It has been my honor and privilege over the past 30 years to care for children and adolescents who have been diagnosed to have ADD (Attention Deficit Disorder) or ADHD, when there is also an element of hyperactivity combined with inattention.
Every time I attend a lecture on this topic or engage in continued education, I am amazed by how various experts in the field agree to disagree on the causes, treatments and prognosis of ADHD/ ADD.
When I am told day after day by the parents of these youngsters that their child can stay engaged with Minecraft or Lego the whole day, and enjoy being creative, it is hard to use terminologies such as “distractible”, “ can’t sit still” or “disorganized”. Clearly, the so-called deficit is not consistent.
The terminology and labelling of these children and adolescents, in my humble opinion, fail to capture the wide spectrum of ADHD/ADD–thus our culture continues its confusion as to the benefits of having ADHD.
Dr. Russell Barkley, one of the world’s leading researchers and experts on ADHD, continues to argue against the notion that ADHD confers benefits. He is quoted as saying, “There is no evidence that ADHD is a gift or conveys any advantages beyond what other people in the general population might have. People with ADHD are individuals, like anyone else, and may have been blessed with particular talents that are superior to levels seen in most people. But these talents have nothing to do with having ADHD; they would have them anyway”
On the other hand, Dr. Edward Hallowell maintains that having ADHD is a gift, and that there are indeed some benefits. This Harvard-trained medical doctor is well known for being the author of a New York Times bestseller “Driven to Distraction”. He is also the founder of the Hallowell Center based in New York (See www.hallowelcenter.org to understand why some honor the benefits of having ADHD)
Dr. Hallowell is very clear—and he may be correct—that the majority of clinicians caring for individuals with ADHD focus on the negative traits such as: distractibility, impulsivity, restlessness, intrusiveness, unfocused, forgetfulness, being disorganized, stubborn and inconsistent.
Although these traits are indeed very real and used as markers for both diagnosis and response to treatments, Dr. Hallowell also argues for acknowledging positive traits ADHD individuals may exhibit—- qualities such as: curious, creative, sense of humor, energetic, eager, spontaneous, idea generators, persistent, flashes of brilliance and sensitive (compassionate)
A 2011 study published in the journal Personality and Individual Differences (White and Shah) reported that individuals with attention-deficit/hyperactivity disorder may actually be more creative. (Some researchers have speculated that Mozart, Beethoven, Thomas Edison and Da Vinci may have had attention deficit traits. We will never be certain of this because the diagnostic tools for this condition did not exist during their lifetimes)
A well-known creative and entertaining public figure, James Carville, who became famous for serving in former President Bill Clinton’s Administration, was diagnosed with ADHD as an adult. Because his daughter was diagnosed with this condition it prompted Mr. Carville, an influential media personality, to look at his own symptoms in more detail (For more information on how adults can explore if they have undiagnosed ADHD I recommend visiting www.CHADD.org)
More studies are needed before Dr. Barkley and those who adhere to his understanding of ADHD will be convinced. Barkley did admit in an interview with the New York Times (Feb 23, 2011; “The Ups and Downs of ADHD”) that “As for particular careers that may be better for those with A.D.H.D., there is no research to address that question. But based on patients that we have seen in our clinics, we have found that certain careers may be more “A.D.H.D.-friendly.” Such jobs include sales, playing or coaching athletics, many trade professions, being a chef, photography or videography, the military, and acting or other performing arts.”
If ADHD is left untreated, the possible positive qualities Dr. Hallowell refers to as “gifts”, may not be fully developed. Once again the road forks when experts debate the best way to treat ADHD. Some doctors focus on medications only and they bristle when media or parents accuse them of being influenced by pharmaceutical companies. The fact is that although some patients may be over-treated the vast majority benefit from the appropriate medications that are available (I continue to blog and Tweet on these controversies on www.healthykids.ca )
An increasing number of psychologists are utilizing the Cogmed working memory training as a compliment to medications (See www.cogmed.com for more information or read Zach Shipstead, Kenny L. Hicks, Randall W. Engle. Cogmed working memory training: Does the evidence support the claims? Journal of Applied Research in Memory and Cognition, 2012; 1 (3): 185)
More research is needed before skeptical clinicians will talk about both the negative and positive qualities of individuals with ADHD. For now, the Barkley camp seems to dominate the agenda and the Hallowell camp is still dismissed as being “unrealistic”.
DR NIEMAN IS A COMMUNITY PEDIATRICIAN. HE HOSTS WWW.DRNIEMAN.COM AND PROVIDES MEDICAL CARE FOR OBESE CHILDREN AT THE CALGARY WEIGHT MANAGEMENT CENTER. HE HAS COMPLETED 88 MARATHONS IN HIS QUEST TO INSPIRE HEALTHY LIVING.
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