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American Morning

The Big Question: Is ADD overdiagnosed?

Aired March 15, 2002 - 07:19   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
PAULA ZAHN, CNN ANCHOR: The big question at this hour, is attention deficit disorder overdiagnosed? A new study offers some surprising and disturbing information on kids with ADD. A Mayo Clinic report released just this week found as many as 16 percent of school aged kids could have attention deficit or hyperactive disorder. The numbers are significantly higher than previous estimates of three to five percent.

Now, some medical experts say the statistics are finally catching up to what they've known for some time. But others fear that studies like this one could result in kids being diagnosed prematurely and over medicated with drugs like Ritalin.

Joining us now early from San Francisco, psychologist Thomas Armstrong, author of "The Myth of the ADD Child," and in Boston this morning, Dr. John Ratey, a psychiatrist and co-author of "Driven To Distraction."

Welcome to you both.

THOMAS ARMSTRONG, PSYCHOLOGIST: Good morning.

DR JOHN RATEY, PSYCHIATRIST: Good to be here.

ZAHN: Good morning.

So Dr. Ratey, we just talked about the study showing that as many as 16 percent of school aged children were likely to have ADD or ADHD. But you actually think that number is on the low side. Why?

RATEY: Well, I think there are a lot of children that are of the more inattentive type who do fairly well in school until they reach college and then they have even more trouble and they there show problems in maintaining the attention, maintaining an organization and we see another whole group of people that show up with problems in, with their attention system.

ZAHN: So these are kid who were never diagnosed earlier on?

RATEY: Right. Right. They don't show up with problems. They do well enough, but they're under achieving a bit or maybe quite a lot given what they can test out on their I.Q. tests and all. But -- and it's either, they're labeled either that they're lazy or they're really not putting enough effort into it. And -- but they get by and they have the structures of this school system and then when they get to college, things start to really begin to fall apart.

ZAHN: Mr. Armstrong, why do you think this is all a bunch of bunk?

ARMSTRONG: Well, I think attention deficit disorder is a sign of our times, really. We live in a short attention span culture. Kids are under incredible stresses these days. I think really we put into this category a whole heterogeneous group of kids. Some of these kids are highly creative. Some of these kids are physical learners. Some of these kids are late bloomers.

I thought it was interesting, Dr. Ratey said that for many the problems begin when they get out of high school. Actually, the literature suggests that ADD begins to go away after adolescence and I think in part, for some kids, at least, it's a developmental factor. Some kids' nervous systems are developmentally immature and need some time to catch up.

I think some kids are in schools where they have to learn according to high stakes testing and rushed curriculum and under these kind of conditions, it's no wonder that we have a lot of distractible, impulsive kids out there and I think it's wrong for us to apply a psychiatric disorder, which is serious stuff, to kids that may be creative or maybe require a whole different approach to education. Some of these kids...

ZAHN: All right...

ARMSTRONG: Yes?

ZAHN: But Mr. Armstrong, you're not saying that ADD doesn't exist. You think it does exist in some cases but too many kids are diagnosed with it?

ARMSTRONG: I think the whole disorder needs to be brought into question. Certainly there are kids who have specific brain damage as a result of illness or accident or in utero incidents that cause, you know, frontal lobe dysfunction, that cause these behaviors.

But I think that that's probably just a fraction of the percentage that we're talking about here in these kinds of studies. You used...

ZAHN: All right...

ARMSTRONG: Yes.

ZAHN: Let me let Dr. Ratey react to that. What about taking into account that kids have all different kinds of learning styles and there's no single classroom that can accommodate all that?

RATEY: Oh, I think that's absolutely true and especially with the press of the information age, the press that we're, the demands we're making on children to do many things all at the same time. I think it's, it is, we're traveling with an attention system that developed back at the hunter-gatherer period of our evolution and we're asked to now deal with all the information that the information age has put before us.

And with our rapid fire culture and all, there's no question about it. The environment plays a big role in bringing this to the fore. But still, and we're all in a spectrum. None of us can really pay attention well enough or all that we're demanded of us at this point. But there's a spectrum of abilities. Like anything in the brain, like our, the spectrum of ability to deal with our moods, to deal with anxiety, to deal with our attention system and then there are those people who lie on the outer edge. And that edge is pretty large.

And this bears understanding, bears identifying, bears getting a handle on it so that one can properly help the child and person manage not only school, but manage their life. I think the whole move...

ZAHN: All right, a final...

RATEY: ... movement...

ZAHN: Yes, I was just going to give Mr. Armstrong the final word for worse of advice to parents who are seeing their kids struggle in the classroom or who might be considering putting those kids on Ritalin because a doctor has told them to do so.

ARMSTRONG: Well, I think Ritalin and other psychoactive medications have a role for some kids and they can pull kids out of a negative cycle. But there are a lot of other non-drug alternatives that parents can consider. I think the expressive arts, for example, giving kids an outlet for their creative energies can be one very practical way in which kids can turn their attention, inattention and their hyperactivity into some creative behaviors that our society badly needs.

ZAHN: All right, gentlemen, we'll have to leave it there this morning.

Thank you for both of your perspective, Thomas Armstrong and Dr. John Ratey. Have a good day.

ARMSTRONG: Thank you.

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