Food dyes and the Center for Science in the Public Interest

This isn’t exactly news – I found this information months ago, when the press release just came out, but I had no time to blog during the summer, so here it is:

An organization calling itself the Center for Science in the Public Interest (CSPI) petitioned the U.S. Food and Drug Administration to ban artificial colorings from food. The press release page has links to the petition itself, and also mentions Dr. Ben Feingold with a link to his Feingold Association of the United States, and two British studies exploring the effects of artificial food colorings on children’s behavior.

The first study was published in 2004, in Archives of Disease in Childhood – “The effects of a double blind, placebo controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children,” by B Bateman, J O Warner, E Hutchinson, T Dean, P Rowlandson, C Gant, J Grundy, C Fitzgerald, J Stevenson.

The second study was published in 2007 in The Lancet – “Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomized, double-blinded, placebo-controlled trial,” by Dona McCann, Angelina Barrett, Alison Cooper, Debbie Crumpler, Lindy Dalen, Kate Grimshaw, Elizabeth Kitchin, Kris Lok, Lucy Porteous, Emily Prince, Edmund Sonuga-Barke, John O Warner, Jim Stevenson.

The CSPI is also “urging parents who believe their children are harmed by food dyes to file reports online at http://www.cspinet.org/fooddyes/.”

Biomedical Treatments for Autism

Saturday, November 1, and Sunday, November 2, 2008 there will be a conference in Weston, Massachusetts titled “Successful Inclusion in School & Community” organized by Autism Conferences of America.

It looks interesting and I would like to see “Learning Social Skills Through Play: Life’s Most Important Skill Made Fun!” by Rick Clemens, MA, and would love to see “Biomedical Treatments for Autism from A to Zinc” by Nancy O’Hara, MD. Unfortunately $95 to listen to two lecture is a bit steep for me, so I’ll have to pass.

However, the conference web site also includes a pdf of an article titled “Summary of Biomedical Treatments for Autism” written by James B. Adams, Ph.D., which sounds very interesting. James B. Adams is Full Professor in the Department of Chemical and Materials Engineering at Arizona State University, and Director of the Autism/Asperger’s Research Program.

The Autism/Asperger’s Research Program site includes a pdf of another publication – “Pilot Study of a Moderate Dose Multivitamin/Mineral Supplement for Children with Autistic Spectrum Disorder,” by James B. Adams, Ph.D. and Charles Holloway, B.S. published in The Journal of Alternative and Complementary Medicine in 2004.

By the way, The Journal of Alternative and Complementary Medicine is the official journal of the International Society for Complementary Medicine Research and the Society for Acupuncture Research. It is a peer-reviewed journal, it has an editorial board, and the publisher’s web page on Manuscript Submission says “A primary goal of this international peer-reviewed journal is the establishment of rigorous and appropriate research methodologies.” The Editor-in-Chief is Kim A. Jobst, MA, DM, MRCP, MFHom, DipAc, and a Visiting Professor in Healthcare & Integrated Medicine at Oxford Brookes University. 

Now, the developmental pediatrician that tracks my son says the studies so far do not prove whether it’s the nutritional deficiencies that cause autism or it’s the autism that causes nutritional deficiencies. But she did give us a referral to see a nutritionist.

In the meantime, I wonder whether I should ditch the regular vitamins for two months and try to enroll our son in the National Vitamin/Mineral Study for Children & Adults with Autism at the ASU’s Autism/Asperger’s Research Program to see what happens. Of course, there’s the risk that he’d be on the placebo and we personally would not benefit from this study.

Eagle Hill School’s graduation speech delivered by Dr. Edward M. Hallowell

Dr. Edward M. Hallowell, a former instructor at the Harvard Medical School, one of the foremost experts on ADHD in the world, and the founder of the Hallowell Center for Emotional and Cognitive Health, was invited by the Eagle Hill School in Hardwick, Massachusetts to deliver this year’s graduation speech. (March 2, 2011 – Eagle Hill School does not have the speech posted to their website anymore, but you can read the text on Dr. Hallowell’s web site, and you can watch the video on vimeo.)

