ADHD: Fact, Fiction and Beyond
A Comprehensive Study of Attention Deficit Hyperactivity Disorder
by Dr. Victoria Martin, M.D.
The single most common cause for referral for evaluation for children and adolescents is academic failure.
Weiss and Hechtman[i] in follow-up studies at 5, 10 and 15-year intervals demonstrated ADHD children performed poorly on achievement tests and failed grades/courses significantly more often than children of similar ability who did not have ADHD. Children with ADHD completed on average 3 fewer years of education than matched controls and were more likely not to graduate high school in spite of having more than adequate ability.2 When ADHD is combined with significant learning disabilities as occurs in more than 30% of cases, the academic impairment is often profound.
SOCIAL FUNCTIONING AND SELF ESTEEM
ADHD people just don’t “get it.” They fail to respond appropriately to social cues, are chronically unobservant of body language and are often intrusive with others. They interrupt, talk too loudly and tactlessly blurt things out without thinking. They ramble on and on rarely completing one thought before jumping to the next. They don’t listen and are often considered to be “insensitive.”
Research on adolescents with ADHD indicates that the social problems of children with ADHD persist into adolescence and usually get worse. Even when the data was controlled for the features of conduct disorder, which can be significantly alienating, by themselves, children and adolescents with ADHD were found to have fewer friends, poorer social skills, and have lower scores on assessments of self-esteem.3 ADHD kids are the “last picked and the first picked on.”
This intuitive sense of how to navigate within a culture develops between 12 and 17 years of age and is one of the major developmental tasks to be mastered. During this time period individuals become aware that words alone no longer carry the meaning in interactions. The real meaning is often conveyed through non-verbal cues such as a look in the eye or a tone of voice. People who are inattentive or speeding from one stimulus to the next often miss these important non-verbal messages. If the development of this intuitive understanding is missed at this crucial stage it is commonly missed forever.
HEALTH AND INJURY
Accidents are the leading cause of death until 44 years of age. Without treatment adolescents with ADHD have 400% more injury producing accidents and 300% more motor vehicle violations than do adolescents without ADHD or adolescents with ADHD who consistently take medication.4 A 9-year study of medical utilization (beyond just the direct costs of treating the ADHD) demonstrated that persons with ADHD have more than double the cost of care as compared to controls.5
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