughter was diagnosed with a mild ADHD. Drugs didn't really help, nor did talk therapy. We went to a clinic that specializes in ADHD, where they diagnosed her with an anxiety disorder. They have found significant numbers of ADHD cases are actually anxiety diorders. The clininc has also had good results with using biofeedback to control some forms of ADHD, allowing patients to grt off drugs.

9:55 AM, November 18, 2005  
Anonymous Teresa said...

Since I know a few boys where are ADHD and have good fathers in the home. I'd have to say that once again the line is being blurred between causation and corrolation.

I do think families of father/mother/kids are the best way to raise children. But - I would certainly hesitate maybe even come to a full stop, before stating that the lack of a father is a causative factor in ADHD. From the little you've posted about it - it looks like it's more of a behavioral problem in those children - in other words how the adults are implementing rules and the role of boys projected by society.

OTOH - I haven't seen the book so I could be wrong about that. This just smacks of the kind of "science" that has infested the cure for cancer race. "This" will up your chances for cancer one week... the next week it actually helps you. As I said causation and corrolation - too many people mix them up.

10:04 AM, November 18, 2005  
Anonymous Don said...

"At the end of the treatment, only 11% of the boys and 2% of the girls had to remain on medication."

How do children in this population respond to female therapists? How do kids with ADHD who come from two-parent families respond to male therapists and positive attachment to the male figure?

I'm not a fan of political correctness at all. But it's just possible that this study was panned simply because the authors' conclusions don't follow from the study's data.

10:10 AM, November 18, 2005  
Anonymous Scot said...

As a male therapist myself, I conccur completely about the need for positive male attachments, the faily obvious absence of birth fathers, and revolving door of negative male role models. However, I heard one lecturer argue that since ADHD is believed to be inheritable, the short attention span of the birth fathers is what leads to their absence; they are unable to stay committed to the relationship. This presents kind of a chicken or egg issue to the discussion.

Personally, I've always held the view that what I call Discipline Deficit Disorder, poor parenting, has a lot to do with many of the kids who are percieved as attention deficit. However, since going to work in the mental health field, I can tell you that there truely are kids who suffer from something organic that causes them to be hyperactive and inattentive. There are still, however, many kids diagnosed or labled ADHD who's problems stem from parenting and the factors presented in this post rather than a mental disorder of their own.

10:13 AM, November 18, 2005  
Anonymous Anonymous said...

ADHD existed before the recent and current craze for the diagnosis. My younger brother, 37, has it, and Dad's strongest characteristic has always been his trustworthiness (his 7-year-old son, my nephew, also has it, and my brother could never be described as absentee in any sense). My ex-fiance, 35, has it, and his father was an amazing, involved father.

My mom had it, and her father was certainly an absentee father in every way, but she was not diagnosed until shortly before her death. The suggestion that it might have really been an anxiety disorder is extremely attractive in her case.

Mightn't it be more truthful to say that the absentee father situation is correlated with the semi-arbitrary assignment of ADHD to the child (as opposed to the actual presence of the disorder)?

10:15 AM, November 18, 2005  
Blogger MEC2 said...

I must certainly echo the statements Scot has made - surely, you will run across the child with a certain tangible disorder related to some physiological factor. But examining the role of the male in social animals, you'll find the lead male performs a valuable, behavioral modifying trait - setter of limits of behavior.

It may sound almost sociopathic, but fear of the alpha male in groups helps define acceptable behavior in young. This of course doesn't argue for scaring young children into behaving - outright threat will create equally if nor more deleterious behavior. But the lead male figure creates a structure inside which young instinctively learn how to operate. Without that figure, the natural instincy to seek boundaries can be unchecked, and lead to behavior we might see as "attention deficit" instead of "discipline deprived".

Grossly simplified for brevity, of course, and it cannot be said that this is a universally applicable diorama for family life. But the experiences in this study do logically mirror these beliefs.

10:29 AM, November 18, 2005  
Blogger acassa said...

Speaking from observation only (I'm not a doctor of anything), this does not surprise me.

I have a nephew, who my husband and I call "Lucifer". Child from hell, for no reason other than his mother is a pathetic excuse for a parent. Never says "no", sets no rules for him, allows him to say and do anything he likes. Not out of a misguided attempt at liberal parenting, but because she genuinely seems bothered that raising a child should require any effort on her part. Did I mention she is a public school teacher?

Her ex-husband is, to put it bluntly, a pathetic excuse for a man. Browbeaten, easily-dominated and ordered around, and never, ever says anything to or does anything with the child unless Mom approves – which she normally doesn’t. Discipline coming from him is immediately rebuffed by her.

It is no surprise, that given this great upbringing, he was unruly, inattentive, hyper and prone to outbursts which often involve a bit of physical “violence” – throwing things and hitting.

He is 10 now and on Ritalin for the past two years. He is an empty shell of boy, but at least Mom is happy that she doesn't have to be bothered with a son that actually has any life in him that might disrupt hers. He is genuinely a sad excuse for a child, and my husband and I constantly worry for his mental health.

Well, I can’t make a long story short, but the point is that most of the children I know who are ADD (I’ve known 4) suffer from nothing that couldn’t be cured by having two parents who showed genuine interest in their lives. Only one seems to have a genuine need for medical help and has two parents who are loving and devoted.