According to the school’s web site “Eagle Hill School is a private co-educational college preparatory boarding school for students with learning disabilities in grades 8-12. Specific learning differences include: Dyslexia, Language Based Learning Disability, Attention Deficit Disorder, Attention Deficit Hyperactivity Disorder, and Nonverbal Learning Disability. [...] Eagle Hill School is the preeminent private high school for students with learning disabilities and ADHD who demonstrate average to above average cognitive ability.”

If I read the information on the web site correctly, the school serves 150 students. Their tuition is $51,692 (day tuition is $36,586).

In addition, from early July through early August, Eagle Hill runs a five-week academic and recreational summer camp for students ages 10-18 who have been diagnosed with specific learning (dis)abilities and/or Attention Deficit Disorder. The tuition for the summer camp is $6,888.

Bartlesville, OK – Gifted/Talented Committee members fail to show up for meeting

I found the following story quite amusing – A Bartlesville Public Schools Gifted and Talented Local Advisory Committee meeting […] didn’t take place because the only person who showed up was Vicki Walker, BPS director of special services. (see Bartlesville Examiner-Enterprise “Gifted/Talented Committee members fail to show up for meeting,”)

Interestingly, according to the Bartlesville Public Schools’ web page titled “Gifted and Talented Education,” the number of BPS students qualifying for the gifted and talented program is far above the state average of 12.8 percent, in Bartlesville Public Schools, 17.2 percent of students qualify. On average the district serves approximately 1,300 students annually in the program.” I wonder what their criteria for admission into the program are. It seems they count everyone who’s taking the Advanced Placement classes.

Of course it’s important to know that Oklahoma is one of eight states where gifted programming is not only mandated (identification begins in first grade) but also funded by state (in 2004-2005, the state allocated $42,200,030 for Gifted and Talented programming). (Davidson Institute’s GT-CyberSource, Oklahoma’s Gifted Education Policies page)

What I find curious is that according to the web page titled “Bartlesville Public Schools’ success in Special Education,” the district has only 727 students (less than 10% of their student population) currently enrolled in Special Education Services (much fewer than the students in the gifted programs), while in 2004-2005 the state’s average was 13.79%. (according to the Oklahoma State Department of Education, Special Education Services information) I wonder what the reason for these discrepancies is.

By the way, I really liked the Oklahoma’s “Special Education Parent Handbook,” especially the “Questions to be Answered during the Multidisciplinary Evaluation Eligibility and Team Summary (MEETS)/IEP Meeting” form on pages 12 and 13 (18 and 19 of the pdf document), “My Personal Directory” form on page 15 (21 of the pdf), and sample IEP form on pages 19 through 25 (25 through 31 of the pdf). I need to bring that to our next IEP meeting.

What do you say to a kid who’s rolling around, punching, biting, kicking? (the story of Gabriel Ross)

It seems Alex Barton is not the only five-year-old verbally abused by his teacher.

While Gabriel Ross has not been voted out of his classroom, he also heard his peers being forced to say they don’t want to be his friends, and he heard much worse things from his teacher .

I first found Gabriel’s story on MND–mensnewsdaily.com in a June 5, 2008 editorial “Kindergarten Cruelty: Not Child’s Play” by Joanne Jacobs.

It seems the story has been first reported on May 25, 2008 by News and Tribune in an article “Tape reveals teacher’s verbal abuse” by Tara Hettinger and was picked up by ABC News a couple days later. (see “Teacher Caught on Tape: Kindergartner ‘Ignorant, Pathetic, Self-Absorbed’” by Jonann Brady from May 27, 2008 and the interview posted on that page)

Gabriel’s story, which broke just about the same time as Alex Barton’s, had some additional coverage but very little in comparison with Alex’s story. I suppose that might be because Gabriel has not been identified as autistic or ADHD, so unlike Alex, he and his parents do not receive hundreds of letters of support from all over the world.

Gabriel’s parents don’t see any difficult behaviors at home, but at school things seem to have been a bit different. Yet even though his teacher, Kristen Woodward, suggested creating a behavioral plan for Gabriel early in the school year, apparently she chose to do nothing about that in the end. Instead, she chose to be mean to him and call him “stupid,” “pathetic” and “ignorant, selfish, self-absorbed, the whole thing.”

Ironically, on the tape, she’s the one chastising Gabriel about making poor choices.

I must say I’m glad to hear that Woodward has been suspended indefinitely. A person who calls little children “stupid” has no right to be a teacher.

