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Attention deficit disorder affects more than just kids

LAWRENCEVILLE - When Karen Gipson's third-grade child began banging his head at school because he "couldn't get the answers out" she decided to have him tested for attention deficit disorder.

Her son, David was tested by a specialist who confirmed he did indeed suffer from the neurobehavioral disorder. David joined the ranks of the estimated 4.4 million kids between the ages of 4 and 17 diagnosed with ADD or ADHD (ADD with hyperactivity), according to Centers for Disease Control and Prevention statistics.

The CDC characterizes ADD/ADHD as "pervasive inattention and/or hyperactivity-impulsivity and resulting in significant functional impairment."

Who has ADD/ADHD

and why?

"They're the kids handing in half-finished assignments. They're the kids looking out the window when the teacher is lecturing. They're the kids answering impulsively without waiting for the pause," said Beth Seidel, who conducts ADHD testing at the Behavioral Institute of Atlanta.

At Hope Springs Christian Learning Center the children with ADD may also be those with the IQ of a genius.

"We have children in our school who have IQs of 122 but they can't read," said director Sharon Anthony. "We've had children who have had an IQ of 135 but couldn't look at a letter and tell the sound. That child had ADHD."

Seidel said she thinks ADD/ADHD is more prevalent in today's society due in part to the instruments used to evaluate it and due in part to the environment.

"I think all these things we have in our environment are changing our neurological processing," she said. "ADHD has a lot to do with our frontal lobe. We're seeing more and more of frontal lobe or executive functioning problems."

According to the CDC, 7.8 percent of school-aged children were reported to have an ADHD diagnosis by their parent in 2003.

The director of the Greater Atlanta Christian School's academic support program, Rhonda Hawkins, said she's seeing a lot of "century integration issues," a characteristic where the body is not working in synch completely.

"We've started testing younger children to make sure their eyes and muscles are working because before we thought they had ADD automatically but now we're trying to look at other areas first before we suggest it's ADD," Hawkins said.

The majority of ADD and ADHD cases are hereditarily linked and Seidel said when parents come to visit her during their discussions one of the parents will inevitably share that they, too suffered from similar symptoms growing up.

Previously it was thought that kids with ADD/ADHD would outgrow the disorder, but Seidel said recent research has showed that's not necessarily the case.

Eddie Barton, a 61-year-old Loganville resident who has been taking Ritalin for the past two years, is a perfect example.

"When I was growing up there was nothing to take (for ADD) so you learn to adapt or you get in trouble. I had a little bit of both," he said.

Ritalin has changed Barton's life for the better.

"It's slowed me down. I'm more relaxed, I listen more, I'm more patient and I think things through rather than running into a situation," he said. "I look before I jump."

Barton has embarked upon a new business and has said it's quelled his morning hyperness and helped him concentrate throughout the day.

Medications

Ritalin, Adderall and Strattera are among the most commonly prescribed medications used to treat ADD/ADHD on the market. The CDC reported 2.5 million youths aged 4 to 17 were receiving medication treatment for the disorder in 2003. This past year Medco Health Solutions Inc., a prescription drug benefit program manager, reported nearly 3.3 million Americans age 19 and younger used an ADHD drug.

As stimulants, Ritalin and Adderall have a laundry list of side effects but few users experience all of them. The most common side effects are loss of appetite and sleepless nights, Seidel said.

Long-term side effects of these drugs have not been examined through a longitudinal study but because a stimulant is in and out of the body researchers have seen minimal long-term effects, Seidel said.

In February, the Food and Drug Administration's Drug Safety and Risk Management advisory committee voted to recommend the agency add the strongest possible warning to some of the drugs used to treat ADD/ADHD.

This recommendation was based on an FDA analysis of more than 300 people who died while they were taking stimulant medications. The agency concluded that in 25 of the cases the stimulant appeared to be strongly related to the deaths, many apparently from heart problems.

However, the FDA rejected the panel's recommendations on March 22 and will not post a warning label on the drugs, which would have included Ritalin.

Drug pushing

At the Behavioral Institute of Atlanta, Seidel said she sees her clients turning less to medication and branching out to other options, but that teachers are pushing Adderall or Ritalin more.

"I do think it's way over-diagnosed because I think we as educators are so pressed first of all, we can't discipline in school, and that is such an area of need," Anthony said.

Hawkins said she, too, has been accused of over medicating children but said she and other teachers at Great Atlanta Christian School would prefer to try other avenues.

"We don't believe medication is the cure-all and it is not the right thing for every child, but there are a few children who have a very definite chemical imbalance and I've seen medication make unbelievable differences for them - but it's not every child."

Efforts to get information for this story from the Gwinnett County Public School system were unsuccessful.

Alternatives

Classroom modifications, such as placing a child in a quiet environment during testing or seating them at the front of the class have been used to help children with mild ADD/ADHD overcome their condition without medication. Other alternative treatments such as group therapy and certain supplements have had positive effects, too.

Karen Gipson never wanted to medicate her child, David, despite his ADD. Finally she caved-in because of what she said was a remarkable difference when he took it.

"He could just focus," she said. "It's quick, less expensive and you see immediate results."

In addition to Adderall, Gipson tries to feed David as much organic food as possible and uses Omega-3 fatty acid supplements, which have illustrated positive outcomes in clinical testing.

"There have been double blind, double placebo trials on ADHD and some have been strongly positive," said Dr. Joe Hibbeln a clinical investigator with the National Institute of Health. Hibbeln has studied the effects of deficiencies in Omega-3 fatty acids in increasing violence and depression for more than 17 years.

In a study published in the United Kingdom medical journal, "The Lancet," women in the Seychelles Islands (a tropical island off the coast of Africa) were studied and data revealed that those women who consumed the most seafood during pregnancy had children with a decreased risk of ADHD symptoms, Hibbeln said.

He was quick to point out, however, that there is no definitive answer as to whether or not what a mom eats during pregnancy will affect the risk of ADHD in their kids.

"There are many studies that suggest it but they are in no way definitive," he said.

Gipson said the combination of the Omega-3 and Adderall is good so during the school year she keeps him on it because he can focus better. However, she's quick to take him off of medication during summertime because she doesn't like the effect it has on him.

"He's very witty and has a real quick wit, almost sarcastic and he's funny," Gipson said of her son, who is now 12. "But if he's on medication he has a bland personality an you can honestly tell a huge difference. My husband and I notice it."