Hx ADD: The Best With What They Had

Welcome me back from the dead, with a long awaited followup on ADD.  As I've threatened, I'm going to touch on several aspects of ADD in the next few days, starting here with a brief history of the "disorder".

ADHD was first classified in the 18th century by Scottish-born physician and author, Sir Alexander Crichton.  He described what seemed to be a mental state of inattentiveness that he called "mental restlessness".

His words: "When born with a person it becomes evident at a very early period of life, and has a very bad effect, inasmuch as it renders him incapable of attending with constancy to any one object of education. But it seldom is in so great a degree as totally to impede all instruction; and what is very fortunate, it is generally diminished with age." (emphasis mine)

He suggested that children afflicted with this restlessness, or fidgets, should obtain special education and that it was apparent that these children could not focus no matter how hard they tried.  Again his words: "Every public teacher must have observed that there are many to whom the dryness and difficulties of the Latin and Greek grammars are so disgusting that neither the terrors of the rod, nor the indulgence of kind intreaty can cause them to give their attention to them."

Yeah, no kidding.  And that's a disorder?

The classification continued to grow in the twentieth century, as one British pediatrician gave a series of lectures to the Royal College of Physicians in London under the name "Goulstonian lectures" on 'some abnormal psychical conditions in children.' The doctor's name was Sir George Frederick Still.

Dr. Still described 43 children that were considered to have serious problems with "sustained attention and self-regulation, who were often aggressive, defiant, resistant to discipline, excessively emotional or passionate, which showed little inhibitory volition, had serious problems with sustained attention and could not learn from the consequences of their actions; though their intellect was normal."

He further described these children as having a certain "moral defect" without a general impairment of intellect.   Make note, he was describing Moral Control--a "control of action in conformity with the idea of the good of all."

Still proposed a biological predisposition to this behavioral condition that was probably hereditary in some children and the result of pre- or postnatal injury in others.  Keep that in mind--it will come up later.

ADHD was not the original term given to this condition.  In fact, it has had several in its long history including "minimal brain damage", "minimal brain dysfunction", "minimal brain disorder", "learning/behavioral disabilities" "hyperactivity", and the aforementioned "Defect of Moral Control."  ADHD wasn't used until the mid-20th century, and the definition has grown to such a degree that now there exist three subcategories, one of which is the disorder without hyperactivity.  In fact, the entire description of ADHD--which has been labeled one of the "best researched disorders" in all of medicine--has changed so often that it is a wonder the current definition has stayed intact for the last sixteen years (concomitant drug-therapies have a way of doing that)

Looking at the history of ADD, it is easy to knee-jerk a "but of course it's a disorder" reaction out of most people.  I mean, come on--how could anybody doubt modern science?  Except for one problem--the science doesn't show all that much (for a later post).  Oh, no doubt, children...er, people...have a difficulty focusing at various moments or during certain activities, particularly those "to whom the dryness and difficulties of the Latin and Greek grammars are so disgusting."  No kidding.

Categorizing this normal functioning of the human brain a disorder was understandable during a period when "conformity with the idea of the good of all," was more than a virtue...it was a freakin' law whether in the books or not.  Any behavior considered morally defect might lead one into an insane asylum, or even subject to a number of "medical treatments" that today we consider barbaric (think lobotomy).

I, in no way, wish to suggest a conspiracy of sorts...but modern science did what it could with the information it had available.  And at the time, it was best to consider any deviation from "normal" behavior a disorder.

But today we know better.  Many people have different ways of learning.  Some are labeled with one learning disability or another.  Perhaps the so-called learning disabled just have different processing styles.  That was my experience working with learning disabled kids at UC Berkeley.  Most came from Montessori schools where individual or self-directed learning is emphasized.  Once these kids came into the stringent learning models that predominate in our educational system, they began failing.  These kids were geniuses--they just needed different methods to help process material.

One reason ADD has had such a long history, I believe, is because it is a normal physiological variant.  Clearly, as the pioneers in the classification of this disorder pointed out, there is usually no deficit in intelligence.  No kidding.  From personal experience, I assure you I could have been labeled ADHD at many points in my education, but they weren't doling out the drugs at that time the way they are now.

Further, despite being one of the "best researched disorders," to date, no clear solution has been found to combat this disorder that afflicts "3% to 5% of children globally."  Why?  Because we all have an attention deficit when we are not inspired by something we are forced to sit through.  They will never find the chemical cause because like depression, chemical changes are the result of a brain state, NOT the cause.

Yes, the experts had to propose a biological cause, because they could find no mental construct that explained the disorder beyond a "Defect in Moral Conduct."  Whereas sodomy could be pinned on sexual deviancy, and thievery on a criminal defect, lack of attention had to be biological.

Conformity to societal norms was then, as it still is now, of the highest tenor (debate someone on this issue to get my point), and as such, the inability to do so in the educational structure was a defect without defense.  It was unfathomable that it might be a defect in the structure itself.  More to come.

Childrens' Vocabulary Linked to Pointing

When speaking to your infant or toddler, gesturing will help increase his or her vocabulary. Scientists have found that the more a child can communicate with gestures, the richer the vocabulary when starting kindergarten. And the ability to use hand and arm gestures to express oneself might be translated later into a better education overall.

