Or so says Dr. Richard Saul, a prominent neurologist, former chairman of pediatrics at Highland Park Hospital in Chicago, and currently an attending physician at Northshore University Health System in Chicago. Saul makes his claim in a new book bluntly titled “ADHD Doesn’t Exist.”
Saul doesn’t deny that both children and adults can have attention deficits or that they can be hyperactive. His problem is the word “disorder.” Disorders, you see, are not determined by blood tests or other such hard evidence-producing measures, but ordinarily by the simple asking of questions: How do you feel? What bothers you most?
To the claim that boys, especially, can be hyperactive, I can hear Saul saying, “You’re kidding!” (Most ADHD patients are boys.) Without being playful, but with words that you know indicate a half-smile on his face, Saul takes the medical and educational profession to task for mislabeling. What we’re calling ADHD, he avers, is a cluster of symptoms, or what he calls a “symptoms complex.” ADHD, says Saul, is a fabrication of drug companies and the medical establishment.
These assertions, by the way, are not coming from a young fresh-out-of-med school doctor, but from an older member of the medical establishment. A lifetime member of the American Academy of Pediatrics, Saul has been applauded by U.S. News and World Report as one of America’s “top doctors.”
Saul faults his colleagues for writing prescriptions for stimulants with only a cursory examination of their patients. He argues that, in the case of children, the symptoms which the establishment calls a disorder are often caused by poor eyesight, sleep deprivation, boredom in school or even giftedness. He tells of a young male patient who was misbehaving in school, but only in math class. Saul’s solution: The boy needed a more challenging math class.
An adult patient thought she had ADHD and had been prescribed stimulants by other doctors. Saul’s prescription for her was to take up a regular exercise routine and cut back if possible on work hours. Weeks later the patient returned to say, “I realize it wasn’t ADHD. It was just life.”
From treating many patients who have complained of the so-called ADHD symptoms, Saul has concluded that ADHD, which was made an official term as recently as 1987, is not a disease of any stripe and should not be listed in the American Psychiatric Association’s Diagnostic and Statistical Manual.
Saul’s controversial, anti-establishment position does have supporters. Family therapist Dr. Marilyn Wedge is one of Saul’s defenders. In her work titled “Suffer the Children: The Case Against Labeling and Medicating,” Wedge claims that Adderall and Ritalin are being given out like candy. In Wedge’s view, the current banner under which we march is No Child Left Un-medicated.
In England last year, a study done by a company named Intelligent Health indicated that the link between exercise and academic performance of children was “too strong to ignore.” The study involved 2,500 children who were asked to walk to school so that researchers could examine any benefits that walking might have. The study concluded that simply by walking to school, the children in the study —– all 7- and 8-year-olds — concentrated better.
Intelligent Health’s founder, Dr. William Bird, deduced that the ADHD children in the study benefitted for two reasons: Physical activity improves brain elasticity and contact with the outdoors has a calming effect on children.
In the field of education, labels for children have waxed and waned. The old attention deficit disorder, birthed in 1980 and killed in 1987, is no longer listed in the DSM. Neither is narcissistic personality disorder. (I know. The labels are awful.) With such a bevy of labels, one wonders if the list of “diseases” is determined by scientific research evidence, or by a committee.
Anyhow, for parents and educators the matter has boundless implications. It raises questions. How many of the disorders are biologically based and how many are relationship based? How much of our children’s inattention, restlessness, and impulsiveness is caused by things at home? How did we become a pill-popping culture that insists on instant cures? Are we OK with the fact that for drug companies, ADHD alone is a $9 billion-a-year business?
There’s little doubt Saul will be dubbed a heretic by his colleagues since the “disorder” gospel is so widespread. Moms and dads, however, should give him a fair ear.
Roger Hines is a retired high school English teacher in Kennesaw.