"I often wonder how Brent would have done with something like
the Montessori concept."
Cindy also thinks that the nature of schooling is part of the problem. "I don't think school has changed much since we were in school, but the kids have changed," she explains. "Teachers still have this set program, but more and more of the kids don't fit into it. I often wonder how Brent would have done with something like the Montessori concept." Cindy praises Brock-Lammers, the Roosevelt 5th grade teacher, for regularly taking her students on outdoor adventures to collect leaves or water samples for science projects and the like. "Brent thought he was just having fun, but in fact he was learning a lot," Cindy says. "It's too bad other teachers don't do more of these things."
Despite these broad concerns, Cindy has absolutely no doubt that ADD exists and that her son Brent has a classic case. ADD may be overdiagnosed, and Ritalin may be overprescribed, she says, but those who say the disorder is a myth or a social invention or a conspiracy of rigid educators have never met anyone like her son. Skeptics do not know what it's like to live with a youngster who never sits still, a youngster who turns on the television and then runs outside, who, even at the age of 12, can't bear to be alone.
"To this very day, Brent has to be in a room with somebody," Cindy says. "If I were to say, 'Take care of yourself for a while,' he'd get frustrated, probably cry. I walk to the doorway, and it's, 'Mom, Mom, Mom.' It's a terrible demand on me."
So who is right? Do youngsters like Brent have a real disorder, or is it just a myth? Between the true believers who see ADD everywhere and the critics who see it nowhere are the moderate majority who would almost certainly acknowledge that Brent has a real problem. Yet even these moderates acknowledge that ADD is overdiagnosed and Ritalin overprescribed.
|Now parents are quick to accept an ADD diagnosis and ask for Ritalin.|
Mark Stein, director of the Hyperactivity, Attention, and Learning Problems Clinic at the University of Chicago, suggests that it's pointless to question the existence of ADD. In fact, he believes it is one of the best-researched childhood conditions. He estimates that 5 percent of the school-age population has a mild form of ADD and that 1 percent is severely beset. Yet in his view, people are going far beyond the data to find ADD where it clearly doesn't exist. "Twelve years ago, the main problem was underdiagnosis," Stein says. "Now it's overdiagnosed so that I see normal 3- and 4-year-olds diagnosed with it. The problem is that when people hear the symptoms everyone thinks their child has it."
At one time, Stein continues, ADD was diagnosed only after other possibilities were absolutely ruled out. Now parents are quick to accept an ADD diagnosis and ask for Ritalin. "But, if you give kids Ritalin who in fact don't have ADD, what are you missing?" he asks.
"This was the first disability I had ever seen where people
would get together and get excited when they learned someone had
Even some extremely unlikely candidates are disgruntled by the ADD-bandwagon phenomenon. Wade Horn, former executive director of the powerful advocacy organization Children and Adults With Attention Deficit Disorders, was so disturbed by what he saw that he resigned his post in 1993, just one year after he had taken it. "This was the first disability I had ever seen where people would get together and get excited when they learned someone had it," Horn says. "There was almost a revivalist quality. You could hear them squealing with delight. Can you imagine someone saying that about schizophrenia? I was trying to moderate that attitude at CHADD by reminding the membership, 'Hey, having this disorder is not great news.' "
Horn believes that 2 percent to 3 percent of the population suffers from ADD. CHADD uses a 3 percent to 5 percent figure, which Horn believes is at least within the realm of possibility. But he's incredulous when he hears, as he sometimes does, people talking about 15 percent to 20 percent. "At that point, it's no longer a disorder but a natural variation," he says. "A kid could be anxious, or he could even have lousy parents, but instead they say it's ADD."
Horn, who believes that Ritalin is drastically overprescribed, remembers with a sense of outrage hearing someone in CHADD remark that the American teenager caned in Singapore a few years ago for spray-painting cars was no more responsible for his actions than if he had had epilepsy and accidentally scratched the cars' paint. The presumption was that the teenager had ADD, which made it impossible for him to control his behavior. "You could see that ADD was becoming a catchall for bad behavior," Ward says. "It was like, 'I have ADD, so you're just going to have to deal with it.' "
Over this past summer, Cindy Shipley fretted about how Brent would fare in the 6th grade. Brock-Lammers, his 5th grade teacher, had been strict but not rigid, providing a delicate line for Brent to walk. He could not get away with forgetting his pencils or disrupting class with clowning. Yet, at the same time, the self-contained classroom had the atmosphere of an extended family. Brent felt at ease.
But 6th grade would be different. Brent would have three teachers, each of whom would teach two subjects. Cindy worried that the absence of a single teacher-mentor and the movement from class to class would cause Brent to forget books and run around in the halls.
A month after the start of school, though, Cindy reports that Brent is having a remarkably good year. He likes his teachers, has several new friends, and is getting good grades. Still, he remains heavily dependent on his mother. As always, Cindy has to help him do his homework.
During the summer, Brent hardly took any Ritalin, only a few times before soccer games and practices; Cindy doesn't believe in using the drug for ordinary playtime. But now that Brent is back in school, he's back on his standard regimen. Cindy hopes the day will come when Brent no longer needs the Ritalin, but she can't imagine when that might be.
"School and the demands it places on Brent are only going to get tougher and tougher down the road," she says. "They say some kids no longer need Ritalin after puberty, but I think Brent will need it at least through high school and maybe even into college. But I really just don't know."