My father volunteers to tutor underprivileged children. Every child he works with lacks a father figure – either their mother is single or their father is in prison. Well over half of his students are diagnosed as some form of ADD.
Anecdotal, yes. Causation or correlation - not sure. But it makes you think how necessary drugs are for a child, when the problem may largely reside externally.

10:31 AM, November 18, 2005  
Blogger Brian said...

Oh god, not another stupid blame the parents book on ADHD. As if parents of ADHD kids don't have enough bullshit with the try this diet, try this natural medicine, you're evil for putting your kids on Ritalin.

I can only tell you about the experience with my daughter. My daughter was extremely active since she was old enough to walk and we just thought she was a bit overactive. By the time she was 5 and in kindergarten it was clear she had much bigger problems.

Adderall and then Ritalin have been a godsend. Before taking these drugs, you could ask my daughter to draw a picture of a house and she'd grab a couple crayons and give you a picture which didn't look like anything. Less than a week after starting drug therapy, you could actually tell the drawing was of a house.

I do not doubt that many kids are misdiagnosed as ADD/ADHD and that more effective parenting and other non-drug therapy methods can work wonders. But the whole "this disease is just bad parenting" is simply nonsense.

10:46 AM, November 18, 2005  
Blogger Earth Girl said...

Anon- some of the social forces Dr. H describes may be the cause of anxiety.

We adopted twin boys when they were almost six. As you can imagine, their biological family was extremely dysfunctional. Both boys "outgrew" ADHD (as diagnosed by the school) with loving discipline, a strong father figure who provided after school and summer care and a loving family. It was a lot of work for everyone, including the boys.

We did medicate one son after having the diagnosis confirmed through independent studies. We only medicated during the school year, and used behavioral approaches in the summer. When he started crashing from the medication, we took him off instead of going to a continuous release form. He's been off for five years and is doing fine.

This is only anecdotal evidence, but the point is that it is extremely difficult to parent "ADHD" boys even with a strong male actively involved. My husband had to be as strong-willed as his sons to be consistent.

10:47 AM, November 18, 2005  
Anonymous Matt said...

I have a child with ADD (not real hyperactivity, just serious inattention), and suspect that I may have it as well. But since I'm not an absentee father, and neither was my father, I can't really contribute much to this discussion except to say that absence of a strong father figure seemingly can't be the sole cause of ADD/ADHD (and I don't think the study was asserting).

That said, it's self-evident to me -- based purely on anecdotal evidence, of course -- that children, especially boys, need fathers. I particularly remember noticing, in college, that my friends and acquaintances who had grown up without fathers were all a little "off" in one way or another. This is not to say that their lives were all in shambles -- they were getting by, or they wouldn't have been attending that particular school -- but they tended not to make very good decisions, and their lives seemed more chaotic than average. That appears still to be true, twelve years later.

10:53 AM, November 18, 2005  
Anonymous Anonymous said...

Hey acassa, in what state (city? but I'll understand if that is too private) does your sister in law teach? Just, you know, curious...

10:55 AM, November 18, 2005  
Blogger reader_iam said...

I won't get into the larger issues that all of you are so aptly addressing.

I do want to pick up a brief reference that you, Dr. Helen made: "declining appreciation for normal boy behavior."

This is something I have noticed for years (I'm middle-aged), even before I had my own son, now 5. There really does seem to be an ignorance, even among people who should know better, as to what is normal developmentally and temperamentally in boys, as opposed to girls.

My son is in all-day kindergarten, a private school that is very structured and also very small, such that most of the entire staff knows of almost every kids in the school. Most of the parents of his classmates are together; where not, both parents are still involved. I think it's safe to say that most if not all of the kids would be considered "above average" as compared to your standard, more diverse public school. They certainly appear to be held to far higher standards of discipline by their parents than you often see these days.

Yet there still seems to be a certain lack of appreciation of how boys of kindergarten age differ from girls of the same age. The expectations, benchmarks and standards seem overwhelmingly based on what one could (generally) expect of GIRLS of that age--or even up to a year older. It makes it harder and more anxiety-producing for the boys, who, significantly, seem almost universally to struggle more with the routines etc. of the school as opposed to the girls.

It really does appear to me now that there's something to the idea that we have gone too far in the "feminization"of education.

But what to do?

11:01 AM, November 18, 2005  
Blogger Helen said...

In general, I do believe that ADHD is a true condition with an organic base in some children--those are the ones who require medication--I have seen these kids in my office and refer them for medication which,like one commentor stated, can be a godsend.

But I have seen the other side also, where ADHD is given as a diagnosis when discipline and the word "no" has not been consistent enough. I had one teacher who was so tired of one boy's antics that she wanted me to diagnose him with bipolar illness so he could get some lithium. I explained that if a child could control his behavior when he wanted to (as was the case with this boy) that he did not have bipolar disorder. I started attending his school for observation, assisted the teachers in a treatment program, and provided structure for him and his behavior improved. My post was not meant as a slam against parents, for I believe we have enough difficulty--it is meant to show how research that does not have politically correct results often gets the shaft.

11:06 AM, November 18, 2005  
Anonymous Anonymous said...

Brian, I'm sorry you drugged your child so she could draw what you wanted her to draw.

