CHADD Applauds International Consensus Statement On AD/HD Issued By Nation's Leading Clinicians (Inglés)
Date: 03-13-2002
Contact: Peg Nichols
301-306-7070 ext. #102

CHADD APPLAUDS INTERNATIONAL CONSENSUS STATEMENT ON AD/HD ISSUED BY NATION'S LEADING CLINICIANS

Top Docs and CHADD Challenge the Media to Stop Portraying AD/HD as a Sporting Event

Landover, MD -- CHADD, the nation's leading non-profit organization serving individuals with Attention-Deficit/Hyperactivity Disorder, applauds the recently released International Consensus Statement reiterating the absolute existence of AD/HD and the damage incurred when media reports suggest otherwise. The International Consensus Statement, authored by Dr. Russell Barkley, University of Massachusetts Medical School, includes the endorsement of more than 90 the world's leading scientists, researchers and clinicians treating AD/HD and other mental disorders.

For the full statement text, click here

"The media have a responsibility to accurately report on AD/HD -- not treat it as if it were some kind of entertaining sporting event, pitting one side against the other," said Barkley. "AD/HD should be depicted by the media and in news reports as realistically and accurately as it is depicted in science: as a valid disorder having varied and substantial adverse impact on those who may suffer from it through no fault of their own or their parents and teachers."

The U.S. Surgeon General, the American Medical Association (AMA), the American Psychiatric Association (APA), the American Academy of Child and Adolescent Psychiatry (AACAP), the American Psychological Association (APA) and the American Academy of Pediatrics (AAP), among others, all recognize AD/HD as a valid disorder. Many of these organizations have issued guidelines for evaluation and management of the disorder for their membership. The International Consensus Statement, however, is the first document issued by an independent consortium of leading scientists concerning the status of the disorder. Among scientists who have devoted years, if not entire careers to the study of this disorder, there is no controversy regarding its existence.

"This is a timely and important document given the challenges that those with AD/HD currently face," said Evelyn Green, CHADD National Board President. "Misinformed legislators are trying to legislate and regulate AD/HD treatment without understanding the science of the disorder, nor its impact on our families, schools and communities. Well-financed 'special interest' groups are organizing campaigns against psychiatry, psychology and mental health in general. And professionals with questionable ethics are encouraging families struggling with the realities of AD/HD to file lawsuits, discontinue treatments and ignore symptoms. These efforts do nothing but adversely affect those afflicted with the disorder as well as those who are dedicated to treating it."

Other facts cited in the Consensus Statement:

* AD/HD is not a benign disorder. For those it afflicts, AD/HD can cause devastating problems.

* Follow-up studies of clinical samples suggest that sufferers are far more likely than those without the disorder to drop out of school (32-40%); to rarely complete college (5-10%); to have few or no friends (50-70%); to under perform at work (70-80%); to engage in antisocial activities (40-50%); and to use tobacco or illicit drugs more than normal.

* Children growing up with AD/HD are more likely to experience teen pregnancy (40%) and sexually transmitted diseases (16%); to speed excessively and have multiple car accidents; to experience depression (20-30%) and personality disorders (18-25%) as adults; and in hundreds of other ways mismanage and endanger their lives.

* Despite these serious consequences, studies indicate that less than half of those with the disorder are receiving treatment.

"Early identification of the disorder is essential to the appropriate treatment of AD/HD," continued Green. "Although there is no cure for AD/HD, there are three highly effective forms of treatment: behavior management, educational interventions, and medication. And although treatment with stimulant medication is the most controversial approach, research demonstrates that it is also the single most effective treatment available. Without treatment, too many people continue slipping through the cracks. And that is yet another reason why we need the media's support and objectivity in dispelling the myths and setting the record straight on AD/HD."

CHADD advocates a Multi-modal approach to the treatment of AD/HD including parent training in diagnosis, treatment and specific behavior management techniques, an appropriate educational program, individual and family counseling when needed, and medication when required

NOTA COMPLETA

International Consensus Statement on ADHD

January 2002

We, the undersigned consortium of international scientists, are deeply concerned about the periodic inaccurate portrayal of attention deficit hyperactivity disorder (ADHD) in media reports.  This is a disorder with which we are all very familiar and toward which many of us have dedicated scientific studies if not entire careers.  We fear that inaccurate stories rendering ADHD as myth, fraud, or benign condition may cause thousands of sufferers not to seek treatment for their disorder.  It also leaves the public with a general sense that this disorder is not valid or real or consists of a rather trivial affliction.

We have created this consensus statement on ADHD as a reference on the status of the scientific findings concerning this disorder, its validity, and its adverse impact on the lives of those diagnosed with the disorder as of this writing (January 2002).

Occasional coverage of the disorder casts the story in the form of a sporting event with evenly matched competitors. The views of a handful of non-expert doctors that ADHD does not exist are contrasted against mainstream scientific views that it does, as if both views had equal merit.  Such attempts at balance give the public the impression that there is substantial scientific disagreement over whether ADHD is a real medical condition.  In fact, there is no such disagreement --at least no more so than there is over whether smoking causes cancer, for example, or whether a virus causes HIV/AIDS.

The U.S. Surgeon General, the American Medical Association (AMA), the American Psychiatric Association, the American Academy of Child and Adolescent Psychiatry (AACAP), the American Psychological Association, and the American Academy of Pediatrics (AAP), among others, all recognize ADHD as a valid disorder.  While some of these organizations have issued guidelines for evaluation and management of the disorder for their membership, this is the first consensus statement issued by an independent consortium of leading scientists concerning the status of the disorder.  Among scientists who have devoted years, if not entire careers, to the study of this disorder there is no controversy regarding its existence.

