New research just published in the Journal of the American Medical Association is questioning whether heavy use of media platforms over time can increase the presentation of ADHD symptoms in adolescents. The study looked at the use of 14 different digital media activities using platforms such as social media, texting and streaming media in a large number of adolescents, 2587, in grades 10 to 12. According to their responses they were divided into three categories, no use, medium use and high use. Adolescents with pre-existing ADHD symptoms were intentionally excluded from the study.
The study’s findings reported that among adolescents followed up over 2 years, there was a statistically significant but modest association between higher frequency of digital media use and subsequent symptoms of ADHD. The results indicated that those with low use of digital media over the two-year period, about 500 adolescents, had the fewest number of symptoms, 4.6%. Those with highest use of digital media showed the highest rate of ADHD symptoms, between 9.5% and 10.5%. The researchers cautioned that the study's findings did not prove cause and effect; more research would be needed to do so. However, they were confident in saying that higher levels of digital media use did increase the likelihood of ADHD symptom presentation in the future.
Please access these links for more detailed information and expert opinion on the study.
Over the past several months CADDAC has been receiving increased calls from families and individuals with ADHD upset that they have been denied the Disability Tax Credit (DTC). It seems to have become more difficult, if not impossible, for those with neurodevelopmental disabilities to be approved for this government benefit. While we encourage those who are applying to include detailed information on how ADHD causes continuous impairment, providing specific individualized examples and outlining additional financial hardships, even when this is done they are most often denied.
A recent article in the Globe, https://www.theglobeandmail.com/opinion/article-the-cra-makes-life-more-difficult-for-people-with-disabilities/ by Andre Picard does an excellent job of summarizing the issues of inconsistency, unfairness and a lack of transparency. Government personnel are vetoing the decision of medical professionals who have deemed their patient to be “disabled” enough to qualify.
Mr. Picard also points out that those with an obvious physical disability have a much better chance of being approved for the DTC. This makes perfect sense when you understand that those making the decision on eligibility have no additional training or knowledge of neurodevelopmental or mental health impairments and would have the same lack of awareness and understanding of these disabilities as the general public. Certainly everyone with ADHD would not and should not qualify for the DTC since impairments caused by ADHD are on a continuum, however those with ADHD on the more sever end of the spectrum certainly should. For change to happen those with these invisible disabilities need to let their voices be heard. Unfortunately the very disabilities for which they require support are the ones that often impair them in their quest to be heard.
This past weekend an important opinion piece, written by several prominent BC ADHD experts was published in “The Province”, a daily newspaper published in BC.
The piece entitled, “Opinion: ADHD is a real brain disorder requiring treatment, despite what some say” opens with a request that BC medical colleagues demand that the Therapeutics Initiative, which is government funded in the amount of 10 million dollars, be de-funded again. The opinion piece goes on to state that the report, or therapeutics letter, created by unnamed experts, most likely none of which are paediatricians or psychiatrists, cherry-picked research and grossly misrepresented ADHD evidence to support their ill-intentioned claims and prejudices. The ADHD experts equates the Therapeutic Initiative’s report, which questions the safety and validity of ADHD treatment, to a psychiatric version of the vaccination debate.
The comment piece outlines the abundance of current ADHD research and the impact of untreated ADHD and states that, “The increased use of ADHD medication in BC is heartening because it suggests that more children are being diagnosed and treated. However, with only four per cent of B.C. children receiving treatment, ADHD is still under-diagnosed and often goes untreated.” While the piece points out that medication is not required by everyone with ADHD, it also states that large review studies have shown and continue to show the benefits of treating ADHD with medication. Furthermore, these medications have been prescribed for more than 80 years.
It is extremely disheartening for those of us who work in the field of ADHD and for those who themselves have ADHD or family members affected by this disorder to be required to continually justify the diagnosis and treatment of a medical disorder that has been proven to be significant and real. What is even more worrisome is that the type of report published by the Therapeutics Initiative, which according to the ADHD experts would never have been published in a legitimate medical journal, was put out by the media only furthering the misinformation on ADHD.
The only way to stop this type of misinformation from continuing to be spread by the media with a goal of sensationalism is for those of us in the field and those impacted by ADHD to speak up.
Therefore, CADDAC sincerely congratulates and thanks these physicians, Drs. Diane McIntosh, BSc Pharmacy, MD, FRCPC, psychiatrist and clinical assistant professor, UBC; Derryck Smith, MD, FRCPC, psychiatrist and professor emeritus, UBC; Don Duncan, MD, FRCPC, psychiatrist and clinical assistant professor, UBC, clinical director, B.C. Interior ADHD Clinic; Dorothy Reddy, BSc, MD, FRCPC, research fellow, psychiatrist; Julia Hunter, BSc, MSc, MD, FRCPC, psychiatrist, for speaking out.
