A staggering 6,000,000 students are now wearing the label ADHD, Attention Deficit Hyperactive Disorder. That’s about 15% of all children (and 20% of boys). “Shockingly, it’s almost certain that kids misdiagnosed with ADHD outnumber those with the legitimate, clinical problem, leaving the disorder so muddied that no one quite knows what to make of it at all.” (That sentence is taken from the most important book of the year for anyone who cares about children.)
The book is ADHD Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic. Alan Schwarz, a brilliant reporter for The New York Times, has written a highly readable, probing history of the condition and the subsequent epidemic of diagnoses.
He tells the story through three central characters, a doctor who might be called ‘The father of ADD’ and two children, but along the way you will also meet some unsavory characters and a few heroic folks as well.
The naming of the condition is a tale in itself. “Minimal brain damage,” “minimal brain disfunction,” “hyperkinesis,” and “hyperactivity” were floated and discarded for various reasons until finally (in 1980) “Attention Deficit Disorder” was coined by Dr. Virginia Douglas, one of the few women in the male-dominated club.
Even the author’s footnotes are revealing. Here’s one about Dr. Keith Conners, an early and important ADD researcher and the developer of the “Teacher Rating Scale” that enabled teachers to diagnosis students (which contributed greatly to the epidemic):
“Conners needed no questionnaire to assess the effects of Ritalin on himself. Late one afternoon, following an exhausting day in the lab, he had to attend an eight p.m. lecture by Harry Harlow, a behavioral psychologist famous for locking young monkeys away from their mothers and studying their emotional demise. Knowing he’d never stay conscious for the whole thing, Conners found the tub of Ritalin capsules so generously donated by CIBA and took one. Within thirty minutes he snapped awake and thought to himself, “This is fantastic!” He kept working until eight. He skipped dinner. He zoned in on the lecture, chatted with folks afterward, and stayed up until three in the morning. Just one dose felt so great, so beguiling, that he never tried the stuff again for the rest of his life.”
Reading this wonderful book stirred up memories of our own reporting on ADD, more than 20 years ago. The result was a 1-hour film, “A.D.D: A Dubious Diagnosis?”
Our year-long investigation was a surreal experience in many ways. Many interviews with scared parents hidden in shadow or behind a screen, with voice-altering equipment to make sure they couldn’t be identified. Angry kids whose parents and teachers forced them to take Ritalin. Kids who boasted openly about selling their Ritalin to other students looking to get high. And money, lots of it, being funneled to a supposedly neutral organization by the drug manufacturer.
PBS and my producing station in South Carolina were extremely nervous about taking on a powerful drug company. They delayed the broadcast for months, made us double our insurance coverage, and insisted that we add a question mark to the program’s title. We knew we had proved beyond a doubt that A.D.D. was in fact ‘A Dubious Diagnosis’ in many, many cases. We had proved that the current epidemic was man-made, a product of greed and hubris, but the powers-that-be were just plain scared.
The program stepped on a lot of powerful parental toes, including those of some in my industry. We reported that many parents actively sought a diagnosis of Attention Deficit Disorder as a way of ‘explaining’ why their child wasn’t on track to get into Harvard or Princeton. In other words, drugging a child was preferable to raising questions about their own parenting or their child’s abilities and interests.
But the investigative process itself is what I remember best. When we followed the money trail, we discovered that Ritalin’s manufacturer was secretly funding a supposedly neutral parents group, ChADD. We also learned that ChADD had secretly infiltrated the US Department of Education and was lobbying to loosen the restrictions on Ritalin to make it even easier to get (at a time when the US was already consuming more than 80% of the world’s supply!).
Ceiba-Geigy knew that we knew what was going on, and, when we went to interview the makers of Ritalin, we were escorted by (seemingly armed) guards into a large room where the drug company had already set up its own cameras to record everything. Despite their advance warning, the Cieba-Geigy spokesman admitted that the company was getting huge benefits by covertly funding the supposedly neutral non-profit, ChADD, which in turn was endorsing Ritalin. ChADD was a messenger, he said.
ChADD’s founder, seemingly accustomed to accolades from parents and to the high life, told us that he felt no guilt about endorsing Ritalin or keeping Ceiba-Geigy’s funding secret. Dr. Harvey Parker told me that Ceiba-Geigy owed ChADD because it was helping so many children by introducing them to Ritalin. And he had no qualms about his non-profit’s efforts to lobby Congress and the government agency that regulated drugs either, even though non-profits are strictly prohibited from lobbying.
No one at ChADD or Ceiba-Geigy expressed any remorse about duping the U.S. Department of Education either. USDE funds had paid for a series of glossy public service announcements in which ‘ordinary’ parents sang the praises of Ritalin. The Department withdrew the PSAs when we reported that all the parents were officials of ChADD.
Katie Couric invited me to debate the issue on the Today Show with the unctuous Dr. Parker and a ‘neutral’ university professor. My colleague John Tulenko had done his homework, however, and discovered that the professor’s work was supported by Ceiba-Geigy, something the Today show did not know. So when Katie asked the professor to weigh on on whether the A.D.D. epidemic was man-made (as we asserted), she attacked me with a vengeance. When Katie gave me the opportunity to respond, I had the great pleasure of asking the professor whether she had told the Today show that Ceiba-Geigy was paying for her ‘research.’ Stunned silence…..
I also wrote an op-ed for the New York Times, “Reading, Writing and Ritalin,” and appeared on Fresh Air, Talk of the Nation, and other cable and NPR shows. We managed to derail the A.D.D. express for a while, but it’s back with a vengeance, as ADHD Nation demonstrates.
Alan Schwarz’s important book, ADHD Nation, is available at your local bookstore and on line. Please seek it out.