Tuesday, February 7, 2012

New York Times Article Blames Parents for ADHD

by Ruth Hughes, PhD

A week ago the New York Times published an article by Alan Sroufe, "Ritalin Gone Wrong," that questions the need for medication in the treatment of ADHD. Even worse, the author claims that parents and environmental stressors are the major causative factor in ADHD. A firestorm of reaction, both positive and negative, has uncovered some deep rifts in our public understanding of ADHD. There are those who are jumping on the bandwagon and decrying families that think a pill is all that is necessary to help a child with problems. (I don’t know any families like this, but I’m sure there must be one somewhere.) And there is the ADHD scientific and advocacy community, who are appalled that information so flawed would appear in the New York Times.

While there is much to be upset about in these claims (and I have been very upset!), there are several assertions that are worth recognizing. There are bad parents in the world, people who do not have the skills, the resources, or the will to be good parents. And the impact on their children, who may or may not have ADHD, is usually negative. Helping these children is one of the major challenges of our society.

I also agree that pills alone rarely are sufficient treatment for ADHD. As the mother of a now-adult son with ADHD, it took a lot more than medication to help him become a productive adult. CHADD always encourages a combination of treatment, parent training and support, school support, and behavioral interventions for any child with ADHD. Medication can help a child focus and be more amenable to learning, but the skills and external supports also need to be put in place.

What is most troubling (and enraging) about this article is that we are back in the dark ages, blaming parents, particularly mothers, for a child’s ADHD. In the article’s most egregious example the author, Alan Sroufe, claims that along with other stressors, ADHD is caused by “patterns of parental intrusiveness that involve stimulation for which the baby is not prepared. For example, a 6-month-old baby is playing, and the parent picks it up quickly from behind and plunges it in the bath. Or a 3-year-old is becoming frustrated in solving a problem, and a parent taunts or ridicules. Such practices excessively stimulate and also compromise the child’s developing capacity for self-regulation.” Excuse me! Does Dr. Sroufe or anyone with a fundamental knowledge of ADHD really believe such nonsense? There is no scientific basis for his claim of “parental intrusiveness” as a factor in the development of ADHD. He is espousing theories that are now decades old and have long since been debunked and surpassed by our research on this disorder.

What is most disturbing, though, is how many people want to believe that it is Mom’s fault. Not so long ago we blamed depression, autism, schizophrenia, and many other mental disorders on parenting. We now know that there are genetic and neurological causes for these disorders just as we know there are genetic and neurological factors in ADHD. Only if we confront this stigmatization and discrimination whenever we see it or hear it, will it disappear once and for all from our culture. Every one of us must confront these beliefs, if we are to set this to rest once and for all. Speak up and speak out. Do not let these beliefs continue to flourish.

CHADD and a number of other ADHD experts responded to the Times article, pointing out the inaccuracies and errors, and countering the claims made by Dr. Sroufe. While they take many different approaches to confronting these issues, all provide great information.

CHADD’s Letter to the Editor of the New York Times

Dr. Edward Hallowell, Response to NY Times Piece “Ritalin Gone Wrong”

Dr. Harold Koplewicz, “Righting the Record on Ritalin”

Time Magazine Columnist Judith Warner, “ADHD: Is Stigma Back in Style?”

In addition, Dr. Max Wiznitzer from CHADD’s Professional Advisory Board has submitted an article to the New York Times as a counter to the article by Dr. Sroufe. We are waiting to hear if it will be published, but will share with all of you in the near future.


Ruth Hughes, PhD, is the CEO of CHADD.

19 comments:

Anonymous said...

What also must be asked, & answered, with any opinion piece is, "Why is this person writing this & why now?" Does he have a book to promote? Is legislation coming up in Congress? Is it an election year? Does the author have ties to an organization or company that stands to benefit if his argument is convincing enough? Also, might someone or some organization be footing the bill to get this info out there? All tough questions that many news outlets have neither the $$, staff or time to investigate; therefore it's easier & cheaper to just run free, spoon-fed copy without question. I am a newspaper editor & I see this happen all the time.

