The study gave a large sample of kids the "Gordon Diagnostic System" GDS test of sustained concentration ability. This dates to the 80s and it consists of a box, with a button, and a display with three digits. There are three different tasks but the main one is a sustained attention test. The goal is to watch a series of numbers and quickly press the button whenever a "1" is followed by a "9". Easy... but it takes concentration to do well.
Over the period of 2000-2006, the researchers gave the GDS to 445 healthy American kids, not diagnosed with any learning or behavioural disorder and not taking medication. They compared their scores to the standardized norms - which were based on a sample of American kids back in 1983.
The results showed that today's kids scored pretty much the same, on average, as the 1983 kids. The average age-standardized scores were extremely close to the 1983 means, across the board. Children diagnosed with ADHD, as expected, scored much worse. Oddly, kids with an Autism Spectrum Disorder did just as badly as the ADHD ones.
One of the researchers on this study is none other than Michael Gordon, who invented the GDS and, one assumes, makes money selling it. (Each GDS kit costs $1595, so someone is making a killing here.) So perhaps we should take this paper with a pinch of salt, because it's kind of an advertisement for the reliability of the GDS.
Still, these results seem pretty solid. That's good news for American children... but bad news for people like Professor Susan Greenfield, who thinks that the internet and videogames are causing an epidemic of ADHD, and all kinds of other problems.
These data suggest rather that, while ADHD diagnoses are certainly rising, children as a whole are not getting less attentive, suggesting that the rise of ADHD is more of a cultural shift.
Mayes, S., Gordon, M., Calhoun, S., and Bixler, E. (2012). Long-Term Temporal Stability of Measured Inattention and Impulsivity in Typical and Referred Children Journal of Attention Disorders DOI: 10.1177/1087054712448961
22 comments:
It's not clear to me from the paper whether the original 1983 sample excluded children with an ADHD diagnosis or not. I hope it did. If not, isn't what the authors found that the means for typical (no diagnosis) children today are roughly the same as those for the general population in 1983?
Let me fix the last phrase for you, you made a small error:
suggesting that the rise of ADHD is more of a cultural shift.
must read
suggesting that the rise of ADHD is due to a faulty definition of the affliction
The GDS must cost about a quid to make.
I was not quite sure what you meant in terms of the final sentence. I understand that the article is about how diagnosis from a sample of children showed "modern" children to have roughly the same percentage of ADHD children as in 1983 but what I didn't understand was the reason for the increased diagnosis rates.
Good to know!
The right on the money mean test score of exactly 100 for normal kids from 2002-2006 according to the abstract compared to the 1983 result of 100 is quite a bit close than one would expect from statistical sampling error in a 445 child study to the point of being slightly suspicious in a study where an author has a potential conflict of interest. It can happen, but an outcome in the 95-99 or 101-105 range would be collectively much more likely than a right on the money 100 result, even though the 100 result is modal.
"I understand that the article is about how diagnosis from a sample of children showed "modern" children to have roughly the same percentage of ADHD children as in 1983 but what I didn't understand was the reason for the increased diagnosis rates."
The percentage of kids who have been diagnosed by a doctor as having ADHD or are prescribed ADHD meds is indisputably vastly higher in 2002-2006 than it was in 1983.
If the same test of members of the general population produces the same spread of result and accurately predicts an ADHD diagnosis than one or two things (and probably both) must be happening:
(1) more kids who are ADHD by the measure the test uses are getting diagnosed with ADHD and prescribed drugs for it (in theory a good thing).
(2) more kids who don't really have any neurological pathology are being diagnosed with ADHD and prescribed drugs for it (in theory a bad thing).
Since ADHD was very likely undiagnosed in 1983 because it was obscure at the time to patients, and referral sources and diagnosticians alike, some increase is probably a good thing if ADHD is indeed a valid psychological concept and this test, among other things, suggests that the diagnosis has some objective meaning.
But, there is no easy way to determine how much overdiagnosis there is of the condition, although few people doubt that there is some.
Also, what is the right result in the gray areas? If a dose of amphetamines is helpful to someone in performing major life tasks that they weren't truly pathological in before, and doesn't have serious long term negative effects when used in moderate doses under a doctor's care, is that truly a misdiagnosis, or is it merely a symptom of society's failure to recognize that people who aren't broken can sometimes benefit from taking drugs (something the military has long been comfortable with recognizing).
wow, you had a big logical error here. The paper just compared performance between typical kids now and in the past. In order to say there is no "epidemic" of non-typical development a study should sample the entire population not just the typical.
