ADHD. It’s a term we hear often but do you know what it’s diagnosis actually means or how it affects children and their families across America? According to the CDC’s statistics, Attention Deficit Hyperactivity Disorder (ADHD) affects almost 10% of children ages 3-171. This means for every ten children you know one of them is most likely affected by an ADHD diagnosis. About two-thirds of those with a current diagnosis receive prescriptions for stimulants like Ritalin or Adderall which can drastically improve the lives of those with A.D.H.D. but can also lead to addiction, anxiety and occasionally psychosis2. What is troubling is that many of these kids likely do not have ADHD at all but have fallen victim to America’s disease of over-diagnosis which is running rampant through our school districts and communities. Hope So Bright created it’s “2016 ADHD Awareness Campaign” in order to bring attention to the abundance of ADHD diagnoses in American children and the desperate need for non-pharmaceutical behavioral programs to help children who truly live with ADHD symptoms.
To spotlight the campaign, Hope So Bright has created an elite team of runners, Team I Run 4 Ultra , which will run for ADHD awareness in the 2016 Marathon des Sables (MdS). MdS is a grueling, multi-stage adventure through a formidable landscape in one of the world’s most inhospitable climates, the Sahara desert. The rules require runners to be almost entirely self-sufficient; they must carry with them on their backs everything except water needed to survive. Athletes are given a place in a tent to sleep at night, but all other equipment and food must be carried. We did not pick this race lightly, the struggle families affected by an ADHD diagnosis deserves our full attention and we will need to use all of our resources together to make a difference and finish the race!
Representing Hope So Bright and our noble campaign are five ultra trail marathoners from all over the world to compose Team I Run 4 Ultra :
Marco Olmo (Italy), Harvey Lewis (US), Jason Schlarb (US), Ricardo Mejia Hernandez (Mexico) and Carlos Sa (Portugal). Though it’s a demanding race the equivalent of 5.5 marathons, nothing will prevent our elite team from their global mission: to make a difference for this issue that affects American children and children worldwide.
Respected psychiatrist Dr. Allen Frances is a professor of child psychiatry at Duke University and was chair of the DSM IV (Diagnostic and Statistical Manual of Mental Disorders) task force. The following is from his commentary “Why So Many Epidemics of Childhood Mental Disorder?” published in the 2013 Journal of Developmental and Behavioral Pediatrics:
Since the publication of DSM-IV in 1994, the rates of 3 mental disorders have skyrocketed: attention deficit disorder (ADD) tripled, autism increased by 20-fold, and childhood bipolar disorder by 40-fold. It is no accident that diagnostic inflation has focused on the mental disorders of children and teenagers. These are inherently difficult to diagnose accurately because youngsters have a short track record; are in developmental flux that makes presentations transient and unstable; are sensitive to family, peer, and school stresses; and may be using drugs. If ever diagnosis should be conservative, it should be in kids. Instead, we have experienced an unprecedented diagnostic exuberance encouraged in part by DSM-IV, but mostly stimulated by the powerful external forces of drug company marketing and the close coupling of school services to a diagnosis of mental disorder3.