Anonymous said...

I read the article as well and was appalled. Lots of jumping to conclusions without even citing sources or studies. I have been living with a brilliant but very hyperactive adhd child for 16 years and could not believe the New York Times would publish such garbage. ADHD medicines are a very necessary for many children and they should not be stigmatized for needeing them. They are medically necessary and very effective. Study after study proves that they work and that for therapies to be effective the medicine needs to be used in conjunction with them. Mild ADHD should not be confused with moderate to severe cases. Without the medication many children would not be able to attend school. My son is now an A student. Without the meds he would not even have learned to read. Used under the supervision of a trained physician they are brilliant and a lifesaver. Shame on the New York Times.

Anonymous said...

This is disturbing comment and wrong information. I want that doctor to come my home and see my 4 children wich only one of them has ADHD. Does that mean my wife or I didn't provide good parenting to only one son. I believe he needs good education and do more research about ADHD.

Maureen Hopkins M.S. said...

CHADD blog

I was 'assured' by a physician in 2002 that ritalin would not stunt my son's growth. "He will catch up if you give him a medication break over the summer, " said he. Well, I'll never know if it did or not but imagine how I feel now. My pharmacist told me , “these drugs work for a while and then you have to up the dosage.” Ideally, they should be used in conjunction with therapy and/or a supportive home and school environment. My son says the worst thing about being an ADD kid was having his peers and teachers think something was wrong with him. He hated that trip to the nurse for his afternoon meds. He hated it even more than being called a dumb ass. We need to start listening to the kids rather than the pharmaceutical companies and psychology professors such as L.Alan Sroufe. I have much to be angry about how my son was treated in the early years of his education. They basically wrote him off but he is now in college. None of this upset me as much as the provincial opinion of Sroufe that ADD is probably not genetic but due to the child's environment. Probably? Huh? BTW, teenagers tell me pot works about as well as ritalin if not better and that's their opinion. Just don't tell the pharmaceutical companies or the flawed parents of children with Attentional differences.

Maureen Hopkins said...

I was 'assured' by a physician in 2002 that ritalin would not stunt my son's growth. "He will catch up if you give him a medication break over the summer, " said he. Well, I'll never know if it did or not but imagine how I feel now. My pharmacist told me , “these drugs work for a while and then you have to up the dosage.” Ideally, they should be used in conjunction with therapy and/or a supportive home and school environment. My son says the worst thing about being an ADD kid was having his peers and teachers think something was wrong with him. He hated that trip to the nurse for his afternoon meds. He hated it even more than being called a dumb ass. We need to start listening to the kids rather than the pharmaceutical companies and psychology professors such as L.Alan Sroufe. I have much to be angry about how my son was treated in the early years of his education. They basically wrote him off but he is now in college. None of this upset me as much as the provincial opinion of Sroufe that ADD is probably not genetic but due to the child's environment. Probably? Huh? BTW, teenagers tell me pot works about as well as ritalin if not better and that's their opinion. Just don't tell the pharmaceutical companies or the flawed parents of children with Attentional differences.

Anonymous said...

Wow! Shame on the New York Times is Right. I have 2 boys with ADHD ages 9 and 11. I am tired of being told that all their problems are "My" fault as their Mother. It was bad enough that I got divorced, partially because my former husband and I didn't see eye to eye on these issues. He still will not let me medicate them and they are both struggling in school and one of them is very depressed. Society should support those of us struggling to get through everyday with these children. I believe that research over time will find that ADHD, Asberger's, Autism, and Alzheimer's are all related. There is definitely a genetic component, exacerbated by our fast pace, fast food, pesticides and colored dyes which make the symptoms worse. But, I have no proof, and I have not been involved in a study....But, maybe youi should post my article in the New York Times. -Mother from RI

Penny Williams said...

