What's in a Label? - Today's Parent Magazine
I strongly disagree with the recent article in Today’s parent magazine “What’s in a Label?” http://www.todaysparent.com/family/parenting/kids-health-labelling-behaviour/, which states that labeling a child with a disorder, be it ADHD, ODD, anxiety or OCD, imprisons a child and gives them the feeling of a life sentence. Liza Finlay, a psychotherapist, goes on to say that these labels allow a child to sidestep any effort to improve. My experiences are far different. From a personal family perspective as well as the perspective of someone who has spoken to thousands of families over the past twenty years, it is the lack of early diagnosis and therefore lack of treatment and access of resources that have imprisoned many children into a life of dealing with the consequences of these disorders. Left untreated, ADHD can lead to additional mental health disorders, increased rates of high school dropout, less years of education, self-medication leading to substance abuse, involvement with the justice system, as well as increased socioeconomic costs.
A psychologist who believes that the earlier mentioned disorders are nothing but behaviours, and that children can simply choose to adopt different behaviours, is an affront to decades of medical research. Does therapy combined with other treatments for these conditions prove helpful? Sometimes, but that does not mean that ADHD is simply a set of behaviours that can be unlearned.
The notion that "once a child is diagnosed with ADHD, parents stop expecting them to behave" is not only ludicrous, it is insulting. Once a diagnosis happens, parents are able to put the child’s behaviour into perspective. They are then able to focus on appropriate parenting strategies to assist that child with their behaviours and access other appropriate treatments.
I certainly agree that additionally focusing on a child’s strengths and working to increase their capacities is essential, but the best way to do this is within the understanding of a child’s overall profile. The lack of understanding of a child with ADHD can lead to all of the above mentioned consequences as well as increased childhood and family stress, family breakup, and, in extreme cases, abuse and children leaving home.
Do we need increased tolerance for those who do not fit into society’s definition of normal? Do we need to expand society’s definition of normal? The answer to both of these questions, of course, is yes. But we need to make sure that while we work on this goal, we don’t neglect the children who are labeling themselves as stupid, lazy and bad because no one has let them know why they might be finding it more difficult to succeed than their peers.
Heidi Bernhardt
President
www.caddac.ca
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I was notified about an incident that occurred during a Vancouver City Park Board meeting which highlighted the continued misunderstanding and stigma which still remains about adult ADHD. Vancouver Park Board Commissioner Melissa DeGenova shamed and stigmatized Vancouver Park Board Commissioner Sarah Blyth, who is the first politician in Canada to go public with ADHD.
Asking a question about Vancouver paying for the cost of business coaching is of course acceptable, making someone with a medical condition feel ashamed for asking for assistance is not.
About a year ago Sarah Blyth asked park board staff for help as she would be chairing some upcoming contentious meetings. She was offered business coaching. At this park board meeting questions were asked with regard to expenses surrounding the ADHD coaching she received. Commissioner Jasper asked staff to bring to the board any related information; and added that chairing the park board is at times a difficult job, and that if a commissioner needed help that he thought the request was reasonable. He also stated that Sarah Blyth was open about being diagnosed with ADHD.
Following this discussion, Melissa DeGenova asked why the governing party would not elect someone capable of doing the job, and further stated that she had disabilities, too. Melissa has two diagnosed Learning Disabilities: dyslexia and written output disorder, and is on the City of Vancouver Disability Advisory Committee. Ms. Blyth and others reported that, as she was leaving the meeting, Commissioner DeGenova proceeded to follow her out the door asking why she was playing the, "Poor me, I have a disability card."
To access Sarah Blyth’s description of the stigma she felt, please click on the following link or copy and paste it into your browser: https://www.facebook.com/notes/sarah-blyth/stigma/10152386409495210
To access Jamie Lee Hamilton’s account of the incident and request for an apology, please click on the following link or copy and paste it into your browser: https://www.facebook.com/jamie.hamilton.9480/posts/461977273945834
Although we have not received any significant feedback from parents or patients reporting distress regarding this shortage it is something that we CADDAC has been made aware of. Should you have any concerns please contact us and we would be happy to speak with you about this. For information on what to do if you are caught short please access http://addadhdblog.com/methylphenidate-shortage-in-canada/?inf_contact_key=f6f12e39fac0ce24a27dc692404b39f579083aeb0d6v
Sincerely,
CADDAC
I just finished listening to a great presentation by Dr. David Goodman about this topic. If you are interested in this topic I would highly recommend you access this presentation sponsored by the National Resource Centre on AD/HD at https://www.youtube.com/watch?v=L7lYicr3s5A.
In his opening Dr. Goodman reviews the actual accuracy of newspaper articles on ADHD research.
He goes on to explain how journalists construct articles with victims, villains and heroes in order to catch a reader’s interest. He suggests that readers try and identify these roles in the storey and also question whether the author is trying to express extreme attitudes to sensationalize the story to increase interest. He points out that many journalists, especially national journalists, have agendas, or have been given agendas by their publishers, so ask yourself “What is the agenda of this article?” as you are reading it. He closes by stating, “The credibility of the information is dependent on the intent of the provider.”
