I think before anyone can objectively decide the answer to the big debate about AD/HD, we must clearly define the following:
What is a normal activity level and attention span for each age group?
How do you distinguish a disability from a diffability?
What exactly is AD/HD? Is it idiopathic hyperactive/inattentiveness or does it include hyperactivity and/or inattentiveness that has a known cause(giftedness, dyslexia, brain damage, etc)?
I would really like to have a discussion about this, but whatever you do, DON'T FLAME! Once people start flaming all rational discussion stops.
PS: Flaming is verbally attacking people, eg. calling people stupid, saying they're bad parents, etc. We know AD/HD isn't just bad parenting. Spoiled brats can act like kids with AD/HD but the vast majority of kids who act like that aren't spoiled brats.
I thought I'd chime in as someone with adult ADD. I don't mean to change the tack of your post, but for me I'm not sure how much any kind of 'great debate' about ADHD matters. Changing the classification of ADD won't change my experience with it. I sought treatment because the intensity and persistence of my struggles with organization, responsibility, task definition/follow-through had far surpassed 'normal' and were repeatedly getting in the way of me living the life I wanted.
This board and other places where ADD is discussed often see questions like yours. But in my experience most such conversations deal with some kind of mythic situation in which immoral educational administrators hand out pills to silence energetic children. If I thought that was the case, would I be incensed about it? Of course. But I was never given pills and I was never tracked as ADD. Yet even as someone with a purportedly very high IQ and from a very privileged background, I failed out of high school (unheard of where I am from) and college as well.
Nonetheless I don't particularly see ADD as a disability. Its closely related to my strengths and talents, and so I see it as an asset (or a beneficial difference) in many ways. But then I (and presumably many kids who truly have it) never got the very real extra help I needed with organization, task management, etc. I've paid more for than that than I would wish on anyone and so I tend to get frustrated with people who seem intent on debasing the very existence of ADD.
In short, kids canít fully speak for themselves, but I think most people with adult ADD will tell you they wished they had gotten help sooner, not based on whatís Ďnormalí but based on their experiences.
Actually, I don't really see it as that myth you described. I think AD/HD is probably overdiagnosed, but there are some people who truly have AD/HD, for whom treatment may be needed. Whether that treatment must be medication is not proven, however. It seems to me that we're often too quick to medicate, and there are often other possibilities, such as behavioral intervention. Also, people with high IQ's can do very badly in school without having AD/HD, basically all that means is that they don't learn well in the school environment. I'm on the edge of the autistic spectrum and learn best by independant research or one-on-one discussion and although I've been identified as gifted I did very poorly in school due to my odd learning style and emotional problems caused by teasing. Once my parents started homeschooling me I did very well since I was in control of how I learnt and free from teasing. Also, studies have shown that profoundly gifted kids(with IQ's of 170-200+) can fluctuate from scoring 100% on a test to scoring 0% depending on whether they'd already had a lot of drill that day.
...objectively decide the answer to the big debate about AD/HD... DON'T FLAME! .
I'm curious exactly what your interest in the topic is, Ettina. Do you have a child that you are concerned about? Are you thinking you might have it? Are you a teacher who hasn't quite sorted out your feelings? Or, are you just looking to have a debate about a topic that doesn't really affect your life?
I can tell from your post that you are new to this board even without your "newbie" label. Those of us who frequent this board live with ADHD day in and day out. There is no great debate about ADD: it is a fact of life.
The only "hot topic" debated on this board is the use of medication. Even then, if you'd been around longer you would have seen that few, if any, of us medicate our children without first exhausting all other possible avenues of treatment including the behavioral intervention you recommend.
If you'll be so kind as to disclose your interest in the topic, I'll gladly share my thoughts about ADD as spectrum, not at all unlike autism. Hey, maybe we could even debate autism while we're at it!
My interest in this topic is as a person who was almost misdiagnosed with AD/HD as a child. My parents insisted that my misbehavior was caused by two factor:
a) post traumatic stress disorder(I was sexually abused by my cousins between the ages of 1 and 5)
b) being treated as developmentally delayed when I was actually gifted
I also knew a kid who had ADHD and was on Ritalin. However, I always thought that since the symptoms came on very suddenly, and as far as I know other conditions that can cause sudden hyperactivity were not checked for, his diagnosis may have been suspect. Anyway, I don't know much about what it's like to have AD/HD, or parent a kid with AD/HD, since I have experienced neither. However, I'd be glad to learn more about AD/HD, and debate the topic about AD/HD(and autism too, but let's concentrate on AD/HD right now). So please do share your opinion.
Thank you so much for clarifying. And I am really really sorry to hear about your traumatic experience with ADD misdiagnosis and otherwise.
Fortunately, most newer books on ADD (and most good doctors and counselors) will begin by strongly stating that ADD should only be diagnosed very cautiously. Over the years, people seem to have become much more sophisticated about first ruling out all other possible causes. Hopefully this will help others in a position similar to yours.
