Talk:Attention deficit hyperactivity disorder

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archived discussion

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Feature Article?

I think this article has FA potential. Anybody else? *Kat* 03:45, 8 May 2006 (UTC)

You know, I think it does have FA potential, if only because it is so representative of ADHD. If you really want to know what its like to to have ADHD, read the whole thing (I don't think I got past the second paragraph) or read the talk page :) (Patrick 15:57, 17 May 2006 (UTC))

I agree. This and related articles such as Anti-ADHD and Methylphenidate are just a jumble of competing ideas. There are sentences that have been edited so much that they are either self-contradictory or meaningless. There are also far too many unsubstantiated, vague and sweeping claims. Trying to sort it out would be a thankless waste of time because whatever good was been done would be undone within days by the same people who created the current mess.

To get a clearer picture of why this is going on it is worth reading Andrew Lakoff. Not only does he provide a well researched history of ADHD but he provides one of the few reasoned arguments for why people hold such strong views about it.

There is much valuable and reliable information in Wikipedia. Attention-deficit hyperactivity disorder would make a good feature article to warn people of what can go wrong.IanWillsIanWills

Amen Classification System / Should not be a FA

I'm afraid that I can't agree that this article should be nominated for a Featured Article in its current form.

In the Diagnosis section it currently reads that: "In recent times the Amen classification has subclassified the DSM-IV classification and this led to improved diagnostic accuracy, which leads to better selection of medication and treatment. In nearly all developed nations (including the US and UK), doctors are required to conduct a SPECT scan in order to correctly treat the brain's chemical deficiencies. Without this scan, incorrect treatment can do damage to the brain." At the very least this needs citation as the DSM-IV is, to my knowledge, the guide most widely used for psychatric treatment by U.S. doctors.

It also turns out that under the Testing for ADHD - Other Forms of Testing section the article currently reads that "Neurometrics, PET scans, FMRI, or SPECT scans have been used to provide a more objective diagnosis. These are not typically suitable for very young children, and may unnecessarily expose the patient to harmful radiation. Because the etiology of the disorder is unknown, and a complete neurological definition of this disorder is lacking, a majority of clinicians doubt the current predictive power of these objective tests to detect ADHD to be used to direct clinical treatment. Currently, the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry recommend against using these neuro-imaging methods for clinical diagnosis of individuals who may have ADHD...An October 2005 meta-analysis by Alan Zametkin, M.D., with the NIMH entitled "The ADHD Report", concluded that these diagnostic methods lack adequate scientific research on accuracy and specificity to be used as a primary diagnostic tool." These statements are cited and directly contradict those in the Diagnosis section mentioned.

What little research I've done leads me to believe that the Amen system does not belong under the diagnosis section as its reliability has not been scientifically proven. If it is kept it in the article, I recommend that it be moved from the Diagnosis section to either the Other Forms of Testing or Alternative Treatments section.

Finally, I feel it is relevant to mention that Dr. Daniel Amen [1] has set up a set of clinics using his methods, which currently charge $3,250 for a comprehensive evaluation.[2]

Some basic research should be done before leading everyone to believe that the Amen system is widely accepted in the medical community.

Thank you. --JoeCollege 06:06, 11 May 2006 (UTC)

Reorganize

I know that it's probably not reasonable to expect this article to be structured or organized in a meaningful way; if you just skim over the headings it's obvious that this is the product of the collective efforts of a large number of people with ADHD. I know we can't organize things, so maybe someone who doesn't have ADHD could come up with a new structure for the article (detailed), and the community can then submit the information. I can't think of anything else right now to improve this; the article is becoming way too long, not to mention the talk page. Does anyone have any other suggestions on how we can bring order to this? (Patrick 16:17, 14 May 2006 (UTC))

I'm sure it wasn't your intention, but please don't be insulting. It's not appropriate to imply that ADHD sufferers are incapable or incompetent as Wikipedia editors, or that editing should be restricted to those without the condition. Wikipedia is the free encyclopedia that anyone can edit, remember. Best wishes, Kasreyn 20:13, 14 May 2006 (UTC)