Two parts of the presentation confirmed my fears that these type of articles increase fear and shame in parents and impact patient diagnoses and treatment. Furthermore, he indicated that the public is easily seduced by articles that sound scientific, but are actually lacking in up-to-date or comprehensive research on a topic, and may sensationalize new unproven research in order to interest more readers.
In the presentation and Q&A period Dr. Goodman offers concrete suggestions on:
An interesting article called "The Smart Pill Oversell" was just published in the latest issue of the online publication Nature International Weekly Journal of Science. Unlike much of what has come out in lately in the media, this article is more balanced; offering a variety of opinions and some interesting points of discussion.
The majority of current studies indicate that medication treatment alone does not improve long term academic performance. ADHD and how it impacts learning is very complex, so why would we expect that medication alone would solve these complex impairments, especially those of executive functioning? This is why multimodal treatment for ADHD: including learning strategies, behaviour strategies, therapy, coaching, and so forth is recommended.
Unfortunately, many forms of treatment are often difficult to access due to the lack of availability, cost, and the continuous demand by schools that students with ADHD prove their learning is actually impaired. This requirement still exists in in many school boards and some universities; although current testing does not accurately assess executive functioning impairment in those with ADHD. At the same time, medication has proven beneficial for many children, and parents should not be made to feel guilty for or fearful of choosing to add this treatment to a child’s regime. They should, however, be fully informed, as some researchers in the article point out, medication is not magic, and will not automatically make their child academically successful.
Recently, many of the researchers involved in the original MTA study and the follow-up of the study are evaluating why long term gains for those in the study were not what they originally expected. This article presents a variety of different viewpoints, including the fact that after three years, these children went back to accessing community treatment, which was most often of a lower quality of care than they received in the study. Peter Jensen’s statement that only one in four children in the U.S. is getting adequate treatment for ADHD is very concerning, because I would assume it is no different here in Canada. Further research is really the only option that would provide us with a definitive answer. Unfortunately, these long term studies are very expensive; and often unethical because they necessitate a control group of children that you inadequately treated for a long period of time.
The article also points out that, while we know that medications for ADHD are misused by those without ADHD as study aids or cognitive enhancers, there is no evidence that these medications actually enhance cognition. Interestingly though, a paper that is cited here states that students who do not have ADHD, report feeling a boost motivation after taking the medication and perhaps that is why they feel their learning has been enhanced. This theory is yet unproven. We should be improving our efforts to educate young adult students that ADHD mediations do not really make them smarter or improve their academic abilities.
In closing, I would recommend this article for anyone interested in the current discussions on ADHD medication.
Heidi Bernhardt
ADHD is neither a mental health crisis nor a cultural one, as Maclean’s Magazine asks in the title of their article this week. It is a mental health condition that needs to be taken seriously as a medical issue, and not used to sell newspapers and books. I was actually interviewed for this article and, as I was assured, by the author, were Canadian medical ADHD experts, this however was not evidence anywhere in this article. One would expect the authors and publishers of the books highlighted in this article to do their utmost to sensationalize the title of their books and create catchy, if inaccurate sound bites, to sell their books, but how easily journalists, such as Kate Lanau fall into line with the marketing ploy is rather shocking. Journalists who use these exact tactics themselves to increase sales totally disregard the harm they do when they sensationalize a medical condition without balancing it with decades of scientific research. How many children and adults who may have received help will go undiagnosed because this misinformation is being promoted? The most unfortunate thing is that some real issues that do need looked at here in Canada, such as the misuse of medication by some post-secondary students, and the lack of training for physicians and educators in ADHD, won’t be discussed because everyone will be focused on the pure sensationalism of this article.
Since the chances that they will publish it are slim, here is my letter to the editor of MacLean’s Magazine.
“It is irresponsible to publish an article regarding a medical condition, in a Canadian publication, using US medical, information statistics and issues with very vague Canadian references, but not include Canadian expert interviews covering the Canadian situation. We are seeing far too much of this type of journalism lately in regards to ADHD.”
This is another perfect example of how the media jumps on anything about ADHD that is controversial.
http://nypost.com/2014/01/04/adhd-does-not-exist/
Harper Collins the publisher is doing a superb job of selling the book even before it is released and the media falling right in line with their marketing plan. Again the hugely frustrating thing is that almost every article and blog about this book does not allow for a rebuttal from the other 99.9 percent of medical experts to comment on some of the sensational statements that are obviously meant as a selling tool for the book. Unfortunately the author and publisher, as well as the journalists who buy into these tactics, totally disregard the harm they do by using sensationalism without balancing it with decades of scientific research. How many children and adults who may have received help will go undiagnosed because this misinformation is being promoted?
As Dr. Kenny Handelman stated in his blog post in January: http://www.drkenny.com/adhd-does-not-exist. I was also reluctant to comment on this fearing I would drive more attention to this book, but taking the high road in the past has not helped to decrease misunderstanding and stigma around ADHD in the past. ADHD professionals understand, as should parents and adults, that making a diagnosis of ADHD means ruling out any other potential reasons for symptoms of distractibility and hyperactivity, as much as it does confirming that the symptoms are due to ADHD. This is a very basic part of the assessment process. But, of course this is fact is not included in these articles.
If you come across any articles promoting this book and its messages, I encourage you to send your comment so people can “Get Real” about ADHD.