CADDAC strongly encourages families and adults impacted by ADHD to send a letter to the editor of any publication that furthers the spread of misinformation about ADHD, even when it is an opinion piece. The test that I use when reviewing an article on ADHD is to question whether the same bias and questioning about the validity of the disorder would occur if the mental disorder being discussed was depression.
Heidi Bernhardt
After receiving numerous e-mails from people unset about this article asking CADDAC to respond, CADDAC submitted this letter to the editor of the Vancouver Sun. Unfortunately the restricted number of words did not allow me to cover all the issues I had with this article, but the hope is that others will also contact the paper about this article.
Re Prescribing of ADHD stimulants has soared in B.C., agency warns
This is an unbalanced article, meant to sensationalize a very complex medical issue that continues to be misunderstood and stigmatized. It is rather shocking that this article only speaks about issues with behaviour and never mentions impairment in attention regulation which causes impairment in daily functioning, long term academic impairment and is the most frequent reason why physicians and parents choose to treat with medication. If 5 to 9% of children have ADHD, than 4% of children receiving medication might very well mean that we are finally doing a better job at diagnosing and treating ADHD. Research has shown that psychotherapy for children with ADHD is not beneficial, but educating adults who spend time with the child about the impairments that ADHD causes and how to support them is. Alan Cassels questions whether smaller classrooms will decrease prescribing of ADHD medication, but a better question would be why is BC not recognizing students with ADHD as at risk learners and educating their teachers on how to better support these students in the classroom?
Heidi Bernhardt
CADDAC's Executive Director Heidi Bernhardt, Natalie Wadell a Waterloo School Trustee and Dr. Ainslie Gray were featured on TVO's The Agenda discussing the lack of recognition of ADHD in Ontario schools as an Ontario election issue this past week.
Directly after our interview representatives from the four parties discussed special education in Ontario schools. You will need to watch this interview until the very end to understand the significance for students with ADHD.
View the episode on special education in Ontario schools
Reading the title of this article, ADHD can be your super power immediately caused me a great deal of concern and I am sure angered many of the millions of Canadians impaired by ADHD. While this article is attempting to be uplifting, and the message that those with ADHD can find fulfilling careers is a good one, many adults with ADHD will find this article very disheartening and frustrating. It makes it seem that those with ADHD just need a diagnosis, some coaching and a good assistant to handle all the paperwork and they’ll be good to go. ADHD is on a spectrum from mild to severe and most often comes with coexisting mental health disorders. Finding a medical professional who is trained in ADHD and not charging a hefty fee over OHIP to assess for and diagnose ADHD is an extreme challenge. Proven treatments such as CBT therapy and coaching are not covered by provincial health care and are extremely expensive. The good news is that while research substantiates that ADHD can significantly impair learning these children can succeed in school when supported. But, how can we expect adults with ADHD to find fulfilling careers when many of our school boards and the Ontario Ministry of Education do not recognize ADHD as a disability allowing these students to access special education resources. So, let’s please also discuss the many barriers that still exist for those with ADHD.
This comment has also been sent to the Toronto Star.
March 29, 2018
Dear Premier Wynne,
We at CADDAC were very interested when we heard your announcements regarding additional funding for special education and mental health.
Childhood ADHD
While this additional funding is welcome and certainly needed, the Ontario parents of students with ADHD are questioning how this additional funding will benefit their children. The fact is that if students with ADHD continue to be excluded from the categories of exceptionality by the Ontario Ministry of Education, and school boards in Ontario continue to use this fact to bar students with ADHD from officially being recognized as exceptional students this funding will mean next to nothing for them.
We have been promised that ADHD will be included as its own category in the new British Columbia Special Education Guidelines by both the former Liberal and now the new NDP governments. Yet there has been no change in Ontario in the past ten years, while other similar neurodevelopmental disorders, that are less prevalent, and often less impairing are listed.
I am attaching a letter that you sent to me ten years ago, outlining the very same response that we continue to receive from the Ontario Ministry of Education. Yet, despite all of these assurances we continue to hear from frustrated, desperate parents sharing heart breaking stories of children being stigmatized and suspended for their medical disability.
While the matter of including ADHD within a category of exceptionality is made out to be insignificant and a mere technicality, in reality it is causing huge issues for many of our students as a recent survey of parents has demonstrated. While it may not be the Ministry’s intent when excluding ADHD from a category of exceptionality, the message educators are receiving is that ADHD is not a disability and does not impair learning enough (even when abundant research tells us otherwise) for the Ministry and boards and therefore teachers to take it seriously. Teachers have shared this belief with us countless times, and they convey it directly to students by accusing them of not trying hard enough. Parents are told that ADHD does not qualify their child for special education support because it does no impair the child “enough”.
Interesting things happen when disorders are listed in a category, education for educators flows and students with ADHD are better understood and supported and representation occurs on SEAC’s and on MACSE giving a voice to those with ADHD.