Not only should we be upset with Dr. Stroufe, but we should also be outraged that the NY Times chose to publish this piece. They knew that the opinions in this article were on the fringe, but they chose to run it because it would get noticed and cause an uproar. The purpose of the newspaper should be to inform, using facts, not to spread untruths for reaction, like a smutty daytime talk show. This was sensationalist journalism and it is irresponsible. They last thing the ADHD community needs is inflammation of the public stigma/ignorance of ADHD. Shame on the NYT.

Penny
http://aMomsViewOfADHD.com

Anonymous said...

I challenge the author of that article to spend the day walking in the shoes of any parent who has one of these brilliant, hyperactive children! My guess is that they would not make it through the day. I am sorry that some people out there still think that ADHD is just a problem with the parents-how misguided and wrong they are. We as parents know what amazing things our children are capable of when medication and guidance are used together to allow the best to come out!

Anonymous said...

This is an absurd article, which has clearly been written by an individual who knows little to nothing of the true affects of ADHD on a child and his/her caretakers/parents. To place blame on a parent for the child's medical needs is absolutely ignorance clearly earmarked at the highest level. For those of us parents/caretakers who live with this day in and day out - kudos to us! We are helping our children learn to survive in what is a backwards society at understanding this disorder, not to mention, providing enough alternative teaching methods for the millions of children sufferring through this. So to those that fight this war on ADHD with the naysayers of an ignorant planet vs those who live on the real planet -- keep fighting...this is your child's future we're talking about! I know I am!

Anonymous said...

The misconception of ADHD and a parent's choice to give the child medication is still amazingly spread. I know I had to be down on my knees, crying and really being desperate before I made the decision to give my son Ritalin. It is not an easy decision for most of us and I still have to find the mother who doesn't secretly fight with blaming herself for her child's ADHD. Even though I now know that I didn't "do" anything, I know I had a hard time getting over blaming me for giving these genes on.
Putting more pressure and blame on the mother is the last thing we need.
Why can't we just work together without trying to promote some political cause. It would make things a lot easier if we all just kept the goal in sight.

educator said...

I am a tutor, and many of the children who are misdiagnosed with ADHD are hands on learners, and very active children. When our society was mostly farmers and ranchers, these children were highly valued. But now that we have become more sedimentary, they are treated as if there is something wrong with them.

It is not the child that is lacking, it is the way they are taught that is lacking. I change my style to fit the child's needs, and these children do just fine with me...no drugs needed.

Anonymous said...

I believe it all makes sense. We need to have an open mind and realize medication is only masking the problem. Go to the source of the issue. By giving meds to my child, I agree that it is stating, you want your kids to be something they are not. I don't want to alter my children’s personality for something that is a short term fix and that their bodies will become dependent on. The organs cannot take it. How do I not know this isn’t caused by a intrusive controlling behavior? Should we dig deep to understand this? We all feed off of energy and what is projected. Are we afraid to look at ourselves and are we so used to blaming other things for our shortcomings or genetics? I try my best to practice what I preach and manage through diet and a reward system. It’s not easy and I don't expect it to be. I hope that my kids will appreciate it later.

Dr Charles Parker said...

An additional important point for any informed consumer: How can anyone find clinical objectivity when the person writing demonstrates absolutely no clinical experience with stimulant meds... except to read reports. This is the second time quite recently [On antidepressants] when NYT editors took it upon themselves to bring attention to good PhD credentials and *no clinical/medical experience.* As I mentioned in the interview with Marianne Russo at this Coffee Klatch interview:

It's like asking a jockey to comment in depth on football. It's not their game.

http://www.blogtalkradio.com/thecoffeeklatch/2012/02/09/ny-times--ritalin-gone-wrong

> Reading a few papers and gossiping with your colleagues at the water cooler simply does not cut into the available, exceedingly well documented ADHD science, and provides no clinical experience wiht the realities in question.