Interestingly, the News and Tribune article also quotes Carol Mooney, who is with the Indiana State Teachers Association, as saying “the school administration’s actions were unfair” and asking “What do you say to a kid who’s rolling around, punching, biting, kicking?”

Well, one thing for sure – when a child is rolling around, punching, biting, kicking, you DO NOT call that child stupid, but try to find out what makes him behave like that!

It just happens that the same day I found out about this story, I read the following in Executive Function in Education: From Theory to Practice, edited by Lynn Meltzer, and published in 2007 by the Guilford Press.

It is critical for teachers, care providers, and parents to realize that people with autism spectrum disorders (ASDs) do not engage in inappropriate behaviors intentionally to be malicious or manipulative. (emphasis mine) [...] A common misconception is that they are capable of learning to behave differently but are just lazy or unmotivated. Students with ASDs and other neurodevelopmental disorders (such as attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, etc.) [...] cannot learn different ways of behaving without interventions that are specifically geared to their learning strengths and styles. It is the responsibility of parents and educators working with these students to address their specific deficits and find effective methods for teaching and reinforcing more appropriate and adaptive behaviors. -”Executive Dysfunction in Autism Spectrum Disorders: From Research to Practice,” by Sally Ozonoff and Patricia L. Schetter, in Executive Function in Education: From Theory to Practice, edited by Lynn Meltzer.

Maybe instead of saying the salute to the flag each morning, the teachers should read this quote every day, as their mantra, and try to abide by it.

Report on Medications and Choices

PAL, the Parent/Professional Advocacy League, and Institute for Community Health (both based in Massachusetts), have just published Medications and Choices: The Perspective of Families and Youth: What Parents and Children Tell Us about Psychiatric Medications which they call “a ground breaking, family-driven study of the decision making process families go through when they choose to use psychotropic medication to treat their child’s mental health needs.”

PAL, the Parent/Professional Advocacy League, is “an organization of parents and professionals who advocate on behalf of children with mental, emotional or behavioral special needs and their families in order to effect family empowerment and system change” founded in 1980s.

Institute for Community Health, is a collaboration of the Cambridge Health Alliance, Mt. Auburn Hospital CareGroup, and Partners Healthcare, founded in 2000 “to improve the health of Cambridge; Somerville, and surrounding cities and towns.”

The 40-pages-long report presents data from a 2006 survey of 274 parents of children who have been taking psychiatric medications and more than 80 teens.

The foreword to the report was written by Joseph Gold, MD, Chief Medical Officer at McLean Hospital, Director of the Community Child Psychiatry Services at Partners Health Care, and Medical Co-Director of the Massachusetts Child Psychiatry Access Project (MCPAP). (for unexplained reasons in the report the foreword is called “Forward,” I don’t know who and how many people proofread the report before publishing it, but someone sure goofed)

What I found especially interesting is that “Parents reported that their health insurance was more likely to cover medication than therapy for their child.” 76% of the families said that “their insurance covered all of the medication visits their child needed” but only 53% said that “their insurance also covered all of the psychotherapy visits their child needed.” It seems health insurance companies think that once you take a pill, that’s it, the problem is fixed.

I also really liked the part covering the teens’ responses to the survey and what they say about being on medication.

No Autistics Allowed? (the story of Alex Barton)

Everyone has already heard this unbelievable story – a teacher in a kindergarten classroom “led” her pupils “to vote […] out of class” a five-year-old being evaluated for Asperger Syndrome.

The first coverage of this story (or one of the first) appeared on TCPalm.com (May 23, 2008 “St. Lucie teacher has students vote on whether 5-year-old can stay in class” by Colleen Wixon).

As the newspaper reports “each classmate was allowed to say what they didn’t like about […] Alex” and “by a 14 to 2 margin, the class voted him out of the class.” Alex’s classmates said that he was “disgusting” and “annoying.” “The teacher then allegedly asked the boy where he would go now that the class doesn’t like him the boy replied, ‘to the office?’ the teacher returned with ‘they do not want you there’ then the 5 year old said ‘home’ the teacher said your mom is at work you can’t go home. He finally said that he would go to the nurse and the teacher sent him out of the classroom to the office where he stayed for the remainder of the day.” (treasurecoast.com, Friday, May 23 “Austistic 5 year old allegedly physically, mentally abused by Port St. Lucie School Teacher”)

Melissa Barton, Alex’s mom was interviewed by CBS and the “raw video” of this thirteen-minute interview is available online.

