Keep An Open Mind On ADHD
By JAMES K. FITZPATRICK
In the January 23 edition of this column, we featured a discussion of the increased tendency to label students with the diagnosis of Attention Deficit Hyperactivity Disorder (ADHD). We quoted from a column by National Review editor Rich Lowry, who argued that there has been an over-diagnosis of ADHD “concocted to justify the giving out of medication at unprecedented and unjustifiable levels,” that has become “a national disaster of dangerous proportions.” Lowry calls it a situation that “has run wildly out of control on the promise of an easy pharmaceutical fix to the natural rambunctiousness of childhood.” Lowry placed much of the blame on pharmaceutical companies seeking to protect a “$9 billion-a-year business with alluring ads suggesting . . . children will become little angels through the wonders of risk-free stimulants.”
Dr. T.W.V., a now-retired Minnesota physician, writes to suggest we go slow on coming to Lowry’s conclusion. He points out that his generation of physicians “was clumsy in handling schizophrenia and manic depression (bipolar disorder). These conditions apparently are rooted in some organic changes and hopefully some specific treatment is possible. We must keep our minds open to the possibility that ADHD may be in the same category.”
Not that T.W.V. dismisses Lowry’s point of view. This is “a tough one,” he writes. “In 34 years in practice I made a diagnosis once of what we now call ADHD — we called it ‘hyperactivity syndrome.’ My partners may have had one or two diagnoses along the same line. I quit practice in 1989.
“I’m not sure how IQ or socioeconomic status affects the current epidemic of over-diagnosis. The question is how to determine a valid diagnosis. But, no question: The current number of students labeled ADHD suggests over-diagnosis. It must be noted that approximately one-third of students are listed as special education students. I suspect this has more to do with guaranteeing employment for teachers than sound medical diagnoses. This could be the ‘farm club’ for ADHD.”
T.W.V. continues, “It is difficult to avoid a strong cultural influence as the cause of the rise in students with ADHD. Health care is so fragmented that physicians rarely have a complete picture. I was convinced during my years in occupational medicine that ‘low back pain’ was the ADHD of our time, over-diagnosed and over-medicated. The pattern was to give patients a pill (Oxycontin) to get them out of the office, or to refer them to an orthopedist, neurologist, or chiropractor in waiting.”
T.W.V. notes that there “are some enhanced MRI studies that suggest a small percentage of ADHD patients may show some frontal lobe changes. I am not a fan of National Geographic, but in their last issue (February 14) they featured an article titled ‘The New Science of the Brain.’ It highlights the complexity of the brain. Of course, the editors of National Geographic see the complexity as a consequence of evolution. I suspect they have not read Stephen C. Meyer’s Signature in the Cell, which advances the evidence for intelligent design theory. (George Gilder summarizes Meyer’s work as follows: ‘Meyer demolishes the materialist superstition at the core of evolutionary biology by exposing its Achilles’ heel: its utter blindness to origins of information. With recognition that cells function as fast as supercomputers and as fruitfully as so many factories, the case for the mindless cosmos collapses. His refutation of Richard Dawkins will have all the dogs barking and the angels singing.’)”
On another topic: The web site Education News on January 6 (EducationNews.org) offered a new way to attack the tenure system for teachers. Until now, it has been mainly parents’ and taxpayers’ groups leading the charge. The new approach? Students are being put in the lead. Education News reports that “nine public school students are in court this week [early February] challenging California’s tenure system, filing a suit that charges their right to a quality education has been violated by the tenure system, which protects bad teachers and permits them to continue teaching.”
It seems so obvious a thesis: You have to ask why someone didn’t think of this argument before.
“Children have the right to access good education and an effective teacher regardless of their circumstances,” said David F. Welch, the telecommunications entrepreneur who spent millions of his own dollars to create Students Matter, the organization behind the lawsuit. According to Education News, “The group describes itself as a national nonprofit dedicated to sponsoring litigation of this type, and the outcome in California will provide the first indication of whether it can succeed.”
The tenure rules in California are similar to those in the rest of the country. They permit teachers, Education News continues, “to receive tenure, or permanent employment status, after only 18 months on the job, and a seniority system that states the last teacher hired, must be the first fired if layoffs occur.
“Teachers unions say the rules are necessary to protect teachers and to make sure they are not fired unfairly. They also say that without these rules it would be harder to attract new teachers. ‘Tenure is an amenity, just like salary and vacation, that allows districts to recruit and retain teachers despite harder working conditions, pay that hasn’t kept pace, and larger class sizes,’ James M. Finberg, a lawyer for the California teachers unions, said this week in his opening statement in court.”
This California case will be seen as a test case that will affect tenure rules around the country. Education News notes that tenure has already been eliminated in three states and in Washington, D.C. “The case in California is the first legal challenge claiming that students are affected by the employment laws. It also uses a civil rights argument stating that poor and minority students are denied equal access to an education due to ‘grossly ineffective’ teachers.”
The New York Times is following the case with interest. Jennifer Medina, a reporter for the Times, reports that “witnesses are expected to explain many of their basic assumptions about how to create quality schools. The first witness for the plaintiffs was John Deasy, superintendent of Los Angeles Unified School District, who largely opposes the tenure rules and the ‘last in, first out’ seniority system currently in place. He told the court that these rules make it hard not to place ineffective teachers at schools with high poverty rates.”
Randi Weingarten, the president of the American Federation of Teachers, responded with the overkill that is unfortunately typical of the teachers unions. She said the California case is “yet another example of not rolling up your sleeves and dealing with a problem, but instead finding a scapegoat. They are not suing about segregation or funding or property tax systems — all the things you really need to get kids a level playing field. They want to strip teachers of any rights to a voice.”
It makes one wonder how she thinks that making changes in segregation, funding, and the property tax system will help schools weed out ineffective and incompetent teachers with tenure.
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Readers are invited to submit comments and questions about this and other educational issues. The e-mail address for First Teachers is fitzpatrijames@sbcglobal.net and the mailing address is P.O. Box 15, Wallingford CT 06492.
