Diagnoses don’t always ADD up

Parents, doctors say schools mislabeling students as having attention disorder

By Stephanie Barrett, Montgomery Journal staff writer Reproduced here with written permission of the Montgomery Journal, Gaithersburg, Maryland

Kay Farrell has struggled all school year to make Montgomery County’s public education officials realize her son is both extremely intelligent and learning disabled. Officials just don’t see it, the mother says, telling her instead that her 7-year-old son, David, may have attention deficit disorder.

“They are not allowing him to be gifted,” said Farrell, whose son is a second-grader at Flower Valley Elementary School in Rockville. “They brought someone in from pupil and personnel services who said, ‘I think he’s attention deficit, have you tried medication?'”

Angered by the school system’s response, Farrell said, “Why is this person with no medical background telling me my child is attention deficit?”

School officials said Tuesday they would not comment on the Farrell case until they received written permission. Flower Valley Principal Wilma Holmes could not be reached for comment yesterday after Farrell provided the school with that documentation.

Cases like the Farrells’ are common, said Jack Leeb, a psychologist in Silver Spring who tested David.

“It happens all too frequently,” said Leeb, who specializes in testing for ADD and learning disabilities. “It’s the diagnosis of choice when a child acts out in school. They don’t recognize this can be something other than what they think it is, which is ADD.”

Raymond Bryant, the school system’s director of special education, said school officials do not diagnose ADD. “That is a medical condition that doctors diagnose. We may say, ‘This child has the behavior typical of kids with ADD,'” Bryant said.

Farrell said she showed school officials reports from an occupational therapist, an optometrist and Leeb, who all agree David does not have ADD, but has visual problems. But those reports have been ignored, she said.

David has perceptual problems, with his “sense of space often off-kilter,” Leeb said.

If David does a cartwheel or somersault, he needs to do three for his brain to figure out he’s done one, Farrell said.

“It’s more than just glasses. It’s more a problem of processing visual information,” said Dr. Stanley A. Appelbaum, a behavioral optometrist in Bethesda who provides vision therapy weekly to David.

Reading five sentences is like reading an entire book to David, Farrell said.

But David also scored as a genius on an IQ test, Leeb said.

Farrell said while at a restaurant David accurately calculated in his head the prices on the menu. In class, he will perform calculations in his head, getting the correct answers and be able to explain how he did the math, but cannot do it on paper and show the teacher, Farrell said.

“He is frustrated with school,” Farrell said.

Farrell said she thinks David should be placed in the school system’s program for gifted and talented students who are also learning disabled.

“I’m dealing with a child with a 12-year-old brain in a 7-year-old body,” she said. “I think he could excel a lot faster in math and science if they allowed him to. If we continue at the rate we are going, he’s going to stagnate and say, “It doesn’t matter.'”

Farrell said private professionals diagnosed her son with the visual problems last summer, and at the start of school she requested that he receive special services instead of being put in regular classes.

“I’m developing a child who doesn’t want to go to school. It’s not fair to him. I know the programs are there,” Farrell said.

Under the federal Individuals with Disabilities Act, a school system must provide a free, appropriate education to disabled students. Attention deficit disorder is not considered a disability under the act, Bryant said.

In addition, Bryant said school officials “ethically, morally, legally” have an obligation to work with students to provide them the best educational environment they can before labeling them disabled.

“We are also charged under the law in providing what supportive services we can from keeping a child from being coded,” Bryant said. “We take labeling as a serious issue.

“To call a child disabled is significant. That label is with him a long, long time. An Admission, Review and Dismissal Committee will look hard at how a child is doing and other strategies that can be used.”

Meanwhile, [Dr.] Appelbaum, the behavioral optometrist, cited cost as a possible reason why school officials have not yet recognized David’s disabilities.

“There is a law that if a patient is diagnosed with these problems, the school has to pay for it, that’s the problem,” [Dr.] Appelbaum said. “They are playing games to try and get out of paying for this.”

Both [Dr.] Appelbaum and Leeb also said increasing numbers of people are mistakenly labeled with ADD by schools, parents and doctors. Leeb said in the past 15 years, he has tested hundreds of individuals to determine what causes each person’s problem. “I found that in general, this came to me slowly, these kids aren’t ADD,” he said. “I probably find in about 85 percent of cases it is some other issue.”

Leeb said, for example, a teacher with 29 students who must constantly deal with one student’s interruption may be quick to suggest the student be placed on Ritalin, the drug commonly used for ADD.

“It’s a way for society. We want everything yesterday,” he said. “I’m not blaming teachers, it’s very easy for all of us to fall in the trap that it must be ADD because we don’t have the time or inclination to find out what it is.”

[Dr.] Appelbaum concurred. “ADD is one of the most misdiagnosed medical conditions in the country. So many kids are taking medication needlessly,” [Dr.] Appelbaum said. “We are a society that’s always looking for the magic pill.”

But Ritalin can cause weight loss or gain, insomnia and irritability, Appelbaum and Leeb said.

Farrell said she hopes her struggle inspires others. “The sad part is I’m sure our child is not the only one going through this,” Farrell said. “I think a lot of parents give up too soon after their first meeting or two with the school system. “The school is not always right. They need to question their children’s education.”

For more information about Dr. Appelbaum’s clinic in Bethesda, Maryland, visit www.appelbaumvision.com.