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	Attention deficit hyperactivity disorder was one of the good articles, but it has been removed from the list. There are suggestions below for improving the article to meet the good article criteria. Once these issues have been addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake.
Article milestones Date Process Result September 16, 2006 Good article nominee Listed October 8, 2006 Featured article candidate Not promoted March 13, 2007 Good article reassessment Delisted
Current status: Delisted good article

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ADD

I'm sorry but what happened to ADD?? Have i been liveing under a rock since i was diagnosed or did it just dissapear?? Theres no such mention of ADD that i can find on wiki (although i just skimmed around\0 There is only one metion of ADD at all on wiki and that is one sentence. Shouldnt there be an ADD section of this page at least or a page of its on? can anyone enlighten me on this subject? 130.123.128.114 (talk) 02:58, 10 March 2009 (UTC)

You may have been living under a rock! The diagnosis of ADD was actually removed from the DSM in 1987; it became the "predominantly inattentive" subtype of ADHD. People still use the terminology because it makes sense, but it's technically not correct. Tim D (talk) 05:16, 10 March 2009 (UTC)

Well thats lame. Is there an article around explaining why ADHD is prevalent over ADD? And maybe it should be in here in a section of history of terminology or something like that. 130.123.128.114 (talk) 20:45, 10 March 2009 (UTC)

I think that would be good. Feel free to add a section under history about the changing terminology used to describe hyperactivity in children. This condition has been refered to be many different name over time and is refered to by different names in different areas of the world.--Doc James (talk · contribs · email) 22:01, 10 March 2009 (UTC)

FYI, there already is a section that addresses the history of terminology and such. But anyway, there are some researchers who argue that the predominantly inattentive subtype of ADHD is a completely different disorder from the combined subtype; it essentially comes down to how they're defined neurologically. I personally wouldn't be too upset if the DSM-V ended up redefining them separately... Tim D (talk) 23:58, 10 March 2009 (UTC)

Yes the classification is debated. The ICD10 uses different terminology and criteria all together. All I was saying is that if the above user find the discussion inadequate then he should feel free to clarify issues.--Doc James (talk · contribs · email) 01:16, 11 March 2009 (UTC)

ADD and ADHD are the same thing. It's just the difference between there being a "Hyperactivity" part there or not. The symptoms (possibly excepting hyperactivity), treatment, and diagnosis are the same. If you want to be technical, ADD is "ADHD predominantly inattentive"--Unionhawk 18:19, 30 April 2009 (UTC)

Really ADD is the same thing as ADHD withouth the Hyperactivity. I think alot more people have ADD then ADHD. So really ADD is just not being able to pay attention and not remembering things. So it actualy covers alot of people. lol--Blake (talk) 21:57, 5 May 2009 (UTC)

I think there should be a separate page for ADD. I personally have ADD and dont like it when people assume ADD and ADHD are the exact same thing. And theres more to it than not being able to pay attention and not remembering things. Please do some research before making a claim like that. There's a distinction between ADD and ADHD. Please do your research. Sas 03:11, 29 May 2009 (UTC)Sas

Please if you disagree find a reference to back up what you say. ADD is the old term ADHD is the new term. Both terms are from the APA.--Doc James (talk · contribs · email) 03:42, 29 May 2009 (UTC)

To be technical, the DSM-IV TR refers to it as "Attention-deficit/hyperactivity disorder" which seems to refer to the optional subtypes. - cyclosarin (talk) 12:16, 11 June 2009 (UTC)

Stimulants and sudden death

Wondering were people think this paper should noted? "This case-control study provides support for an association between the use of stimulants and sudden unexplained death among children and adolescents."] The FDA recommends caution WRT the result which should be commented on as well.--Doc James (talk · contribs · email) 14:38, 16 June 2009 (UTC)

If I recall correctly the FDA has mandated stimulants have a black box warning for sudden death so I don't see why not.--Literaturegeek | T@1k? 01:08, 17 June 2009 (UTC)

surely this level of detail should go in the article of stimulants, not the article on ADHD. --Vannin (talk) 01:55, 17 June 2009 (UTC)

How about the article about the treatment of ADHD? Stimulants are not used for much else. And the FDA does comment specifically that this study should not lead to masses of parents removing their children from treatment.--Doc James (talk · contribs · email) 01:58, 17 June 2009 (UTC)

Vannin has a point, article is on ADHD. I think Attention-deficit hyperactivity disorder management and perhaps also stimulants article are more relevant.--Literaturegeek | T@1k? 02:02, 17 June 2009 (UTC)

The consensus is,...or was, that there was no increased risk of sudden death from the therapeutic use of stimulants. At face value this primary source challenges that notion. It is important to note that this is a single study and it is a correlation study. Correlation does not equal causation.

