ADHD: Current thinking about an old disorder

Dr. Russell A. Barkley, a professor in the Department of Psychiatry at the Medical University of South Carolina, is an authority on attention deficit hyperactivity disorder. He's the author of "ADHD and the Nature of Self Control" and "Taking Charge of ADHD."

He'll be sharing his expertise at the Feb. 4 conference of the Utah Association of School Psychologists, where he'll be the keynote speaker.

ADHD is a complicated subject. The definition alone is long and complex and seems subject to interpretation.

We asked him a few questions about recent developments regarding ADHD.

Deseret Morning News: What's the credible research showing regarding the causes of ADHD?

Russ Barkley: The disorder has now been shown to be highly genetically influenced. More than 80-90 percent of the variation in the behavior pattern in people, regardless of country, has been shown to be controlled by genetics. These studies, which are now very numerous, are all consistent in showing that social factors inside the home (parenting, TV, diet, videogames, etc.) play no significant role in causing the disorder. But events outside the home as well as unique events that can happen to a child (birth complication, pregnancy problem, head injury, disease, lead poisoning, etc.) may also be causing a smaller percentage of cases of ADHD.

Deseret Morning News: What's the credible research showing regarding the treatments or methods of helping a child with ADHD?

Russ Barkley: For most cases, a combination of medication (either stimulants or Strattera) with counseling of the parents on more effective methods for managing difficult child behavior, and consultation with schools on classroom and curriculum adjustments, works the best. Each of these approaches alone has weaknesses that the others can help correct. We have also learned that treating children for short periods of time produces no lasting benefits. Like diabetes, treatments have to be maintained longer to result in improvements that really matter.

Deseret Morning News: What would you tell parents who have just faced up to the fact that they have an ADHD child who is difficult to manage?

Russ Barkley: First, it's not your fault. As I noted above, the disorder is largely of genetic and neurological origins. So, give up the guilt. Second, while parents may not cause ADHD, they can determine just how impaired a child will be and whether that child goes on to also develop serious defiance or depression by how they deal with the child. Lax or abusive disciplining not only won't help but may contribute to additional problems.

Third, we know more about ADHD and its treatment today than at any time in history, so be thankful you weren't raising one of these kids 20-30 years ago.