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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

ADHD, It's Really Real

Allan N. Schwartz, LCSW, Ph.D. Updated: Nov 16th 2007

To those people who insist that ADHD does not exist and that children are being wrongfully medicated the American Journal of Psychiatry published an impressive piece of research that proves beyond any doubt, the reality of this diagnosis. Dr. Michael Stevens, MD designed a study to explore the regions of the brain affected when subjects are performing certain tasks. The subjects were divided into groups of people with and without ADHD. During the performance of these tasks the brains of the subjects were scanned by fMRI.

What is an fMRI?

An fMRI is a variation of the MRI, which is a non invasive method of looking at what is happening internally when someone is ill. MRI refers to Magnetic Resonance Imaging. The MRI provides doctors with exceptionally clear pictures of the inside of a patient's body. An fMRI does the same with a major difference. The letter "f" refers to Functional Magnetic Resonance Imaging which means that activity in the brain, for example, can be traced. In other words, a living picture is provided by this technology.

As a result of this technology, Dr. Stevens was able to trace the activity of brain cells or neurons while subjects were performing tasks. He was also able to see how different parts of the brain were functioning at the time of the fMRI. The study clearly showed that the brains of subjects with ADHD are different than subjects without the disorder. In addition, the differences occurred in the parts of the brain having to do with allocating attention. In effect, the brains of the subjects with ADHD were unable to distinguish between important stimuli in the environment versus background noise.

Conclusion:

When shown to doubting parents, the fMRI pictures leave no doubt about the need for medication that allows youngsters to focus their attention on what is important without being distracted by things that are unimportant.

Also:

Dr. Stevens study coincides with additional research recently published by the National Institute of Mental Health and the National Institute of Health, showing that the brains of children who have ADHD are three years less mature than those of normal children. The particular areas of the brain that are less developed affect the ability to control impulses. This explains some of the hyperactivity found in many of these children.

The good news is that most of these children's neurological systems and brains do catch up with their peers so that they become better able to control themselves by adulthood. Of course, this maturing process may not occur in every individual or at the same rate of speed. There are vast numbers of adults who have ADHD and do not realize it. Among adults, this remains highly under diagnosed and under medicated.

What are your thoughts about this issue?

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

    Reader Comments
    Discuss this issue below or in our forums.

    an adult phd psychology student with ADHD - john - Sep 3rd 2008

    I have had ADHD all of my life, no shock there it is a difference in neural functioning afterall.  The problme I have with the current method of looking at ADHD is the final D as in disorder. ADHD has as many good points to its different type of functioning as bad, and maybe more. The brain does not filter as much but it does allow for better perception of variable interconection.  For the english majors out there a poet with ADHD has little difficulty coming up with analogies, simlies etc. It allows one to think around problmes in novel ways. It has its problems but so then does "normal" whatever that is thought.   I see ADHD as more an adjustment disorder, not unlike being left handed in a right handed world. Trying to explain this to those without ADHD however is often like trying to explain the color blue to a blind person, the other person cannot fully percieve the experience.

    Concerned Doctor and the Use of ADHD Meds for Children - Dr. Allan N. Schwartz, LCSW, PhD - Nov 18th 2007

    Dear concerned Doctor and all readers:

    You are absolutely correct in pointing out that the use of powerful cerebroactive drugs in small children can be dangerous and counter-productive. Upon rereading my posting I see how it can be easily misconstrued that I advocate the use of these drugs with small children. Alas, the written word failed me and lead readers to a conclusion that I do not myself accept. I was referring to adults when I stated that many go undiagnosed and might benefit from medications.

    However, even in the case of adults, there are many behavioral training and coaching techniques that can be used to help individuals focus their attention and control their impulses and their memory. In fact, I am an example of just such a person, as I wrote in an earlier posting. When I was a child there was no such diagnostic category as ADHD and family and teachers believed I was lazy. I taught my self how to overcome my difficulties and became successful at school later, in College.

    I want to thank the concerned doctor for pointing out my error in writing and and state that I fully agree with his comments. This is exactly why we have these postings and welcome comments.

    Dr. Schwartz

    No doubt...but meds? - - Nov 17th 2007
    While there is little doubt that a percentage of our population has this brain difference, funding for many of the studies comes from the pharmaceutical industry. Some of us who have worked in child mental health question the wisdom of giving cerebroactive drugs to young children. Many children do not respond well to these drugs, and their families experience a rollercoaster ride through various drug trials, sometimes accumulating more problems than they started with. Is there another way to help children that struggle with inattention, hyperactivity, and impulsivity? Do we really have to drug them? The research says that most of them will grow out of it anyway.


    A concerned doctor. 

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