The FDA did comment on the study, "It's hard to characterize the results as reassuring," the FDA's Robert Temple said at a news conference. Still, Temple said, it's possible that the study missed stimulant use by the car-accident victims, because the parents of children whose deaths were unexplained might have better recall years later of what drugs they took. It's not a robust finding," he said, noting that if only one more automobile victim had been found to have taken an ADHD stimulant, the difference between that group and the sudden unexplained death group would no longer have been statistically significant. But, Temple said, "that doesn't mean that this is off the table and we're not concerned about it anymore." --scuro (talk) 03:57, 12 July 2009 (UTC)

Low arousal theory

A question is asked at this article's talk page which I cannot answer. Just a heads up. - Hordaland (talk) 18:20, 20 June 2009 (UTC)

I've shorten that article by half and removed 1 of the 3 references. See its Talk. The article could just as well be deleted, but I'm leaving it there. - Hordaland (talk) 00:09, 7 July 2009 (UTC)

These speaks to a symptom of ADHD? Who are the proponents of this theory? My fear is that it may be a business. Not sure if this belongs on the ADHD page unless someone wants to flesh it out for us.--scuro (talk) 20:46, 21 July 2009 (UTC)

Section tagging the controversies section

I'm posting a cleanup tag on the controversies subsection for the following reasons:
1. This section needs copyediting for tone and flow. It reads choppily and awkwardly.
2. Some statments needs to be clarified. As an example, "One source of controversy is that the pathophysiology of ADHD is currently unclear." Who is it a controversy for? For anti-psychiatrists and the like, they argue that because there currently no definitive pathophysiology, ADHD doesn't exist. For the researchers in the field there is no question that there is a pathophysiology, but there are probably competing ideas on the precise identity of it.
3. Currently the section contradicts some of information in the main article ADHD controversies

"the promotion of ADHD to the public as well as policies aimed at schools which force schools to identify children with ADHD being blamed for over diagnosis." There is no mention of or only faint passing references in ADHD controversies about and "promotion of ADHD to the public" and "policies which force schools identify children with ADHD being blamed for over diagnosis".

"the high rates of ADHD diagnosis" - There are mainstream sources that say ADHD is under-diagnosed or may be under-diagnosed in certain populations like girls or adults (NICE). Also this controversial view is currently presented without any counterbalancing information. This statement presents as fact that over-diagnosis is due to alleged policies which force schools due identify children with ADHD, when there is are also arguments that overdiagnosis might be due to vague diagnostic criteria. And again there are mainstream sources which state that some populations have ADHD under-diagnosed. This should probably be reworded somehow to better express the over-diagnosis debate.

4. Some aspects of ADHD controversy which have substantial page-time on the main controversies page are totally ignored here. These include impact of labeling and politics and the media. A mention for both could be worked in. Sifaka 00:56, 27 June 2009 (UTC)

You must have (at least) 2 monitors; how do you keep track to compare? The controversy section here is supposed to be a summary of the contoversy article. Should one rather begin there? - Hordaland (talk) 19:25, 6 July 2009 (UTC)

With regards to controversies, I don't believe the points below have been addressed yet. I've posted them again so that we can move forward on this issue.

1. What is the controversy?
2. What is the majority and minority viewpoint about the controversy?
3. Have both viewpoints been stated clearly with due weight according to wiki standards?

As wiki states WP:UNDUE "Undue weight applies to more than just viewpoints. Just as giving undue weight to a viewpoint is not neutral, so is giving undue weight to other verifiable and sourced statements. An article should not give undue weight to any aspects of the subject, but should strive to treat each aspect with a weight appropriate to its significance to the subject. Note that undue weight can be given in several ways, including, but not limited to, depth of detail, quantity of text, prominence of placement, and juxtaposition of statements."

Input would be most welcome.--scuro (talk) 04:07, 12 July 2009 (UTC)

I hadn't heard from anyone and wondered if some of you are considering what was stated but need more time to comment. Does anyone need clarification on the points made? If I can be of service to anyone please let me know. I'm eager to clean up what I perceive to be this long standing undue weight mess with regards to controversy.--scuro (talk) 16:44, 15 July 2009 (UTC)

Why do you not write something with references to the literature that you think is better / more balanced than what we have. Post it here and we can then discuss these proposed changes?--Doc James (talk · contribs · email) 17:01, 15 July 2009 (UTC)

It is entirely possible, as Sifaka suggests at the top of this thread, that we do need a more general discussion before attempting concrete re-writes? We don't have one controversy (as suggested by scuro "What is the controversy?"), but several. Sifaka explains/defines some of them; why not start there? - Hordaland (talk) 08:44, 16 July 2009 (UTC)

I've no problem with the viewpoint that there are several controversies. I also agree with you that a general discussion would be the best approach. Can't seem to find Sifaka's classification of controversies. Can anyone find a link?--scuro (talk) 10:57, 16 July 2009 (UTC)

