My name is Cathy and I have a 10 year old step-son, Justin, who has lived with me about 50% of the time for the last 8 years. Four years ago, he was "diagnosed" (if you could call it that) with ADHD. He was immediately put on Ritalin and has shown absolutely no improvement in the last 4 years. In fact, he is getting worse. We received his report card yesterday...2 Cs and 4 Ds. He has check marks in most of the behavioral areas of the report.

Justin had a bad start. His parents split and both went off to pursue lives that did not involve him. He was frequently (3 - 5 times a week) sent to stay with a verbally abusive grandmother who called him horrible names. She was a severe alcoholic and frequently ignored the boy all together. He rarely saw his parents, and he attended a low income, poorly run daycare. I met him a month before his 3rd birthday. Justin has an older brother, Carl, who was 6 at the time. It seemed that when I arrived on the scene, their dad realized what he'd been doing and turned his life around and started becoming a good, solid parent. Their mother saw a new mom coming into the life of her children, and she also started becoming a better mother. However, her treatment of the children was so unbalanced that everyone in the family noticed her favoritism toward Justin. Obviously, you can see the effect that this had on him. He could do absolutely no wrong in her eyes. What made this situation really bad, was the fact that she was the complete opposite with her other son, Carl, and she displayed this negative behavior towards Carl right in front of Justin. She was literally reinforcing to Justin that, as I just said, he could do no wrong in her eyes. Needless to say, Justin's behavior began to get out of control...he had no limits put on his behavior from the get-go. He had little or no rules, and everything that he did was considered "cute" or just "his personality." I'm sure you can imagine what a struggle the last 8 years have been for is very difficult to teach a child about social conduct or responsibility when 50% of the time, he doesn't have to deal with it. Any consistencies in parenting are completely non-existent.

When Justin entered kindergarten, his teacher pulled us aside one day and told us (his father and I) that she knew which parent would be picking him up from school each day just by the behavior that he displayed in the classroom. She said that when we were coming, Justin was attentive, socially integrated, and a joy to be around. But on the days that his mother would be picking him up, he was wild (jumping, yelling, hitting, etc.), completely inattentive, and all-around naughty -- too naughty to handle in the classroom. On those days, Justin spent the majority of his time at the time-out table. After we learned of this, we began to make surprise visits to the classroom on days that his mother would be picking him up. We never actually went in. But each and every time that we went, we would peek in from the hallway - and sure enough, Justin was at the time-out table. When we tried to talk to his mother about it, she just about went nuts. She was extremely defensive (not that I can blame her for that, I probably would be too). However, it seemed that she just began to sort-of unknowingly reinforce his negative behavior even more. I think that she just could not bring herself to see what we saw...until that summer.

Justin's behavior with his mom became completely unmanageable (most of which we did not know of at the time). She could not control him no matter what she tried. I really have no idea what she did try, but I can only assume that it was about as effective as I had seen with her in the past. The only thing that I do know, is that when it came to him not listening to her, that is when she started to see a problem. I understand how difficult it is as a parent to realize that you've screwed up with your child. I have 3 1/2 year old twins of my own. But this went as far as a total denial.

