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Attention Deficit Hyperactivity Disorder transcripts! Here is the transcripts from the ADHD video for those that could not access the video.
********************************************************** Attention Deficit Hyperactivity Disorder: What Every Parent Should Know
Hosted By: Lisa Clark, Participants:
Patricia Quinn, MD -
Peter S. Jensen, MD - New York State Psychiatric Institute, Columbia University
Webcast Transcript: Recorded Live: March 13 2001
LISA CLARK: Almost everyone has heard about Attention Deficit Hyperactivity Disorder, or ADHD, as it’s commonly known. And you may be aware that there’s a debate as to whether it’s a real or an invented disorder. But few people understand what the term really means, or realize how many children and adults may have ADHD.
So, does ADHD exist? And if so, what exactly is it? What are its causes and its effects? How is it diagnosed? Well, joining me to discuss and many other issues about ADHD are two experts in the field. Dr. Patricia Quinn is a Developmental Pediatrician who is in private practice in Washington, D.C. And also joining us, Dr. Peter Jensen, Professor of Child Psychiatry at Columbia University in New York.
I think the first thing we need to make clear is whether ADHD is a real disease. Is it, Dr. Jensen? DR. PETER JENSEN: Well it definitely is. We’re able to actually quite accurately and reliably diagnose the condition. We’ve tested the disorder in many different countries around the world actually. And in every place we’ve looked, we find that it does exist. That children do have these symptoms and the syndrome. And when it does occur in children, it’s very severely impairing and has lifelong consequences for many of these children. LISA CLARK: What sort of causes have been identified that may lead to ADHD? DR. PATRICIA QUINN: I think the primary cause is genetic, in that we do see family histories of other members having the same or similar problems—usually several children from one family. There have actually been some recent studies diagnosing certain subtypes of ADHD, finding a gene and a chromosome and being able to identify it by that means. There’s other ways, though, and other conditions. We know chronic low levels of lead can lead to problems. Fetal alcohol syndrome. Prematurity. Obstetrical complications during the pregnancy. Or even infectious disease: meningitis or encephalitis can lead to hyperactive symptoms or inattentiveness in the children who’ve had these disorders. LISA CLARK: And just as important as discussing some of the causes is to discuss some of the things that do not cause ADHD. Dr. Jensen, I’ll throw that one your way. For one thing, too much sugar is not causing ADHD in children. DR. PETER JENSEN: No, too much sugar does not cause ADHD. The things that we think have been misunderstood, but at one time were thought to be supposed causes, are bad parenting and bad teachers, not enough discipline, sugar, and food additives. And so there’s a lot of myth and misunderstanding. And many times parents or others will chase those supposed causes down, sometimes causing them a lot of grief, and sometimes delaying an effective intervention that really could be helpful to the children. LISA CLARK: How many children actually have ADHD? DR. PATRICIA QUINN: A low estimate would probably be 2-4% of the population. If you look at attention deficit in general, from various causes, not ADHD, you can see numbers as high as 16-20% of the population. But if we are conservative and use the diagnostic criteria that we have for diagnosing the disorder that Dr. Jensen referred to, it’s probably about 2-4%. LISA CLARK: And I understand that boys are more prone to ADHD than girls. Why is that? DR. PETER JENSEN: Well, I think that we know across all mammalian species that males of the species tend to be more active, per se. There’s more motor behavior. And there’s probably many, many reasons for that. But that normal activity shouldn’t be confused with ADHD, per se. But when you have a high amount of that activity, it does mean you are more likely to be identified with a condition. So because the males tend to have more of the motor behaviors, motor activity, they get more easily identified, probably at some disservice to the girls, I should point out. And Dr. Quinn could probably tell you about that. DR. PATRICIA QUINN: Absolutely. One of the things we’re finding, with the understanding that there could be an inattentive type of the disorder, where the children or adults are more hypoactive, more inattentive, trying to stay in the background, is that they actually may appear shy and withdrawn. When we started seeing the inattentive type and documenting that and finding it in boys, we found sitting right next to them was a little girl who also had inattentive type ADHD. And they don’t call