An editor posted this link on my talk page. Dr Silver is, "...a Child and Adolescent Psychiatrist, is in private practice in the Washington, D. C. area. He is Clinical Professor of Psychiatry at Georgetown University Medical Center. Prior to his current activities, he was Acting Director and Deputy Director of the National Institute of Mental Health of the National Institutes of Health. Prior to his positions at the National Institute of Mental Health he was Professor of Psychiatry, Professor of Pediatrics, and Chief of the Division of Child and Adolescent Psychiatry at the Robert Wood Johnson School of Medicine. For more than thirty years his primary areas of research, clinical, and teaching interest have focused on the psychological, social, and family impact of a group of related, neurologically-based disorders—Learning Disabilities, Language Disabilities,Sensory Integration Dysfunction, and Attention Deficit Hyperactivity Disorder". I think he would meet the criteria of an expert in the field, and the book is considered a clinical book. He clearly delineates between between current research and medical perceptions of little current controversy. Specifically, "current debate over ADHD within the research and medical communities has been minimal and mostly concerned with subtle details within the diagnosis process and treatment program". That would seem to be at odds with what the article states about current perceptions, based on citations that are 10 or more years old.--scuro (talk) 03:36, 19 July 2009 (UTC)

I don't see why that ref cannot be used scuro. You can use the book citation template Template:Cite book to cite it.--Literaturegeek | T@1k? 21:48, 19 July 2009 (UTC)

Ambiguity in the culture section.

The first paragraph of Attention-deficit hyperactivity disorder#Culture is difficult to follow. What do "The core impairments are expressed in different cultural contexts" and "ADHD is considered differently based" mean. Who are "they?" I am adding some inline tags requesting clarification. Sifaka 01:01, 27 June 2009 (UTC)

I still don't think part of the culture section has been made more readable, so I will explain in more depth.

ADHD is considered differently based on how those who have an interest in the topic approach the subject. --> This statement is awkwardly worded making its meaning unclear. "Considered differently based" is especially unclear in the "these words don't make sense together" kind of way. Based on what?

Depending on one's paradigm, the meanings of ADHD related subjects and terms vary within the everyday language of lay persons. --> "One's paradigm" is unclear. Does it refer to one's beliefs about existence of ADHD or how it is treated?

Part of this section was also directly copied from the abstract of the paper. It is now paraphrased. Although the source was cited, I want to point out that it is probably a violation of WP policy to copy-paste text without paraphrasing it unless it is quoted. (There wasn't a strong statement that I saw on the policy page to this effect but it seemed to be implied).

Also I am wondering if the title of the section should be changed to something like Perception of ADHD instead? Thoughts? Sifaka 23:29, 4 July 2009 (UTC)

The whole first paragraph in "Culture" belongs far above, in "Causes". Can probably be combined into a section up there. The explanation in quotes applies to ADHD, not just to the high frequency, I think.

The "differently based" sentence is not good, but not as bad as you'd have it. Read it with a comma after "differently". I think it says that people have different approaches to the topic, and, based on this, they "consider" it differently. I'd say: Obviously they do... But "consider" isn't a good word here. That paragraph makes an interesting point, but is so unclear that no one is going to get it.

"Culture" is a strange name for the section, but not sure "Perceptions" is any better? Maybe "In society"? Or does the content needs its own section, at all? There are parts which quite specifically echo "Controversies" (high frequency, etc.); could/should they rather be there? What is the point of including this section? I suppose it's sorting out various types of experts, lay people & media? - Hordaland (talk) 22:21, 6 July 2009 (UTC)

Thanks for clarifying the "differently based" line. It makes a lot more sense when you mentally insert a comma, but the whole sentence is kind of vague. I agree that the first paragraph belongs somewhere else. (epidemiology? I'm not sure.) The last paragraph (baseball) probably belong in the epidemiology section. As a name "ADHD in society" is ok too but maybe "ADHD in popular discourse" or "popular culture"? Ignoring the two paragraphs that belong in other sections, I think the culture section has two main focuses: How lay people perceive and discuss ADHD and instances of when ADHD became a popular topic and attracted a lot of attention - enough attention to affect general perceptions. I think the material is different enough in scope from that in the the controversies section to warrant its own section, but there are probably some details that need to be resolved. Sifaka 03:12, 7 July 2009 (UTC)

"Culture," "Perception of ADHD," "ADHD in society," "ADHD in popular discourse," "ADHD in society," and "Popular culture" were suggested above. I just happened to be over at NPOVnoticeboard and saw this suggestion in another context: "Societal views." I like it. Perhaps it could be its own section, instead of looking to be a part of "History." Alternatively the content could be considered history. Leaning toward "Societal views." - Hordaland (talk) 18:10, 10 July 2009 (UTC)

There is supposed to be a standard format for medical articles. I believe "Culture" can be one of the major subheadings and I have no problem with "societal views" being a minor subheading within that area. On the other hand, is this section just a rehashing of "alternative theories", which already has it's own section?