That said, I'm still not sure exactly what you would like to debate. If you'd like to learn more about what its like to live with AD(H)D, this board is a great place to look around.
to make it a short explaination.. we 'people inflicted with AD/h/d have to take a stimulant to SLOW our process of behavior..
is that a disability or 'diffability' ....
when you pick up a banana b/c you are hungry, but then place it down b/c the phone rings, and then you find it 2+hrs later only to REMEMBER 'oh.. i wanted to eat a banana' THAT IS A DISABILITY..
i will type more later, just wanted you to see this as i thought it...
What is your definition of disability?
Isaac Newton once asked a person over to his house for dinner. Then he completely forgot he'd invited them. He sat down for dinner, pondering something. The servants served up his dinner(but not his guest's since he hadn't mentioned his guest to them) and placed it in front of him. He didn't react. Then the guest came and rang the doorbell several times, with no response. The guest finally came in and sat down, waiting for Newton to notice him. Finally, the guest got so hungry that he ate Newton's meal. A long while later, Newton paused in his pondering and looked at his plate, at which point he said:
"If it weren't for the evidence in front of my eyes, I would have sworn I hadn't eaten dinner."
Had he not been like that, though, he would not have made the discoveries he did. Now, was his absentmidedness a disability? Other's opinions may differ, but I'd say no, it was a diffability. My definition of disability is something that inherently causes problems with no benefits. If it causes problems in our society, but not in others(eg being dark-skinned) then it's not a disability by my definition. If it inherently causes problems, but also benefits(like Newton's meditative pondering) then I think it's a difference. By my definition, being deaf is not a disability, since in a society where the vast majority couldn't hear, being unable to hear would not cause very many problems. An analogy for this is:
Imagine if almost everyone could smell as well as a dog can. People with a very weak sense of smell would be called 'smelling impaired'. Now, let's say one of these smelling impaired people ended up in our society. Suddenly, s/he would no longer be considered disabled, but instead normal. Was s/he disabled? In my opnion, no.
I'm afraid my own answer probably isn't too interesting. Anyone who's read my posts probably knows I do see ADD mainly in the way you describe as a 'diffability' because its more serious problems are intertwined with some very real benefits. I guess I've never found it very helpful or productive to think of myself as somehow limited or otherwise disabled. Its just a part of me and it means some things are abnormally difficult for me while others are very very easy.
And while there are definitely others here who would not agree, I really do think ADD is best understood as a 'product' of our time, culture, etc. I find it very difficult to think of any mental difference or illness as being timeless. History gives way way too much evidence of how these things change.
BUT, that said, ADD is no less 'real' - no matter how I understand it I still have to be able to pay my bills on time, and figure out how to live the life I want. So it for me its an *absolutely* necessary classification because it gives me a framework in which to understand my struggles and get help. If someone wants to call it a disability, I just shrug. It really doesn't matter so much to me.
Yo, 6er99!-- Thanks, Ettina! And double-thanks for your Newtonian anecdote. Definitely resonates. I just answered a thread on ADD and "relationships"(Hi Sodawater! I see you chimed in on this, too). The symptom I was 'focusing' on there was how thought-speeding, esp. with a co-ADDer, can impact relationships negatively, and that the term "ADD 'relationship'" is kindof an oxymoron, since people tend to flee from a relationship which is characterized to a significant degree by negative interactions resulting from this kind of problem. And here's a couple of other classical ADD symptoms: bananaical "forgetfulness" (like, aphasia or amnesia?) and Newtonian "hyperfocus" (like seriously dis-attentive! Wow, Newton really had it bad, huh?). These are nails in the social 'coffin' of ADD relationships and dis-ability, so to speak. [OK, the connotation of 'coffin' is bad, but it's a common metaphor; maybe 'basket', as in social 'basket case', would be better.]
Note: the rest is pretty long, but I think 'diff-'erentiating these is pretty complex, so my apologies in advance... (but we DO spring ahead an hour tonite, so I'm thinking that I need to make up for 'lost time', you know. ARGH! )
But, to the 'diff' between 'dis-' vs. 'diff-' ability, maybe looking at this in terms of the term 'dys-' might help (well, maybe not, but I'm gonna try...). By definition, 'dys-' can imipily both 'bad' and/or 'difficult'. Unfortunately for definition (or in medicine, diagnosis), 'bad' can be good, depending on relative or absolute perspective, e.g. as a political analogy: in WWII, the Allies were 'bad' from Hitler's perspective, but he was 'bad' to the Allies', yet, the Soviets (technically, one of the Allies) were 'bad' to the non-communist Allies. So 'bad' or 'dys-' needs to be carefully evaluated, especially in a clinical sense. To do that, 'objective' evidence is needed, and, what is 'good' in this sense is what is overwhelmingly agreed to across the [very well-educated and experienced] medical community over many many years and peoples.
So, in a medical sense, 'bad' usually means something more like: has validatable evidence of causing significant and ongoing dysfunction, either of the part [e.g. organ] of the person who has the dysfunction, or to other parts, or eventually to the person in general, and through that person to other persons. [Fortunately, dis-abilities don't seem to be contagious, but unfortunately, they seem to be often inherited, as seems to be the case with ADD.]
