Brian Kean and Attention-Deficit Disorder - Case Study Example

1 Brian Kean and ADHD Brian Kean orchestrated a research study using the critical social technique of research to look at the diagnosis or ADHD and the sociological impact, both generally and individually, of that diagnosis. As he writes his findings, it would be an understatement to say that he finds using the diagnosis of ADHD to be very negative as it is written now. He concludes that the individual as well as the greater society is harmed in multiple way. He does not put forth any positive sides to using the diagnosis. This writer will explore the valid aspects of his conclusions. However, this writer also finds great concern with any such extreme stand on this topic or any other topic for that matter. It is this writer’s experience that taking the extreme stand that Brian Kean has taken arouses more emotion than intellect. One must be careful, as the old proverb says, ‘not to throw the baby out with the bath water’. Type of Research First, when looking at research one should look at the study itself. This is a critical social research paradigm. The goal of the researcher wants to “provide protection of the rights of the child, who is subjected to the treatment as a result of a decision by others” (Kean 2005). Clearly this is a subjective stance on the part of the researcher with which to begin. Critical researchers, by definition, assume that social reality is historically based and is created by people; that is people’s opinions and then kept alive as it is passed on by culture. Critical researchers hope to change this cultural passing on of a belief with which they do not agree. The main task of the critical researcher is to be a social critic. Critical research focuses on oppositions, conflicts and contradictions in society and hopes to eliminate the causes of alienation and domination in a society ( Myers, 2007). The reader must recognize that the data collected in this type of research is chosen with a purpose in mind. This type of research begins with a premise and then sets out to find the evidence to prove it. There is not blind collection of data to find all information from which to form a conclusion. About the Researcher The next question is then, who is Brian Kean? Brian Kean’s biography on the Southern Cross University in New South Australia states he is employed there as a Lecturer in Special Education. His academic background is a B.A. in Education and an MA in Special Education. He lists his area of expertise in Mental Health and Secondary Education. He has held various academic positions in the field of special education for twenty-two years (Southern Cross University). His background academically and professionally certainly qualifies him in the field of Special Education in Australia but it is difficult to understand where is proclaimed expertise in the field of Mental Health comes from. Keeping the type of research and the background of the single researcher in mind this writer will look at Mr. Kean’s concerns about the diagnosis of ADHD and the negative ramification his finds to the individual and society. Diagnosis in Practice can be Applied to a Diverse Range of Problems Mr. Kean is saying that the child may be having trouble in school or in their relationships with parents and that those behaviors are interpreted as symptoms of ADHD. He states there are no credible findings in brain malfunction, biochemical imbalance or neurological disturbance that is proven. It is difficult to know how he accounts for of brain imaging finding where researchers have been able to look at the function of the brain and not just watch symptoms of the disorder. Brain imaging shows not only the structure of the brain but the processing of the brain. This imaging gives more information about the neurochemistry of the disorder. In ADHD the catecholamine-rich fronto-subcortical systems appear to malfunction. There seems to be a catecholamine disruption (Brown, 2000). The Journal of the American Medical Association (2002) reports that ADHD brains are 3-4% smaller that those of children who do not have the disorder. They have also ruled out medication as the cause of the smaller brains. This comes from research using scientific method. Utility of Drugs for Changing Behavior Mr. Kean states that Health Care professionals prescribe medication to change the behavior because he thinks health care professionals along with everyone else think the medications correct the neurological and biochemical or brain malfunction even though it has not been scientifically proven. There are so many assumptions here it must be broken down. ADHD is diagnosed by behaviors and there is scientific research that shows the efficacy of medication in changing behaviors and improvement in production of the individual as a result of that behavior change. Meta-analysis’s have shown that 70% of those diagnosed with ADHD show a positive behavior change resulting in better functioning as a result of taking amphetamines (Murphy & Gordan 2004). These are correlative studies using double blind selection. 