AD/HD: Diagnosis and Treatment Often Miss the Mark
Posted Oct 14 2008 4:07am
AD/HD, ADD, ADHD - The diagnosis is often missed - and since the diagnosis is missed, treatment objectives are missed even more frequently.- But why?
Let's take a moment to really look at clinical function - with one example of ADD from an unexpected source: a physics professor. This will be a short note on a very frequently observed problem: Our diagnostic grid for ADD Spectrum Disorders [with multiple expressions of attention related issues] is almost purely descriptive - with the inevitable consequence that we most often treat labels, not people. The public is mad because, more frequently than not, our measurements simply don't consider their pain.
ADD involves much more than "hyperactive," "inattentive" and "combined!" And if you are smart, you must, obviously, be lazy...
In evaluations for ADD/ADHD we don't measure, we don't consider clinically, cognitive function in context - especially if you are really smart! If you are really smart with a bunch of degrees, you couldn't possibly suffer with ADD/ADHD, right?
I have repeatedly witnessed this frequent oversight for years - and that's why I think we should change our perspective, - and why I am busy writing my book. If you see enough brains with SPECT brain imaging, and compare those brains with clinical findings and results from the Conner's Continuous Performance Test [others agree], you will see how that test frequently misses the mark.
Many who suffer with ADD show good results on the Conner's CPT - they pass the test, but show classic ADD
findings on brain scans and clinically - if you ask the questions more
Our current criteria for ADD is simply how the patient looks, how they respond to testing in a given context. We know ADD diminishes Pre-Frontal Cortical Function, but we just don't ask the questions that consider brain function.
I have a patient with 2 PhD's and a Master's Degree, about 55 years old
[two degrees in physics, and the other in another field of science] -
he simply can't think when the variables become unpredictable and, in
the context of time, too abundant to manage in a give time frame. He is
wonderful in the context of mathematics, but simply can't take the
responsibility of working socially with the unpredictable variables
present in management with a team.
In math he can think, in the team he freezes.
Do you know anyone that has been overlooked like this... just think for a moment.
Why do we miss the details? We are not looking carefully at how to measure, how to consider brain function,
- and then, one step further, we don't measure the specific reality, the context, of
adaptive and maladaptive function. But it's so easy - more coming in
Do leave a comment if you have seen this oversight, - and pass this note along to your friends who have an interest in this frequently overlooked topic! cp