A.D.H.D. and It’s Prescription Treatments

Posted on January 4th, 2014 by Denise | No Comments

A.D.H.D. and It’s Prescription Treatment

An Article Review

By

Denise Koonce OTR

I believe it useful to pass on the information and opinions of an article I recently read.  It was printed in the New York Times on December 14 of this year.  The New York Times article explores the significant increase over the last 13 years in the amount of prescriptions written for individuals diagnosed with Attention Deficit Hyperactivity Disorder (A.D.H.D.).  The article initially focuses on the comments made by Dr. Keith Conners while speaking to a group of fellow A.D.H.D. specialists in Washington.  Dr. Conners was one of the strongest and longest fighters for the recognition of the diagnosis and the impact the symptoms have on the individual.  He is a psychologist and professor emeritus at Duke University and has worked tirelessly to have the diagnosis recognized as a true neurological disorder over the last 50 years.  However, he has recently voiced concerns about the significantly disproportionate increase in the recommended medications which have been prescribed over the last 13 years for A.D.H.D.  He noted that data from the Centers for Disease Control showed that the number of children on medication, predominately stimulants, for A.D.H.D. has risen exponentially from 600,000 children in 1990 to 3.5 million.  The rise in written prescriptions therefore also correlates with a disproportionate rise in the diagnosing of individuals with A.D.H.D.  Some of his words to describe this rise was “The numbers make it look like an epidemic.  Well, it’s not.  It’s preposterous,” Dr. Conners was quoted in a later interview with The New York Times.

Those numbers reflect a concern I personally have had as a pediatric occupational therapist regarding the over diagnosis of individuals with sensory deficits as individuals with A.D.H.D.  It was not just in my work arena that I would come across such circumstances but within my personal community when speaking to friends and relatives that the subject would come up and the result would be medication instead of sensory based therapy intervention first or at least an evaluation to rule out the need for therapy.  I would speak to friends who stated their children’s school teacher or school district was suggesting their children exhibited signs of A.D.H.D. and might benefit from medication.  It appeared that medication or stimulants specific for a diagnosis of A.D.H.D. was the new fast easy way to improve a child’s ability to succeed at school.  I would always ask if sensory based therapy had been recommended and if not that it would be advantageous as a possible additional treatment option.  It is in my professional clinical opinion that many of the children diagnosed with A.D.H.D. could have benefited from sensory based therapy treatment and may have been able to progress without the addition of medication but that option wasn’t the fastest or easiest.

The article goes on to explain how the role of pharmaceutical companies and their subsequent marketing campaign has impacted the significant rise in prescription stimulants given for A.D.H.D.   This occurred in part because the federal guidelines were loosened in the late 1990s allowing pharmaceutical companies to market stimulants directly to consumers.  This was a significant change as the information was no longer only in the hands of the treating physician but was now being blasted across television, newspapers, and magazines.  The marketing campaigns were now directed towards parents and predominately towards mothers.

My comments should by no means decrease the legitimacy of the diagnosis of attention deficit hyperactivity disorder and therefore the appropriate use from the stimulants prescribed to help the symptoms of the disorder.  However, I believe it to be very important that we as therapists be aware of the role pharmaceutical companies play in the lives of the children we treat.  I encourage you to read the article in its entirety as it is very informative.  In doing so, please share your thoughts regarding its content and how it might be reflective in your practice.

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