With regards to ambuguity, the lede sentence is just as confusing within the context of society, "Adaptive explanations of the high frequency of ADHD in contemporary settings propose that "the disorder represents otherwise normal behavioral strategies that become maladaptive in such evolutionarily novel environments as the formal school classroom." However, one study showed that inattention and hyperactivity appear to be at least as problematic at home as at school". What, or who believes in "adaptive explanations"? Is this Hunter/gatherer terminology? The sentence contradicts itself. Either ADHD is really only a problem in the classroom or it isn't. That is unless you want to divide this into majority opinion and minority opinion. The bigger problem is that the opening line should summarize the whole section.

The second sentence/paragraph(?) again contradicts itself, and yes...is not clear. The sentence seems to be written from the "social construct" theory. ie ADHD exists because the medical community has created terms etc, and people use these terms, so the disorder exists. Thoughts on all of this?--scuro (talk) 11:17, 16 July 2009 (UTC)

I think that you may be right about what that paragraph is about, but, I can't tell at all... I'm not sure that that paragraph even belongs in a culture section, but, it's too confusing for me to be able to tell one way or the other. And, of course, the source for that paragraph is blocked by parental controls... I'm going to take a guess and say that it's redundant. Revert if you disagree.--Unionhawk 20:22, 16 July 2009 (UTC)

The line that I quoted in my previous post is now the lede sentence. Problems noted in that last post still exist. This sentence could also be removed, and a new lede sentence could be added. Or, does someone else have a solution?--scuro (talk) 02:37, 18 July 2009 (UTC)

Comorbid conditions

OK so can someone tell me after checking out citation 102 and 103 (which are identical) which states in the conclusion "There is no published evidence to suggest that either the short or long term treatment with methylphenidate increases the risk of developing seizures in children with ADHD."

can be reconciled with...

"Some forms of epilepsy can also cause ADHD like behaviour which can be misdiagnosed as ADHD"

The citation is regarding the drugs to treat ADHD and the correlation b/w the 2, not a diagnosis.

josst10 (talk) 01:46, 8 July 2009 (UTC)

Did you read the full citation? I don't see what you are trying to say. I recall reading that citation and it did mention that epilepsy can causes ADHD like symptoms which can be misdiagnosed.--Literaturegeek | T@1k? 02:10, 8 July 2009 (UTC)

Reconciled? Cutting out weasel words your two quotes say:

1. Person with ADHD will not get seizures from taking methylphenidate
2. Person with epilepsy may show ADHD-like behaviour

What's to reconcile? - Hordaland (talk) 14:33, 8 July 2009 (UTC)

I don't see a conflict either. Both are telling clinicians to be careful to determine whether the child has ADHD, epilepsy, both, or . htom (talk) 17:23, 8 July 2009 (UTC)

questionable sentence in the lede?

"In the first decade of the 2000s, ADHD diagnoses have increased dramatically in the United States, prompting some scholars from various fields to question the scientific validity of this relatively recent childhood disorder".

Didn't the dramatic increase of the diagnosis of ADHD occur in the 90's? The use of "some" creates an undue weight issue in this sentence. Who are these scholars? Are they majority, minority, or fringe? That's kinda of important for the lede paragraph, don't ya think? The Journal of Ethical Human Psychology and Psychiatry is also of questionable standards. It has no wiki entry and was founded by Peter Breggin. I could be wrong but I don't believe it is viewed as a scholarly journal. An article from this journal is used as the citation for the sentence. Anyone have input here on who put that sentence in and if it should be removed from the page?--scuro (talk) 04:33, 12 July 2009 (UTC)

I am not at this time offering any opinion on whether that sentence should stay or go or be revised or be differently sourced.

I looked around a bit and see that Jeanne M. Stolzer, Ph.D., is (or fairly recently was) an Assistant Professor of Child Development at the University of Nebraska @ Kearney. Her "research interests include the biocultural implications of attachment parenting, the multivariational effects of labeling children, and challenging the existing medical model which seeks to pathologize normal range child behaviors." ...from this PDF, 2006. So we see which camp she's in: probably minority but not fringe IMO.

She's been using the phrase "the last decade" for some time. That phrase cannot be used in an encyclopedia article which is meant to be read 5 and 10 and 20 years from now. - Hordaland (talk) 13:20, 12 July 2009 (UTC)

Utter geniuses who are Nobel Prize winners, and dominate their fields,...have been known to take on extremely controversial positions outside of their field of expertise. One scientist that comes to mind was an utter racist to the core. Their reputation in one field has little credence within another field. Likewise, the position that one holds means little. The question should be, is this person a recognized expert in the field of ADHD, and if she is, why isn't she publishing in mainstream journals instead of "alternative" and exclusive journals? Is there a better source?--scuro (talk) 14:16, 12 July 2009 (UTC)