ADHD and Science

        We cannot over emphasize the point that, as a matter of science, the notion that ADHD does not exist is simply wrong.  All of the major medical associations and government health agencies recognize ADHD as a genuine disorder because the scientific evidence indicating it is so is overwhelming.

        Various approaches have been used to establish whether a condition rises to the level of a valid medical or psychiatric disorder.  A very useful one stipulates that there must be scientifically established evidence that those suffering the condition have a serious deficiency in or failure of a physical or psychological mechanism that is universal to humans.  That is, all humans normally would be expected, regardless of culture, to have developed that mental ability.

And there must be equally incontrovertible scientific evidence that this serious deficiency leads to harm to the individual.  Harm is established through evidence of increased mortality, morbidity, or impairment in the major life activities required of one's developmental stage in life.  Major life activities are those domains of functioning such as education, social relationships, family functioning, independence and self-sufficiency, and occupational functioning that all humans of that developmental level are expected to perform.

As attested to by the numerous scientists signing this document, there is no question among the world's leading clinical researchers that ADHD involves a serious deficiency in a set of psychological abilities and that these deficiencies pose serious harm to most individuals possessing the disorder.  Current evidence indicates that deficits in behavioral inhibition and sustained attention are central to this disorder -- facts demonstrated through hundreds of scientific studies.  And there is no doubt that ADHD leads to impairments in major life activities, including social relations, education, family functioning, occupational functioning, self-sufficiency, and adherence to social rules, norms, and laws.  Evidence also indicates that those with ADHD are more prone to physical injury and accidental poisonings. This is why no professional medical, psychological, or scientific organization doubts the existence of ADHD as a legitimate disorder.

        The central psychological deficits in those with ADHD have now been linked through numerous studies using various scientific methods to several specific brain regions (the frontal lobe, its connections to the basal ganglia, and their relationship to the central aspects of the cerebellum). Most neurological studies find that as a group those with ADHD have less brain electrical activity and show less reactivity to stimulation in one or more of these regions.  And neuro-imaging studies of groups of those with ADHD also demonstrate relatively smaller areas of brain matter and less metabolic activity of this brain matter than is the case in control groups used in these studies.

These same psychological deficits in inhibition and attention have been found in numerous studies of identical and fraternal twins conducted across various countries (US, Great Britain, Norway, Australia, etc.) to be primarily inherited.  The genetic contribution to these traits is routinely found to be among the highest for any psychiatric disorder (70-95% of trait variation in the population), nearly approaching the genetic contribution to human height.  One gene has recently been reliably demonstrated to be associated with this disorder and the search for more is underway by more than 12 different scientific teams worldwide at this time.

Numerous studies of twins demonstrate that family environment makes no significant separate contribution to these traits.  This is not to say that the home environment, parental management abilities, stressful life events, or deviant peer relationships are unimportant or have no influence on individuals having this disorder, as they certainly do.  Genetic tendencies are expressed in interaction with the environment.  Also, those having ADHD often have other associated disorders and problems, some of which are clearly related to their social environments.  But it is to say that the underlying psychological deficits that comprise ADHD itself are not solely or primarily the result of these environmental factors.

This is why leading international scientists, such as the signers below, recognize the mounting evidence of neurological and genetic contributions to this disorder. This evidence, coupled with countless studies on the harm posed by the disorder and hundreds of studies on the effectiveness of medication, buttresses the need in many, though by no means all, cases for management of the disorder with multiple therapies.  These include medication combined with educational, family, and other social accommodations.  This is in striking contrast to the wholly unscientific views of some social critics in periodic media accounts that ADHD constitutes a fraud, that medicating those afflicted is questionable if not reprehensible, and that any behavior problems associated with ADHD are merely the result of problems in the home, excessive viewing of TV or playing of video games, diet, lack of love and attention, or teacher/school intolerance.

ADHD is not a benign disorder.  For those it afflicts, ADHD can cause devastating problems.  Follow-up studies of clinical samples suggest that sufferers are far more likely than normal people to drop out of school (32-40%), to rarely complete college (5-10%), to have few or no friends (50-70%), to under perform at work (70-80%), to engage in antisocial activities (40-50%), and to use tobacco or illicit drugs more than normal.  Moreover, children growing up with ADHD are more likely to experience teen pregnancy (40%) and sexually transmitted diseases (16%), to speed excessively and have multiple car accidents, to experience depression (20-30%) and personality disorders (18-25%) as adults, and in hundreds of other ways mismanage and endanger their lives.   

Yet despite these serious consequences, studies indicate that less than half of those with the disorder are receiving treatment.  The media can help substantially to improve these circumstances.  It can do so by portraying ADHD and the science about it as accurately and responsibly as possible while not purveying the propaganda of some social critics and fringe doctors whose political agenda would have you and the public believe there is no real disorder here.  To publish stories that ADHD is a fictitious disorder or merely a conflict between today's Huckleberry Finns and their caregivers is tantamount to declaring the earth flat, the laws of gravity debatable, and the periodic table in chemistry a fraud.  ADHD should be depicted in the media as realistically and accurately as it is depicted in science -- as a valid disorder having varied and substantial adverse impact on those who may suffer from it through no fault of their own or their parents and teachers.

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