No long term studies on stimulant meds? I rounded up 5 in about 5 min.

NYT editors: One gaff is too many, two should provide sufficient embarrassment to correct your "expert" selection process. Lives are at stake, both ADHD and depression create immeasurable pain and failure in too many lives to sleep on these blunders.

cp

CHADD of Grand Rapids said...

Maureen is worried that meds may have stunted her son's growth and that the shame and stigma her son experienced, due to having to take medicine at school, caused him more harm than benefit.

For some reason, it appears that the doctor was trying to come up with some rationale, however baseless, to justify this past year’s Adderall’s shortage. Hmmm... Now, why would that be?

In the process, he has once again stirred up the disinformation campaign that adds to parents' anguish, self doubt, grief, feelings of inadequacy, isolation, guilt, and fear about an otherwise effectively and safely treatable disorder, even years later. BTW, my son has been on substantial doses of stimulants since age four, is over 190 pounds, 6 feet tall, is still taking stimulants, and claims he's "swimmin'in women!" 'Great to hear yours is in college, Maureen!

2eMom said...

"CHADD always encourages a combination of treatment, parent training and support, school support, and behavioral interventions for any child with ADHD."

I attended a CHADD national conference four years ago. I have a profoundly gifted/ADD child. I didn't necessarily feel I had CHADD's support.

How could I say this, you wonder? The ENTIRE conference was all about helping children, parents and educators! But you didn't address the needs of twice exceptional learners.

For starters, look at what you advocate. Medication and all the rest. No matter how you spin, there's a lot of pressure to medicate. You may say not really, we even had an alternative therapy fair. But there's a lot of pressure foisted on parents who are queasy about medication.

We medicated. I never liked it. I never got support for that reluctance. Make no mistake about it. Medication is front and center.

Now I'll address the rest of your interventions. You automatically assume parents have the resources to go after all the rest, everything you recommend in addition to meds. Because if you're child is gifted and you don't have the money or time to pursue all the rest, you're out of luck. If our kids are being inundated with homework and no accommodations, where do you find the time to drag them to all the therapies you recommend?

And again, the emphasis is still on the medication. It's often the first resort, not the last.

Now I'll get to my most important point, school cooperation. I sat at your conference, heard the recommendations you suggest, and thought, what planet are you on? Parents of gifted children will tell you there's often no school support. Or scant, spotty and inconsistent.

We are still stuck in an outdated mode that says that your child gets help if he or she is functioning BELOW grade level. Or failing. What do you do with a child who is several grades ahead? We've known since the 1980's that giftedness can co-exist with ADD. But this is a point we parents have a very difficult time driving home.

We entered the public school system when my daughter was in 5th grade. We scheduled a 504 meeting. The school psychologist put an arm on my shoulder and said, "Mom, you need to get used to B's. What is so terrible about B's?" "Nothing," I shot back. "It's not about the grade. If it was up to me, there'd be no grades in elementary. It's about a child who is doing A quality work and turning everything in a day late."

"It's a gifted program," the psychologist countered. "She can't be A in everything." He didn't hear me. She was denied accommodations.

You know what happens to these kids. It's not the A. It's the assault on their ego, their self esteem, their self worth. They work like a dog, it's a masterpiece and it's a C because it came in two days late. Their needs are not met, they don't get the accommodations and school doesn't wake up until they are failing. By then, much damage has been done and they often collapse when they get to college.

Oh, wait. I started off with medication. When you medicate and tell the school, there's a collective sigh of relief. Oh, good, now we don't have to do a thing.

Anonymous said...

Is anyone really surprised by an article like this in the New York Times? They've been publishing garbage articles for years now, apparently no longer seeing a need to cite references since they aren't actually reporting facts.

Thrive Center Columbia, Md said...