Wendy Portillo, Alex’s Teacher, has been “reassigned” to another position while the school board is investigating the incident to decide what to do next. She has not commented on the incident to the media, per the advice or order of the school officials, as I understand.

TCPalm.com has a page with links to all articles on their site covering this story, including editorials, some in defense of Wendy Portillo.

The May 29, 2008 article “Police report reveals teacher’s side of incident in which boy ‘voted’ out of Port St. Lucie class”, by Coleen Wixon has a link to a pdf file of the narrative portion of the police incident report which so far is the only place where one can read Wendy Portillo’s side of the story.

What surprised me from this report is that she filled out a discipline referral for Alex for “pushing up the table with his feet.” His classmates’ work was sliding off the table as a result, and for that he was sent to the principal’s office.

I am also floored by Portillo’s statements in her testimony that “the students in class were all her priority and she would protect them like ‘a bear defending her cubs’” that “she would not let them hurt anyone and she would not let anyone hurt them.” It is quite obvious she did not consider Alex as one of the cubs. I bet Alex will remember for the rest of his life the way she hurt him and humiliated him in front of his classmates. (Just as I still remember my second grade math teacher hitting me and my classmates on the palm with a ruler, or my first grade PE teacher calling me antisocial in front of the whole class, and that was a really long time ago.)

Portillo also claimed “she felt if [Alex] heard from his classmates how his behavior affected them that it would make a bigger difference to him, rather than just hearing it from adults.” That’s why she “polled the class to see how [Alex’s] peers felt about his return.” And that comes from a teacher who supposedly is trained and certified to teach special needs children.

I don’t know who trained Wendy Portillo in teaching special needs children and what special needs were covered in her training but she sure doesn’t know squat about autism.

I am shocked that discrimination like this comes from a person who is a minority and I’m pretty sure has been discriminated against herself and should know what it feels like to be criticized for just being who you are and for something you have no control over.

Alex’s classmates telling him what they don’t like about his behavior will not change his behavior because he has no control over it, just as she has no control over the color of her skin. How would she feel like if her peers told her they don’t want her as part of the teaching faculty because of her race? I’m sure she’d be outraged, as she well should be. Luckily, even though there’s still plenty of “below the surface” racial discrimination in this country (which people feel very uncomfortable talking or writing about) such open racial discrimination is illegal in the U.S.

Unfortunately, it seems there’s still a long way to go to combat the legal discrimination on the basis of a neuropsychological disability. I’m sure it would not even occur to Portillo (or at least she would not dare) to put a minority child or a child in a wheelchair or an overweight one through a “vote” like this.

I also could not believe some of the comments left by readers in response to the news reports about Alex. And as much as I’d like to think that the comments against Alex and supporting Portillo and the exclusion of children on IEPs from regular classrooms were written by “trolls” – people who post inflammatory remarks just to stir up people and make them angry – I’m afraid that a lot of those comments truly are what people who wrote them think and believe and that’s what they teach their children.

One of Alex’s classmates, Jessica Moore, cried when Mrs. Portillo was removed from the classroom. She was among those who voted Alex out of the classroom and sees the incident as a “non-event.” Her father, Terrence Moore, of course doesn’t see anything wrong with that picture and calls Portillo a “very caring teacher.” (TCPalm.com, May 29, 2008 “Police report reveals teacher’s side of incident in which boy ‘voted’ out of Port St. Lucie class”)

I am terrified to think whether any of parents of my son’s classmates would want him removed from the classroom. Some of the behaviors that made Alex’s peers vote against him were humming or eating paper. My son doesn’t hum or eat odd things anymore, at least not in school, but he used to. He stopped doing that because he received a lot of accommodations and behavioral interventions at his integrated preschool. If he had a teacher like Wendy Portillo, I’m sure he’d be voted out sooner or later as well.

Everyone who has or worked with an autistic child knows that even with the high functioning kids the symptoms are quite noticeable right away. I’m floored by the fact that Alex has been in school since September and for the past nine months the school has done nothing to help him when it is widely documented that for autistic children intervention and support at this age is crucial and can make a lot of positive difference in the future.

