Does AD/HD really exist as a disorder?

It's been a busy day. I walked about 45 minutes inside the church for exercise, then walked through an exhibit in the narthex of an organization for people interested in AD/HD (attention deficit hyperactivity disorder) and learning problems, then went to women's Bible Study (Jennifer Rothschild), then helped a friend with her MS Walkathon mailing, adhering labels, stuffing envelopes, sorting zip codes and stuff. In my walk through the narthex I looked at some of the vendors materials and picked up some reading material. I also noticed that about 99% of the people attending and the vendors were women, although supposedly most of the people with this disorder are males.

I'm concerned that what is probably fairly normal little boy or male adolescent behavior, at least at the milder end, is labeled, pathologized, medicated, and sometime criminalized. I picked up a free issue of Attention, December 2007, published by an organization called CHADD, Children and Adults with Attention-Deficit/ Hyperactivity Disorder. Leafing through it, I see that AD/HD has become a big business in the last 20 years. Here's the advertising I saw: many colleges and special schools; the drug Concerta; the drug Vyvanse; a study funded by the government to see if there are specific genes that contribute to AD/HD; special summer camps for AD/HD kids; transitional curricula for getting into college; boarding schools; nutritional supplements; numerous appeals to send money to or join CHADD, which has special VISA cards, vehicle donation, workplace donations through United Way, a discount medical insurance card, estate planning and a corporate contribution program; special toys for LD kids; and special watches for behavior modification and self-monitoring for medication.

There was an article on having a proactive strategy to deal with difficult behavior, such as each parent having a role, establishing a daily routine, teaching organizational skills, and clearly communicating your expectations and being consistent. Fine. I have no problems with those. But the #1 strategy? Well, the author called it "Maintaining a disability perspective,"--in other words, seeing that your child has a legitimate medical condition that undermines self control. The worst article was "The price we all pay," with the most outlandish statistics I've ever seen in my life, none with citations. Would you believe that incarceration costs due to AD/HD (40% of the prison population) cost over $16 TRILLION just for the AD/HD prisoners. That's so bizarre, I can't even imagine it got past the editors.

"Signs of [ADHD] may be minimal or absent when the person is under very strict control, is in a novel setting, is engaged in especially interesting activities, is in a one-to-one situation, or while the person experiences frequent rewards for appropriate behavior" (DSM-IV, p. 79). How many diseases or conditions--like depression or diabetes, OCD or cystic fibrosis--go away or are controled with attention from someone else? Is drugging children worth it, if keeping them busy with interesting things or other rewards work too?

We are pathologizing our children--especially little boys. Send them outside to play; get them a rowing machine for raining days. Turn off the TV. Hire someone to teach them tennis or horseback riding. Give them interesting and exciting things to do--like work. If medication is necessary, have something prescribed for you.

Update: I e-mailed the editor with a list of questions and received a reply: "That $16 trillion figure was the author’s mistake, and we regret that the error was not caught prior to publication. Please see the correction of that figure, which was published in the February 2008 issue of the magazine." She also said that references for the article are in the on-line version. That's really poor form, in my opinion. If they are printed with the article, it is much easier for the reader to spot the mistake. If I hadn't just read the Pew article, I probably would have skipped over it. But at least she responded. When I published in library journals in the 90s, the editors selected and checked, and the peer reviewers checked, and then I had to check the galleys.