When Justin entered the first grade, I was pregnant and had nothing better to do than to go to his school and talk with his teachers about his progress. I was repeatedly told, week after week, that they (he had 2 1st grade teachers) did not see any problem with him in the classroom. His marks were notes ever came home...he enjoyed school very much and adored his teachers. However, Justin's behavior at his mom's house was still out of control. He had tried setting 2 fires and would not listen to anything she told him. Justin's mom and I had many discussions about the differences in his behavior between our two homes. In January of that year, I received a phone call from one of Justin's teachers. She told me that Justin's mom had requested that she call me and tell me about all of the problems they had seen with Justin in the classroom. I was stunned, to say the very least. She told me that they had seen uncontrollable, negative behaviors since the start of the school year. I asked her why she never mentioned any of this to me throughout the numerous visits that I had made to his classroom that year, and her reply stunned me even more. She said that they "did not notice a problem with Justin until his mother pointed it out" to them. I could not believe my ears. Did they not have an opinion of their own on this matter? They went so far as to mention (in a very round-about way) that it would be in everyone's best interest (but I got the feeling that it was for their own best interest) if we took Justin in to be tested. They didn't mention what they thought that he should be tested for, just that he should be tested. Within three minutes of hanging up with them, Justinís mom called me to ask if I had talked to the teachers. Within 24 hours, she had made an appointment with her family doctor (who did not know Justin whatsoever), an appointment that we were told nothing about. Within 72 hours, Justin was on Ritalin 3 times a day. The doctor saw him for 10 minutes, and wrote the prescription based on his mother's testimony alone. We immediately set up an appointment with our own family doctor. He observed Justin in the office playroom for 30 minutes, and then reported to us that there was no way in the world that this child had ADHD. He sat in a chair for the entire 30 minutes, unsupervised, didn't flich, twitch, run, jump, or anything else that would appear overactive (and he had not begun the medication yet). Justin also understood that he was with us that day, and that certain expectations of him were a constant. Our doctor recommended 2 very good parenting books for us to recommend to Justin's mother. That just made her extremely angry.

From that point, it was a battle. He has it, he doesn't. It was nothing more than a battle of reasons. Justin's mom set him up with an ADHD specialist, who obviously agreed with the first diagnosis. He recommended behavior therapy, but it was not mandatory (for example, as is a blood test for a Lithium prescription), so he has never seen a therapist. After hearing a little summary from that doctor about what behavior modification entailed, I think that Justinís mom sort of unconsciously decided that it would just be easier to hand him a pill and a glass of water 3 times a day. Our little boy could not sleep, he cried all the time, he would not eat, and he was severely depressed. We had to change our entire life around to accommodate a diagnosis that we did not even believe in. Over the next 6 months, his behavior showed no change whatsoever, except that he appeared somewhat drugged at times. Every single thing that he did was excused by his mother, right in front of him. If he got in trouble in school, then his mom would tell the teachers, again right in front of him, "He can't help it. He has ADD." Once again, total reinforcement - basically, she excused anything that he ever did. If he was bad, it was because he had ADD. If he was good, it was because the Ritalin was working. Justin had absolutely no role whatsoever in his own actions. And I could see that there would be no end in sight to all of this and that Justin was plummeting down a dangerous highway towards adolescence.

Justin was always, from the time he was a toddler, allowed to decide when he wanted to eat when he was with his mother. If he did not want to eat dinner with the rest of the family, then he could go out and play. Then he would come in at 9 or 10 at night (pretty late for a little kid to be out playing on a school night) and would tell his mom to take him to Burger King, and she would. Not once in a while, but 3 - 5 times a week. We had very different rules in our house. We all sit down and eat together. It's the only time of day that we have together. There is no way that we would ever run him to Burger King late at night just because the nice dinner that we had fixed him interrupted his play time. I could go on forever giving you hundreds of examples just like this one. When Justin was told at our house that he had done something wrong and he could not go out and play for the rest of the day, then that meant that he could not go out and play for the rest of the day. When the same happened at mom's house, he was out playing in 5 minutes - consistently. And I am not exaggerating this one bit. So it didn't take long before he didn't want to come over anymore. I don't blame him. After all, if murder was legal and we could get away with it, we all would have killed somebody at some point. So, even though his dad had the legal right to take him on his days off (3 days one week, 4 days the next and then alternating every other week like that), he got to the point where he started feeling bad and didn't want to make him come over. Enforcing rules was ruining their relationship, even the simplest of rules (i.e.: you need to turn off your tv before you go out to play). And we could not enforce rules on his brother Carl if we couldn't do it with Justin. It was such an all around bad situation that I could hardly take it anymore.