University of Chicago researchers looked at the communication habits of fifty Chicago-area families of varying socioeconomic status. They found that the children (aged 14 months) whose parents used the most gesturing to communicate with them (and vice versa) had the greatest vocabulary. The gestures were not a form of sign-language but instead a way to communicate everyday concepts and objects--for instance, pointing at an object while naming it, "Yes, that's a dog," or signifying directionality like "up" "down" or "big."

Another interesting find was that families of higher socioeconomic status tended to use more gestures on average than those of lower income and lower educational status. The way parents talk to their children from babyhood onward has been previously found to influence vocabulary early on; and it persists into later life, ultimately leading to better overall education. On average, children from higher socioeconomic families produced 25 meanings in a 90-minute period, while poorer children produced only 13. This study does a good job of explaining at least one reason why poorer children enter kindergarten with smaller vocabularies than their financially better-off classmates. Kindergarten vocabulary is a predictor of how well youngsters ultimately fare in school.

So the take home lesson here is when speaking with Junior, use lots of hand gestures. Hey, you don't have to be Italian or from Brooklyn to get into talkin' witchya hands. Heck no, start today--you'll be doing your kids a great service in the learning department, as communication is the first form of problem solving. Getting started early in brain training is often of great advantage; but saying that, it's not too late to start with your toddler now, either.

Older Americans Living Longer

Older Americans are wealthier and living longer than ever before. So says the National Institute on Aging's report titled, Older Americans 2008. According to the report, the number of older people in the U.S. living in poverty has gone down, education has increased, and life expectancy has increased.

Americans today are living on average to 84 years old--that's seven years older than the generation that turned 65 in 1900. Despite this, some problems exist. For instance, obesity has risen significantly in the last 10-15 years. In the 2005-2006 study period, 37 percent of women aged 65 to 74 were obese, and 24 percent of women age 75+ were obese. This is up from the 1988-1994 study period, when 27 percent of women age 65 to 74 and 19 percent of women age 75 and over were obese.

Despite evidence showing exercise to improve and prolong life, older Americans are just not jumping on the bandwagon. Only 25% of people 65 and over are exercising or participating in leisure-time physical activity on a regular basis. No bueno. And no surprise that health care costs rise significantly every year following peoples' 65th birthday

So some good news and some not so great news about areas that can definitely use improvement. Overall though, I think quality of life is improving for people as they get older, and I think as health and wellness becomes more ingrained into the public consciousness, these numbers will only get better.

Political Correctness and Health

I try. I really do. But sometimes I just can't help it. As much as I want to leave the political stuff to political writers, every once in a while I've got to speak up. According to findings of a new study, education levels and socioeconomic status have important yet different effects on health.

According to the study, a person's education level independently (when adjusted for income) determined a person's likelihood of becoming ill or disabled. OK, no problem there. We know that the more educated a person is, the more likely he or she will know which behaviors are health enhancing and which are detrimental. Further, more education leads to a better understanding of various and alternative therapies, thus leading to a greater probability of self-empowerment when it comes to one's health.

Socioeconomic status, on the other hand, determined how a person's illness would progress. Whether an illness became chronic and how likely a person was to die during the study also depended on one's income level. For instance, ill or disabled people with annual incomes below $10,000 were three times more likely of their illness progressing than people earning $30,000 or more per year. Also no surprises here, as lower income individuals are less likely to seek out or afford quality health care.

However, here is what I take exception to: According to Dr. Pamela Herd of the University of Wisconsin-Madison, the study's lead author, the findings are "really about the way that poverty has negative ramifications for health," noting that poor people may live in worse housing, have a more difficult time obtaining healthy foods, and have a tougher time getting health care. And poverty can increase stress levels, she adds, which in itself can worsen health.

Uh, and how about the other factor? Like how being financially stable, let alone wealthy, requires focus, discipline, and plenty of blood, sweat, and tears. All the same things needed to achieve and maintain good health. It also requires being proactive and empowering oneself in many areas including education, finance, professional life, social life, family life, and spiritual life. How about that?

I know that's not the PC thing to say. Oh no, it's much more correct to say that being "stuck" in poverty is a form of victimization; poor people being at the mercy of circumstance, of which they have very little, if any, control at all. Moreover, for one to pull oneself out of poverty, or at least survive, is highly dependent on social and governmental change. I guess this means socialized...oops, I mean universal health care. Says Dr. Herd, "We already know what people need to do to be healthier. What we talk about a lot less is what kind of structural changes need to be made for people's health to improve."

What a bunch of baloney. No doubt, education and economic levels enormously influence health. But I hardly think it's because people don't have medical care at their fingertips. Hell, in a lot of ways, those that don't are the lucky ones; at least they can investigate other options. More likely, those people who diligently focus on their mental growth, and in turn their financial growth (even if it's relatively modest), also focus on their physical health (to varying degrees, of course). And, in general, they probably treat their health with the same care and discipline that they approach other aspects of their lives.

There, I've said it and I'm sticking by it. This isn't a belligerent bout of insensitivity at all; no sir. It's an observation that any type of growth requires work--hard work--as well as focus, discipline, and a burning desire for evolution, despite one's obstacles (we've all got obstacles, and money is simply one of the many in existence). Achieving and maintaining great health also requires these same things. And the power is in the individual. Everything else is just a cop out.