I have moved the source down to the controversies section scuro. There has been an increase both in the 90's and 2000's. It is not a review article. I have no idea who added that citation or sentence to the lede.--Literaturegeek | T@1k? 21:48, 12 July 2009 (UTC)

The controversy section should be a brief summary of the controversy page, not a catch all. What is the value of this sentence? The facts appear to be wrong, the source questionable at best, and the conclusion OR. I'd suggest removing it all together or finding a better source that states the same thing. It detracts from the quality of the article.--scuro (talk) 01:38, 13 July 2009 (UTC)

I would need to read the full text first, so dunno how they based their findings. As I did not add the ref, I want to wait and hear from other users first. I don't mind one way or the other if that ref gets deleted or not.--Literaturegeek | T@1k? 11:19, 14 July 2009 (UTC)

You are welcome to read the text, the issue though, is the source. Content within the source, in that regard, really doesn't matter. A possible solution here would be to put the "dubious" tag on the citation until you have had the time to consult other editors. The tag may pull in other editors with insights. Is this a workable solution..or do you still need more time?--scuro (talk) 15:27, 14 July 2009 (UTC)

Since there has been no response I've deleted the sentence and citation. Feel free to return the material but please explain why it should be included in talk.--scuro (talk) 14:04, 21 July 2009 (UTC)

I agree with Scuro here. We have a controversies article. Given that, the material under Controversies here should represent a summary of the most important material from that article, with high consensus, like a mini-lede, and the controversies article would contain all the citations, the summary need not be cited at all, and extensive quotes are really inappropriate. The removed material should be moved to the controversies article if it is not already there. (Indeed, the summary might actually be the lede of the Controversies article if it has been well done. Good work, Scuro. --Abd (talk) 15:23, 21 July 2009 (UTC)

Ty Abd. Would you be willing to fix this section?--scuro (talk) 15:08, 22 July 2009 (UTC)

Please remind me in January

ArbCom follow-up: diff, FYI.—Preceding unsigned comment added by Hordaland (talk • contribs) 09:28, July 14, 2009

Terrible Writing

This article's introduction is simply terribly written. What is up with all the quotes? I think the introduction to this article shows some of the weaknesses of group writing. —Preceding unsigned comment added by 63.209.224.182 (talk) 22:34, 20 July 2009 (UTC)

causes section

It would be my opinion that none of the alternative theories would have real acceptance in the Scientific and Medical communities as causes of ADHD. The low arousal theory speaks to a symptom. Diet as a direct cause of ADHD would also not have acceptance in those communities. This creates undue weight issues. As a solution, may I suggest that his material be moved from the causes section. It could be moved to the culture section because it is society which believes many of these things. I'm open to other ideas.--scuro (talk) 23:02, 20 July 2009 (UTC)

There is a box in this section with the following sentence in italics, "As of mid-2009, the consensus on a sensible approach to nutrition for children with ADHD is the same recommended for all children: eat a diet that emphasizes fruits and vegetables, whole grains, healthful unsaturated fats, and good sources of protein; go easy on unhealthy saturated and trans fats, rapidly digested carbohydrates, and fast food; and balance healthy eating with plenty of physical activity. (Emphasis added) ". Stylistically is this supposed to be done?--scuro (talk) 14:12, 21 July 2009 (UTC)

We are writing an encyclopedia for the general population. Ideas held by that general population should also be discussed even though they may be wrong. This is similar to many article were we have sections on alternative medicine even though there is no evidence for much / all of it.--Doc James (talk · contribs · email) 14:46, 21 July 2009 (UTC)

ADHD by the way exists in a social cultural context. This is more important in this condition than most because it is a pediatric condition (which means families / school / governement) becomes more involved.--Doc James (talk · contribs · email) 14:52, 21 July 2009 (UTC)

The issue is appropriate weight and if this information belongs in the "causes" section. We do not look to society for answers as to what causes ADHD. I'm not advocating that the material be deleted, rather that it be moved, and or be shortened because of undue weight issues.--scuro (talk) 15:08, 21 July 2009 (UTC)

If one looks back at the history of pyschiatry one sees that less than fifty years ago many of these ideas were by far the majority opinion. There are still many in academics who beleive they place a role. There is very little currently on each of the three ideas.--Doc James (talk · contribs · email) 17:16, 21 July 2009 (UTC)

The issue here is that the section is the "causes" section. Sure, things have moved at exponential pace when it comes brain science and psychiatry. But 50 years is a coons age in this field, even 25 years ago is more like an archaic period. There are many academics with a variety of ideas, but would you not agree that if the information is about the causes of ADHD, that this would fall under the realm of science? That you may have majority and minority within this field, and those outside that field may very well fall under fringe opinion?--scuro (talk) 21:07, 21 July 2009 (UTC)

