Someone Please Wake Up Andrew Rosenthal

‘Ritalin Gone Wrong’ was the headline on the front page of the New York Times Sunday Review today, a publication which is generally seen as a source of reason, not underinformed pseudoscience. But there it was, Professor Emeritus L. Alan Sroufe’s lengthy discourse on his belief that “ADD is probably not genetic, but due to the child’s environment.”

To summarize his hypothesis: Since experience can have an effect on neural development (we must point out, and vice versa), and since the neonatal neurological/biological assessments available to him in the 1970s did not detect any signal later correlated with the development of ADHD, he concludes ADHD must be the result of experience, rather than any inherent structural anomalies. One of the possible environmental ’causes’ suggested by Sroufe is “patterns of parental intrusiveness that involve stimulation for which the child is unprepared. For example, the child is playing, and the parent picks it up quickly from behind and plunges it in the bath.” Surprise, momentary alarm, annoyance, frustration perhaps….but ADHD?  Talk about unsupported belief systems…

We would not deny the possibility that heritance and experience may interact, but the absence of conclusive biological evidence from 1973 does not establish evidence of absence. Sroufe points out the frequent comorbidity of ADHD with depression and anxiety as if it explains away the former as a manifestation of the latter, whereas contemporary clinicians are very familiar with the way that these disorders so often coexist. Sroufe decries the use of medication as reflecting a “societal view that all of life’s problems can be solved with a pill,” when in fact competent psychologists and psychiatrists are well aware that effective treatment of ADHD is multimodal, often combining medication with therapy.

The fact that a retired professor in Minnesota has such an antiquated and simplistic view of the disorder and its treatment is not in itself a problem. But placing it in such a prominent position in the New York Times, without so much as an opposing viewpoint, gives it an imprimatur of credibility that it does not deserve. The next few weeks will see a flood of letters to the NYT, but what will not be so evident to the naked eye will be the hundreds of families where well-intentioned parents may not realize just how underinformed and misguided this piece was, who may question the need for ADHD meds for their child. One must wonder if–had an opinion piece espousing schizophrenia as the result of a ‘schizophrenigenic mother’, or autism as due to a ‘refrigerator mom’ (two equally discredited anachronisms), been submitted to Andrew Rosenthal (the editor responsible for the Sunday Review), would he have given them the go-ahead without seeking out a responsible counterpoint? Rosenthal was asleep at the switch on this article, and unfortunately, it will  be children and their families who will pay the price for it.

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2 Responses to Someone Please Wake Up Andrew Rosenthal

  1. A postscript on this posting: While the initial image was of parents opting out of medication for their children with ADHD, a more disturbing thought in retrospect is of obsessional ‘helicopter parents’ scrutinizing their parenting history and practices for this kind of “parental intrusiveness”–and for those with ADHD children, setting the stage for self or spousal blame: ‘If only you had waited to put him in the bathtub.’ Parenting is difficult enough–parenting in the context of ADHD is even harder. Greasing the skids for futile and errant blame-placing was irresponsible on the part of both author and editor.

  2. Anonymous says:

    Irresponsible indeed. As the mother of an ADHD child with known lineage of the condition along with other comorbidities in my family, I can’t believe all my siblings and their spouses treated their children with the same parental intrusiveness as I am suddenly suspected of. Raising an ADHD child teaches one, if nothing else, immense patience.

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