11:29 AM, November 18, 2005  
Blogger dadvocate said...

In 1976, I got my first "real" job as a juvenile probation officer for the state of Tennessee after graduating from college. In those days divorce was much less common than now. Because of this I remember clearly that in my initial caseload, all boys, 69 of 71 came from homes with no fathers present. This ratio held true of all the caseloads in Knox County, TN where I worked. Obviously, there was some sort of connection between boys being in trouble with the law and absent fathers.

I also believe " a declining appreciation in our culture of what constitutes normal boy behavior" is a great part of the problem. Haveing grown up during this period I know, many things that boys did in the 50's and 60's would now land you in juvenile court, in therapy or on medication. Boys were disciplined for misbehavior but adults also realized that much of this was the "normal" growing up process for boys instead of defining these behaviors as some sort of pathology.

Scot - this lecturer is full of crap "However, I heard one lecturer argue that since ADHD is believed to be inheritable, the short attention span of the birth fathers is what leads to their absence; they are unable to stay committed to the relationship. This presents kind of a chicken or egg issue to the discussion." In divorce our legal and social system gives almost every advantage to the woman in terms of child custody and domestic issues. If you do some research on this rather than just listening to what some lecturer feeds you, you will find something quite different from what this lecturer said.

11:44 AM, November 18, 2005  
Anonymous Anonymous said...

Very interesting theory on the effect of a positive father role model. I have four children - the younger two, a girl followed by a boy both have been diagnosed with forms of ADD/ADHD. Both were on medications. The daughter was 12 when the dad left and suffers from issues related to this still. She is being treated for depression and ADHD. My son was doing horribly in middle school (12) - forgettng things and bad school performance. He went on meds - the drugs made him angry so I took him off - during this period a positive male role model entered his life and he began to change.

I read another book which said children with unstable home lives develope ADD - I believe the title is the "Myths About ADD" It makes sense too me that all the trauma associated with a broken home can change the way the kids process information - I am not sure the fathers are all to blame, but I do agree it does not always require meds.... Why are we seeing this "ailment" so much in this generation? I think for the reasons listed in the article and this other publications seems to agree!

11:48 AM, November 18, 2005  
Anonymous Kat said...

This is a very touchy and tough subject, I am going thru it with my 12 yr old daughter as we speak. We are trying therapy, because I feel very strongly that drugs should be a last resort. I do not want to hardwire her responses to the world at this age, nor do I want to have her learn that taking a pill will make her feel better unless it is absolutely necessary. That is what we are trying to determine now, is whether or not it is necessary, and if it is, after all other options have been exhausted, we will go with the meds.
My experience with ADHD has led me to wonder if I could possibly be a contributing factor at times, my thought processes have always been at best, random. We have a family joke about the "Left turn at Albuquerque" where we will tangent in a conversation, but my daughters and I can follow, where as people who don't know us may not. I once took a test to see how I would best learn, and maxed out on the 'abstract,random' scale, not a drop of concrete or linear in the results.... Wish I could remember the name of the test. Could this be a part of it? Who knows.

11:49 AM, November 18, 2005  
Blogger Lou Minatti said...

This comment has been removed by a blog administrator.

11:52 AM, November 18, 2005  
Blogger Lou Minatti said...

Dr. Helen, the answer to your question is... no. Lack of parental skills does not causes ADHD.

Why don't researchers look into the hereditary aspect? I speak from personal experience, myself and my son. Kids with ADHD (used to be called hyperactivity when I was a kid) literally cannot control themselves. Punishment, praise, all the good parenting in the world have NO EFFECT on this. None!

The "Johnny is an empty shell after Ritalin!" talk is pure nonsense. While medicated the children are NORMAL. They are able to study. The other kids like them. No longer are they treated as the spaz.

ADHD has always been around, but we've only really noticed it the past few decades as our society has changed. No longer do children run free for most of the day. Children go to school for many more hours, and most are supervised throughout the day. In other words, there are more adults around to notice children's behavior. It's like saying "Tennessee has more tornadoes now than 100 years ago!", when in fact there are simply many more people spread throughout the state who can spot them.

11:55 AM, November 18, 2005  
Blogger brylin said...

I urge caution before adopting the latest "findings."

That being said, recall the story of Robin Warren and Barry Marshall who won the 2005 Nobel Prize for Medicine for their 1982 discovery that helicobacter pylori, not stress, is the cause of stomach ulcers. The point is that even in the 21st century there is the possibility that current treatment may not be the best course.

So more research should be done but the 11% and 2% numbers sound very promising.

12:03 PM, November 18, 2005  
Anonymous Richard Aubrey said...

ADD and ADHD may be organic, but the general use of the term includes all kinds of behaviors including what tires out a parent but is otherwise normal.

For this reason, anecdotal evidence is not going to prove any one thing or another.

At one end, meds are necessary. At the other end, nothing is wrong and the concern is more about how much effort it takes to parent.

The problem is that undisciplined behavior can mimic real ADHD in the view of some non-professionals--I include teachers who are not mental health professionals and who get, if anything, a quick&dirty exposure to the subject which is oversimplified--as can normal boy behavior in the view of people who aren't used to boys or aren't used to boys who haven't been sat upon by people who aren't used to boys.