You got me wrong, I'm not saying that people with ADHD are incompetent, I would be insulting myself! I realize that there are some things that I have difficulty with as a person who has ADHD, such as time management, organization, data management, etc, so I cope with those difficulties by joining forces with others who happen to be extremely organized, for example; that way, the aspects of my personality that need improvement don't inhibit my most appreciated features. Therefore I am suggesting that contributors with ADHD join forces with others in the same way. (Patrick 13:05, 15 May 2006 (UTC))

Hmm, I see. Personally, my opinion of those editors I've seen who have ADHD is that they tend to make quite good editors. ADHD is primarily a difference in the quantity of things one's attention focuses on, and the degree. A distributed project such as Wikipedia is excellent at including both those who excel best at focusing on a sole article, and those whose preferred focus is to watch many articles and tweak in small ways. That's what I love about this project: as long as someone is willing to be civil and take constructive criticism well, they can always find some way to help here.  :) Kasreyn 11:08, 16 May 2006 (UTC)

I took a machette to this article a little over a year ago. Can't believe that it has gotten so messy again! I think still think it has FA potential, but I gotta agree, now is not the time. Maybe I'll clean it up again this summer. --*Kat* 08:16, 16 May 2006 (UTC)

Hey, I'm glad someone agrees that the article requires cleaning, it's not meant as an insult, look at my user page; I do agree is Kaseryn that ADHD people combined probably have the largest number of edits on Wikipedia. This site is like a playground for peole like us, there is always something new to read or some project to start. Granted, I can say I haven't finished very many projects but I've started a lot, even in the last two weeks alone. This isn't necessarily a bad thing, I happen to know things about a lot of different topics that other people have never heard of, especially things that I'm currently interested in. Cleaning up this article is an enormous task, especially if it is done in a manner that keeps it from getting messy again. It will take the combined effort of many to accomplish this. We should start by archiving some of the stuff on the talk page so we have some room to talk, this is insanely long; secondly, we should look through the article and find items that can be moved to different articles, as well as things that are not relevant.(Patrick 17:44, 16 May 2006 (UTC))

Comparative Behavior

"teenage pregnancy (30–35%)" If the section is stating that the proportion of people with ADHD are involved in a teenage pregnancy 30-35% more than those without ADHD (as in if 3% of teens are involved in a pregnancy 38% of teens with ADHD are involved in a pregnancy), then that is simple not true. If the section is claiming that people with ADHD are 30-35% more likely than people without ADHD to be involved in a teenage pregnancy then that is an extremely misleading statistic, probably making a difference of only 1% more teen pregnancies. William conway bcc 20:05, 14 May 2006 (UTC)

The data is certainly questionable, but it leads to an interesting obvservation: if ADHD is indeed inheritable and if the statistic is in fact accurate, then, in a few generations, we can expect the vast majority of people to have ADHD, because of the increased number of offspring from parents with ADHD. Even if the statistic is grossly overestimated and only lies at 1% of (unwanted) pregnancies above the norm, as you suggested, we can still expect to see the vast majority of pepole to have ADHD several generations in the future. Therefore if there are any more pregnancies from ADHD parents, compared to non-ADHD parents, almost everyone will eventually have ADHD. Therefore, the "disorder", or whatever it will be classified as, will effectively disappear, and people who don't have the ADHD gene will probably undergo some sort of treatment to compensate for their "difficulty to multitask" or perhaps "obsessive behavior", "over-organization", "rigid personality", "lack of spontaneity", etc. (Patrick 13:17, 15 May 2006 (UTC))

An interesting speculation, but it doesn't hold up. For one thing, even if ADHD sufferers account for an increasingly larger slice of the teenage-parent pie, that says nothing about the much larger portion of society who do not have teen pregnancies, nor about the established fact that the children of teenaged parents have statistically lower life expectancy (due to poor parenting and poverty, typically). A combination of distinct minority status and relatively lower life expectancy do not seem to indicate a trait that is going to make much headway in the gene pool. This is only addressing our culture, as well; there are still many cultures in the world where teen marriage and pregnancy is common or the norm, in which case ADHD won't make a noticeable difference. Kasreyn 04:25, 16 May 2006 (UTC)