4 The other part of this is the assumption that the generally held belief is that medication cures the neurological component. This writer can find not references supporting this belief. Certainly it is not what physicians Hallowell and Ratey (1994) were telling laymen and professionals alike in their book Answers to Distraction. They cautioned readers not to see medications as a cure, only as a treatment of symptoms. The School is the Problem Mr. Kean is basically saying that a child who’s behavior is not acceptable in school is frequently sent for a diagnosis of ADHD when the real problem was that the child was being bullies or put in a behavioral program that caused the child to be unhappy and that was what was causing the behavior problems in the child. Dr. Susan Siegfried (personal communication August 13, 2007) the clinical supervisor for SPC Family Services in Minnesota does the assessment and diagnoses for many counties and school systems in that state. She states that very often she is called in to a school and told by the classroom teacher, or school counselor, that a child has ADHD. She believes their expectation is that she will provide that diagnosis so special provisions can be provided as well as to obtain medication hopefully to change the child’s behavior. She estimates less than half of the time a diagnosis or ADHD is really appropriate. She also notes that the diagnostic criteria requires that the child must be having problems in multiple locations not just school. Therefore, the possibility that school is causing the problem is greatly reduced. She also uses objective testing and she of course follows the diagnostic criteria in the 5 Mental Health Diagnostic Manual which requires much more than just inappropriate behavior in school. Diagnosis Does Not Address Social, Educational and Environmental Causes Criteria C in the DSM states that the symptoms must be present in two or more settings and there must be clear evidence of significant impairment in social, academic or occupational functioning. The need to be having trouble in multiple setting reduces the effect on one setting on the child. If the child is having trouble with something at school it is unlikely the same behaviors would show themselves in the home setting. Certainly this is not a perfect measure but it is an attempt to find balance. It feels to this writer like Mr. Kean is trying to blame everyone, especially schools for the problem. Blame is not important finding an accurate diagnosis and finding a helpful treatment is. Risks to Society Mr. Kean identifies risks for society from danger from using medication to treat the disorder, which was addressed earlier in this paper, to causing a polarization between believers and non believers. Each he claims is only putting our information to support their own opinion. This writer response is, is that not by definition of social critical research what Mr. Kean is doing? Certainly the Mental Health professional do not claim that their diagnosis is perfect but they are continuing to do research to improve it. The criteria, to which Mr. Kean does not specifically reference, is quite specific if followed carefully. Again this writer calls for balance rather than emotional finger pointing. Conclusion It is important to look at all this information. The danger is when one looks at only one side of an issue as Mr. Kean had done. Certainly the diagnostic criteria for ADHD could be and likely will be improved as new science about the disorder is known. Hopefully, research as to the input of socioeconomic conditions will continue to be researched and hopefully conditions can be improved to reduce their effect if they are a factor. There is strong scientific evidence that this is a neurological disorder so helping these individuals involves learning more and dropping the stigma that comes as a result of people like Mr. Kean who over react. Mr. Kean is in a great position as an educator to make changes in the school system to better facilitate these students and it would be best if he stayed with his field of expertise and allow the mental heath professionals and the medical professionals deal with the diagnostic criteria and the medical treatment. References American Academy of Pediatrics (2000). Clinical practice guidelines: Diagnosis and Evaluation of the Child with Attention-Deficit/Hyperactivity Disorder. Journal of Pediatrics, 105, 1158-1170. American Psychiatric Association: Statistical Manual of Mental Disorders, Fourth Edition Revised. (2000). Washington, DC, American Psychiatric Association. Brown, T.E. (2000). Attention-deficit Disorders and Comorbidities in Children, Adolescents, and Adults. Washington, D.C.: American Psychiatric Press, Inc. Hallowell, E. M. & Ratey, J.J. (1994). Answers To Distraction. New York: Pantheon Books. Kean, B. (2005). The Risk Society and Attention Deficit Hyperactivity Disorder (ADHD): A Critical Social Research Analysis Concerning the Development and Social Impact of the DAHD Diagnosis. Ethical Human Psychology and Psychiatry. 7(2); 131-144. Murphy, K.R. & Gordon, M. (2004). Assessment of Adults and Children with AD/HD. In Barkley, R. (Ed.) Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. (pp345-369) New York: Guilford Press. Myers, M. D. (2007). Qualitative Research. MISQ Discovery Retrieved August 13, 2007 from http://www.qual.auckland.ac.nz/. Southern Cross University. Kean Brian. Retrieved August 13, 2007 from http://www.scu.edu.au/schools/edu/index.php?page_id=71&menu=6_109. Read More