If you consider the evolution of the race, expecting a six-year old to sit quietly at a desk for six hours a day, doing work for which he is not evolved and which has no obvious benefit, and looking forward to at least a dozen more years of the same is insane.
That it works as well as it does is a miracle.
At the very least, we need to let boys do what boys do, which is run into each other, roll in the dirt, shout and climb and test themselves.
It's one thing to expect them to live a civilized life while giving them these outlets. To close off the outlets, too, is absolutely beyond any rational explanation.

The other part of the boy's evolution is his civilizing by a male figure. Why do we figure we can get along without it now, given that it's been the case for a million years?

Story. In South Africa, for some bureaucratically-obscure reason, the adult male elephants were removed from a large game preserve. Things started going downhill. Rhinos were showing up trampled and gored to death, large swaths of trees were smashed, water holes trampled into muck. The villains, it turnes out, were adolescent male elephants.
Showing a brilliant insight, the preserve authorities brought back the big guys and things calmed down.
Nope. No lesson there.

12:13 PM, November 18, 2005  
Anonymous Anonymous said...

The same politically correct (feminine) attitude that brands boy behavior too aggressive brands fatherly discipline as too dictatorial. I have witnessed the simultaneous horror of single moms at male boundary-setting and the almost immediate positive reaction of their male children to the same. Male aggression in boys is not necessarily or essentially violent, and fatherly boundary-setting is not necessarily or essentially cruel. It is, in a way, an objective approach that simply stands in contrast to the more subjective and nurturing aspect of feminine parenting. One voice stands for the objective, hard fact of reality that says NO without remorse or sympathy -- the other voice is sensitive to the internal, psychological experience of a child. (Of course this is a crass oversimplification, but it characterizes the different weighting in the approaches, as ideally both the father and mother are a blend of the two approaches.)

12:18 PM, November 18, 2005  
Blogger Greg Kuperberg said...

I have to wonder whether this study, which was mentioned in a book that I have no direct access to, only actually compared two-parent households with one-parent households. It is true that two-parent households are usually one man and one woman, and that single parents are usually women. But that does not mean that "male role model" means the same thing as "two parents".

It is very easy to believe that many single-parent households are simply short of labor. The parents may have no time to supervise, teach, or discipline the children, on top of house chores and holding down a job. Or if the single parent doesn't have a job, that introduces a host of other practical problems. It's no surprise if the children in these households are more likely to be disruptive at school, less likely to care about their homework, and more likely to be diagnosed with ADHD.

But this scenario is not specific to men or "role models". The first question is whether the parent or parents have enough time to properly raise their children, not what kind of "role models" they are.

So if the authors of either the book or the study wanted to prove their case, they would have to compare, for example, male single-parent households with female single-parent households. Or they could compare households with two women parents to households with standard heterosexual families. Maybe that was their comparison, but I would be a bit surprised.

12:26 PM, November 18, 2005  
Blogger submandave said...

Like many mental illnesses, diagnoses of ADD and ADHD are, to my knowledge, largely based upon behavioral patterns and not physically quantifiable phenomena (e.g. white-cell count, streptococyl culture, etc.). (Dr. Hellen, please correct me if I'm way off base in this characterization). As such, there is always the potential for two children to be exhibiting identical behavioral patterns based upon completely distinct causes. While both children may respond favoribly to medication (after all, it's a biological and chemical response), this may be a clasic case of "treating the symptom" rather than actually addressing the real problem.

12:33 PM, November 18, 2005  
Blogger SWBarns said...

Anonymous (11:29 AM), I'm sorry you are such a jerk.

You represent a big part of the problem that children with ADD have.

12:36 PM, November 18, 2005  
Blogger Jamie said...

Geez, Anonymous, do you really think that the quality of Brian's daughter's drawing was the decision-maker for Ritalin? Could it be, maybe, that Brian was using his daughter's drawing as an indication of her former deficit of control and her current improvement? IOW, for heaven's sake, judge not.

My parents, both teachers of dedicated and sensitive mien, recommended to me the book, Why Gender Matters. I pass on that recommendation. Among other things, it discusses certain organic differences between boys and girls (such as their perception of color and hearing acuity) that could lead to an early-childhood diagnosis of ADD/ADHD. For instance, if a teacher isn't aware of boys' statistically less acute hearing, and uses the "correct" mild and gentle tone of voice (usually) she was taught, she might end up with a roomful of attentive little girls and a roomful of variably attentive little boys. Fascinating book.

12:41 PM, November 18, 2005  
Blogger Mike Rentner said...

Personally, I believe that these diseases are little more than fabrications of drug companies who profit monetarily and of psychiatry professionals who want to do something, anything, to make it appear that they have some understanding of how minds work.

I just got back from Iraq, and whereas I really like the local psychiatrist we had, if anyone was sent to him for any problem almost the only remedy was drugs.

Your best friend just burned to death in front of you? Have a happy pill.

You have a problem with authority? Have a happy pill, it beats losing a stripe. Yeah, that solution was never abused by immature Marines.

Clinically depressed, not quite with it mantally? Have a happy pill for four months, no time for counseling, and no, we're not going to send you home even though you're useless to your fellow Marines in that drug induced stupor.