This is psychiatry were the diagnostic criteria are decided by group consensus. Psychiatry is the least scientific of all the medical subspecialties. So no I do not agree that the cause falls under the realm of science. The science at this point does not claim to have answer. The cause is unknown the patho is unknown. Therefore the discussion of cause at this point is mostly philosophy. --Doc James (talk · contribs · email) 21:59, 21 July 2009 (UTC)

If ADHD is real or not, is not a debatable issue here. Nor is Psychiatry, and its supposed failings. The issue is what is majority, minority, and fringe opinion on the topic of what causes ADHD? Neither the social construct theory(notion that ADHD is fake}, nor the other alternative theories, or diet theories, would meet the threshold to be considered majority or minority opinion with regards to causes.--scuro (talk) 12:34, 22 July 2009 (UTC)

We know that that is your opinion. Others have disagreed. We can wait for more comments if you want.--Doc James (talk · contribs · email) 14:31, 22 July 2009 (UTC)

Really what this is about is how one determines majority, minority, and fringe opinion. Comments on that topic would move this forward.--scuro (talk) 15:11, 22 July 2009 (UTC)

I have provided evidence on the controveries page that this is one of the majority opinions in the general population. This is a general encyclopedia therefore needs to address the topic in a manner that deals with the questions of a general audience. --Doc James (talk · contribs · email) 16:22, 22 July 2009 (UTC)

how to properly reference?

How would one properly wiki reference this citation? http://books.google.com/books?id=gjojY1WoIOIC&pg=PA4&lpg=PP6&output=html --scuro (talk) 23:08, 20 July 2009 (UTC)

It is a strange URL. My recommendation is to cite the book, not the Google URL: first, because the user may want to order the book or seek it at a library; and second, the Google URL could change over time. You could use the book template. My personal preference is to just type in an MLA citation that should look something like this:

Here's how it will look in the Notes section: Silver, Larry B. Attention-deficit/hyperactivity disorder. American Psychiatric Publishing, Inc.; 3 edition (September 2003) ISBN 1585621315; Online: http://books.google.com/books?id=gjojY1WoIOIC&pg=PA4&lpg=PP6&output=html July 20, 2009

Further down from where Google shows you the page, there is a box on the left side as to where to buy the book from several difference dealers. Any one of those will contain the info for the full citation, including ISBN.

I'm sure other editors will have other ideas for you. Thanks for being conscientious about your citations. Afaprof01 (talk) 23:40, 20 July 2009 (UTC)

I've added a place for references to show up on the talk page so that I can see exactly how it should look like and practice. Tweak it if you wish.--scuro (talk) 00:46, 21 July 2009 (UTC)

1. Silver, Larry B. Attention-deficit/hyperactivity disorder. American Psychiatric Publishing, Inc.; 3 edition (September 2003) ISBN 1585621315; Online: http://books.google.com/books?id=gjojY1WoIOIC&pg=PA4&lpg=PP6&output=html July 20, 2009

I forgot to thank you for explaining this. The real test will be the next time that I want to include a citation. Hope your still around then!--scuro (talk) 14:05, 21 July 2009 (UTC)

see also section

There seems to be a lot of links that don't belong there. Are there guidelines for this section?--scuro (talk) 14:09, 21 July 2009 (UTC)

Guidelines say this section should be avoided and this links should be combined into the text.--Doc James (talk · contribs · email) 17:12, 21 July 2009 (UTC)

Feel free to edit away. I'll get around to it if it's not done, sometime in the future. The business links should be removed immediately.--scuro (talk) 21:09, 21 July 2009 (UTC)

James, are you sure that "should be avoided" applies to See also? Or maybe External links? "See also" section on the page Misplaced Pages:Layout doesn't seem to say that See also should be avoided. (However, links which already appear in the article should not be repeated in a See also section.) - Hordaland (talk) 10:04, 22 July 2009 (UTC)

More on what is not accepted WP:ELNO. Links should be directly related to the topic and undue weight in this section also applies.--scuro (talk) 12:44, 22 July 2009 (UTC)

The see also links are internal links, not external links, just to clarfiy.--Literaturegeek | T@1k? 12:50, 22 July 2009 (UTC)

Based my statement on this ] were it says avoid if possible.--Doc James (talk · contribs · email) 13:30, 22 July 2009 (UTC)

Is there any link that is a "must"?--scuro (talk) 15:12, 22 July 2009 (UTC)

No, it is just a guideline, it is not a must, above I said should. It is just a recommendation for a good article. Most of them are in the text anyway and thus I have removed them.--Doc James (talk · contribs · email) 16:17, 22 July 2009 (UTC)

See also links are internal (link to wikipedia articles/pages on wiki site), so wrong guideline is cited. External links are links to pages outside of wikipedia domains, usually linked in either further reading or external links sections. I have read some guideline somewhere though that if a see also link is linked in the article then it should not be linked at the bottom of the article.--Literaturegeek | T@1k? 17:04, 22 July 2009 (UTC)

Pattophysiology section

-The opening statement states, "The pathophysiology of ADHD is unclear and there are a number of competing theories.". Surely there must be majority opinion here in the scientific community and should this be stated at the front of this section?

