John Rosemond, MS is a nationally-syndicated columnist and parenting expert who’s made a name for himself by promoting a lot of old-fashioned parenting skills. You know, like spanking. I suppose there’s nothing wrong with ignoring research data and science that’s been published in the past few decades (if that’s your thing).
But I was a little taken aback by Rosemond’s recent answer to a parent’s concern that her child may have attention deficit hyperactivity disorder (ADHD).
Rosemond starts his reply off with this outrageous claim: “First and foremost, there is no good science behind the diagnosis of ADHD.”
He goes on to say:
The claims that it is genetically transmitted and involves “biochemical imbalances” and brain differences have never been conclusively proven.
Rosemond makes a critical logical fallacy here — believing that you have to understand the cause of a disease in order to properly diagnose and treat it. We still don’t understand what exactly causes cancer. Does that mean we can’t diagnose or treat it? Of course not.
I’m not aware of any ADHD researcher who thinks that ADHD is the result of “biochemical imbalances.”1 I’m also not aware of any ADHD researcher who believes that ADHD is genetically transmitted like hair or eye color.
What researchers do believe is that there is a genetic heritability factor that accounts for some — admittedly — small percentage of a person being at risk for this diagnosis.
But the misinformation doesn’t stop there:
To my knowledge, none of the medications in question have ever reliably outperformed placebos in clinical trials. Their necessity is highly suspect, in other words.
That’s simply false. For any drug to be approved by the U.S. Food and Drug Administration (FDA), it has to go through a series of expensive, time-consuming research studies called clinical trials. Two sets of the clinical trials need to demonstrate that a drug is effective not only to treat the disorder or condition, but that the new drug is more effective than a sugar pill (placebo).
If a drug is shown to be no more effective than placebo, it wouldn’t be approved by the FDA. In fact, most drugs that are researched don’t make it past this stage, because being more effective than placebo is actually a pretty high bar to clear.2
To say that he’s not aware of any research demonstrating ADHD medications’ effectiveness over placebo is just plain odd. Surely Rosemond is aware this is how the FDA approves drugs, so wouldn’t he also know there are literally dozens of studies demonstrating the effectiveness of ADHD drugs?
Rosemond goes on to say:
Then there’s the matter of testing a child to determine if he has ADHD. The plain fact is that none of the published diagnostic criteria depend upon test results. They refer to behavior, period.
That much is true. A good ADHD diagnosis is made primarily by a mental health professional, such as a school psychologist, child psychologist or other similar professional who extensively and primarily works with children. And one of the requirements of any ADHD diagnosis is that the problematic behaviors occur in more than one setting.
A child having a hard time at school only — without any attention or concentration problems at home, playing sports, or with friends — generally wouldn’t qualify for an ADHD diagnosis. That’s why it’s important to strictly adhere to the behavioral criteria set out in the diagnosis. This is where most misdiagnosis occurs — a professional who doesn’t ask enough of the right questions to ensure the problem does exist in more than one sphere (and that the problem behaviors are just as serious in those other spheres).
But he either misunderstands the purpose of psychological testing (which is extremely odd, given that he calls himself a family psychologist), or is misrepresenting the purpose of further testing. Psychological testing would find the strengths and weaknesses of the child’s attention and concentration skills, honing in on the things that need work and ensuring that any treatment planning is focused on the right things.
The testing could very well demonstrate — and sometimes does — the child has no problems with attention or concentration, meaning that an ADHD diagnosis would not be appropriate.
Rosemond appears to be a bit of a relic, living in a time where children’s bad behavior could be fixed by a good swat to the butt. There’s no doubt that this old-timey, no-nonsense approach has its supporters — hence his popular parenting column. But in an effort to be so definitive in his answers, he seems to be providing misinformation about the complicated issues surrounding the diagnosis and treatment of ADHD.
Read the article: John Rosemond: Easy to get distracted by ADHD ‘bad science’
- And, in fact, I’m not aware of any mental illness researcher who still subscribes to that marketing nonsense, although new research into gut health suggests there may be something interesting there. [↩]
- I won’t delve into the methodological issues about some of these studies; that’s for a more technical audience. But I acknowledge there are flaws and problems with many of these clinical trials. [↩]