So, I conclude from this study that the correlation is that these kids were actually given non-drug treatments and improved. Blaming it on an absent father is convenient, and politically correct. If it gets psychiatrists to take some initiative and do some work to help people, I'm all for whatever excuse works.

Frankly, psychiatry is poorly developed as a science and these happy pills serve mainly to give legitimacy to those who want to believe that we've made progress in understanding the human mind.

12:55 PM, November 18, 2005  
Blogger Greg Kuperberg said...

Speaking of role models, first I would comment that you do not even need a study to know that "positive role models" have a positive effect. That is a claim that mathematicians would call "true by definition". If a role model had a negative effect, you wouldn't call that person a "positive role model".

I suppose that it is useful to quantify the positive effect of positive role models. Even if you know by definition that a number is positive, it may or may not be a large number. :-)

But if you want to be thorough, you should look at not only positive male role models, but also negative male role models. Again, by definition, a negative role model has a negative effect, but you could still ask just how negative.

In particular let's look again at the role of the male role models in the lives of the two teen criminal suspects, Ken Bartley and David Ludwig. Ken Bartley's dad, who is also named Ken Bartley, shot and killed a man himself. David Ludwig's dad had 54 guns floating around the house, according to new reports.

Now I understand full well that guns don't kill people, gunmen kill people. Just like I understand that television doesn't stupefy people, people watch television; and that alcohol doesn't will itself to be drunk, rather people drink alcohol. Even so, a household can have too many of any of these things. You have to wonder what the parental message is — in other words, what kind of role model the parents are — in a house with 54 open liquor bottles, 6 to a room; or or a television in every room; or in this case, 54 guns floating around the house. It is unlikely that any of these are just collector's items that are not intended to be used.

Lest you think that alcohol is a loaded comparison, take a look at this picture from a hunting trip that Ludwig took last year with friends or family, probably with his dad. How old is that kid in the lower left with a beer bottle in his hand? It looks like a laissez faire family with respect to both guns and alcohol. Great.

"Son, could you pass me a beer? I think that there is still one sitting behind those handguns."

With "role models" like these...

12:57 PM, November 18, 2005  
Anonymous Anonymous said...

I am a 70 year old white male, educated through a doctorate (non-behavioral science) who is now retired.

I willingly choose to spend positive (I try to remain non-judgemental) time on my own hook with boys who are in trouble with the authorities ("at risk") modelling behaviors which have worked for me in my own life.

This works for the boys (and I receive a real gratification). I come to love the kids and celebrate their courage, initiative and simple spunk!

The folks who are in charge of changing these boy's behavior seem to me to be unwilling to investigate why the boys are thus enabled to acquire anger management modes...and so quickly.

I've done no studies but am an observer of the changes wrought in our society since I was a boy and today's society"s "take" on "how" boys should "be".

My own view is that the boys are more willing to make changes than are the experts.

1:13 PM, November 18, 2005  
Blogger Pete said...

I’m new to a site that allows anonymous posters so I’m not sure which anonymous this is for but it’s to the one who posted at 11:29 a.m:

We’re a Ritalin success story, my friend. Our daughter struggled mightily up until midway through the 5th grade before she was diagnosed with ADHD. Believe me, we consulted with her pediatrician, counselors, and tutors, convinced she just had poor study habits or parents who lacked proper disciplining skills. Once the diagnosis was made, and Ritalin started, yes, she was like another person: happy, able to do tasks given her, interested in school. One piece of dramatic proof: her handwriting which had been illegible suddenly was neat and precise. Did we medicate her because we were unhappy with her handwriting? Friend, simply put, those are fighting words.

You do a terrible injustice to our darling daughter. Her medication was as needed as much as a near-sighted person needs corrective lenses and has allowed her to have a life that was denied her before. Our only regret is that we didn’t do this sooner because her learning skills are so far behind her peers and her challenge now is to catch up.

Oh, and by the way, what kind of person makes that kind of post but has to hide behind a mask of anonymity? Have the courage of your convictions, for heaven’s sake.

1:14 PM, November 18, 2005  
Anonymous Anonymous said...

This post brought back memories of an article that I wrote many years ago. I titled that article “Defining ADHD Down.” The title was taken from Daniel Moynihan’s article in the American Scientist, “Defining Deviancy Down.” In my article, I proposed that the high number of ADHD diagnoses had more to do with cultural variables than with organic factors, while leaving open that there would likely be a number of children who would exhibit characteristics associated with ADHD that could be based on organic factors. I could have had the article published in a political or public affairs journal but wanted it to appear in a special education or psychology journal. The article was rejected over three years by seven different journals. Each time, the Editor and reviewers refused to consider that some ADHD diagnoses were rooted in cultural, including familial, factors. In fact, the article never received one good review that was based on its contents. Instead, the comments of some reviewers were critical (and many times derogatory) of the cultural thesis. I finally gave up when I realized the manuscript would not be published in a special education or psychology journal, and would likely be damaging to my career if it were published. I found the reviewers’ comments and the entire process quite revealing about these fields.

1:29 PM, November 18, 2005  
Anonymous Anonymous said...

