
Thousands of Toddlers Are Medicated for A.D.H.D., Report Finds - zackmorris
http://www.nytimes.com/2014/05/17/us/among-experts-scrutiny-of-attention-disorder-diagnoses-in-2-and-3-year-olds.html
======
skywhopper
Please, don't take this very seriously, the guy oversimplifies and
misrepresents ADHD symptoms, our environment, and treatments.

A few specific quibbles:

The article says it's not a "disorder", but a "disorder" in psychiatry-speak
means "Any pattern of psychological or behavioral symptoms that causes an
individual significant distress, impairs their ability to function in life,
and/or significantly increases their risk of death, pain, disability, or loss
of freedom." ADHD symptoms may not represent a disorder for every individual
in every situation. It's fine to say "change the environment" but that's not
always an option.

Not to mention the "hunter-gatherer vs farmer" dichotomy doesn't explain the
rise of ADHD diagnoses in the last 20 years mostly in the US vs other western
countries, which are just as rich and just as regimented.

The other issue I have is with Thom Hartmann's description of ADHD which
focuses on distractability and hyperactivity, but those are just two of the
most common of the many symptoms that make up ADHD.

Finally, the woman apparently is familiar with abusing Adderall herself.
Speaking as someone who has ADHD and benefits from Adderall, I don't
experience it as "crack". Nor have I found it remotely addictive. Certainly
it's less addictive than caffeine.

The general points are fine (schools and workplaces in the US have issues of
their own that encourage ADHD-like symptoms), but the details are wildly
wrong.

~~~
drzaiusapelord
>It's fine to say "change the environment" but that's not always an option.

I think that's more up to the individual than the institution. My own story is
a typical "I didn't know I had ADHD until it was too late," and I do wonder if
I would have a better life if I just went straight into the workforce instead
of spending a couple extra years trying to finish college and not realizing
why its so hard for me. I even had a decent IT job in college, but thought it
so shameful not to have a college degree that I quit to continue my studies
and, of course, get deeper into debt. Maybe some personality types just don't
work well in those environments. Insert typical "higher education isn't for
everyone" debate here.

>Not to mention the "hunter-gatherer vs farmer" dichotomy doesn't explain the
rise of ADHD diagnoses in the last 20 years

Maybe because society has reached a point where we can discuss these things
without the idea of punishment and without applying morality to it? ADHD kids
in the past were beaten, called losers, call sinful, called stupid, etc.
Society hit them as hard as it could, yet it didn't fix anything. We've moved
away from that mode of thinking and realized that some kids just aren't going
to grow out of it and its not their fault. The same way that Alzheimers has
been part of the human condition for god knows how long yet we only
"discovered" it 1906. Before that, we just thought it was part of getting old
and didn't realize its actually separate from aging the same way ADHD is
separate from being an energetic child.

> Certainly it's less addictive than caffeine.

Getting off caffeine is trivial. Adderal withdrawal can be very serious for
many people. I consider most ADHD meds to be pretty serious drugs. I don't
think that's very controversial.

~~~
JohnBooty

      Getting off caffeine is trivial. Adderal withdrawal can
      be very serious for many people. 
    

This is obviously anecdotal, but I've discontinued Adderall (by tapering my
dosage to zero over the course of 3-4 days) on numerous occasions with zero
withdrawal or side effects.

Quitting caffeine by the same method is quite a bit more difficult for me.

~~~
tekalon
Same. I've had no issues with 'addictions' to caffeine or to my meds, despite
doctors worrying about it. I know my brain/body reacts to caffeine/stimulants
differently than others due to my ADD.

------
tokenadult
It doesn't look to me like an original source is the basis of the kind
submission here. The byline is "New York Times," but this submission is not
from the New York Times website.

The submitted article mentions a study published by the United States Centers
for Disease Control and Prevention (CDC), and I see that the CDC has a
homepage on ADHD[1] with numerous subpages.

Searching Google News for more news on the recent statement discovers
stories[2] leading back to the 16 May 2014 report in the _New York Times_ [3]
mentioning statements by a CDC official at a recent conference (that is, not
yet an official report from the CDC nor a peer-reviewed journal article). The
conference presentation, according to the _New York Times_ report, is alarming
to many doctors who work with young children.

The bit about ADHD as an evolutionary adaptation is tacked on in reference to
ideas from "Journalist Thom Hartmann," who doesn't seem to have any particular
expertise in health reporting. There are better sources for the same
underlying idea, that some of the behavioral signs characteristic of ADHD may
not be maladaptive in all life circumstances.

[1]
[http://www.cdc.gov/ncbddd/adhd/index.html](http://www.cdc.gov/ncbddd/adhd/index.html)

[2] [http://www.indianagazette.com/news/home-lifestyle/rise-in-
ad...](http://www.indianagazette.com/news/home-lifestyle/rise-in-adhd-
diagnoses-in-toddlers-under-scrutiny,19883849/)

[http://www.the-leader.com/article/20140520/NEWS/305209955](http://www.the-
leader.com/article/20140520/NEWS/305209955)

[3] [http://www.nytimes.com/2014/05/17/us/among-experts-
scrutiny-...](http://www.nytimes.com/2014/05/17/us/among-experts-scrutiny-of-
attention-disorder-diagnoses-in-2-and-3-year-olds.html)

------
dang
We changed the url from [http://www.mediaroots.org/10000-toddlers-on-drugs-
for-non-di...](http://www.mediaroots.org/10000-toddlers-on-drugs-for-non-
disorder-a-d-h-d/), which links to this.

