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So will dissenters now say that we are just treating people for the test and not for real life?
That's exactly what the dissenter in the article is asking.
In a book I read by Russell Barkley, one of the doyens of ADHD research, he said that if screening questionnaires were boiled down to just one question, the best question to ask would be "Are you easily distracted?" That question goes a long way toward identifying children or adults who have issues with attention control. He says multiple question screening questionnaires are still more reliable, but that one question about ease of distraction has enough sensitivity and specificity

http://en.wikipedia.org/wiki/Sensitivity_and_specificity

to be useful for brief screening.

What I find interesting, as a Baby Boomer, is how much the paradigm has changed. When I was a kid, only children who were "hyperactive" were considered to have a problem. People who had trouble concentrating were not considered to have a psychological [after edit: or medical] issue, and of course in those days it was thought that few or no adults had any such issue [after edit: as "hyperactivity" or "attention deficit."] There does seem to have be evidence that many people grow out of either the hyperactive or inattentive type of ADD/ADHD, and that impulse control and attention focus are learnable, but apparently they are more learnable for some people than for others under matched training conditions. The medical interventions do appear to be helpful in their own right.

"What I find interesting, as a Baby Boomer, is how much the paradigm has changed. When I was a kid, only children who were "hyperactive" were considered to have a problem. People who had trouble concentrating were not considered to have a psychological issue, and of course in those days it was thought that few or no adults had any such issue."

More than likely when you were growing up, homosexuality was considered a mental illness. We've learned a lot since then. :-)

"There does seem to have be evidence that many people grow out of either the hyperactive or inattentive type of ADD/ADHD, and that impulse control and attention focus are learnable, but apparently they are more learnable for some people than for others under matched training conditions."

You don't grow out of bonafide ADHD. It's with you for life much like OCD or bipolar disorder. You can learn to cope with it better, but you can't really make it go away (even with drugs though they help a lot).

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You don't grow out of bonafide ADHD.

That's not entirely Barkley's view. (Barkley is the principal investigator for some of the largest longitudinal studies of ADD/ADHD.) I'm not aware of any researcher on the subject who would say that as a global statement. I'd appreciate seeing a citation for any source you have seen that says this.

> “It’s essentially a dull, boring task,” he said of the Quotient system, “so do you want to medicate your child to pay attention to dull, boring tasks?”

Absolutely. Real life isn't always fun and games. Of course, medication won't make your child enjoy those dull, boring tasks. But it will at least make them capabale of paying attention to them.

Tests for AD(H)D focus on 2 different aspects: attention and hyperactivity/impulsiveness. Key to any diagnosis is not the occurrence of individual symptoms, but how many you have in each category, the degree to which you have them, whether they appear in different settings, for longer than 6 months and they are actually life impairing. Simply being forgetful/distracted/dyslexic/argumentative etc by itself isn't a clear cut sign that you have AD(H)D, as they may have entirely different causes.

Slightly unrelated, but if anyone is interested in reading more about the topic, Edward Hallowell's 1994 book Driven to Distraction is a seminal book on the topic and includes some of the classic signs used to analyze the condition.

http://en.wikipedia.org/wiki/Driven_to_Distraction

His 2005 follow-up Delivered from Distraction, focuses on how to make the most out of it if you have it and harness your strengths (creativity, charisma, energy, intelligence).

tl; dnr

Just kidding. In reality, this is a very helpful read. I'm wondering whether I have an attentional disorder myself, and many of the same questions the author closes with are my questions.

This is just my personal experience with friends who had add. My previous 2 roommates at two different places were taking ADD pills. Somehow after their pills ran out they kept complaining how they're not gonna be able to do their homework, study, etc, yet they were able to sit and play complicated computer games for hours on end.
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That's not surprising, since (despite the name) ADD doesn't imply an inability to focus at all times. Those with legitimate ADD have an unusually hard time directing maintaining focus except under highly stimulating conditions. Complicated computer games are one of the few things that an ADD person is likely to maintain focus with.

That's not to say that your roommates cases were legitimate. They may not have been. But your description isn't necessarily evidence of a mis-diagnosis.