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History

Association for Children with

Learning Disabilities

-established in the mid 50's

Main Objective: To disseminate information on learning disabilities

History of the Controversy:

Schooling

Early 1920's-Compulsory Education

Adopted the medical model, and thus led teachers and schools to view ADHD as a medical problem

At this time, children first appeared to display signs of hyper-activity

Education Reform: greater focus on order and efficiency in the classroom

Highly influential-Helped drive the medical movement

Educational authorities sought assistance from the medical field

?? Is the ADHD diagnosis and medical treatment a product of social management?

History

1950s- ADHD added to the DSM

1960's- ADHD was termed as "minimal brain damage"

-This sparked rise in drug treatment, and also gained publicity in mass media

1980- DSM III was published with a stronger emphasis on childhood disorders- Added ADD to the list of disorders

1990's- prevalence of physician visits for childhood diagnoses increased fivefold

-How do we efficiently treat such a large population?

Psychologists' View (+)

Psychodynamic Psychotherapy

  • Some psychologists support the biomedical model
  • Medications help children function independently and successfully
  • In the DSM V, ADHD is classified as a neurodevelopment disorder
  • Many studies show that medication treatments yield the best results

Focuses on the unconscious and past experiences to understand and regulate behavior

History: Government Involvement

  • Therapy draws from theories of Freud, Jung, and Alder

Two main governmental actions took place in the mid-70's as ADHD become more widespread

Summary

Goal: To build a strong relationship with others

References

Controversy: Is medication the most effective treatment for children with ADHD?

1. Only MD's can diagnose and prescribe treatment

Psychodynamic Psychotherapy: Theories of Origin

Outcomes of Psychodynamic Psychotherapy:

Psychologist View: Primarily, the belief is that further analysis into alternative treatment options should be evaluated

Outside Forces View: Primarily, the belief is that medication effectively targets the symptoms of ADHD thus allowing students to succeed in school settings

Historical Context: ADHD only became recognized after mandated education was enforced in the 1920's. Big question: Was the medication designed to treat children with ADHD, or was it designed as a form of social control?

ADHD arises from disturbances in ego-functioning

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doi:10.1002/jhbs.20471

Conway, F. (2012). Psychodynamic psychotherapy of ADHD: A review of the literature.

Psychotherapy, 49(3), 404-417. doi:10.1037/a0027344

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Children & Youth, 19(2), 10-15

Foltz, R. (2012). Twenty years of medicating youth: Are we better off? Reclaiming Children &

Youth, 20(4), 31-36

Kluger, J., Cray, D., Park, A., Klarreich, K., & Whitaker, L. (2003). Medicating young minds. (Cover

story). Time, 162(18), 48-58.

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disadvantage? (For). Journal Of Paediatrics & Child Health, 42(9), 544-547. doi:10.1111/j.1440-1754.2006.00919.x

Mayes, R., & Erkulwater, J. (2008). Medicating kids: Pediatric mental health policy and the

tipping point for ADHD and stimulants. Journal Oo Policy History, 20(3), 309-343.

Mayes, R., Bagwell, C., & Erkulwater, J. L. (2009). Medicating children : ADHD and pediatric

mental health / Rick Mayes, Catherine Bagwell, Jennifer Erkulwater. Cambridge, Mass. : Harvard University Press, 2009.

Mayes, R., & Rafalovich, A. (2007). Suffer the restless children: the evolution of ADHD and

paediatric stimulant use, 1900-80. History Of Psychiatry, 18(72 Pt 4), 435-457.

Musser, E. D., Galloway-Long, H. S., Frick, P. J., & Nigg, J. T. (2013). Emotion Regulation and

Heterogeneity in Attention-Deficit/Hyperactivity Disorder. Journal Of The American Academy Of Child & Adolescent Psychiatry, 52(2), 163-171.e2.

Nguyen, K., & Cantor, G. (2006). Historical and Cultural Institutional Analyses of the Emergence

of Attention Deficit/Hyperactivity Disorder. Conference Papers -- American Sociological

Association, 1.

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Stroh, J., Frankenberger, W., Cornell-Swanson, L., Wood, C., & Pahl, S. (2008). The Use of

Stimulant Medication and Behavioral Interventions for the Treatment of Attention Deficit Hyperactivity Disorder: A Survey of Parents’ Knowledge, Attitudes, and Experiences. Journal Of Child & Family Studies, 17(3), 385-401. doi:10.1007/s10826-007-9149-y

Wedge, Marilyn. (2011). Suffer the children: The case against labeling and medicating and an

effective alternative. Publishers Weekly, 258(3), 44.

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ADHD. American Journal Of Bioethics, 5(3), 57-59. doi:10.1080/15265160591002890

-Positive long-term outcomes

2. It was advised that pharmaceutical companies promote treatment solely through medical channels

A: Theory that outside forces can be an overwhelming source of anxiety

-Medication treatments still prove to be more effective

B: Theory that ADHD is highly

determined by the child-parent relationship

-Trauma

-Monetary Drive

-Family Challenges

Garrod, A. (2012). Adolescent portraits: identity, relationships, and challenges (7th ed.). Boston: Pearson.

....Results such as these further feeds the debate

**Social Control?

So medication seems effective. Is it the best treatment option?

ADHD: Is Medication the best treatment option?

Psychologists' View (-)

Psychologists'

View (-)

  • Most psychologists believe that medicating children with ADHD is bad
  • Many negative side effects have been discovered from the use of medication to treat ADHD
  • There are many alternative treatment options that do not have negative side effects
  • **Turns into a debate about what is the root of the disorder?

"The assumption that all psychiatric disorders are rooted in brain dysfunction is a slippery slope leading to reckless application of treatments with little understanding of the long-term implications on child and youth development."

-Robert Foltz

Behavior Therapy:

-heavily rooted in the theory of behaviorism

Outside Forces:

Teachers

Teachers often first suggest the diagnosis (51.8%)

-Focuses on the idea that we learn from our environment

They often suggest that the child should be medicated

Why are the incidences of ADHD referrals so high?

-Main objective: to reinforce desired behaviors while simultaneously eliminating undesired behaviors

-simply higher incidence of ADHD?

-poor classroom management?

-inability of the teacher to apply

behavior analysis techniques?

If most psychologists think

medication is not the best treatment option for ADHD...

Outside Forces:

Pharmaceutical Companies

why is medication still the driving force?

*Do we change the

child or do we change

the teaching?

Parents report that the most influential professional in terms of treatment are physicians

Literature and Posters in physician's offices: funded by pharmaceutical companies

MTA Study

Often leads to: One-sided view

Pharmaceutical Companies

Parents

3 main groups:

  • medication group
  • behavior therapy group
  • combination of medication and behavior therapy

Teachers

Media

Children in the combo group showed significantly greater improvement

Outside Forces: Parental Influence

Study by Jennifer Stroh et al.

Surveys were completed by parents with children diagnosed with ADHD, and by parents whose children were not diagnosed with the disorder

Results:

-All parents believed that medication had short-term positive effects

-Only parents with children with ADHD believed there were long-term benefits as well.

-Parents with children with ADHD were blind to the negative side effects of the medication.

-Self-Justification?

Outside Forces: Children's View

Some children report positive feelings toward ADHD medication as it has helped them succeed in school

Efron et al. 1998 study found that most children experience negative feelings toward medication

Gretchen's view of medication:

When on medication, "it is like the driving force behind who I am is sucked out of my body leaving me feeling like a hollow shell"

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