There has been tremendous coverage of Alex’s story on blogosphere. I especially like the post “Wendy Portillo’s Psychological Mob Lynching of a 5 Year Old” on Thinking in Metaphors (I like too many parts of this post to quote it, I’d have to quote the whole thing)

and “Alex Barton” on Life with Joey where the author writes

“Not only was Alex Barton emotionally abused, but so was his entire class. […]This was an assault on an entire classroom of children, with Alex Barton as the focus.” (the entry also includes links to other blogs discussing Alex’s story)

Another blogger on MOM – Not Otherwise Specified (I love the title!) makes a very good point for inclusive education in her post “The tribe has spoken”

“In the midst of a difficult, troubling year, Alex Barton’s teacher called his village together and rallied them against him. Bud {the blogger’s son} also had a difficult, troubling year and, interestingly, his teacher also called his village together for a tribal meeting. Unlike Alex, Bud was not there for the meeting. And the agenda for Bud’s tribe’s meeting was distinctly different: one of the special ed team members came in to talk to Bud’s class and help them understand Bud a little better – help them understand the things that are difficult for him, the things that are easy for him, and the things they could do to support him through the challenging times. Like Alex’s village, Bud’s village came together. But Bud was embraced instead of exiled.”

And finally, I found very interesting the entry “Why I am closing the comments on two posts” on Asperger Square 8, where the author writes

“Around the web, you can find comments stating that she did the right thing, that children must be made to behave through any means available. You will also find people saying she should be harmed emotionally and/or physically for her crime. I’ve heard that she is undeserving of life. This is not acceptable to me. […] I know that if my worst moments were shown to the world, were discussed on numerous sites, some with nearly a thousand comments now, I would not want to continue living. Yet I believe in redemption (not in a passive sense, but through hard work toward change) and I hope that others, including Portillo, do too.
When people start coming to my blog and talking about revenge and sending people to hell, it is time to take a break. […] For the sake of the other Alexes, those whose names are not in the spotlight, it is time to turn our attention toward the larger societal problems, those which allow bullying to occur, not just in one school in Florida, but throughout this nation.”

I agree – even though I’m afraid the war on discrimination will never be won completely, we cannot stop trying. That’s why I’m planning to request putting in my son’s IEP “educating the school staff about autism and ADHD and the types of accommodations and interventions required” – a suggestion I picked from A Parent’s Guide to Special Education: Insider Advice on How to Navigate the System and Help Your Child Succeed, by Linda Wilmhurst and Alan W. Brue, published by AMACOM in 2005.

Gifted Education – Federal level

Even though the United States has a federal definition of gifted students, there is no federal-level mandate to identify gifted students and place them in gifted programs. As a result each state has its own rules about gifted education.

Despite no mandate, in 2008 there are federal funds for gifted programs through the Javits Grant, “available to institutions of higher education (IHEs), local education agencies (LEAs), nonprofit organizations, other organizations and/or agencies, and state education agencies (SEAs).”

As the Javits Grant web site states “The purpose of this program is to carry out a coordinated program of scientifically based research, demonstration projects, innovative strategies, and similar activities designed to build and enhance the ability of elementary and secondary schools to meet the special education needs of gifted and talented students. The major emphasis of the program is on serving students traditionally underrepresented in gifted and talented programs, particularly economically disadvantaged, limited English proficient (LEP), and disabled students, to help reduce the serious gap in achievement among certain groups of students at the highest levels of achievement.”

The National Association for Gifted Children is rallying the gifted community to contact their state representatives and senators to support funding for the 2009 Javits program because, “as he did seven times before, President [Bush] has requested $0 for the Javits program in his Budget Request to the Congress.” NAGC also has a web site showing which representatives and senators have already co-signed the letters requesting $11.25 Million for the Javits Program in fiscal year 2009.

By the way, no Javits grant competition was held in 2007 and 2006 due to lack of funds.

In 2005, the U.S. Department of Education received 140 applications for the Jacob K. Javits Gifted and Talented Students Education Program and funded 14 Priority Two grants totaling approximately $3.5 million.

In 2004, due to limited funding in 2004, no Javits grant competition was held and the funding was distributed among high quality proposals that were submitted in 2003 http://www.ed.gov/programs/javits/fy2004abstracts.doc.

And in 2003, the Department received 105 applications for the Javits competition and funded two Priority One and five Priority Two awards totaling $8.17 million.

