Does that kid need Ritalin -- or is he just baaad? Diagnosis: The 'attention deficit/hyperactive disorder' industry is booming.

The Argument

January 25, 1998|By Brenda L. Becker | Brenda L. Becker,SPECIAL TO THE SUN

Back in Catholic school, when we Baby Boomers sat 45 to a classroom and often two to a desk, most of us behaved so well for the Sisters of Charity that you could hear a pin drop. Most, that is, except George.

George lived life with shirt tails, shoelaces and spitballs flying. His knuckles surely had ruler-rapping calluses. He spent most of grade school standing in the corner, where he somehow absorbed enough to go on to higher education and a career as an accountant. We met decades later and reminisced about his days as class clown. "Yeah," he grinned subversively. "I was a baaaad little boy."

Today, George would probably be on Ritalin and under counseling, with a formal diagnosis of attention deficit/hyperactivity disorder, or ADHD. He would have an "alternative learning style," not ants in his pants.

There's a booming growth industry in psychoactive drugs, therapy and special education these days, and the recent identification of widespread ADHD and other, related learning disabilities has both arisen from that boom and fueled it.

If this sounds like an enlightened new era for the Georges of this world and their parents, one might think again after sampling the spate of recent books on how to "parent" such "differently abled" children.

These volumes, such as "The A.D.D. Book" by William Sears, M.D. and Lynda Thompson, Ph.D. (Little, Brown, 320 pages, $37.95) and "The ADD/ADHD Checklist" by Sandra Rief (Prentice Hall, 256 pages, $11.95) reflect the backlash against overprescribing Ritalin as a quick fix to keep hyperactive kids glued to their seats in class.

These are earnest efforts by well-intentioned professionals to help parents cope with seemingly impossible children. All concur that drug treatment, if used, must be part of a "multimodal" strategy, overseen by the vigilant parent-as-advocate.

Boy, are those modes multiple. They include social skills training, cognitive therapy, neurobiofeedback (a sort of computer game played with brain waves via EEG), tutoring, progressive muscle relaxation and individual education plans.

Then there are "tools": checklists, questionnaires, charts, day planners, egg timers, stickers, points, tokens and more, all to help a hyperactive youngster harness his attention span and control his baser impulses without squishing his self-esteem. It is hard to resist wondering whether life was easier for everyone when Sister Mercy just kept smacking George on the knuckles.

Supposedly there are more than 2 million school-age children with ADHD, some 70 percent of whom are taking Ritalin or other drugs. The therapy folks insist that ADHD has been there, cruelly misidentified, all along. Their books resound with heart-rending testimonials from emotionally crippled adults (less resilient than George, apparently) who languished under the stigma of dummy or daydreamer when they were, in fact, afflicted with a neurobiologically distinctive brain.

Parents of an obstreperous, distractible child are warned that their exasperating tot needs nothing but an enveloping tide of positive feedback, structure and behavioral modification to channel his energies and unleash his prodigious creative potential. (Edison, Mozart and Einstein were ADHD, we are told, although it is unclear how they managed to persevere in the absence of Ritalin and sticker charts.)

Most of all, insist the therapists, the behavior of the ADHD child must not be seen as lazy or bad, but merely inappropriate -and everyone in the child's life must be coached to understand this.

In the ADHD universe, forgetting your homework and saying the dog ate it is a diagnostic criterion, biting your baby brother is your neurotransmitters begging for some metabolic balance and throwing the family cat out a second-story window is the misguided act of a potential aeronautics engineer.

The most useful checklist, found in none of these books, would be titled "How to tell when your ADHD child is just being a rotten little brat."

Shore up the ego

If some aspects of this "diagnosis" applied to up to 5 percent of all children are troubling, brace yourself for the next wave:

Adults with ADHD. Yes, it's not only for kids anymore; up to 60 percent of ADHD children have persistent symptoms in adulthood, and many are taking Ritalin to help them focus better.

If you fidget incessantly, blurt things out rudely, can't remember to pay your electric bill until the lights go out, frequently lose the car keys and can only pay attention to stuff that really interests you, you are differently abled, my friend, and there are support groups waiting to shore up the ego left in tatters by your nagging mother, teachers, boss and wife. (ADHD sufferers are disproportionately male.)

Professional advocates for ADHD children - the ones adamantly opposed to "labeling" - offer ready advice on getting ADHD tagged as a disability in order to access the federally mandated menu of special education benefits.

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