Ten percent of Tennessee children now diagnosed with ADHD

By CLAUDIA PINTO Staff Writer - THE TENNESSEAN

Walt Campbell was every preschool teacher's nightmare.

The 4-year-old seemed unable to sit still and focus. His mother, Pam Daley, said he would snatch toys from other children, jump on chairs and run wild during story time.

"The teacher was always calling from school," Daley recalled. "He was constantly in timeout. They couldn't control his behavior."

Walt, now 12, was diagnosed with attention-deficit/hyperactivity disorder. The diagnosis is more common in Tennessee than in almost all other states. To some people, this means doctors and parents here are better at identifying and treating the debilitating illness; to others, it signifies that Tennesseans are more prone to numb normal childhood behaviors with serious drugs.

Tennessee has the fourth-highest percentage of children ages 4 to 17 who have been diagnosed and are taking medication to treat ADHD, according to a 2005 study from the U.S. Centers for Disease Control and Prevention.

Arkansas, Alabama and Louisiana, respectively, take the top three spots.

Ten percent of children in Tennessee have been diagnosed with ADHD, vs. 7.8 percent nationwide, according to the study. And of the 10 percent diagnosed, more than 6 percent are taking medication to treat the condition, compared with a nationwide average of about 4 percent.

Just why there are more children in Tennessee diagnosed with ADHD and taking medication to treat it is unclear.

Dr. William Cooper, an associate professor of pediatrics at the Monroe Carell Jr. Children's Hospital at Vanderbilt, theorizes that several factors are probably involved.

He said one primary reason may be that Tennesseans in general use more prescription drugs than people in other states. He said, too, that doctors and parents here may have a greater awareness of the illness.

"It's hard to know if too many or too few children are being diagnosed," Cooper said.

Not everyone is pleased about the relatively high number of children in Tennessee taking drugs to treat ADHD.

Rep. John J. Deberry Jr., D-Memphis, the chairman of the House Children and Family Affairs Committee, believes too many kids are taking drugs when alternative methods could be used to treat their problems.

"These children who need discipline, training and mentors are being medicated and their brain chemistry is being changed," Deberry said. "Too many people ? rather than taking the time to intellectually and psychologically deal with the problems ? medicate children out of their minds."

Causes are unknown

Symptoms of ADHD include inattention, impulsive hyperactivity or both. The causes are unknown. But the condition is reported 2.5 times more frequently in boys than in girls, according to the CDC.

While the symptoms may sound like typical childhood behaviors, Cooper says the difference is that the symptoms in children with ADHD are so severe that they interfere with everyday functioning.

"If they are constantly being pulled out of class and have failing grades, then that's a problem," he said.

Deberry believes the diagnosis is often handed out too quickly in an attempt to deal with problem behavior. "I think the majority of children don't need to be on it," Deberry said. "How is it that now an entire generation of children is on psychotropic drugs? We grew up without psychotropic drugs, but we knew about getting our behinds whupped."

ADHD medications do carry heath risks.

Drugs subject to abuse

Common drugs used to treat the condition are Ritalin and Adderall. Both are Schedule II Controlled Substances, meaning they have a high potential for abuse. Side effects can include nervous tics, insomnia, weight loss and, in rare cases, heart problems and sudden death.

Daley, the founder of CHADD Franklin, a support group for parents of children with ADHD, says she sometimes hears parents voice concern that the medicines numb their child's personality.

"They say they're more quiet or describe them as zombie-like," she said.

Medication can be an effective way to treat ADHD, Cooper said. However, he stressed that medication should not be the first resort or the sole treatment. Behavioral interventions, he said, should be tried first and, even if unsuccessful, should be continued along with medication.

Daley, of Franklin, said she tried a variety of behavioral interventions but nothing worked.

"We tried the reward system. We had a sticker chart and he'd get a sticker when he did something good," she said. "We'd play soothing music to try to calm him."

At her wit's end, Daley decided to give drugs a trial run. She said her son's behavior immediately improved and he was able to concentrate and even succeed in school.

"It's like putting on a pair of glasses. You immediately see better. He was able to focus," she said. "There was so much stress in our home. It was all about this child ? keeping him safe, keeping him out of trouble."

"The benefits have outweighed the risks."