ADHD is Brain Developmental Delay, Not a Difference in Brain Structures

Attention Deficit Hyperactivity Disorder (ADHD) is about delays – not differences – in brain development, according to a new study from the National Institute of Mental Health.

Researchers took magnetic resonance imaging (MRI) scans of the brains of 223 children with ADHD and 223 without the disorder. They found that the cortexes of the ADHD group reached peak thickness at age 10.5, compared to age 7.5 in normal children.

“I think it is good news. I think it means that this sort of basic brain biology is intact, all that’s different is the timing of it,” said Dr. Phil Shaw, lead researcher. “If ADHD was a complete deviation away from normal brain development, you’d expect the sequence to be completely disrupted. It wasn’t. So we think this is pretty strong evidence that ADHD is more of a delay in brain development.”

The developmental delays were in front of the brain’s outer mantle or cortex, which is are important in attention, planning, and controlling thought. This was a fifteen-year study and the first to use the most advanced technology to study brain development in ADHD children.

“We know that ADHD is a real problem for children and their families and schools, and it does need treatment,” said Dr. Shaw. The study does not mean that parents should “just sit and wait three years and your kid will be okay.”

He said that he could not explain why some children seem to outgrow ADHD.

This study appears in the Proceedings of the National Academy of Science.

Keep Kids with ADHD on Meds During Sleepover Summer Camps

Doctors often advise children with Attention Deficit Disorder to “take a break” from their medications at least once a year, usually when school is out. The reason is that these medicines affect the physical development of children.

“By taking children off during summer,” said Dr. Josephine Elia of Children’s Hospital of Philadelphia, “you do allow some room so a growth spurt can occur.”

However, what if your child is going away to summer camp? Should parents stop the child’s medications?

Newsweek reporter Samantha Henig interviewed doctors, camp counselors, and parents and concluded that it may be better to keep the children medicated at sleepover camps.

Many parents have the mistaken belief that vigorous exercise will temporary alleviate their children’s symptoms. However, experts told Henig that is not the case. Structured sports offered by summer camps cannot treat symptoms of ADHD, but can only channel children’s energy.

Taking children off medications can put them at risk during activities that require concentration like mountain climbing or canoeing, according to Dr. Edward Walton, pediatrics professor at the University of Michigan.

“It also puts an unfair burden on the counselors,” he said. “It’s difficult to ask someone who’s just meeting your child, just forming a relationship and trying to keep them safe and happy when the child is not at his best.”

What is even more distressing for counselors is that parents take their children off medications without informing the camp of their child’s condition or usual medications. Sue Scheff, a parent advocate for Attention Deficit Disorder, told Newsweek that she did that herself.

“Within a week’s time I’d get a call saying he’s misbehaving and I’d have to send the medication up to get him on track,” she said. “Maybe it was a selfish decision. I just wanted to take him off so I didn’t have to explain to everybody why he was on medication.”

The best course is to discuss any medical condition with the child’s camp counselors and administrators.

Over two and a half million children take medications for ADD.

ADD Drugs Do Not Increase Likelihood of Substance Abuse

A new study reveals that young adults who took drugs to treat Attention Deficit Disorder as children are no more likely to abuse drugs or alcohol than other young people.

“Some previous studies showed an increased risk of substance abuse associated with stimulant treatment, and other studies showed both no association and a protective effect from treatments, but those studies had some methodological limitations,” reported Michael Monuteaux, author and assistant director of research at the pediatric psychopharmacology program at Massachusetts General Hospital.

The researchers interviewed 112 males ages 16 to 27 about their drug and alcohol habits 10 years after they had been diagnosed with ADD. More than 70 percent had taken stimulants and 22 percent were currently taking them. However, the researchers found no link between taking stimulants and increased substance abuse.

This study appears in the American Journal of Psychiatry.

More Parents Joining Their Children in Treatments for Mental Disorders

Your doctor has just diagnosed your child with attention deficit disorder. As she discusses ADD symptoms with you, you see yourself in those symptoms. You realize that, like your child, you too have problems paying attention when others speak, focusing on a task, organizing your work, keeping appointments, and so on. Suddenly, your life makes sense as you realize you have been struggling with ADD for years yourself.

In the past ten years, there has been a surge in diagnoses of childhood disorders like ADD, bipolar disorder and Asperger Syndrome. Since the early 1990s, the number of new childhood cases of disorders has more than tripled. The latest survey from the Center for Disease Control indicates that one in every 150 American children has autism. As millions of children receive medical treatment and interventions at school, many of their parents realize that they have similar issues themselves.

“It is happening very frequently,” according to Dr. Gregory Fritz, the academic director of Bradley Hospital in Providence, RI, the largest child psychiatry hospital in the United States. In an interview with the New York Times, Dr. Fritz said, “Sometimes it’s a real surprise because the child is the first one in the family ever to get a thorough evaluation and history. The parents are there and they begin to see the pattern.”

Experts like Dr. Fritz report that the parents’ new understanding of their own problems can be both a good and a bad thing.

Some parents feel guilty for “passing on” genes that may have created their children’s disorders. Others have suspected for years that something was wrong with them, but would rather ignore it.

Dania Jekel, director of the Asperger Association of New England, said, “The adult may have spent a lifetime compensating for the problem and is still struggling with it and would rather not be identified that way.”

However, many adults experience liberation after receiving a diagnosis of a neurological or mental disorder. Author Diane Kennedy describes in her book The ADHD/Autism Connection how her family came to better understand and accept her husband’s behaviors once they put them within the context of high-functioning autism. Her husband received that diagnosis after their three sons were in treatment for Attention Deficit Disorder.

In other families, finding out that one or both parents have the same syndrome as their children lessens the guilt a child may feel for being a problem to his or her family. The parent and child can undergo treatment together and share new coping strategies. In that way, the parent with the syndrome becomes the child’s main source of support.

See “Your Child’s Disorder May Be Yours Too” by Benedict Carey, The New York Times, December 9, 2007.