~~~
dfc
When I went to go back and see if I could find a link to the actual CDC paper
the NYT layout did not seem familiar; and then it occurred to me "I bet dang
changed the link and I bet he took the additional time to let us know he
changed the link." As always thank you for your transparency.

------
dec0dedab0de
What could a 3 year old possibly have to focus on that they need to take
amphetamines?

~~~
mikevm
ADHD is a grossly mislabled condition. It should be more appropriately called
"Executive function disorder"[1].

Kids who have the hyperactive "subtype" of ADHD tend to move non-stop to the
point where they injure themselves, and they also don't seem to listen to
their parents. I'm not sure how much of this behavior shows for 3 year olds
though...

[1]
[http://en.wikipedia.org/wiki/Executive_functions](http://en.wikipedia.org/wiki/Executive_functions)

~~~
ctdonath
_tend to move non-stop to the point where they injure themselves, and they
also don 't seem to listen to their parents._

Sounds like a quintessential 3 year old.

~~~
chimeracoder
The symptoms of depression, when described glibly, "sound" like a
quintessential teenager.

That doesn't mean it's not possible (or useful) to distinguish between a
"normal" teenager and one who is depressed and needs treatment.

~~~
mkohlmyr
Of course the point he was making is that the distinction made by that
description is weak.

------
RankingMember
There's a difference between methamphetamine and Adderall (mixed amphetamine
salts). I say this because the host indicated that kids are primarily on
methamphetamine. Meth can be prescribed legally, but I don't know anyone who's
ever been prescribed it.

~~~
adamgravitis
Methyl, not metham. Rather substantial difference.

~~~
mikevm
You're confusing methylphenidate (active ingredient in Ritalin/Concerta) and
amphetamine salts which are used in the other family of stimulants such as
Adderall, Vyvanse, etc...

~~~
nsp
Methamphetamine(as desoxym) is also available as a prescription for add/ADHD,
though like the OP I've never heard any cases of it actually being used, and i
believe it's pretty rare. [http://www.rxlist.com/script/main/mobileart-
rx.asp?drug=deso...](http://www.rxlist.com/script/main/mobileart-
rx.asp?drug=desoxyn&monotype=rx-ids&monopage=2)

------
marak830
Do these people not understand that they are children? I work with 4 and 5
year olds 8 hours a day, there is no way you could tell an adhd child from one
without, their still developing. In 3 months i have seen every child in my 24
class change how they act, talk and play.

They shouldnt have children.

Edit: 550am fat thumbed typing.

------
EGreg
Yet another reason to reform schools so that kids can actually learn instead
of exhibit ADD while being told to sit still at a time in their lives when
they love to run.

[http://magarshak.com/blog/?p=158](http://magarshak.com/blog/?p=158)

ADHD is the "Hysteria" of the 21st century

[http://en.m.wikipedia.org/wiki/Hysteria](http://en.m.wikipedia.org/wiki/Hysteria)

------
tlogan
There are definitely kids with ADHD for whom medications definitely help.
However, from my personal experience, it seems like it is a little "over
diagnosed". But I could be wrong - this is just my very limited experience.

Are there any material (video or similar) showing how an average ADHD kid
behaves today vs. 20 years ago?

~~~
aidenn0
It is both over and under diagnosed. Teachers are likely to refer any highly
disruptive kids for screenings, while ignoring less disruptive kids.

However, being disruptive isn't a particularly good proxy for "has ADHD" and
someone without ADHD that is referred has a higher chance of being diagnoesd
with ADHD than someone with that is not referred. This results in a lot of
kids who end up being treated who shouldn't and plenty of kids who go
untreated who could benefit.

------
mpg33
Dr. Russell Barkley is one the world's leading experts on ADHD.