-Not sure what the following sentence is concluding. Is it stating that Neuroimaging is not a diagnostic tool? "Neuroimaging studies in ADHD have not always given consistent results and as of 2008 are only used for research purposes.".--scuro (talk) 14:22, 21 July 2009 (UTC)

That the pathophysio is unclear is stated by many sources and is the majority opinion (see uptodate for example). Neuroimaging is not used in a clinical setting to diagnose ADHD only to rule out other possible problems. It is used in research settings only.--Doc James (talk · contribs · email) 14:37, 21 July 2009 (UTC)

I agree that there is no definitive definable cause, yet there are theories about the cause and this where one could state majority opinion. With regards to Neuroimaging, perhaps the sentence could be more clear?--scuro (talk) 14:43, 21 July 2009 (UTC)

One states what is agreed upon. Everyone agrees that the pathphysio is unclear. Than it is follow by different ideas of what some consider might be possible.--Doc James (talk · contribs · email) 17:11, 21 July 2009 (UTC)

Having read a large number of papers on the topic, there doesn't seem to be a majority opinion among researchers about what causes ADHD although the prefrontal cortex and lobar volume and dopamine misregulation seem to be popular. Also there could be several different causes that have similar effects. It's confusing. The research community seems fairly unified behind the idea that there probably is a biochemical/neurostructural difference, but they don't know what that is yet or what causes it yet. Unfortunately I don't have sources for that statement.

Regarding the neuroimaging studies, basically what it means is that that it isn't a good idea to try to diagnose someone with a "computed tomography , computerized axial tomography , or magnetic resonance imaging ." I have the feeling that the reason why boils down to significant variation between people (and perhaps also doctors/researchers not being sure of what to look for). While over a large number of people averaged together, reduced lobar volume in some areas of the brain may be statistically significant, the variation in size may be large enough that it is impossible to tell if a single patient is in the ADHD group or the control group by looking at lobar size alone. Sifaka 01:23, 22 July 2009 (UTC)

Sifaka is right. The majority would believe in biochemical/neurostructural differences, and that should be stated in the opening. I did try to look at the citation but you can't have access unless you pay the subscription. Are not such links to be avoided?--scuro (talk) 13:43, 22 July 2009 (UTC)

Most of the published literature requires payment. As long as you can reasonably get it at an academic library.--Doc James (talk · contribs · email) 14:30, 22 July 2009 (UTC)

Thoughts on the first part of my last statement?--scuro (talk) 15:13, 22 July 2009 (UTC)

I would disagree the majority beleive that the patho physio is unknow. The idea that it is biochemical is just the leading hypothysis. And this is the way we have it presented.--Doc James (talk · contribs · email) 16:12, 22 July 2009 (UTC)

My thoughts scuro are that you say "I agree that there is no definitive definable cause", but yet are disputing a sentence that you agree with.--Literaturegeek | T@1k? 17:07, 22 July 2009 (UTC)

diagnosis section

Not sure about the appropriateness of having lede sentence of this section start like this, "No objective test exists to make a diagnosis of ADHD". There is no objective test for Migraine headaches or most disorders. It's not that this information is not valid information, it's that by making it the lede sentence, undue weight issues come into play.--scuro (talk) 14:43, 21 July 2009 (UTC)

This sentence puts what comes after it into context. Some headaches do have a diagnositic test ( ie CT for CNS tumours ) but many conditions you are right do not. I do not see any undue weight issues.--Doc James (talk · contribs · email) 17:03, 21 July 2009 (UTC)

The undue weight issue is that you don't give context first. You state how how diagnosis is achieved and then you give context.--scuro (talk) 13:48, 22 July 2009 (UTC)

Agree and switched arround. BTW it is not me who states. This page is edited by numerous people.--Doc James (talk · contribs · email) 14:36, 22 July 2009 (UTC)

My apologies for not being more specific in my statement. The "you" was a generalized "you".--scuro (talk) 15:16, 22 July 2009 (UTC)

management section

-If one has an outside link to that section with an article on that topic, should the section on the main article not be brief?

-The major treatment method is medication sometimes in combination with other treatments. By starting with behavioural treatment first, undue weight issues come into play.