I see what you mean; it's one thing that there may be an increased number of teen pregnancies among ADHD teens, however, most people carry ADHD into adulthood; there is no cure and it doesn't just go away by itself. If you're going forget to use protection, or simply choose not to use it, and believe me, this is far more likely to happen to people with ADHD (see impulsivity, forgetfulness, etc) this behavior will likely continue into adulthood. What makes matters worse, from an evolutionary standpoint, is that ADHD people tend to associate with other ADHD people; therefore this can really lead to an ADHD "epidemic" generations down the line, even if it is just because ADHD people have a tendency to find each other, even in adulthood.(Patrick 17:54, 16 May 2006 (UTC))

First of all the point you made about the spreading of an epidemic is flawed. If any of the statistics about ADHD are true then yes people with ADHD would have a higher birth rate. BUT if any of the other statistics about higher rates of STDs and job related injuries are true then people with ADHD would also die quicker, which would cancel out the higher birth rate. Secondly, this article states that 30% to 70% of those with ADHD continue to have the disorder in adulthood, which is not necessarily a majority. Third, this complete section, and ALL of its information, is unreliable as it has not been cited. William conway bcc 20:13, 19 May 2006 (UTC)

This section of the article has not been cited. Requests for citations were made on May 12, 2006. How much longer should the uncited material be left on the page? I personally feel it should be left for one more week, (until May 26th) and then deleted if it cannot be cited. William conway bcc 20:13, 19 May 2006 (UTC)

Spring Cleaning by *Kat*

A little bit late, but then I am a procrastinator.  ;-)

Removals/Explanations

It is important to understand that a diagnosis of ADD or ADHD or variants is made by a subjective evaluation by a mental health professional. There is currently no clinical diagnostic test for the disorder, although a gene has been discovered that may cause ADHD in humans as well as chimpanzees and gorillas. Furthermore, the symptoms of these disorders can be attributed to a variety of other facters. Some believe that the diagnosis is used to label behavior problems rather than identifying the actual disorder.

This paragraph was removed from the intro section because it is contradictory and does not add anything to the introduction.

This is often combined with problems inhibiting responding to distracting events that often draw the person off-task. Those with ADHD also have difficulties re-engaging the previous task once they have been distracted. The hyperactivity is typically most evident in early to middle childhood and declines significantly with age. By adulthood, it is most evident in a feeling of restlessness or inner or subjective hyperactivity as well as a need to be busy or engaged in physical activities. The impulsiveness or poor inhibition persists throughout childhood into adulthood and may be manifest verbally (excessive talking, interrupting others, blurting out answers before questions are finished, saying what's on your mind without regard to its consequences, etc.) or physically, as in doing things on impulse or a dare. Those with ADHD are often more involved in risk-taking activities and, as a consequence, suffer 2–4 times the rate of accidental injuries as do unaffected children or adults. A newly identified subset of children now classified as having ADHD are called the Predominantly Inattentive Type and may often appear to be day dreamy, spacey, confused, in a fog, staring frequently, slow moving, sluggish and hypo-active. Researchers call these children Sluggish Cognitive Tempo but this is not a commonly used diagnostic label. Some reserve the term ADD for those with Predominantly Inattentive Type due to the lack of hyperactivity in these individuals.

I've attempted to boil this paragraph down to its bare essentials. I'm sure I think that some the details given above will need to be reincorporated, but that is a decision that I want to put off until later.

From Causes

It has been demonstrated that children who have at least one parent diagnosed with ADHD are more likely to be diagnosed with ADHD. Studies show that a parent with ADHD is eight times more likely to have a child with ADHD than a parent who does not. A child with ADHD is seven times more likely to have a sibling with the disorder than a child who does not have ADHD. The concordance between identical twins if one has the disorder is 78%.<>

No where to put it

In studies that used both teachers and parents in the United States, Canada and Australia the difference has been significant. For example, one of these studies (Wolraich, 2004) found American teachers identified ADHD in 25.5% of a group of 6,171 children but parents identified it in only 7.8%.