Just for some perspective, but people, anecdotal data sucks. Say it with me. I-T S-U-C-K-S! Yes, you probably know a boy with ADHD whose dad won Father of The Year and has perfect brothers and sisters. That's fine and all, but you can't extrapolate that experience to the general population.
This study isn't trying to claim that ADHD is caused soley by the abscence of a positive father figure, but that said abscence plays a role in the development of ADHD. Feel free to criticize the methodology (can a male therapist take that role?) but please keep your personal experiences where they belong, as personal experiences and not as critiques.

1:33 PM, November 18, 2005  
Anonymous steve said...

One book suggests that fathers still willing to spank are generally positive role models; wonder what the correlation between ordered, disciplined families (i.e. typical in flyover country) and a lower incidence of ADHD is?

1:40 PM, November 18, 2005  
Anonymous Steve said...

Sorry if I broke up the party....

2:23 PM, November 18, 2005  
Blogger Helen said...

Steve,

I doubt you broke up the party--my attention span is short--thanks for your comment--I do know that order and structure, and consistent discipline for kids who have been diagnosed with ADHD kids and bipolar disorder is important and appears to reduce behavioral symptoms.

2:38 PM, November 18, 2005  
Anonymous David said...

It's funny how science may be catching up with conventional wisdom. In a conversation with a teacher several years ago (back when ADHD was just call ADD) she told me that she and her peers jokingly referred to it as "absent dad disorder".

2:55 PM, November 18, 2005  
Anonymous Anonymous said...

At least some ADHD cases are simply people with personalities that do not fit in well with the regimented rigors of school. That applies even to modern schools, which are not so much "anti-discipline", but who have the discipline conducted by peer bullies rather than mature adults.

I sometimes wonder what the world would have been like had Da Vinci, Newton, Edison, or Einstein been put on Ritalin. I am so grateful they grew up in more flexible times, and had parents who met their needs as individuals - and protected them from the tyranny of society, church, and community.

3:31 PM, November 18, 2005  
Anonymous Anonymous said...

Mec2: It may sound almost sociopathic, but fear of the alpha male in groups helps define acceptable behavior in young. This of course doesn't argue for scaring young children into behaving - outright threat will create equally if nor more deleterious behavior.

I would like to see more of these alpha males start leading by example. Then they would really start earning some respect. It's so &#@$&* easy for the "fearless leaders" of the world to be hypocritical corrupt pashas while expecting everyone else to live like monks.

3:37 PM, November 18, 2005  
Blogger Assistant Village Idiot said...

Symptoms are difficult to separate out in the young. The joke is "anxiety is a symptom of everything."

I have seen enough biological cases of attentional disorders to know that they exist. I have also seen both child and adult cases in which some unsuspected medical cause, such as anemia, allergies, or parasites can cause attentional symptoms.

And yet...

You don't have to work long in the field to note that there are a lot of boys unable to keep themselves under control, and an unusual percentage of them do not have fathers in the home. The deficit in those cases seems to be Dad's attention.

I suspect more than one thing is being measured. Dr. Daniel Amen claims to have identified 6 varieties of attention disorders, and further claims to find a difference in their PET scans. Whether that turns out to be so or not, the inability to sit still/pay attention is a rather general symptom, possibly attributable to many things.

Our own story is that my wife and I were both the spacey type of attention-deficit children, able to daydream or immerse in a book to an extent that interfered mildly with functioning. As an adult, I was diagnosed with Obsessive-Compulsive Disorder, which is now classified as an anxiety disorder. The older of our two biological children showed some spaceyness, plus the normal amount of squiggliness for a boy young for his grade. The second son was even more able to intensely immerse in a book or movie than even we were: the sort of boy who reads many grades above level but is unable to attend to directions. He was eventually on low-dose imipramine for 18 months in 5th-6th grades. It worked very well, and he gradually grew out of his attentionl problems through puberty, as we had hoped. He is still able to immerse intensely, as we are, and that is an advantage now that he is in college.

I am of the opinion that having to overcome something is good for children. The difficulty arises when they have too many things to overcome and it squashes them.

6:22 PM, November 18, 2005  
Anonymous Kate said...

I would imagine that many children with ADHD inherited from their fathers. And I would imagine that men with ADHD are often not as good at being husbands and fathers. So it would follow that fathers with ADHD are more likely to be out of the picture, thus leaving their genetically endowed ADHD children in single-mother homes.

8:44 PM, November 18, 2005  
Anonymous Anonymous said...

Well, this message board is certainly full of anecdotal evidence. The question is not what the exceptions are, though, the question is whether the majority, or simply a large number, of ADHD sufferers is correlated with lack of strong male role models.

I've got ADHD out the wazoo, which is why I'm posting to an almost zero-impact blog message board, which will be viewed by relatively few people, strongly influencing few if any of them, instead of doing work I ought to be doing. Yes, my father was absent. Yes, I do suffer from frequenct feelings of abandonment and that feeling has permeated every aspect of my life. Does this prove anything? No, but it makes me more than willing to believe that there might be a causative link.

8:47 PM, November 18, 2005  
Blogger B. Durbin said...

ADD is, unfortunately, a catchall definition that has become meaningless for useful discussion— witness the controversy on this thread regarding drugging or not drugging ADD children.

It really comes down to a few points:

1. Lots of children have difficulty paying attention in school and elsewhere.

2. Some of those children have a definite medical disorder. (I am married to someone with ADD, which he describes as "being unable to concentrate on something you want to do." I would be unsurprised to find out it was an anxiety disorder of some sort, as some anti-depression medications help him keep focused.)

