We are all familiar with the so-called â€˜placebo effectâ€™. This is where someone begins to feel significantly better after receiving â€˜fakeâ€™ medication (usually a sugar pill or a tablet with no active pharmacological ingredients). The existence of the placebo effect amply demonstrates that the belief that a condition is being treated can sometimes be as powerful as the treatment itself.
Significant new research (published in the Journal of Development & Behavioral Pediatrics) points to the widespread occurrence of the placebo effect when it comes to ADD/ADHD medication. This should perhaps be expected as the effect has been shown to occur with just about any kind of medication imaginable. What makes the findings surprising however is that the placebo effect did not occur in the ADD/ADHD patients themselves but in their caregivers! In other words, the belief that a child is being medicated was sometimes enough for parents or teachers to significantly modify their attitudes to, and expectations of, that child.
The study was conducted by pediatric psychologists from the University of Buffalo and found that, when caregivers believed that children were receiving ADD/ADHD medication (e.g. Ritalin and Adderall) they would view them more favorably and treat them more positively â€“ whether medication was actually involved or not!
The lead author of the review Dr. Daniel A Waschbusch summarized their rather alarming findings as follows: â€œ”The act of administering medication, or thinking a child has received medication, may induce positive expectancies in parents and teachers about the effects of that medication, which may, in turn, influence how parents and teachers evaluate and behave toward children with ADHD. We speculate that the perception that a child is receiving ADHD medication may bring about a shift in attitude in a teacher or caregiver. They may have a more positive view of the child, which could create a better relationship. They may praise the child more, which may induce better behavior.“
The findings of this research project is a damning indictment of the well documented â€˜rush to medicateâ€™ whenever there is the slightest suspicion that ADD/ADHD might be involved. The pressure to do so often comes from teachers who explicitly and implicitly signal that little Johnny will have a much tougher time in class if Ritalin is not added to the mix as soon as possible. Parents are often so intimidated by this stance that they meekly accept the â€˜recommendationâ€™ to go and see a medical professional that can be relied on to supply the â€˜correctâ€™ diagnosis and treatment. This is the exact path that thousands of young people take every year: A path that leads to unnecessary exposure to very dangerous chemicals and an accompanying label classifying the child as â€˜difficultâ€™.
The suggestion, implicit in the research quoted above, that positive outcomes can be achieved by some focused attention and high expectations is a rare and welcome nod in the direction of plain old fashioned common sense. As a society we need to be reminded that it is a fallacy to believe that every problem can be solved by medicating it away.
It is my belief that parents should educate and equip themselves to deal with the pressure to â€˜diagnose and medicateâ€™ that they will perhaps have to deal with. This preparation should focus at being ready with answers and arguments on both the side effects and the effectiveness of ADD/ADHD medication.
Side Effects: The evidence that ADD/ADHD medication can have some pretty nasty unintended consequences is mounting by the day. Medicines like Ritalin, Strattera and Adderall have been implicated in everything from suicidal thoughts to increased susceptibility to addiction. The fact is that you are dealing with powerful mind-altering chemicals: A fact that should not be obscured by comforting advertising copy and the glib reassurances of those who benefit financially (or otherwise) from their distribution.
Effectiveness: The research quoted above is another nail in the coffin of the â€˜defenseâ€™ that the perceived dangers of the products are obscured by the fact that they are so effective in improving attention. This is a very difficult assertion to prove when it comes to long term use of products like Ritalin. Could it, further, be the case that all that is really needed are some lifestyle modifications (as suggested in the â€˜3 Steps ADDâ€™ Program) and a more positive engagement with the child? If the answer to this question is â€˜yesâ€™ (as I believe it is) it would perhaps leave pharmaceutical companies with radically reduced profit margins. This is, however, a negligible price to pay for giving our kids back the privilege of living their lives without unnecessary â€˜chemical crutchesâ€™!
* The full article, entitled, Are There Placebo Effects in the Medication Treatment of Children With Attention-Deficit Hyperactivity Disorder? Can be found on the website of the Journal of Development & Behavioral Pediatrics
* A shorter discussion of be accessed on Science Daily.