attention to themselves as the boys do, so people don’t pick it up as readily. That’s why we’re not seeing it. But it certainly does impair their functioning, leading to a lot of self-esteem issues and a lot of more problems. LISA CLARK: Since early intervention is critical with this, as with so many other things—early treatment helps a child learn to adapt to this situation and to be able to learn well and function well—what should parents and teachers be looking for om their child? DR. PETER JENSEN: Well I think the teachers have to be very aware. And they usually are pretty good at this, of finding the children whose hyperactive symptoms or inattentive or distractible symptoms, are interfering with their functioning, actually causing them problems in getting on and getting by. Now if it’s a girl, for example, or even a boy who’s inattentive only, he or shemay not get picked up because he’s not necessarily causing problems. But it may be a problem for that child if he or she isnot doing well in school and is suffering because of peer relationships or has other symptoms as well. And so a high level of awareness or recognition that, in addition to the hyperactive symptoms,we have to be on the look out for some of these other inattentive, less noticeable symptoms. Also parents, if they only have one child, may not have much of a comparison. Teachers have 30 children. And they have a lot of chances for comparison. So sometimes a parent may hear from others, "You know, your son, your daughter, has this or that difficulty." And it may be hard for them to appreciate that early on because they may not see their child in the same setting that others will see their child. And they have lots of other ways of kind of handling it. And they say, "Go out in the yard and play." and that kind of thing. LISA CLARK: Dr. Quinn, do you have any advice for parents on how to distinguish between hyperactive behavior and overactive behavior, that might be age-appropriate? DR. PATRICIA QUINN: A very common question parents usually ask is, "How can I distinguish my child’s behaviors?" And I always try to help them out with the word ’purposeful.’ If a child is playing, he may be very active, or she may be very active playing with their toys, making a lot of noise, running around a lot. But it’s all purposeful behavior. They’re playing appropriately with the toys. A child with ADHD who has trouble paying attention may have trouble also interacting with the toys. And they may pull them apart and take them out of the drawers and onto the floor, whatever. But they don’t play with them for a long period of time, and they don’t engage with the toy. And that makes a difference. LISA CLARK: What does it feel like for the child who has ADHD? What’s going on for them? DR. PATRICIA QUINN: It’s extremely frustrating for them. They feel that they are not as smart as other kids. They feel that they can never do anything right. One of the first things, when I interview older women and we tell them they have this disorder, they say, "You mean I’m not stupid?" They really do feel that they can’t do things that other people can do easily. I had a little three year old boy in my office one day sitting there very cutely, swinging his feet and smiling. And I said, "Why are you here?" And he said, "Because I’m bad." And I said, "Why do you think you’re bad?" And he said, "Well if someone yells at you all day long, you’re bad." So these children get a lot of self-esteem problems. They really can’t get along with other children. They don’t know why they’re always messing up; why they can’t do it the same way other kids can do it. And it leads to a lot of pain, not only in their lives, but in the family. There’s a very high incidence of divorce in families of children with ADHD. 40% of parents have made a job change because their child has ADHD. And there’s a financial burden on the family to have a child with this disorder as well. LISA CLARK: Indeed. I have one last question. If you suspect your child has ADHD, where do you go for help? DR. PETER JENSEN: Well any well-trained pediatrician should be able to make this diagnosis. And that’s not always the case that the doctor you go to is well-trained. So parents need to be educated themselves and on the look out. And if they have concerns, that they’re not quite sure they’ve been fully addressed by whoever they’ve seen, then they should be willing to get a second opinion. But a pediatrician, a trained family practitioner, a psychologist, a psychiatrist, these are people who should be able to make the diagnosis. LISA CLARK: Well, I’d like to thank both of you for being here to discuss this and to give our audience a place to start as they learn more about ADHD. Thank you very much, Dr. Patricia Quinn, Dr. Peter Jensen.
© 2006 Healthology, Inc. ----------
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