3. Some children are reacting to circumstance rather than to internal chemistry.

4. At this point, we can't really tell the difference. We can only surmise from outside effects.

Medication works on medical problems. When used in other situations, it is a Bad Idea™.

All good now?

8:54 PM, November 18, 2005  
Blogger Greg Kuperberg said...

The right way to say it is that ADD is a catch-all, and not even a definition. A real medical condition in some people, or maybe more than one etiology, has been co-opted by the nearly universal complaint that children don't pay enough attention and have trouble standing still.

These fuzzy semantics and the fuzzy thinking that goes with it, not to mention fads and drifts in interpretation that inevitably tend towards overdiagnosis, is really the biggest problem with psychology in general. I think that it's a much bigger problem than political bias in psychology, although the two concerns are related. Two different psychologists can use the same word to describe completely different things. Sometimes one psychologist will freely conflate completely different things with the same name. To some extent this is not the fault of psychologists, it's just because the topic itself has too many uknowns. But some psychologists seem to outright enjoy fuzzythink and go completely overboard with it, and typically they carry a political agenda too.

Anwyay, since there is no characterized etiology of ADHD, the only working definition of ADHD is the pattern of its diagnosis. The semantic meaning of the condition changes as diagnosis changes. This is intellectually very bleak. I can only hope that one day the condition will be tied to specific etiology, at least conjectured etiology, as is known for Down's syndrome and credibly suspected for schizophrenia and dyslexia.

9:13 PM, November 18, 2005  
Anonymous Fred said...

My assertions

1. ADHD is very real and a certain percentage of the population has it.

2. ADHD is not caused by poor parenting.

3. Poor parenting does result in behavior that closely resembles ADHD in many children.

I liked that phrase Discipline Deficit Disorder...

10:11 PM, November 18, 2005  
Blogger Galt-In-Da-Box said...

Children don't pay attention and have trouble standing still when they are subjected to, and forced to submit to hours of mind-numbing monotonal monologue from "public education's" overpaid babysitters.
Coercion is antagonistic to learning.
The biggest bureaucrat bloc that doesn't want to hear that (NEA) has latched on to the ADD thing and has, through government bribes, got the psychologists and pharmacists on board.
The most common factors in the ADD/ADHD home are
1. Lack of a positive male parent/role model.
2. Excessive amounts of processed sugar, potatoes and synthetic carbohydrates in the diet.
3. Projection by the single-parent mother of the excuses for all her failure onto the child/children.

2:00 AM, November 19, 2005  
Blogger Galt-In-Da-Box said...

P. S. It doesn't take a "global village" to raise a child, it takes a couple parents committed to something more than 20 minutes of gratifying eachothers lust.

2:06 AM, November 19, 2005  
Blogger M. Simon said...

Here is another study covering the same ground from a different standpoint:

More Vindication. It finds the correlation of drug use with absent fathers. It deals with ADD/ADHD as well.

This might also be of interest:

A well known secret.

And a drug company angle:

The War On Unpatented Drugs

2:41 AM, November 19, 2005  
Blogger M. Simon said...

Mike Rentner,

PTSD is a real problem. Everybody gets it short term. Genetics determines whether you get over it quickly.

Genetic Discrimination

In the not too distant future we will have a test to help in diagnosis.

A test for PTSD

BTW the problem is common with police and other emergency responders:

Police and PTSD

I have been of the opinion for some time that a lot of what we call ADD/ADHD is really PTSD.

As to the prevalence of mental conditions in the general populace:

Tobacco is an anti-depressant. That is a clue.

5:13 AM, November 19, 2005  
Blogger M. Simon said...

BTW we used to know a lot more about people's reaction to PTSD than we do now.

Here is what we knew in the Civil War era:

The So;diers Disease.

5:31 AM, November 19, 2005  
Blogger Henry Cate said...

I have been surprised at how many of the comments are negative, without having read the book or the study. It seems like it is an interesting hypothesis, that one of the causes of ADHD is related to good fathers. Did Sherlock Holmes constantly tell Dr. Watson not to make conclusions without having data?

12:50 PM, November 19, 2005  
Anonymous Anonymous said...

----------------------------------
I am married to someone with ADD, which he describes as "being unable to concentrate on something you want to do."
----------------------------------

As an adult with severe ADD who has attempted to go off medication unsuccessfully more times than I can count, this is one of the best descriptions I have heard of what it feels like. It can be incredibly frustrating, and cases of medical ADD are quite real.

That said, cases of medical ADD are also much, much more rare than the number of children on Ritalin or Adderall would indicate. ADD has got to be one of the most over-diagnosed diseases in modern history, which doubly annoys me since it engenders a degree of skepticism towards those of us who actually *have* a genetic problem.

And it has a definite genetic component; you can see it sticking out like a sore thumb by tracing my family tree. My mother-who is a quantum physicist-was diagnosed with adult ADD in her 40s while working on another degree. ADD seems to have a tendency to affect people of above-average intelligence; I've no statistics on that, but it does seem plausible from what I've observed.

1:27 PM, November 19, 2005  
Anonymous ereynol said...