In response to Frances’ commentary, pediatrician Claudia M. Gold, MD adds that:
The challenge… is to avoid over-diagnosis while at the same time not under-treating those who need help. Most of the children who receive these labels, and their families, are struggling in significant ways. They do need help, and sometimes lots of it. The issue is inextricably linked with the need to “name” the problem, a need comes in part from both clinicians and parents, who may feel more of a sense of control if what they are struggling with has a name, and also insurance companies who require a diagnosis for reimbursement of services. Psychiatric diagnoses in children, by definition, place the problem squarely in the child, when in fact it is almost always more complex than this. Genetic vulnerability and environment both have an important role to play4
“Naming” the problem also makes it far easier for pharmaceutical companies to advertise that their medications are effective treatments for this supposed “epidemic”. Dr. Frances adds that three years after DSM-IV was published, drug companies introduced new and expensive on-patent drugs that provided the incentive and resources for an aggressive marketing campaign to psychiatrists, pediatricians, and family doctors. Simultaneously, successful drug company lobbying gave them unrestricted freedom to advertise directly to consumers. Parents and teachers were inundated with the message that ADD was terribly underdiagnosed and easily treated with a pill. Sales of ADD drugs ballooned to an astounding $7 billion3
The main problem lies with the medication itself — powerful drugs should be used only as a last resort and always in conjunction with behavioral therapy. Historically, however, instead of first offering parents the option of therapies such as ABA (applied behavioral analysis), American doctors have been prescribing powerful, highly addictive antipsychotics and stimulants before trying less-invasive methods. Not only are these drugs highly addictive, they are riddled with negative side effects. Though drug companies have received billion-dollar fines for off-label marketing to kids, the fines pale in comparison to the enormous revenues made from the sale of these drugs.
While pharmaceutical companies have enjoyed profits it is our children who suffer. Of note, the inappropriate use of antipsychotics and stimulants is most pronounced among children who are economically disadvantaged and oftentimes are kids in foster care3. Instead of finding the real reason kids are acting up, an unnecessarily high number of children are being over-medicated. It is part of our awareness campaign to shed light on the serious flaws of this system and to offer a solution.
Applied Behavior Analysis (ABA) is an effective, non-pharmaceutical method proven to make a world of difference for children with ADHD. It uses how an individual child learns to create a custom, systematic teaching strategy rewarded with positive reinforcement to create lasting, meaningful changes in behavior. According to Autism Partnership, a leading authority on ABA:
ABA employs teaching where the objectives of intervention are to teach your child those skills that will facilitate his development and help him achieve the greatest degree of independence and the highest quality of life possible. Although many different techniques comprise ABA the primary instructional method is called Discrete Trial Teaching (DTT). DTT involves breaking a skill into smaller parts, teaching one sub-skill at a time until mastery, allowing repeated practice in a concentrated period of time, providing prompting and fading as necessary and using reinforcement procedures5
Every child with ADHD deserves the chance to learn these skills, don’t you think?
Your support will give us and all the families affected by ADHD the hope we so desperately need. Because A proper non-pharmaceutical treatment program is so rare, funding through traditional sources has been limited which makes your contribution even more important. We hope that you will choose to support Team I Run 4 Ultra in our efforts to allocate proper treatment and to spread awareness for those who live with ADHD.
Founder, Hope So Bright
1Bloom B, Jones LI, Freeman G. (2013). Summary health statistics for U.S. children: National Health Interview Survey, 2012. National Center for Health Statistics. Vital Health Stat 10, 4. Retrieved from http://www.cdc.gov/nchs/data/series/sr_10/sr10_258.pdf
2Schwarz A, Cohen S. (2013, March, 31) A.D.H.D. Seen in 11% of U.S. Children as Diagnoses Rise. New York Times, p. A1. Retrieved from http://www.nytimes.com/2013/04/01/health/more-diagnoses-of-hyperactivity-causing-concern.html?_r=0
3Frances A, Batstra L. (2013) Why So Many Epidemics of Childhood Mental Disorder? Journal of Developmental and Behavioral Pediatrics, 3 (4), 291-292. Retrieved from http://journals.lww.com/jrnldbp/Citation/2013/05000/Why_So_Many_Epidemics_of_Childhood_Mental.12.aspx
4Gold, CM. (2013) Too many Psychiatric Diagnoses for Children: an Epidemic of Labels. Retrieved from https://www.boston.com/lifestyle/health/childinmind/2013/06/too_many_psychiatric_diagnoses.html?utm_campaign=coschedule&utm_source=twitter&utm_medium=hopesobright
5Applied Behavior Analysis (ABA). (2015). Autism Partnership. Retrieved from http://www.autismpartnership.com/applied-behavior-analysis