NCL's Comments to The American Academy
of Pediatrics on ADHD Policy Statement

November 15, 2001

Dr. Joe Sanders
Office of the Executive Director
The American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098

Dear Dr.Sanders:

The National Consumers League would like to express our support for the conclusions and recommendations of your October 2001 Policy Statement, “Clinical Practice Guidelines:  Treatment of the School-aged Child with Attention Deficit/Hyperactivity Disorder (ADHD)”  (Pediatrics, Volume 108 Number 4, pp. 1033-1044).  It is our hope that the well reasoned, medically sound and compassionate principles embodied in the Policy Statement become the foundation for the health system’s and the public’s approach to ADHD diagnosis and treatment.

As you may know, NCL is a nonprofit consumer advocacy organization founded in 1899 to represent consumers and workers in the marketplace and workplace.  Among the priority public policy concerns of the League are food, drug, and healthcare.  We have worked with the AAP on occupational safety issues, especially regarding children in the workplace on the Child Labor Coalition for several years.  In addition, we provide information and educational materials to consumers so they can make wise and well informed decisions, participate in the legislative and regulatory arenas and on several boards and coalitions that focus on healthcare. 

In recent years, it has become quite apparent that ADHD is a legitimate neurobiological disorder, and today it is officially recognized not only by AAP but also by the U. S. Surgeon, the American Medical Association, the American Academy of Child & Adolescent Psychiatry, and numerous other institutions and experts.  The National Mental Health Association reports that as many as one in every twenty children has ADHD.  On average, about one child in every classroom in the United States needs help for this disorder, according to the National Institute of Mental Health.

As a consumer organization, NCL is particularly concerned about the growing body of evidence showing that, if left undiagnosed and untreated, ADHD can have severe effects on the child, the child’s future as an adult, his or her family and society at large.  In addition to academic problems, a child with ADHD typically lacks many social skills, and therefore, has a hard time making and keeping friends, participating in after school activities, and maintaining good family relationships.  Children with ADHD may be at higher risk for criminal behavior and substance abuse, if the disorder is left unmanaged.  Clearly, it is a condition that deserves to be treated as a national medical health priority.  In this context, it is well founded to treat ADHD as a chronic condition, while freely drawing on the collaborative resources and efforts of not only the treating clinician, but also the parent or guardian, the child, and school personnel, as directed by the new AAP guidelines.

Of course, the diagnosis and treatment of ADHD is not without problems. We believe that some – not all – of the concerns expressed about the reliability of ADHD diagnosis are well worth addressing.  According to the best information available, too often ADHD is misdiagnosed or not diagnosed at all.  Therefore, NCL applauds the AAP guidelines that call for clinicians to reevaluate the original diagnosis, if the treatment for a child with ADHD has not met its goals.

Perhaps, most important, the guidelines are helpful in reestablishing that, “For most children, stimulant medication is highly effective in the management of core symptoms of ADHD,”  and recommending that “the clinician should recommend stimulant medication and/or behavior therapy, as appropriate, to improve target outcomes in children with ADHD.”  While in no way should medication be regarded as a “silver bullet” treatment, as a consumer organization we are acutely aware that some agenda-driven groups have sought to stigmatize the use of medications in the treatment of ADHD to the severe detriment of ADHD children and their families.  We must all work together to ensure that the fruits of medical research and up-to-date behavior modification therapy are accessible to children with ADHD.

NCL will do what it can to see that these extremely useful guidelines are known to and embraced by our members and constituents.  As always, we would be pleased to cooperate with AAP in efforts and programs to reach the public and healthcare professionals with this new information.

                                                            Sincerely,

                                                            LINDA F. GOLODNER

                                                            President

CC:  Dr. Charles Homer
        Dr. James Perrin
        Dr. Martin Stein

The National Consumers League, founded in 1899, is America's pioneer consumer organization. Our mission is to identify, protect, represent, and advance the economic and social interests of consumers and workers. NCL is a private, nonprofit membership organization. For more information, visit www.nclnet.org.

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