This is ridiculous. I am an ADD adult, married for 19 years, and have 4 children, 3 of whom are on ADD medication. My parents have been married for 49 years. While lack of a father may affect some percent of those suffering the symptoms of ADD, it does not account for many of the ADD-sufferers in my experience.

Those who claim ritalin turns kids into zombies are simply ignorant, because it's a stimulant. Those who need it are normal when under its influence, and those who don't need it get buzzes. That's why it's a controlled substance, and abused by high school and college kids.

We have used the "glasses for the mind" analogy many times to persuade friends who have ADD children to give the medication a chance. For all of the stories about overmedication, I've never met a kid on ritalin who didn't need it, and met many others whose parents refuse to admit that their precious angel might have a "mental disorder."

3:08 PM, November 21, 2005  
Anonymous Anonymous said...

Okay I've read the whole comment string, and what pops out is that there are way too many things being called ADD/ADHD, so that confusion is rife.

Anyone remember C. Lendon Smith? He is/was an MD who wrote books called things like "Feed Your Children Healthy Food" and good common sense. I ran across an old book of his trying to figure out why my new husband and his children were so wigged out all the time -- antsy, frantic, anxious, touchy. Dr Smith noted anecdotally that he saw much of that behavior in people with blue eyes. He wondered after decades of seeing this if there wasn't something genetic in Northern Europeans, a recessive trait, that led to this kind of emotional chaos. Think of the prototypical moody Celt -- just what Smith was talking about. Since then, I've noticed the same tendency -- the antsiest of all tend to have yes, blue eyes.

Just another anecdote...but isn't noticing patterns a logical place to begin an analysis and structure an investigative study?

Oh, and he's now my former husband. On top of his own antsiness, he was a lousy father who believed expecting even slightly conforming behavior was cruel and unusual ... because he had never been able to conform except by extreme effort which could not be sustained.

1:13 AM, November 24, 2005  
Anonymous G.V. said...

I jus finished reading some of the comments that others have posted. My son is about to turn 6 years old and was diagnosed last year with ADHD. I have thought that may be there is something in the foods that we feed our children that might make them act the way they do. But on the other hand my son had always been real attached to his father. We split up when he was about 3 years old. He is a drunk, but still my son always wanted to be with him. Now that he has a step father, he listens more to him than to me. I feel bad because I know that if it was up to him he would live with his father. His step father doesn't think he has ADHD but now I don't know what my son has. He does miss his father and doesn't spend alot of time with him. His father is too busy with other things.

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Blogger Graham Strouse said...

ADHD, like nearly all of the 374 (?) disorders listed in the DSM-IV does not meet the medical criteria doctors use to define diseases & disorders.

A bunch of shrinks, many of them with ties to Ciba (now Novartis) put together a list of symptoms & took a vote.

This is capitalism gone astray. Read Tom Paine & Adam Smith more closely folks. Paine's first concern was tyranny of the majority. His second, that the colinies be free to trade with Europe, freely & without being embroiled in Across The Pond Hoo-Rah.

The thing is, we actually had STUFF to trade back them. Goods, commodities. We were exporters, not importers & what we exported was raw materials, not McMarketing.

And Adam Smith explicitly warns of the dangers of unfettered capitalism, monopoly merchants who abuse their capital by converting it into unchecked power.

Same thing Paine said.

Now we've got McDoctors. You know that 1 in 10 American boys aged 10-12 is in a Ritalin-based drug or near equivalent. Also 1 in 25 girls.

You know that the Univeristy of Texas did a preliminary study in 2005 involving a small (12 kid) ADD study using normal dosages for a brief period and every one of them developed chromosomal abnormalities.

I spoke to a talk who said "The study was flawed" and he was staring at his feet when he said it & fiddling a lot.

How about bring recess back, stick a fork in All Children Left Behind, stick some basketball hoops up on your garages so kids have a place to play & remember what Dr. Spock said:

Love 'em. Feed 'em. Leave 'em alone.

'Nuff said.

6:24 PM, August 30, 2006  
Anonymous Anonymous said...

To reader_iam

Please! If your child's school can't tell the difference between the maturation of boys and girls, then there is something wrong with that school. It's a known fact that boys don't mature as fast as girls, and if they assess them on the same level, then something is wrong. The problem is probably that your school is TOO structured. If those kids had something to do with their hands and were allowed to think outside the box then there wouldn't be a problem, male or female.

10:43 PM, January 19, 2007  
Anonymous Anonymous said...

To ereynol

Too much ritalin does turn kids into zombies. I've seen it as a teacher. Yes it is a stimulant, but stimulants have an opposite effect on true ADHD or ADD children. For example, you can give an ADHD child coffee and it will calm them down, but give a non ADHD child coffee and it makes them hyper. No, the only contributing factor to ADHD that a father gives is his genes. But a lot of children are being mis diagnosed because of their behavior because of the absence of a father, or some other issue. I personally would choose herbal remedies or the Ron Davis method before putting my child on a prescription drug with all the side effects. As a teacher I promote that method before anything else. As a (private school) teacher, I would rather see a child's wonderful personality and have to stand by him through the entire class, before I comotose him with drugs. I think people should look more closely at the school their children are attending before putting their children on drugs for ADHD or ADD.

10:58 PM, January 19, 2007  
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