Monday, December 2, 2013

The week in ADHD news

Well, apparently there is hand-wringing about baseball players on Adderall. The Los Angeles Times says Major League Baseball players received 119 exemptions for ADD medications last season (incidentally, dear L.A. Times, the preferred term these days is ADHD. You might want to make a note of that), which is apparently a record number. Also, seven players were disciplined for unauthorized use of Adderall; the exemptions became necessary as of the 2006 season, when MLB banned amphetamines. The number of exemptions has risen every year.

The Times says that according to the MLB's numbers, one in 10 players has been diagnosed with ADHD (not ADD), which it calls "at least double the incidence of ADD in the general population." Uh, for real? Because literally just last week, the CDC said more than 1 in 10 U.S. kids has been diagnosed with ADHD, per a 2011 survey. That's just kids, not adults -- and plenty of adults have been getting diagnosed for the first time in the past generation or so, after spending their whole lives wondering what was wrong with them. (Don't believe me? You go read the posts on the ADDitude boards.) I'm no statistician or math whiz or even remotely comfortable around numbers of any sort, but if the CDC is correct, then how in the world is the MLB number double the general population?

I think what the Times is getting at is that players are scoring legal methamphetamines so that they can, well, score. And field the ball, presumably. Except here's the thing. It's not unrealistic for an athlete to have ADHD, any more than it is for a singer/actor/writer/artist. Exhibit A: Michael Phelps. Exhibits B and C: Shane Victorino and Andres Torres. ADHDers tend to have ridiculous amounts of energy and a need to burn it off. They tend not to do well in very rigid surroundings. They'd much rather be moving about than, say, filling out TPS reports.

As always, don't take my word for it. Per ADDitude magazine:

Many experts say a connection between ADHD and athletics makes sense. "Having ADD can actually be an advantage in certain sports for ADHD children," says Mike Stabeno, author of The AD/HD Affected Athlete. "While some activities require intense concentration, that's not always the case with athletics. Everything happens instantaneously. You're in there for 10 minutes, you've got five people trying to take your head off, three referees, four teammates. You need to take in everything that's going on all at once. That's how people with ADD go through life. So it makes sense that they thrive in this field." 

So 119 out of 1,200 baseball players having ADHD doesn't sound unrealistic to me.

Sure it's possible some of those diagnoses are specious, or made on a snap-judgment basis, or made for the access to medications. Of course it's possible. Is it possible that every single diagnosis is bogus? Again, not a statistician, but I don't think so. I think the real issue, again, is this assumption that ADHD itself is bogus and people just get diagnosed so they can get the meds. And that assumption will never stop irritating me. We've spent the past year and a half doing occupational therapy, behavioral therapy, social skills classes, pediatric psychiatry and classroom accommodations, not to mention the money we've dropped on a weighted vest, compression shirts, triangular pencils, etc. You think we're doing all this for a bogus diagnosis? I assure you: No.

In slightly less exasperating news, there's this article about a startup company that's launching a game next year that's supposed to improve kids' focus using a brain-to-computer interface. It's currently in testing.

The distinction of the Atentiv system, according to Atentiv founder and Chief Executive Eric Gordon, is the precision with which its technology calibrates each individual's mental circuitry and then zeroes in on electrical activity related to attention, as opposed to memory, for instance, or critical thinking. A numerical indicator on the screen gives a real-time reading of the child's attention level, the numbers fluctuating from zero to 100.

The goal of the game is to get a bird to move along a winding road and perform certain tasks that require tapping keys. But the bird speeds along, or slows down and stops, depending solely on the degree to which the user stays focused.

It's not an easy task, as this reporter found when he tried on the headband [which contains sensors to monitor brain activity]. Willing oneself to "pay attention" can bring the bird figure to a stop. The user must ignore all distractions—including the mind saying, "Focus! Focus!" 

There are a few other companies offering similar "games" -- Cogmed and Lumosity among them -- but as the article notes, there have been studies debunking the usefulness of those companies' products. Still, assuming testing goes well, it could be promising ... mainly because I think all this effort put into helping kids improve their focus has got to result in something useful, at some point. And then families have a tool in addition to, or in place of, medication -- and then maybe ADHD loses some of the stigma. So I'll be curious to see how the Atentiv testing plays out.

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