Careful assessment must include indices of IQ scores and adaptive functioning screens. This is essential since many children and adolescents are incorrectly diagnosed as having ADHD or ADD when, in fact, their principal problems are a direct result of Borderline Intellectual Functioning (IQ 70-85) and impaired adaptive skills. Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 8th Ed., 2005, devotes Chapter 26.3 to a detailed review with clinical illustrations and proposed treatments (Ninivaggi 1999, 2005).This precludes the use of psychostimulant medications, which often complicate the clinical presentation.

Again, I've attempted to boil this down into something that says essentially the same thing in fewer (and shorter) words.

Pycnogenol

Pycnogenol, a flavinoid extract of pine tree bark with potent antioxidant activity has anecdotally been reported to have a beneficial effect on attention span in children with ADHD. Experimental tests, while not ruling out a possible effect, have been inconsistent.

This article is too long already, and this bit isn't very significant, so I'm cutting it.

The Institutes for The Achievement of Human Potential

Established in 1955, IAHP is a non-profit organization dedicated to improving the health and development of children who have some form of brain injury, including children diagnosed with Attention-deficit hyperactivity disorder. The IAHP claims that with a home program consisting of a healthy diet, clean air, and respiratory programs many of these children can be well without the need for medication. The IAHP publishes the results of its treatment for over 1700 children on its website. (IAHP website[3].

Sounds too much like an advertisement for me to want to keep it.

(From Cerebellar Stimulation)

Moreover, independent research that is currently under way on the DORE program, yielded only suggestive results that the method works. However, more research is necessary in order to prove the validity of this alternative treatment. As Dr. Hallowell states in Delivered from Distraction, “we must remain critical, even sceptical, until we have a full body of research to give us a definite answer”(p.238)

Again, thinly veiled advert.

(Under Nuerofeedback)

While many papers have been published, they have fallen short of scientific standards. Only two studies have used randomized assignment to treatment and placebo groups and neither found significant results from this treatment

Nothing wrong with it, but I think this is information that would be better placed in the Nuerofeedback article.

From Positive Aspects

Some argue that ADHD does not necessarily slow down a person's learning process. However, all longitudinal studies of ADHD children followed to adulthood find them, on the aggregate, to be significantly less educated than control groups of children followed over the same period of time, (see Weiss and Hechtman, 1993, Hyperactive Children Grown Up, new York: Guilford, guilford.com). Some argue this is due to an educational system which focus on organization and long lectures that handicap ADHD individuals, which may lead one with ADHD to receive less formal education despite possessing high intellect. Clearly certain individuals have benefited greatly from ADHD. Michael Flatley, originator of Riverdance, was diagnosed with ADHD during his childhood in Chicago. He was also a golden glove boxer. He has also repeatedly walked out on situations where people in charge tried to tell him what to do.

To see ADHD positively may seem somewhat problematic to anxious parents but it is at least a perspective that should be kept in mind. With or without hyperfocus, a common manifestation, ADD/ADHD in combination with successful coping skills may be utilized to achieve remarkable accomplishments in some people. Of course, favorable socioeconomic conditions and the home environment play key roles.

Kind of useless and redundant.

Famous people and ADHD

Among the individuals often listed is comedian Robin Williams, whose spontaneous humor, hyperactive manner, and other noted behavior (not all constructive) have combined to earn the him the label "Poster child for AD(H)D." Notwithstanding inspirational value, cited by critics is the fact that Williams' personal medical records are not public information, so including him and many others found on such lists falls below reasonable criteria for validity. (More to the point, the public behavior of Robin Williams does not resemble ADHD. The pressured speech, punning, and flight of ideas found in mania are a closer fit, but the above considerations apply.)

Ozzy Osbourne has said he has been diagnosed as having ADD and dyslexia

There were two paragraphs in this section. I took one and moved it into "positive aspects" and this is the other. I'd like to keep it cut because there are no citations, its not encyclopedic, and there is already an article dedicated to this anyway

Sources removed

Supplementation with flax oil and vitamin C improves the outcome of Attention Deficit Hyperactivity Disorder (ADHD). Prostaglandins Leukot Essent Fatty Acids. 2006 Jan;74(1):17-21. Epub 2005 Nov 28.

Singh M (2005). Essential fatty acids, DHA and human brain. Indian J Pediatr. 2005 Mar;72(3):239-42.