'Dis-' implies the lack or impairment of an ability. So, I think that hearing loss is a clear dis-ability in the clinical and probably legal sense, although it can be and is increasingly mitigated through technology advances, social contextual improvements (non-discrimination re: disabilities), behavioral modification (learning lip-reading, signing, etc.), etc.-- which makes the disability less dysfunctional but I think still a disability. And to the extent that the society does not routinely and pervasively offer migitations to [partally] deaf people, it can be an incredibly and sometimes tragically, debilitating disability. It's a matter of degree AND a matter of what is 'good'/'bad', AND a matter of mitigation, too-- it is complex.
Hopefully, not to overdo the point but to try to establish what "good"/"bad" are in the more clinical/medical sense, here's some common examples. 'Good' is your heart NOT having ventricular-septal or valve 'defects', myocardial infarctions ("nectotic" parts, as results from heart attacks), etc.. "Good" is your brain NOT having significant nervous system pathologies, resulting in recurring electrical storms aka 'seizures' or littler, aperiodic ones aka 'tics'. [There is a second-or-third 'cousin' of behavior that results in people not remembering for a couple of minutes that they did something-- hopefully NOT like but sometimes actually robbing a bank-- and of course there's another cousing involving narcoleptic or seriously 'bad' insomniacal behavior aka sleepwalking that can be pretty disabling (like NOT being awake enough to prevent falling down stairs and breaking your hip 'bad'-- and, 'worse', several times). These are pretty severe forms, true; but I hope they make the point that there are behaviors like the ones in this context that are a matter of degree, recurrence, and pretty clear and significant 'deviations' from 'norm', especially 'objective', like an Xray or MRI, or visually seeing the broken bone or hearing the heart's arrhythmia, that can reasonably be considered to be 'dis-abilities'.
I think it's just that psychological things are often not as well-validatable by objective, physiological/anatomical evidence, i.e. are mostly validatable by 'behavioral' observation, and so, pretty tricky to establish, especially given the significant variations in people, in the degree of affliction, in the 'co-morbid' relationships (e.g. bipolar, etc.), etc.
In going through ADD diagnosis, it was stressed to me that ADD is thought to be a heritable problem (that is, probably inherited, but also could be congenital, ie occuring around birth) and a significant part of 'adult ADD' is to establish ADD-associated symptoms/evidence in the person's childhood and through his/her life. Things like racing thoughts, blurting, hyperfocus, perhaps fidgeting (the classical hyper-active kid not yet on ritalin who disrupts the class, acts out/maybe even 'hits'/'strikes' out at people or his/her environment), that happen all the time to people are often sufficient 'validatable evidence' that a significant deviation ("diff-erence) from 'norm' exists and that if there is similar evidence that resulting behavior negatively affects the individual or society, and that it is significantly 'unremediable', then there's a case for a 'dis-ability'.
Well, certainly "diff-'erent! (like, WAY, sometimes). So are, by definition, 'dys'-function and 'dis-ability', but in the sense that I've just related, 'dis-'ability is something more and probably something that can be validated clinically relative to human physiological/psychological 'norm'.
So, given this, it's probably not surprising to you that I think ADD (or anything analogous, bi-polar eg.) can be disabling to some degree. And despite the fact that it can be remediated or moderated to some degree by various therapies, e.g. meds, or even, analogous to hearing aids, EST (hunoz !). But hopefully self-awareness, behavioral/clinical theapies, meds, etc., will be a sufficient Rx for a sufficiently large part of those afflicted that people and society will not be chronically dis-abled re: ADD (or anything else analogous to it).
But if you're thinking/talking "LEGAL" dis-ability, then that's BEYOND clinically diagnose-able dis-ability, probably because there's $$ involved, and, you know, SOMEbody's gotta pay! ["Follow the money", Deep Throat, was known to say...).
Though ADD is not as 'objectively' diagnosable as, say, inoperable or incurable cancer or paralysis of some degree, it might still be a form of dis-ability, just maybe not meeting 'legal' criteria. And maybe even, depending on the diagnostician, say a given psychiatrist (but maybe NOT to another), the dis-ability might NOT meet 'clinical' "standards" clearly enough to be clinically diagnosable as "AD[H]D (adult; inattentive)", or whatever, AND be defensible by both 'peer'review and results from established therapies established through significant practice, observation, and validation, both in the general population and with individuals of a given diagnosis.
But, paradoxically, or maybe oxymoronically, like Newton, it (ADD) or a chief symptom (hyper-focus) can be somewhat dys-functional as well as profoundly self-beneficial, AND, simultaneously!! is what really confounding to me, I will tell YOU! ["And I am OUTAHERE", as Dennis Miller used to say.]
So, definitely 'diff-'erent, likely clearly and chronically and sometimes acutely 'dys-'functional, and ergo 'dis-'abling, and so, if chronically and 'badly' enough: a dis-ability. Alas...
But, there's knowledge in power, you know. Wait! [Am I sometimes 'dyslexic', too?? Maybe I have a 'complex'! ] So, thanks be to Healthboards and all its networking cousins, everywhere!