Dr Linda Helps - Let’s say you are about to go for the million-dollar question on, Who wants to be a millionaire? Regis looks at you intently and asks, “What causes Attention-Deficit/Hyperactivity Disorder (AD/HD)? Your choices are:  a) brain chemistry b) genetics c) behavioral problems of concentration, impulsivity and/or hyperactivity? d) we don’t know for sure.

Since you forgot everything you learned in Psych 101, you decide to use your last lifeline. “Regis, I’m calling an old college buddy, Associate Professor David Stein, Ph.D. from the Psychology Department at Longwood College in Farmville, Virginia.”

Dr. Stein answers the phone, is read the question and says emphatically, “The answer is C. My research challenges the idea of a neurobiological base for AD/HD. AD/HD kids are ‘normal kids who simply do not think or pay attention to what they are doing, and if parents learn to rigorously control the consequences of their children’s behavior, these children make dramatic behavioral improvements, thus rendering such drugs as Ritalin unnecessary.’1 You can count on me-C is the answer. I’m 80% sure.”

Back to Regis, “Is C your final answer?” “Yes, C is my final answer.” Regis looks at you with pity,” Oh, I’m so sorry. The correct answer is D because we still don’t know what truly causes AD/HD. Dr. Stein’s research is interesting but many others in the field of psychology and psychiatry hold different views.”  

Suddenly you remember (you crammed for the show) that the American Medical Association says that AD/HD is a neuropsychiatric disorder even though there is no known medical or neurological cause. The theory contends that people with AD/HD do not have enough brain activity to focus on what they are doing or control their thoughts. Stimulant medication appears to increase brain activity and give AD/HD people more ability to control thoughts and actions.

Distraught, you leave the set. Not only have you lost a million dollars but you could kick yourself. You forgot about cousin Tim. Tim’s main problem was an inability to persist in effort. It was true that Tim didn’t pay attention, was sometimes hyper, had a lot of problems following rules, and didn’t respond well to traditional rewards and punishments. But sometimes Tim “kept it together.” Actually Tim is on Ritalin and doing well in school and at home.
Tim was diagnosed AD/HD by a trained psychologist after his mom read about the symptoms in a pop magazine. She was hoping there was a blood test or definitive way to make the diagnosis but there isn’t. Instead Tim’s family, along with teachers at school, church and extracurricular activities were asked to rate Tim on a number of scales. The therapist gathered information about Tim’s family life as well.

Tim completed a physical to make sure there was no other medical condition responsible for his symptoms. The psychologist also gave tests on attention and impulsivity in order to developmentally compare Tim to children his age.

Tim’s family could have answered that million-dollar question. Oh well, live and learn (and lose a few bucks along the way)!  

1 Quote taken from David B. Stein for the APA Public Communications, Public Affairs Office, 1998 APA Annual Convention Media Advisory