Pine DS, Klein RG, Lindy DC, Marshall RD. (1993) Attention-deficit hyperactivity disorder and comorbid psychosis: a review and two clinical presentations. Journal of Clinical Psychiatry, 54 (4), 140-5.

Pine DS, Klein RG, Lindy DC, Marshall RD. (1993) Attention-deficit hyperactivity disorder and comorbid psychosis: a review and two clinical presentations. Journal of Clinical Psychiatry, 54 (4), 140-5.

Kept, but...

Computerized tests

Computerized tests of attention are not especially helpful in providing a further independent assessment because they have a high rate of false negatives (real cases of ADHD can pass the tests in 35% or more of cases), they do not correlate well with actual behavioral problems at home or school, and are not especially helpful in determining treatments. Both the American Academy of Pediatrics and American Academy of Child and Adolescent Psychiatry have recommended against the use of such computerized tests for now in view of their lack of appropriate scientific validation as diagnostic tools. In the USA, the process of obtaining referrals for such assessments is being promoted vigorously by the President's New Freedom Commission on Mental Health.

I'm keeping this paragraph for now, but we need some examples and citations.

Not Sure

Under Incidence

Not sure what I want to do with this yet, so I'm sticking it here until I decide. Most Some of this will might be reincorporated in some form.

Some experts theorize that ADHD is under-diagnosed in girls, since their symptoms tend to be less dramatic than those in boys and thus draw less attention from parents and teachers. This may be due to a lower likelihood of aggressive and antisocial behavior in girls and possibly a higher incidence of the inattentive type of ADHD among girls. Even girls with hyperactivity, however, are under-detected because their hyperactivity might manifest in non-physical ways, such as excessive talking.

Others (e.g. Singh ) explain the difference as being due to a lower tolerance of the normal range of boys' behavior that has developed in the past fifty years. That is, they claim that many boys are diagnosed with ADHD who do not, in fact, meet the diagnostic criteria but have attracted attention for other reasons. More rigorous diagnosis would lower the incidence in boys to that of girls.

Speculation exists to explain the higher diagnostic quota in the U.S. One theory suggests that due to the high-risk traits of ADHD-affected people, it can be suggested that there was a higher prevalence for ADHD in the immigrants heading for America in former centuries than in the general population. No evidence exists at the moment to support such a popular idea. And it is becoming increasingly evident that ADHD can be found in equally high rates of countries with far less migratory patterns, such as in Japan and China.

Another explanation put forward by the United Nations International Narcotics Control Board is that the increased incidence in the U.S. can, in part, be explained by the fact that the U.S. permits direct marketing of ADHD drugs to the general public whereas most other countries do not.

It is also possible that social and other factors may underlie ethnic and gender differences. For example, obstacles to ADHD treatment are higher in the African-American and female populations. Cultural factors also inhibit treatment being sought.

Since most explanations of the disorder are expressed in biological terms (see #Possible causes) the incidence should not vary between communities or countries when adjusted for possible factors such as smoking during pregnancy. However some research has, found that such differences do exist. Jensen et al studied children in four U.S. communities finding that only 12.5% of children diagnosed with ADHD had been treated with stimulants but that the incidence of diagnosis, while averaging 5.1% (roughly the DSM-IV prediction) varied from 9.4% in Atlanta, Georgia to 1.6% in Puerto Rico. They also found that the incidence was higher in urban than rural communities and higher in more affluent than less affluent.

Yet another theory, links the statistical difference mainly to a higher problem awareness and competence in the U.S. due to the longer research and public acquaintance with ADHD. Although all of these theories have some support, many are debated. At present most research focuses on broadly medical issues with very little probing possible social and economic explanations of the observed differences.

Recommendations

• We need to broaden the data given the Incidence section. Right now it is very US-centric. We should incorporate facts and figures from other countries such as Japan, Australia, and Mexico.

• I'd like to separate the Timeline into a separate article. It doesn't really fit into this one.

• I'd like to archive the first hundred topics on this talk page.

So...What do you think?

notes to Kat #1

Thank you for asking for my input. I can see you and others have done a lot of work on this difficult subject.