[https://www.youtube.com/watch?v=KQC-
Nk5OOfE](https://www.youtube.com/watch?v=KQC-Nk5OOfE)

------
obiefernandez
sloppy, at best. the reporter lost me about a minute in when she said that
ADHD medications were "methamphetamanine-based"

------
lelf
[http://en.wikipedia.org/wiki/Hunter_vs._farmer_hypothesis](http://en.wikipedia.org/wiki/Hunter_vs._farmer_hypothesis)

[https://en.wikipedia.org/wiki/ADHD#Genetics](https://en.wikipedia.org/wiki/ADHD#Genetics)

------
Scienz
Personal anecdote, since there are some comments here by people claiming an
early ADHD diagnosis might have changed their life: I was "diagnosed" with
ADHD about five years ago, at around age 25, and it was a horrible experience.
I'm not sure if I have ADHD, but at the very least was very depressed at the
time, and they gave me some self-evaluation asking a bunch of questions like,
"Do you have trouble concentrating? Does your mind wander?" Of course being
very depressed I tended to be pretty hard on myself answering, they gave me
the diagnosis, and at the first sign I gave of skepticism about it they
basically ridiculed and humiliated me, telling me I was in denial and nothing
in my life would ever change unless I started taking medication. They
completely ignored any other problems I was having and other possible
explanations once they pinned the ADHD label on me. In a conversation that
lasted an hour, I didn't get a single word in after making the comment, "Well
I'm not really sure if I have this..."

A few years later I did try taking some Adderall, unofficially acquired from a
friend, and in three days it caused me to start having all kinds of mental
health problems (OCD and Tourette's type symptoms, fyi) that I'm still not
fully recovered from. Admittedly I think I took a bit too high of a dosage,
but I'm scared to even try again if only three days of something could
basically turn me halfway insane. Maybe if I'd started on only a half dose it
wouldn't have happened, but I'm worried about the fact that such people were
trying so hard to push a drug that ended up having those kinds of effects in
only three days from only a slightly elevated dosage.

So I definitely think this whole thing is a huge pharma scam at this point.
I'd be highly skeptical of any ADHD diagnoses, especially when they're all
based on self-reporting (notoriously unreliable) and a bunch of therapists,
teachers, etc. who are quick to jump to whatever explanation fits with their
prejudices about a person. It scares me that they're pushing these drugs on
people, especially at such young ages, not to mention how it prevents the real
underlying problems from being solved.

~~~
pavel_lishin
I have to take your story with a big ol' bucket of salt, because you ignored
medical professionals, and then tried to self-medicate with un-prescribed
drugs of unknown dosage.

~~~
Scienz
Point taken - I may have ADHD or I may not, as I implied I don't really know,
and the bad reaction to adderall obviously isn't universal. Though I'll also
say the dosage wasn't unknown, and the professionals gave me extensive reasons
not to trust them. Drugs don't affect you differently depending on who
prescribed them, and the main point of the story was that I didn't trust these
people to accurately diagnose or prescribe anything. If they won't even let me
question them about their diagnosis, I wouldn't trust them to listen to me
about my reactions and side effects either.

This is a controversial subject though, so I'm going to step out now. Just
wanted to share the story of my negative experience with it.

~~~
chimeracoder
> the main point of the story was that I didn't trust these people to
> accurately diagnose or prescribe anything.

Your experience is an indictment of bad psychiatry, which nobody here would
defend. But you explicitly say you wouldn't trust them to diagnose you with
anything (I wouldn't either), so I'm not sure why you then draw the conclusion
you did:

> So I definitely think this whole thing is a huge pharma scam at this point.
> I'd be highly skeptical of any ADHD diagnoses

(FWIW, your comment is gray as I write this; I didn't downvote you, but I
wanted to explain why I think someone might have).

------
bayesianhorse
This kind of ridiculing ADHD is down right dangerous. Children with untreated
ADHD, even at a very young age, are at riks to suffer depression, bipolar
disorder and bad social skills later on.

ADHD is a very tough condition to understand. The repercussions of deciding
not to treat a child are severe and unequivocal. A child with untreated ADHD
will be much less happy, much less social, much less successful (in every
sense of the term) and less healthy than need be. Which is sort of the point
of treating it.

------
gojomo
Does the idea that thousands of toddlers have been prescribed ADHD-drugs
become _more_ or _less_ concerning, once you consider some of those
prescriptions may be schemes to acquire pills for diversion to other,
unprescribed older users/buyers?

------
dfc
Does anyone have a link to the actual CDC paper? I found some ADHD
publications from Dr. Visser but they do not seem like they are related to the
material presented at the conference.

------
Im_Talking
And yet cannabis oil, which is non-psychoactive and an effective treatment for
a myriad of issues including ADHD is still illegal at the federal level.

------
aidenn0
TLDR: The ability to store fat is an evolutionary adaption, therefore obesity
isn't a problem.

