Jennifer had her hands full. Thomas, her four-year-old, and Henry, two-and- a-half, were running rings around her as she cradled six-week-old James. That one moment of peace she hoped for in the coffee shop next to a public library in Adelaide, Australia, wasn't happening. Her older sons screamed, cried, picked up and dropped things, darted around and just wouldn't stand still. Was their behavior normal or the very early signs of Attention Deficit Hyperactivity Disorder (ADHD)?
Over the past few decades, millions of parents all over the world have been asking themselves and their pediatricians that same question - and getting inconclusive answers because there has been no comprehensive test for ADHD.
That is up until now. Australian researchers have just announced a breakthrough -- a new testing method that is 96% accurate in determining who suffers from the disorder that is characterized by impulsivity, lack of self-control, hyperactivity and inattention. Working through the University of Sydney, a consortium of scientists identified ADHD sufferers by using a computer tool (called IntegNeuro), that sees how the brain performs when put under increasing load by carrying out game-like tasks.
"Our study has shown for the first time that there is a biological basis to ADHD which can be reliably tested to diagnose it," said University of Sydney Professor of Cognitive Neuropsychiatry Leanne Williams.
Estimating that the disorder affects at least one child in every classroom worldwide, she said the computer tool -- introduced in Sydney and Adelaide as well as in Israel - should cut down on misdiagnoses and make it easier for parents and doctors to decide whether any medication is needed. "For clinicians and parents," Williams said, "there is great peace of mind knowing that there is evidence that a child has some physical or biological change that makes it necessary to be medicated."
But, ironically, almost at the same time as Williams was making that statement, another new Australian study - the world's first into the long-term effects of stimulant medication on children with ADHD - raised questions about whether drugs do any good at all.
The research, funded by the Western Australian Department of Health, and involving 131 children charted from birth up to the age of 14, concluded that there was "little long-term benefit of stimulant medication" and some downsides for ADHD sufferers.
It found that among children with the disorder, those who take medication like Ritalin and dexamphetamine are 10 times more likely to perform poorly in school than those who don't and that the drugs don't help with depression, self-perception or social functioning.
Furthermore, the study discovered that consistent use of medication leads to higher blood pressure, increasing the risk of heart attacks and strokes even into adulthood.
The report's co-author, Lou Landau of the University of Western Australia, said the researchers were surprised by the results because they went counter to previous findings. He was careful not to suggest that drugs should never be used to treat ADHD, telling the Australian Broadcasting Corporation (), "Treatment should be a partnership between the parents, teachers and doctors and it does include health checks, education support and, in some cases, stimulant medication may be justified."
But the study is sure to fuel the ongoing debate over medication, especially in light of the staggering increase in the quantity of psycho-stimulants used to treat ADHD -- it tripled worldwide between1993 and 2003, according to a report by the University of California, Berkeley.
Opponents of using drugs hailed the findings. Western Australian Labor Member of Parliament Martin Whitely, a longtime campaigner against medication, told "The Australian," "The ADHD industry's claim that without medication ADHD children risk academic failure has been shown to be complete bull. It's not just that ADHD drugs don't improve long-term school performance, they drag kids down."
Attention deficit support groups countered that the sample was too small, went contrary to other studies and that medication had to be part of the treatment options and, for some sufferers, was possibly the only option.
"Drugs are right for some people but not for others," said Bruce McDonald, Secretary Treasurer of The Attention Disorders Association of South Australia (ADASA). He told Provoices that there is no one-size-fits all answer to the drug question. "It's an individual thing," he said.
For longtime Adelaide schoolteacher Liz Pritchard the study brings some needed balance to the ADHD picture. In the decades she taught children, from preschool to high school, she witnessed many abuses in diagnoses and prescription. She told Provoices that in one case a doctor was prescribing stimulant medication by phone, without even seeing the children.
"There was an absolute flood of ADHD diagnoses accompanied by medication for very young children," she said, "three and four year olds who were well supplied with Ritalin." But Pritchard says she understands that for parents, "struggling to manage other aspects of their lives and anxious for their offspring to be liked and accepted by others, a drug that would produce more docile children inevitably appealed."
The controversy -- and the parents' dilemma -- continue.