There are two schools of thought about ADHD. One says that ADHD is over diagnosed and that ADHD medications are over prescribed, and that really only a small percentage of people actually has the disorder. Some people who agree with this analysis point to the influence of the television, videos, and computer games, which are designed to jump from image to image and soundbite to soundbite, and which tend to fragment the attention and over stimulate the mind. They suggest that these influences make normal children behave in a way that seems hyperactive, which may swell the numbers of those demonstrating the symptoms associated with ADHD.

The other group says that ADHD is under diagnosed and that it is a more common disorder than is generally thought. Television and computer games may produce similar behavior in some people, but ADHD is still a genuine, clinical problem, and many people could benefit from appropriate ADHD treatment.

One reason for the controversy over ADHD is that definitions of the disorder vary. Surveys of teachers that require them to rate the behavior of the children in their classrooms and identify the proportion with ADHD get varying results, because different researchers use a different cutoff point to distinguish "normally" active, impulsive, distractible children, from "abnormal" levels of hyperactivity, impulsiveness, or inattentiveness.

Moreover, ADHD may take different forms in different children. A few years ago, the condition was known as ADD, or attention deficit disorder, but researchers now include "hyperactivity" in the name. This may obscure the fact that some children are inattentive and impulsive but not hyperactive. These children have a disorder that interferes with learning in school, but their problems are not as obvious as those of hyperactive children.

The question remains: is ADHD a medical fad or an epidemic? It is neither. It is a distinct, identifiable medical disorder that tends to run in families. Although much of the public awareness of the problem has focused on North America and the fact that more than 1.5 million children in the United States alone are receiving medication for the disorder, ADHD is not a North American problem. It is found in children all around the world.

If you suspect that your child or one of your students may have ADHD, your first step is to learn more about the disorder before jumping to conclusions. The next step is to have the child evaluated by a physician. Don't be too quick to slap a label on any child, but, at the same time, don't ignore behavior that may signal a problem that could interfere with the child's schooling and later success in life.

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