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COLUMN: ADHD is real, Just ask my family

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CINCINNATI -- “ADHD isn't a challenge.”

“Maybe parents should be parents and stop using ADHD as an excuse for your kid to act like an a****** in school”

“And for the record, although ADHD is listed as a disability, it's not an excuse in any case for violent, or disrupting behavior. People need to learn to stop making excuses for their kids and hold them accountable for their actions.”

“He's not disabled!!! It's ADHD!!!”

ADHD is not a disability, it's a behavior issue”

These are just a few comments made by the public after news broke last week that a Northern Kentucky school resource officer used handcuffs to restrain two children who were, by definition, disabled. Video of the incident sparked a lawsuit filed by the ACLU and Children’s Law Center against the Kenton County Sheriff’s Office.

The ACLU said the children involved had PTSD, ADHD and “other” unnamed disabilities.

Amidst arguments for and against the use of restraint devices in schools, use of force by police and even corporal punishment when parenting, another question arose: Is ADHD even a disability?

While my initial instinct -- as someone whose family has been controlled by ADHD for 17 years -- is to argue for the legitimacy and seriousness of Attention Deficit Hyperactivity Disorder, personal experiences can’t definitively prove anything.

But science can.

Attention Deficit Hyperactivity Disorder is as legitimate as dyslexia, autism, Down syndrome and even blindness and deafness.

Many claim ADHD is an excuse for bad behavior, over-diagnosed or a made up disorder, but no one would ever dare question someone’s blindness or autism diagnoses.

While questioning the actual existence of a disability that affects millions of people and their families may be offensive to some, I understand why some people ask about the legitimacy of ADHD.

If you were born before 1975, it’s likely that you didn’t hear the words Attention Deficit Hyperactivity Disorder as a child or in school. Your teachers probably never heard of ADHD or ADD. Thus, you grew up in a time where this disorder, which is now gaining momentum and prominence exponentially, was basically nonexistent.

But the fact is, ADHD exists. It’s one of the most common neurodevelopmental disorders in the country.

This map by the CDC shows the percentage of schoolchildren with ADHD diagnoses per state.

A neurodevelopmental disorder affects how the brain grows and develops, as defined by the Centers for Disease Control and Prevention. These disorders affect brain function by stunting or limiting brain or central nervous system development. Other neurodevelopmental disorders include autism spectrum disorder, Down syndrome, fetal alcohol syndrome, fragile-X syndrome and Tourette syndrome, among others.

So?

Brains affected by ADHD look different from what doctors consider to be the “average” brain.

It’s undeniable that these pictures, from MIT’s McGovern Institute for Brain Research, show two brains functioning very differently.

Specifically, MIT found people with ADHD have trouble synchronizing the two major “hubs” of their brain while in “default mode,” or when unengaged in a specific activity. Thus, people with ADHD have difficulty balancing tasks and focusing simultaneously.

Additionally, the part of the brain that controls executive function, or cognitive tasks -- like addition and subtraction or memorizing song lyrics -- is impaired, which MIT says is something ADHD sufferers never “grow out of.”

Another question that flits around the topic of ADHD: Is it over-diagnosed?

Seven percent of school-age in the U.S. have ADHD, according to the American Psychiatric Association. More people in the U.S. are diagnosed with diabetes (9 percent), dyslexia (10 percent) and acid reflux (20 percent) than ADHD.

So, are too many people diagnosed with ADHD? If you answered yes, then you must also think too many people are diagnosed with diabetes, dyslexia and acid reflux.

Again, with any medical diagnosis made by a licensed, professional doctor, is it really ever fair to say any condition is “over-diagnosed?” Shouldn’t every illness or disability be recognized and treated, at the discretion of a doctor?

Dr. Ryan Macks is a clinical psychologist with his own practice in Mason. He works with many patients struggling with ADHD. He said he's experienced some pushback from people -- those he described as "more old-school" -- who think firm discipline can fix any problem with kids.

"ADHD is a real, legitimate issue," he said. "But there are a lot of instances where a teacher or parent or even a medical professional is hasty to label a child with having ADHD."

Macks said he's met with frustrated parents who told him a teacher or babysitter said their child is disruptive and needs to be put on medication. At that point, the parents are desperate for a diagnosis and prescription.

"That being said, ADHD is something we can prove conclusively," he said. "Anyone who says ADHD isn't real obviously hasn't done any medical research or spent much time with children.

"You can tell immediately when a child has ADHD. A happy, healthy and smart kid who can't sit still, feels a need to open drawers and touch everything? The impulse control just isn't there. That's ADHD," Macks said. "And there's not a teacher in America who will tell you that ADHD is not a real thing."

Macks sees many regular patients from the area, children and adults, who suffer from ADHD. Cincinnati Children's Hospital Medical Center opened an entire center dedicated to ADHD in 2005.

But is ADHD a disability? Absolutely, Macks said.

"Any developmental disability diagnosis, especially ADHD, can disable someone," he said. "A disability is anything that impairs a person regularly. While a lot of people may be able to think of times that they were bored or jittery, most people can get through their work or school day without any major hindrance."

The definition of a disability could be a factor in some people’s refusal to recognize ADHD as an actual, serious disorder.

Disabled means parking spots to some. For others, it means wheelchairs, physical deformity, an inability to communicate, or such serious impairment that government assistance will fund everyday life.

