Dear Sir,

It was with some interest that I read the article What You Should Know About Attention Deficit Disorder by Edward W. after having it handed to me by a member of our church. There were elements of the article that were insightful, helpful, and needed to be said in a public forum, especially the discussion of the moral and spiritual dimensions of behavior. For this part of the article I applaud Mr. W.

However, Mr. W's discussion on the physiological/biological aspects of ADD ADHD was lacking to the point of being misleading to the readers. I am sure that Mr. Welch had no intention of misleading any readers, as that would hardly reflect the "biblical guidelines with which to understand ADD" that he seeks to communicate. Therefore, for the sake of clarifying some details, may I present the following evidence. Perhaps in the near future you would run an article that would present some of this information to your readers, so that they have an accurate understanding of the disorder.

We continue the dialogue here in part five, Mr. W turns his attention to medications used to treat ADHD. He writes,

"That a stimulant drug would help some children focus seems paradoxical. You would expect that children would be even more physically and mentally excitable when taking it."

First, the effects of Ritalin, or any stimulant including caffeine, are not "paradoxical" in ADHD individuals. They are predictable. And they are effective.

Two significant contributors to ADHD are a lack of dopamine, or an effective lack of dopamine, in the frontal lobes, and a restriction of blood flow in the frontal lobes. Research supports this.

Stimulants, from caffeine to Ritalin, are known to do two things well: increase blood flow, and increase dopamine levels in the brain. Therefore it is not paradoxical at all. One would expect that stimulants would increase performance for individuals with this condition, and they do in about 75% to 80% of the cases.

"One thing, however, is clear. Ritalin does not treat any known chemical deficiency in a child's brain."

What research supports this position? Why is this "clear?"

Ritalin does in fact "treat known chemical (deficiencies) in a child's brain." It does in fact increase the utilization of dopamine. This action and benefit is similar to other medications, such as antidepressants, used treat other known brain chemical deficiencies such as a lack of serotonin.

While it is true that stimulants to not "fix" the condition, this does not take away from its usefulness. Insulin does not "fix" diabetes either. But in the short-term, stimulants, like Insulin, works to "normalize" or at least "improve" the situation. To say that stimulants "are not a cure" is true. Insulin is not a "cure" either. But both are helpful.

Thank you for your time in considering this perspective.

This is the end to part five of this discussion. You can learn more about Attention Deficit Hyperactivity Disorder by visiting the ADHD Information Library's family of web sites, beginning with http://www.ADD101.com.

Douglas Cowan, Psy.D., is a family therapist who has been working with ADHD children and their families since 1986. He is the clinical director of the ADHD Information Library's family of seven web sites, including http://www.newideas.net, helping over 350,000 parents and teachers learn more about ADHD each year. Dr. Cowan also serves on the Medical Advisory Board of VAXA International of Tampa, FL., is President of the Board of Directors for KAXL 88.3 FM in central California, and is President of NewIdeas.net Incorporated.