Doctor skeptical of ADHD ‘labelling’ - New Zealand

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Doctor skeptical of ADHD ‘labelling’

Wednesday, 20 April 2011

By Motion

A VISITING Swedish paediatrician says parents and teachers should be

sceptical about “labelling” children with ADHD, and of drugs like

Ritalin prescribed to treat it.

Leif Elinder, a doctor who was based at Whakatane Hospital from 1985

to 1990, said some naughty children were being misdiagnosed with a

neuropsychiatric condition like Attention Deficit Hyperactivity

Disorder.

As a result amphetamine and stimulant drugs were being prescribed

with inadequate unbiased research into their long-term effects, he

said.

He believed in most cases, the cause of the behaviour was cultural,

not medical.

“I’m sceptical of medical solutions because very rarely is it a

medical cause – 95 to 99 per cent of the time it is a cultural

problem.

“Parents have less time for their children. Teachers have classes

that are too big.

“Kids need to be attended to especially when they do nice things,

and often they are only noticed when they do something wrong,” the

father-of-four said.

In the late 1990s Dr Elinder became concerned Swedish doctors were

unnecessarily prescribing amphetamine or stimulant drugs for

children diagnosed as ADHD.

He read an article by prominent neuropsychiatrist

Gillberg and school doctor Sophie Ekman that claimed 10 per cent of

Swedish children had a lifelong neuropsychiatric dysfunction.

Dr Elinder was concerned by the figure, the result of a longitudinal

study, believing less than one per cent of children would actually

qualify for such labelling.

He took the researchers to court three times and won the right to

examine the raw data from the study.

Each time researchers refused to co-operate and, after the final

ruling, Gillberg’s associates shredded more than 100,000 pages of

data, citing participant confidentiality.

They were convicted of obstruction, fined and given suspended

sentences.

During the court battles Dr Elinder was accused of being an

antagonist and having links to the Scientology religion – though he

has none.

“I wouldn’t have taken the challenge of going up against Sweden’s

most famous researcher unless I thought there were good reasons to

look at this material and take a closer look at the data.

“I’m worried that doctors will use this research and assume this is

a congenital or hereditary condition when there is no proof.

“No long-term studies have been done because there is no funding for

them.

“In the absence of any unbiased research I think it is better to

stick to the assumption that it is a cultural condition and should

be treated in a cultural way.”

Mr Elinder believed the criteria for determining an ADHD diagnosis

were “so arbitrary that any child failing at school could get a

diagnosis”.

There were no medical tests, he said. Diagnosis was based on an

interview with the child’s parents and sometimes teachers, which is

interpreted by the doctor.

“If a doctor says this is congenital or this is hereditary, how can

parents or teachers argue against that?

“It’s a quick-fix solution, a medical solution – just give them a

drug – and it relieves parents and teachers from responsibility.

“But the knowledge parents and teachers have is more important that

the knowledge doctors have about naughty kids.

“My message is be sceptical when doctors say this is congenital or

hereditary.

“Of course congenital conditions exist but they are rare.”

An example of a cultural treatment could be swapping some of a

child’s television time for time spent “sitting on their parent’s

knee reading a book”.

Mr Elinder is visiting New Zealand for three months and recently

spent a fortnight with friends in Whakatane, which he described as

“absolutely the best place in New Zealand”.

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