Medically, the CDC defines developmental disabilities as “a group of conditions due to an impairment in physical, learning, language or behavior areas. These conditions begin during the developmental period, may impact day-to-day functioning, and usually last throughout a person’s lifetime.”

Legally, the ADA says “a person with a disability is a person who has a physical or mental impairment that substantially limits one or more major life activity.”

Clearly, ADHD fits the bill, both medically and legally.

Someone may be skeptical of someone with ADHD being allowed to “get” something as a result of a diagnosis.

No, parking permits aren’t issued to people with ADHD. And people with ADHD don’t qualify for special grants or stipends as an immediate result of a diagnosis.

Under the Americans with Disabilities Act, companies and schools must accommodate for “mental conditions,” the category under which ADHD falls.

In the workplace, people with ADHD can be allowed limited accommodations, but nothing extraordinary like more pay for shorter hours, excessive breaks, etc. If requests are backed by ADA workplace rules, employees can modify their job responsibilities or adjust their office spaces to accommodate difficulties related to ADHD.

Most commonly, children with ADHD can qualify for an Individual Education Program (IEP) to help accommodate any extenuating needs related to their disability. These accommodations can follow a child all the way through college.

IEPs can allow for unlimited testing time, quiet and private testing rooms, intervention specialists and classes, alternative testing and homework methods – such as oral testing or testing broken up into shorter sections with breaks.

Students with ADHD can benefit significantly from an IEP. I know, because my 17-year-old brother is one of those students.

My brother was diagnosed with ADHD at age 6, which is the youngest that any doctor would officially diagnose someone with the disorder.

My mom swears she knew something was wrong when my brother was 18 months old. He didn’t talk, didn’t like to play with peers or siblings and he didn’t sleep -- even when obviously very tired – until all distractions were clear. She said he hated wearing shoes and socks and shirts with “itchy tags,” he cried all the time and needed nearly constant calming stimulation, like a pacifier or having his head scratched.

Doctors tested him repeatedly for deafness, tests he would consistently fail because he, simply, wasn’t listening. He was too busy looking through drawers and walking around the room to sit still and listen for sounds to come through headphones. Eventually, doctors confirmed that he could hear but couldn't listen, stay still or concentrate on anything.

In my mom’s own words, “Even when he couldn’t go anywhere, he wanted to be free and on the go, doing nothing at all in particular.”

Growing up with my brother (or even spending a week with him) would make anyone understand how real ADHD is.

I see ADHD every day when he gets up for work with the intention to take a shower but ends up engrossed in some loose knob on a dresser drawer and, two hours later, still hasn’t left the house (inability to balance tasks and stay focused).

I see ADHD when I notice the television noise, light from the side lamp and wind generated from the ceiling fan are all “bothering” him at the same time (overloaded senses).

I see ADHD so blatantly when he sits down to work on homework. From the time he gets home until 11 p.m. at night, he struggles to finish assignments that are meant to be brief, many times classwork that he didn’t finish. It’s a vicious cycle of staring at his assignments, his pencil, thoughts wandering elsewhere, catching himself and returning to his work, and so on.

Financially, ADHD causes stress for our entire family.

Eleven years after his diagnosis, he takes five medications per day, but his regimen changes every few months as the effects wear off and new medicines hit the market. And, while they help, the cost of the medications end up being a burden.

His medicines cost thousands of dollars each month, even with insurance. But not having the support of these medications is simply not an option, even when it costs us a vacation or a new family car.

There are eight people in my family. While only one has ADHD, the disorder affects all eight of us. It’s hard to live with, but it’s even harder to watch.

My brother doesn't want to have ADHD. He would love to deny the existence of ADHD, like so many uninformed people do. He wishes, more than anything that it wasn’t real, that it was just an excuse or a made-up, not serious disorder.

But ADHD is real, and he’s living proof.

Millions of other families across the U.S. have a similar story to tell about their collective struggle with ADHD.

The rate of divorce for parents of a child with ADHD are almost double that of parents of children without the disorder, according to the Journal of Consulting and Clinical Psychology.

Another study in abnormal psychology found parents of children with ADHD are more likely to drink alcohol, specifically as a means of stress relief.

And children with ADHD are at an increased risk for depression and even suicide, according to the National Center for Biotechnology Information.

ADHD brings heartache, pain and suffering to individuals and their families. It doesn’t discriminate by race, ethnicity, class or status.

To deny the existence of ADHD isn’t only ignorant, it’s insensitive.

Rather than scoffing at a medical diagnosis of ADHD and belittling claims that children affected by the disability should be allowed alternative options and treatment in school, consider this real disorder and how acceptance by the masses could be part of a successful solution.

Accepting ADHD isn’t only humane, it’s proactive, the same way being educated about the signs of a diabetic coma or stoke could save someone’s life.

Denying the existence of ADHD will only fuel the problems it causes. Calling it a “fake disorder,” an excuse -- or worse, the product of bad parenting -- are the kinds of comments that make families feel even more isolated and frustrated than before.

So, rethink your comments about ADHD. Show compassion for kids and families who didn’t choose to suffer from this disability, but who do choose to educate and help others understand.

For more information about ADHD, visit the CDC or American Psychological Association.

How many children in Ohio are diagnosed with, treated for ADHD?

How many children in Kentucky are diagnosed with, treated for ADHD?