Most of the grants were awarded either to state departments of education or universities and colleges that train teachers to specialize in gifted education. Very few school districts received federal funding.

I was a bit jealous to find that the GATE program at the Davis Joint Unified School District in California – one of the school districts that received federal grants –offers self-contained classes for gifted children. (The program’s site includes the district’s restructured standards specifically for the GATE program.)

I also liked the Gifted Programs page of the Page Unified School District in Page, Arizona, which offers “enriched curriculum with the flexible grouping of students […] to facilitate differentiated instruction.”

From among the districts that received federal funds, the closest one to where we live – the Nashua, NH School District – does not seem to have a link straight from their home page to their “REACH: Recognizing Extraordinary Abilities in Children” program site.

According to another page I found through the search engine, in 2007-2008 school year 618 students participated in the REACH program and the district is planning to allocate $335,099 to REACH in 2008-2009 FY. (see page 4 of the document).

I could not find much detailed information about the program on the REACH site. It seems students identified as gifted “have their needs met through accommodations proscribed within individual action plans (IAPs)”, which sounds very much like the Individual Education Plans (IEPs) used in Special Education. But it’s not clear from the information posted whether the program is self-contained, or offers pull-out, or simply provides differentiates instruction within a heterogenic classroom.

Either way, it’s not our district, so our son cannot attend that program.

Parental psychiatric disorders and children with autism

The May 5, 2008 issue of Pediatrics published an article “Parental psychiatric disorders associated with autism spectrum disorders in the offspring,” written by the UNC research team, led by Julie Daniels, PhD, assistant professor in the departments of epidemiology and maternal and child health at UNC’s School of Public Health.

As I understand, the team reviewed birth and hospital records from Sweden and looked at the numbers of psychiatric disorders in parents and the numbers of autism in children. And yes, there seems to be a link between the two.

But what I found interesting is how this news is reported, beginning with headlines to the way the results are described in the news about this study.

Take, for instance the following headlines:

Don they make it sound like the child’s autism is the cause of parent’s mental illness? In other words, if you have an autistic child, there’s a high chance you’ll develop a mental illness as a result, which is not what the study is saying, I believe.

Some headlines’ language is more neutral:

But simply because they put “autism” in the first part of the headline I still think someone could understand these headlines as pointing to autism as the cause of parents’ mental illness.

I found just a couple of headlines that put the “parents’ mental illness” language at the beginning (just like the article to which they are referring):

In other words, the way I would understand these headlines without reading the article underneath, the parents’ mental illness is related to a child’s autism, but without reading more, I wouldn’t know in what way – which one causes the other.

And finally, I found it quite amusing that the Russian Pravda’s headline “Parents with mental disorders more likely to have autistic children” is pretty much the opposite of the Washington Post’s headline.

Pravda‘s headline, by the way, as blunt and to the point as it is, does seem to get the gist of what the researchers are saying, but I’ll have to look at the actual article to confirm.

Heart Conditions and ADHD

The American Heart Association recommends that children with ADHD should get “careful cardiac evaluation and monitoring, including an electrocardiogram (ECG) before starting treatment with stimulant drugs.”

Apparently, “studies have shown that stimulant medications like those used to treat ADHD can increase heart rate and blood pressure.” And while “these side effects are insignificant for most children with ADHD; however, they’re an important consideration for children who have a heart condition.”

What I found very curious is the following: “Surveys indicate that ADHD affects an estimated 4 percent to 12 percent of all school-aged children in the United States, and it appears more common in children with heart conditions. Studies report that, depending on the specific cardiac condition, 33 percent to 42 percent of pediatric cardiac patients have ADHD.” What is the link between heart conditions and ADHD?

Interestingly, during the recent American Psychiatric Association, a pediatric psychopharmacology researcher at Harvard, “emphasized that there’s no evidence that stimulant or non-stimulant medication for ADHD causes sudden death.” By the way, his talk was sponsored by drugmaker Abbott Laboratories, which is working on a new drug for ADHD.

What’s the issue here? Money, of course. It’s expensive to do ECG on every child diagnosed with ADHD. And then if a heart condition is detected (in a whooping 33 to 42 percent of the cases) the parents will be told about the risk of side effects and as a result may decide to avoid medications. This recommendation obviously is not in the financial interest of both insurance companies and drug makers.