I finally requested a placebo trial to see what would happen, and all agreed to it. I'll tell you this, 2 weeks per trial is NOT LONG ENOUGH. Justin's two weeks of the "no condition" part of the placebo was nothing more than a terrible withdrawal syndrome. He had terrible gastrointestinal problems, eating problems, sleeping problems, and if you looked at him sideways, he would cry for over an hour. And to ice this lovely cake, we all got to fill out SUBJECTIVE tests on our obviously already biased opinions of his behavior throughout this trial. It's pretty easy to guess what happened here...teachers and mom had Justin rated with a score of 61 and 95, respectively, during the "no condition" part of the trial. Justin was not only kept on Ritalin, but his dosage was doubled.

Since that point, his father and I have decided that it is completely pointless to argue this any further. The only stability that Justin would ever get in his life is if we didn't enforce rules and treated him the same way his mother did. That was not an option. So we just eased up a little, dropped the subject all together, and sat back and watched. Justin attends a public school (the largest elementary in our state, Sioux Falls, South Dakota) and I have never seen a larger group of oblivious people gathered in one building in my entire life. Every time I have been to one of his conferences and hear his teachers talk, I feel like I have been zapped into
The Stepford Wives. They have no interest whatsoever in what is happening in Justin's life outside the classroom. As long as he blends in and doesn't bring attention to himself, then in their eyes, whatever we're doing is working. What a sad commentary on our public school system. Justin gets called down to the office at 11:30 everyday and has to miss a half hour of class just waiting in line for his pill. Last year the city council voted on a bid to build a school just for kids with Attention Deficit in our town of 120,000 people. We live in a town with a crippling epidemic. (Thank God they voted it down, they figured that the money would be better spent giving themselves a pay increase.)

Anyway, the point of all of this I'm sure has become clear: what are parents like us to do? We have a child here with no boundaries of an kind, surrounded by people who absolutely refuse to take the time and energy teach him what he needs to know to grow up in this world, reinforcing his negative behavior with nothing more than an inaccurate label. There are thousands if not millions of kids just like him....I am not saying that ADD does not exist. It does. And Ritalin has been a Godsend to those families. But it has become an absolute demon to families like ours where the diagnosis and prescription was nothing more than an easy out over consistency and effective disciplining. We need help and it seems that there is nowhere to turn. Everyone we have ever talked to is so willing to just sit back and accept the easy answer that they aren't even willing to listen to the possibility that maybe this child was socially maladjusted from the get-go by fault of his own caregivers, not a completely unidentified malfunction in the brain. It's easier to put him on a highly controversial medication with highly controversial subjective tests (taken by the very people that were already convinced that he had ADD before they ever dialed the phone to get the whole ball rolling in the first place) than it is to have to admit to yourself and others that you may have possibly made a mistake somewhere in your parenting.

What should we do? How on earth can this continue? I am going to be faced with a teenager with absolutely no concept of consequences, and this boy will be living in my home, with my children. He is only going to continue to get worse until he gets the proper help that he needs. The next thing that I am going to hear is that he has ODD and he needs to be on Prozac and whatever other new fad drugs have hit the market by then. We really need help here, and with all of the extensive research that I have done on this topic, you are the first one that I have bumped into who is not only a medical doctor, but who is even willing to acknowledge that a flip side to this coin even exists. I'm sorry, I haven't read your book. I just found your web site last night and I immediately thought, "This is the man I need to talk to". But I will be reading it in the next couple of days.

You have no idea how anxious I am to hear from you. I'm not even sure what it is that I want you to say about all of this. But something needs to be done, not just for my child, but to prevent this from happening to any more children. Our kids these days have enough problems to deal with. I will take this to Washington if I have to. It is that important. There is not enough definition in this entire area, and someone needs to bring that to the forefront of public attention.

I look forward to hearing from you and I thank you so much for taking the time to read this lengthy letter.

Sincerely, C. A.

There's little I can say about this powerful story except to reprint it in full.