I do have a few comments:

In your paragraph on nutrition as a treatment, the sentence remains:

 Granted, according to a recent meta-analysis, there is little scientific 
 evidence for the effectiveness of the Feingold diet in treating ADHD specifically

Unfortunately, I do not have the full text of this report. However, in Schnoll's meta review, the abstract itself states:

• Attention-deficit hyperactivity disorder (ADHD) is multidetermined and complex, requiring a multifaceted treatment approach. Nutritional management is one aspect that has been relatively neglected to date. Nutritional factors such as food additives, refined sugars, food sensitivities/allergies, and fatty acid deficiencies have all been linked to ADHD. There is increasing evidence that many children with behavioral problems are sensitive to one or more food components that can negatively impact their behavior. Individual response is an important factor for determining the proper approach in treating children with ADHD. In general, diet modification plays a major role in the management of ADHD and should be considered as part of the treatment protocol.

• "Increasing evidence" is not the same as "little evidence" .....

• I wrote to Dr. Schnoll for her comment, and she answered, "The comment that the studies conducted did not eliminate all the foods listed on the Feingold diet was correct, but more importantly, the amounts of food dye and additives that were tested did not even come close to what children consume in a typical diet."

May I suggest, as wording: According to a recent meta-analysis, there has been little scientific evidence for the effectiveness of the Feingold diet in treating ADHD specifically, but this could be because most of the research has focused only on food dyes, in amounts far below what children consume in a typical diet, and the diet eliminates much more than that.

done. *Kat* 01:28, 2 June 2006 (UTC)

You might also include the newer Lau study which shows that a combination of additives (the way we get them in the real world) has much more effect than each alone ... see http://www.diet-studies.com/adhd.html#Lau2005

Note #2

Under Cerebeller Stimulation, is the sentence:

As noted above several studies have shown that the cerebellums 
of children with ADHD are notably smaller than their non-ADHD counterparts. 

• The link at "above" does not go anywhere

fixed. *Kat* 01:25, 2 June 2006 (UTC)

• In your resources, are they using children who are untreated? It can be argued that stimulant medication actually may change the size of parts of the brain.

I didn't read the resources. My intention was to re-write the article. *Kat* 01:25, 2 June 2006 (UTC)

• It can also be argued that this is not necessarily genetic but caused by vaccine damage since vaccines are given in infancy, before the brain has matured. Dr. Mary Megson in her presentation to Congress which you can see here claims that ADHD is a type of vaccine damage ....she talks also about children whose moms have night blindness, indicating a G-protein problem, which she says is a risk factor for autism or ADHD resulting from vaccines -- in other words, maybe our genetic research should be aimed at identifying those children at risk for sensitivity to additives or vulnerability to vaccine damage (or both), rather than continuing to give one-size-fits-all treatment to babies and blaming "genetics" for the damage done. When we talk about genetics here, we forget one thing -- there is no way to have an epidemic of a genetic disorder, unless we have done something in the environment to impact a (previously harmless) genetic variance. .... well, this is not encyclopedic, just ranting, but maybe there is something in there you can use.

I've read about that too, but I believe this theory has been discredited. *Kat* 01:25, 2 June 2006 (UTC)

Note #3

The following paragraph seems to have been left as it was originally, before your editing:

 In the 1980s vitamin B6 was promoted as a helpful remedy for children 
 with learning difficulties including inattentiveness. After that, zinc 
 was promoted for ADD and autism. Multivitamins later became the claimed 
 solution. Thus far, no reputable research has appeared to support either 
 of these claims, except in cases of malnutrition.

Thus, in a couple of sentences, this paragraph denigrates B6, zinc, and vitamins. Not only does it say that there is NO REPUTABLE RESEARCH but the tone is negative and biased - sounds like the Quackbusters have been here.

B6 (and other vitamins):

• First, about B6, there is actually quite a bit of research. Dr. Rimland once told me that there were 18 consecutive studies showing that B6+Mg was helpful, and there were no studies showing it was harmful. I cannot document that, at the moment, but I will get back to you on it later. Meanwhile, you can see what he wrote about B6 for autism.

• There is the Harding 2003 study on vitamin supplements working as well as Ritalin. See it here.