Ignorance Hurts: Ritalin Critics Mislead the Public on Effective ADHD Treatment

Richard Silver, M.D., Psychiatrist
Anita Bajaj, M.D., Child/Adolescent

Samantha L. Marks, M.S., Psychology Associate
Ellen Kaplan, M.Ed., Executive Function Coach

With the recent shortages of stimulant meds for ADHD, it’s easy for everyone to start pointing fingers at doctors, pharmaceutical companies, and even the government for having created the overreliance on medications to treat ADHD. Blaming parents, however, as L. Alan Sroufe did this last week in the New York Times, is neither accurate nor productive.

Parents struggle every day with knowing what to do with their children with ADHD, and when Sroufe makes a statement such as “ADD behavior problems in children have many possible sources…especially patterns of parental intrusiveness” he sets us back to the days when Bruno Bettleheim blamed mothers for creating their childrens’ Autism.

Suggesting eliminating medication such as Ritalin cheats parents and children of a key tool in the comprehensive ADHD toolbox. Anita Bajaj, M.D., Child and Adolescent Psychiatrist, says that “since we know that ADHD medications work well in the short-term, we can catch potential problems early in life and modify them, with a powerful impact in the long run. Early treatment reduces ADHD-related risks such as poor academic performance, low self-esteem, social problems and poor decision making, which might result in troubled relationships and increased substance abuse.
So even if what Sroufe suggests about Ritalin merits some consideration -- that it only provides short-term relief – the medication still allows children immediate relief from symptoms, and lets parents and providers put into place a comprehensive plan for long-term treatment of ADHD symptoms.

The best treatment for ADHD involves a multi-disciplinary team of psychiatrists, psychologists, executive function coaches, parents, and teachers. Psychiatrists will evaluate the child’s symptoms and decide if a medication could provide some improved attention and concentration, and diminish impulsiveness and hyperactivity. The psychologist, or other mental health professional, will assess if there are underlying related or co-existing conditions, such as anxiety, depression, or social problems that are complicating or exacerbating the ADHD.

The mental health professional will also work with the parents to establish a behavioral plan for the home, which includes improving organization and chores, managing outbursts and inappropriate behaviors, and improving family communication.

Executive function coaches, or professionals with specific training in Executive Function Disorders (EFD) such as ADHD, are also crucial to treating the child with ADHD. EFD is a specific weakness in the frontal lobe impacting the ability to focus, plan and act in a goal directed manner. Often EFD impacts a child’s educational and social development, warranting additional supports in organization, time management, and study skills. The executive function coach is a certified individual who helps children and adults manage these cognitive and behavioral challenges.
Until we know more information in order to expand our ADHD treatment toolbox, we cannot eliminate even one important tool such as a medication like Ritalin.

Parents should seek out information on medication options for ADHD, as well as EF coaching, and other psychological and behavioral therapies. This comprehensive approach helps children, adolescents and young adults address issues of ADHD and thrive most effectively.

Rose Cohen, Director
410-740-3240
www.myThrive.net

SOverly said...

Though environmental stressors can trigger ADHD episodes or possibly make the symptoms more dominant, they are not to blame for the disorder. I get very upset when I hear that people blame parenting for ADHD or when they say it is lack of discipline! ADHD is a proven mental disorder where the neurotransmitters and brain activity are very different from those without ADHD, so how does a parent cause that? ADHD has been researched and documented since the early 1900's and still people want to insist that it is not real or is an excuse for bad parenting, it really upsets me. In my opinion, ADHD is not widely recognized and accepted as a real disorder and I believe that is due to lack of education on ADHD and that the awareness of ADHD needs to be spread and understood. Leaving ADHD untreated can have severe negative impacts on the child for the rest of his/her life! That's why i have created a blog all about Child ADHD facts, my stories with my ADHD sons and different treatments for ADHD to get children and parents to better understand ADHD and get the children the best treatment available for their symptoms. http://www.childadhdinfo.blogspot.com.

lumin smith said...

Running or climbing excessively when it's inappropriate (in teens this may appear as restlessness) is one of the symptoms of Adhd.
Adhd Symptoms