Thanks so much. Got information from here.
Why istn't there a GDS app available? Would be easy to program and cost a few bucks.
Sam: It would be easy to program it as an app, yes. Or a Flash thing to run in a browser.
It is my understanding that many are often 'diagnosed' with ADHD without a full diagnostic workup. In my experience as a psychometrist, an astounding number of cases of ADHD are misdiagnosed. Often, students will complain of symptoms of ADHD, which are non-specific and often attributable to other concerns, such as anxiety or depression. Furthermore, I find that the diagnostic criteria of symptoms being present since childhood is often overlooked. A recent study found that an alarmingly small proportion of people diagnosed with ADHD on a college campus actually met the DSM criteria. There's a lot of interesting research on this.
I also think that the current cultural climate has been optimal for ADHD to catch on as a 'meme'. Anything related to moments of inattention or distractibility is often labeled as being ADHD-like. In other words, people have difficulty teasing apart the symptoms (which we all experience from time to time) and the true disorder.
ADHD is a massive fraud created by School institutions in order to manage the children's (mis)behaviour required by said administrators. Can't sit still listening to the teacher drone on about boring stuff? Forgetting homework (only because one did not want to do it and for which a true admission would bring about a punishment? Running or climbing trees inappropriately? Appropriate for whom? A brain disorder? Do me a favour! ADHD is used by schools to manipulate statistics and grab extra dosh from the state. Sir Ken Robinson describes this farce succinctly.
@ADHD is a massive fraud
http://www.youtube.com/watch?v=FopyRHHlt3M
As I wrote on twitter, your conclusions are wrong.
in this article GDS shows difference between children with typical development and children with ADHD, so it supports the conclusion that ADHD diagnosis today is based real attention problem.
Then there is no difference between typical children today and in the past. But if in the past ADHD were not diagnosed you would expect the typical results from the past to be lower.So it seems that either the increase in ADHD is real, or that in the past children with ADHD performed better on this task. Either way the paper supports the claim off increase in attention problems.
'Increase of attention problems'?
Probably because attending school is so much more sh1t than it was 30 years ago. Not because children have changed. Brave New World eh?
we know the rate of "children" (those under 18) being diagnosed with add/adhd is rising, but it would be interesting to look at the rates of teenagers and the rates of children children separately. I wouldn't be surprised if the rate of diagnosis among teens is growing just as rapidly if not more rapidly than the rate among children.
We are quick to point to parents, teachers, psychiatrists and big pharma as collaborating to make children more controllable through stimulants. But what if it is partially the kids themselves? Consider the 15 year old who needs to cram for a test and takes some of her friends adderall. After finding it useful, she either thinks she has ADD or decides she just wants a prescription to adderall so she presents the symptoms to her doctor and gets diagnosed. Teens pretty much diagnosing themselves with add/adhd happens more often than we publicly admit.
I like Andrew's comment about "society's failure to recognize that people who aren't broken can sometimes benefit from taking drugs" I think that sums up the unspoken side of the rise of add/adhd.
Julia - of course it is not only parents and teachers but children who are seduced by having the term ADHD ascribed to them. Encouraged by society. After all it is only a few years ago that they were defined as 'feebled minded' or 'minimally brain damaged'. It is all just a massive pseudo scientific scam. Who benefits? Follow the money....
and actually the fastest growing group who 'suffer' from ADHD are now adults! Google 'adult ADHD' - it is the new bi-polar!
Anon, teens aren't seduced by the term ADHD, they are seduced by adderall. You are misinformed if you think teens who are currently getting diagnosed with ADD were recently defined as feeble minded. It is the ambitious and competitive high schoolers who want a step up on their grades and SAT scores through adderall. Read this article: http://www.nytimes.com/2012/06/10/education/seeking-academic-edge-teenagers-abuse-stimulants.html?_r=1
Follow the money, yeah, but also follow the SAT scores
To all the 'ADHD s a fraud' folks:
Yes, it's obviously over diagnosed - but that does not mean it's not a real thing. I personally have more sympathy for the assertion that there is a spectrum of attention modes, some of which are better suited to life in a regimented society, with the recognition that there are genetic aspects involved which can end up stacking the deck against individuals who have an especially problematic attention/information processing modality.
But the West is obsessed with medicalizing difference, so here we are.
Or maybe I'm just lazy and somewhat dumb... but least I'm not an asshole who assumes that everyone who claims to experience the world differently than I do is making up an excuse for why they aren't as good as I am at something.
Great article! :D
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