Many Ontario parents that we hear from on a daily basis are frustrated beyond belief. They have expressed doubt that change will happen for their children with ADHD n Ontario under your present leadership.
However, I do think that this could change. I believe that they would really like to support your proposed funding initiatives for special education and mental health however it seems that children with ADHD have been left out again. Parents will require an honest guarantee that this funding would indeed benefit their children with an explanation of how this would occur. Unfortunately they have lived with platitudes and rhetoric for far too long.
Adult ADHD
Adults with ADHD also see themselves as excluded. There was no mention of therapy for those with ADHD, only anxiety and depression. Research informs us that untreated ADHD can cause anxiety and depression and that Cognitive Behaviour Therapy is hugely beneficial for those with ADHD. When we treat anxiety and depression without treating the underlying ADHD all treatment is unsuccessful. In addition, adults with ADHD are being charged over OHIP for assessments. Why are some mental health disorders supported in your additional funding and other not?
We are also contacted by adults with ADHD routinely and I just presented to a large group of Ontario adults with ADHD. I believe that this group would also really like to support your plan for additional funding for mental health, but they too find that they have been given no reason to do so.
I would like to meet with you Premier Wynne to discuss how we can assure those with ADHD that your initiates will offer them additional support and services.
Sincerely,
Heidi Bernhardt
President, Centre for ADHD Awareness Canada
With cc to
Hon Indira Naidoo-Harris
inaidoo-harris.mpp.co@liberal.ola.org
Hon Helena Jaczek
hjaczek.mpp.co@liberal.ola.org
The Toronto Star was sent this letter by CADDAC in response to the Liberal party’s promise for increased funding for special education resources.
Additional funding for special education is welcome and needed, but Ontario parents of students with ADHD are questioning how this additional funding will benefit their children. If change does not occur, this new funding will mean next to nothing for these students. The Ontario Ministry of Education and many school boards in Ontario refuse to recognize students with ADHD as students who qualify for special education resources. Despite the fact that an abundance of research exists, demonstrating ADHD’s risk to learning when students are not supported, few educators are receiving training on ADHD and others are barred from offering support. ADHD is the most prevalent neurodevelopmental disorder seen in schools. The exclusion of ADHD in Ontario special education categories, when other similar disorders are included, smacks of discrimination.
Heidi Bernhardt
President, Centre for ADHD Awareness Canada
Premier Kathleen Wynne and the Toronto Star were sent this letter by CADDAC recently in response to the Liberal party's promise for increased mental health funding, in particular for children and youth.
Hon Kathleen Wynne
Leader, Liberal Party of Canada
Dear Premier Wynne,
Additional funding in Ontario for mental health is certainly needed and very welcome. Resources are few, wait times are long and physicians are charging over OHIP for assessments. However, parents of children and youth with the most prevalent childhood mental health disorder, Attention Deficit Hyperactivity Disorder (ADHD), and adults with ADHD are wondering if they are going to be left out again. ADHD is never mentioned during metal health awareness campaigns, in press releases by mental health hospitals, or by national and provincial commissions on mental health. ADHD is not being addressed by our government. There are no working committees on ADHD in Ontario although significant socioeconomic costs result when we do not diagnose and treat this disorder. Abundant research has shown less academic achievement and fewer years of education leading to lower paying jobs, more accidents, an increase in additional mental health disorders, more substance use and abuse, less employment and a greater need for social assistance, more involvement in the justice system and a two-fold risk of early death. When we link these costs with the fact that ADHD is one of the most treatable mental health disorders, that students with ADHD can go on to post-secondary education when supported and become successfully employed in the career of their choice, it makes no sense that we are not giving this mental health disorder more attention.
Heidi Bernhardt
President, Centre for ADHD Awareness Canada
The Ontario election is quickly approaching so this is the opportune time to make your voice heard. You MPPs think that their constituents do not care about ADHD because they do not hear from families with ADHD, but they do hear from parents of children with Autism.
Is this true? Are you uninterested in ADHD?
Are your MPP and those running in your constituency aware of government policies that impact families with ADHD? For instance, are they aware that students with ADHD in Ontario do not qualify for recognition as exceptional learners? This identification would give them the same rights to special education resources as students with other neurodevelopmental disorders such as learning disabilities and Autism. Are they aware of the extensive wait lists and additional costs of receiving an ADHD diagnosis and treatment? Are they aware of costs to the health, child and youth, social service and justice systems in Ontario when we do not diagnose and treat ADHD?
For more information on ADHD advocacy in Canada access our past Blog.
CADDAC is asking parents, extended families, adults, health care providers and anyone interested in children and adults with ADHD to contact their MPP and those running in their riding.
Your MPP is required to meet with any constituent that requests a meeting.
We need you to do at least one of these things before the June election:
CADDAC has developed Election Documents for you to use, points for you to make and questions to be asked when meeting with your MPP or attending a town hall meeting. Template letters are also available to assist in your letter writing.