• See Berdonces 2001

• See the Kidd review 2000 which refers to several of the alternatives besides vitamins, and the full text is attached there too

• Remember that B6 is a cofactor in the making of neurotransmitters serotonin, dopamine, and orepinephrine ... See some interesting information about it.

• See Part 1 and Part 2 of a study on B6 and Downs syndrome.

• And how about this one? Coleman showed that B6 worked as well as Ritalin, and laster longer, with fewer side effects. This study has never been disputed - it has simply been ignored.

Zinc

• Back in 1979, Brenner reported that kids with ADHD had different trace minerals.

• You have already mentioned the Ward 1990 study and also the one in 1997 where he found that kids with ADHD lost zinc (resulting in behavioral disorders) when exposed to coloring.

• If you go to MedLine and do a search for "zinc adhd" you will find 16 studies and reviews in prestigious journals. It is certainly not right to say there has been no reputable research
  • See the Arnold 2005 review in which he says "Numerous controlled studies report cross-sectional evidence of lower zinc tissue levels (serum, red cells, hair, urine, nails) in children who have ADHD, compared to normal controls and population norms."
  • Even in Tehran, they are finding that zinc can be useful in addition to Ritalin. See Akhondzadeh 2004

Note #4

Other alternatives such as Ginko biloba .... again, it says there is NO RESEARCH. Since I have found research in a quick search of MedLine, I don't think we can say that. See the Lyon 2001 study for example. The free full text is there, too. I don't know anything about Ginko, etc, can we say something less biased-sounding? Encouraging further research is a far cry from saying there is none as though the issue is closed.

Views on Parenting

I noticed that the views on parenting section was left, dispite the fact that the entire section does not cite its sources. I suggest that the section be deleted two weeks from now (June 16, 2006) unless there are any objection to allow it to remain longer. 4.249.84.35 05:45, 2 June 2006 (UTC)

I object! I suggest that it remain because it represents the logic behind another perspective that many feel is crucial to a fair presentation of the issues. The contents of the citation mentioned in that section covers many of these criticisms. Limiting such discussion to an anti ADHD page, even if mentioned in this article, fails to do justice to this point of view. Although I recognize that this section (written mainly by me, Simon Sobo, MD) strays from the predominant point of view in my profession I strongly feel that it is a valid perspective that is being dismissed a little too easily. It is almost impossible to have this point of view represented in the major journals, but as I note elsewhere, I am not a nut and have the support of many in the profession who feel similarly. The contents of the section repeatedly emphasize that it is controversial, and make no attempt to falsify information. Citations have an important purpose in allowing readers to track down sources to make sure the information being presented is not false, but they are not an end in themselves. The issue is the transparency of how information is arrived at and is generally a good thing, but it also can contribute to group think, so that information can be screened by "experts". I know that sounds awfully paranoid, but we are talking about an issue here that involves billions upon billions of dollars spent on care, so objectivity is truly a problem.

I would invite the above user to go to my  article [4] for a discussion of the issue of objectivity. 

But here are a few links about the problem of objectivity It was like a whitewash Go to the section of this admittedly anti ADHD site to the discussion of Professor Pelkey's difficulties having his views represented in the journal his own article that published his article

Or perhaps this editorial about journal objectivity in the NEJM by then editor Marcia Angell will be helpful Is Academic Medicine for Sale. It is noteworthy that Dr. Angell went on to writing a book about this subject. She has since been repeatedly portrayed as some kind of nut in order to discredit her point of view. One has to wonder how the editor of the NEJM could ever be characterized this way, except she has dared to take on the powers that be. In my article there are also references to an article by the editor of the Lancet along similar lines.

So yes when there are billions of dollars involved objectivity becomes difficult to maintain and "experts" are not always what they seem.

I believe the user offering to delete the section on parenting is innocent of foul motives and is simply trying to be "scholarly". But why is the insistence on citations and the desire to delete this section being pursued by a person who is invisible. This user name thing was explained to me on the talk page but I still don't get it. Exactly what does the above user know about ADHD and why is this so important to him/her. Who are you?

WRONG WRONG WRONG WRONG WRONG

ADD is NOT the same thing as ADHD. Damnit...