- The Washington Times - Sunday, October 4, 2009

From the Mailbag: Ann Hester of Charlotte, N.C., writes in a letter to the Charlotte Observer that I should get out in the real world more and meet the “mothers and fathers of the countless well-behaved children who live in our community.”

First, Ms. Hester, I am fairly certain such children are certainly not countless. Second, I also am convinced that parenting in Charlotte reflects the state of parenting in the U.S., which is to say, it is not generally commendable. We have lost our collective parenting “way,” and America’s parents are a desperate bunch, which is why I am able to successfully pose as a guy who has all the answers.

But since I take requests, here’s a story that might be more to my respondent’s liking: When her 6-year-old daughter threw a bit of a fit in the middle of her dance class, her mother told her, in front of the class, that she would not be going to a friend’s house that afternoon as planned but would spend the rest of the day in her room, contemplating her misbehavior.

Another mother, aghast, said that was too harsh, that four minutes in time-out was the rule for a 4-year-old. The same mother then admitted she spent a good amount of time putting her daughter in time-out. Regardless, the first little girl spent the day in her room. Now, when a problem begins to emerge, mom has only to remind her daughter of the policy, and she gets control of herself.

The moral to the story: If a consequence does not produce a permanent memory (and time-out most definitely does not), then it has been a waste of everyone’s time.

Keep those cards and letters coming!

Hot off the presses: As reported in the Sept. 9 Journal of the American Medical Association, researchers from the National Institute on Drug Abuse and other institutions claim to have found that when compared with the brain scans of “normal” folks, those of adults diagnosed with attention deficit hyperactivity disorder reveal abnormal dopamine processing. The evidence is being hyped as support for the claim that ADHD is a physical disease.

This is fascinating. A diagnosis of pneumonia or any other known physical disease is made on the basis of objective, verifiable evidence — an X-ray, for example. A diagnosis of ADHD is made on the basis of a clinician’s subjective judgment. According to the diagnostic criteria, the person so diagnosed “often” does this or that, and “often” is never quantified.

It is patently impossible to claim, with any degree of certainty, that someone “has” a disease when the supposed disease defies objective measurement. Therefore, the idea that brain scans were done on folks “with” ADHD is debatable.

Besides, brain scans of folks with psychiatric disorders often move toward normal after talk therapy. How can talking to someone cure a physical disease? The answer, which is well known in psychiatric circles (or should be): Just as the brain influences behavior, so behavior influences the brain. In other words, finding relative differences in the brains of people who often behave in ways that are not functional is to be expected and proves nothing.

Interesting also is the fact that in these perennial ADHD brain scan studies, a certain number of people with the diagnosis show no brain abnormalities at all. By comparison, anyone diagnosed with pneumonia will produce an abnormal X-ray.

Finding a supposed biological dysfunction in people who have a disease that cannot be precisely defined justifies treating those folks with drugs. In that regard, several studies have discovered that children diagnosed with ADHD often respond as well to placebos (fake drugs) as they do to expensive compounds marketed by pharmaceutical companies and often used to treat the behaviors being called ADHD. If ADHD is a biological disease, it is a strange one indeed.

The bottom line is that the JAMA study constitutes no definitive proof of anything. And the ADHD beat goes on.

Family psychologist John Rosemond answers parents’ questions on his Web site (www.rosemond.com).

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