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From Our Readers

ADHD in Kids: What's Really Going On?
The article, “ADHD in Girls: Wide Range of Negative Sequelae” (Psychiatric Times, September 2006, page 1) failed to mention that the 4.4 million children aged 4 to 17 years in whom attention-deficit/hyperactivity disorder (ADHD) (a “disease” that was rarely, if ever, diagnosed in the 1960s) has been diagnosed could, in fact, be victims of an addiction to the rapidly changing images of the television set, which intersect with a child's feelings of fear, boredom, passivity, and irrelevance, producing symptoms that later surface in the average classroom.

Teachers have told me that in the 1940s, along with a few cases of “minimal brain dysfunction,” almost every child could be classified as having “attention-deficit disorder.” It wasn't until the 1960s that teachers had to become entertainers to hold the attention of their now “hyperactive” pupils.

In the meantime, progressive schools such as The School in Rose Valley (in Rose Valley, Pa) never see—as far as I know—a case of ADHD, because kids are able to get up and run around during the day. In fact, increased exercise is now becoming a standard treatment recommendation, as is moving all television sets to the family room. The New York Times published an article titled “TV's Toll on Young Minds and Bodies” (August 3, 2004) by Jane E. Brody, in which she cited a study from Children's Hospital in Seattle showing that “for each hour [of television] watched a day, the risk of developing attention-deficit/ hyperactivity disorder increased by nearly 10%.”

Of course, one cannot easily explain why ADHD is diagnosed in a mere 10% to 12% of children when more than 90% watch television and when there are teachers who will say that 75% of the kids in their classes are hyperactive.

Meanwhile, in order to really solve the problem, it may be time to discuss the causes of ADHD and thus avoid the risk of medicating a developing brain, since there are, presumably, potentially deleterious long-term side effects in at least some cases.

Robert E. Kay, MD, Philadelphia
Psychiatrist (Retired)

Psychiatric Drugs for Kids
Are psychiatrists prescribing too many drugs for children or not enough? As Michael Jonathan Grinfeld's story (“Psychiatric Drugs for Kids: How Many Is Too Many?” Psychiatric Times, October 2006, page 1) makes clear, there is not enough good scientific and epidemiologic evidence to resolve this paradoxical question. David Fassler, MD, child and adolescent psychiatrist and clinical professor at the University of Vermont College of Medicine, was no doubt correct in his assertion that media coverage of drug studies may make some parents and physicians reluctant to treat a child's disorder with drugs that could very well be effective. However, public concern about prescribing psychiatric drugs for children is not just a matter of biased or incomplete media reporting; there are real
scientific questions that have not been satisfactorily resolved.


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