Lax parents blamed for 'attention deficit' behaviour

[Matthew Kirkcaldie]

In article <bgpd55$rnh at library2.airnews.net>,
 "Jeff Utz" <kidsdoc2000 at hotmail.com> wrote:

> If you go to www.pubmed.gov (PubMed, the database of millions of medical
> articles) and search for ADHD + brain imaging, 221 articles come up. Of
> course, not all of them answer your question.

True - but all of these studies are based on regional blood flow and 
receptor binding, qualities which change on a minute-to-minute basis in 
normal brains without suggesting that there's a structural abnormality 
or a pathological process at work.

Observable processes which result from brain activity still fall under 
the category of behaviour in my book.  Brain imaging allows better 
observation, but it's not more fundamental than activity in the skeletal 
musculature or the ANS.  For example, if we observe an increase in blood 
flow to a particular gyrus, there is no way of knowing whether metabolic 
demands have increased because the region has more information to deal 
with, or is trying to suppress its inputs, or is subject to increased 
feedback from other brain regions.  Imagine trying to deduce the 
workings of a city by measuring the amount of light coming from its 
buildings.

Changes in receptor binding indicate large-scale differences in activity 
over a period of time, but there is no way to extract a causal 
relationship out of this correlational data.  Altered receptor 
distribution may produce changed behaviour for these people; equally, 
their "abnormal" behaviour may produce alterations in receptor density 
once new patterns are established.  Neither case provides a basis for 
preferring a behavioural treatment over a pharmaceutical treatment, or 
vice versa.  

If a behavioural treatment is shown to be effective, I say go ahead with 
that, rather than trying to alter the activity of transmitter systems 
whose coarsest effects on behaviour are poorly understood.  Our brains 
have evolved to enable us to operate effectively in the environment in 
which we find ourselves, and to adapt behaviour accordingly.  Why is it 
so hard to accept that children with ADHD have grown up in an 
environment in which this pattern of behaviour produced positive 
feedback initially?  The argument about siblings in the same family is 
specious: who really believes that parents treat all their children in 
exactly the same way?  Doesn't parenting experience change parenting 
practice?  And besides, who knows what the cues shaping behavioural 
development REALLY are?

      Regards,

         Matthew.