-Are not experimental treatments fringe? This whole section takes up way too much space in the article, especially considering that it has it's own separate article.--scuro (talk) 14:50, 21 July 2009 (UTC)

The organization of presentations of treatments in medicine always follow: pychological, pharmaceutical, surgical. This is regardless of which of the three modalities is the most effective.--Doc James (talk · contribs · email) 14:55, 21 July 2009 (UTC)

Would that conflict with wikipedia's undue weight policy? These are not subject headings after all. Anyone know more about this?--scuro (talk) 15:03, 21 July 2009 (UTC)

This is the way medicine is presented but we can see what others have to say.--Doc James (talk · contribs · email) 17:00, 21 July 2009 (UTC)

(I moved this section up from below since I didn't realize someone was already discussing this.) I noticed Doc James swapped the order of the management section to behavioral, pharmacological, and then experimental from P., B., and E.. In your edit summary you said it goes that way (it always goes behaviour, pharmacology, surgery). I originally put the discussion of the swap and my reason why here. My reason in brief was that I ordered the section to match the order of effectiveness of the different kinds of treatment per the sources. I wanted to note when I originally reordered the section, I swapped the entirety of the ADHD management article so it goes pharmacological, behavioral, experimental. Just to be clear, I'm not against the reordering although I prefer the p,b,e ordering pending better reasons. I was wondering if there was a good reason that I missed for doing it the other way. I also wanted to know if there was a manual of style I was missing. I checked Misplaced Pages:Manual of Style (medicine-related articles) and unfortunately it doesn't say anything on the topic. In any case the treatments article should be in the same order as the section of the main page for consistency's sake which may mean it needs to be reordered as well. Sifaka 00:34, 22 July 2009 (UTC)

Seems to me that in an encyclopedia aimed at the general public, the preferred or most oft-used treatment should come first. Physicians/scientists who might check what Misplaced Pages has to say on the subject should understand that reasoning. - Hordaland (talk) 09:18, 22 July 2009 (UTC)

So since environmental / pyschological measures are used for all children with ADHD well medications are only used in 70% of US children with ADHD a less frequently in other coutries we should have the section on pyschological measure first?

This would make it similar to hypercholesterolemia, obesity, and hypertension were diet and exercise are always recommended first. They very rarely work but are still always mentioned first even though medications are recognized to be much more effective. Have posted this question at MOS ]--Doc James (talk · contribs · email) 13:24, 22 July 2009 (UTC)

prognosis section

-It would be my opinion that the literature states that once you have a diagnosis of ADHD, a significant amount of this population would suffer some form of long term impairment. I'm not negating that the fact that a percentage of this population no longer appears to have ADHD as they grow older, nor that a significant percentage of this population finds coping mechanisms. The second paragraph in this section would attest to longer term impairment, and that sort of conclusion should open the paragraph.

-the last sentence doesn't belong in this section, perhaps it belongs in the management section?--scuro (talk) 15:00, 21 July 2009 (UTC)

I agree the last unreferenced sentence should be removed till a reference is found.

There is significant morbidity. And this is discussed. What changes are you suggesting exactly? We could reverse the two paragraphs.--Doc James (talk · contribs · email) 17:10, 21 July 2009 (UTC)

The last sentence should be moved or deleted, the paragraphs should be switched in order, and information about longer term impairments should be added.--scuro (talk) 15:21, 22 July 2009 (UTC)

Agree and done.--Doc James (talk · contribs · email) 16:15, 22 July 2009 (UTC)

symptoms section

It is my opinion that the second sentence in this section is not majority viewpoint. "The symptoms of ADHD are especially difficult to define because it is hard to draw the line at where normal levels of Inattention, hyperactivity, and impulsivity end and clinically significant levels requiring intervention begin.". The validity of the assessment is widely accepted by those in the field and there is a fair degree of certainty in the diagnostic tools.--scuro (talk) 15:15, 21 July 2009 (UTC)

I must disagree. There is a great deal of disagreement between the two side of the Atlantic for example. The UK limits prescibing of stimulant to specific physicians for example because of this concern. The validity is widely accepted but this does not mean it is an easy diagnosis to make.--Doc James (talk · contribs · email) 17:06, 21 July 2009 (UTC)

I don't have the ref in front of me since it's a book, so I can't check if that line is misrepresenting what is being said in the book. The way it is currently written doesn't appear to be discounting the validity of the diagnostic assessments; I think it is simply stating that there is a continuous spectrum of inattention, hyperactivity, etc. and that drawing the line between ADHD and not ADHD is difficult. That issue of where to draw the line is at the center of Sub-clinical ADHD by the way. Sifaka 00:54, 22 July 2009 (UTC)

In reading the Nice Guideline(pg 18), it states that the same symptoms used, only that the ICD criteria are more strict for a diagnosis and has additional requirements. The issue is not how define the symptoms or if the symptoms are nebulous. Sifaka and Doc James, perhaps if it was stated more clearly there would be no possibility of confusion.--scuro (talk) 15:36, 22 July 2009 (UTC)

"A study..."

In reviewing the article there seems to be a lot points made based on a single piece of primary research. As I understand it this information is to be used sparingly after majority and minority have been stated. The danger in only using a PS is that OR may happen.--scuro (talk) 15:22, 21 July 2009 (UTC)

Which are you refering too?--Doc James (talk · contribs · email) 17:07, 21 July 2009 (UTC)

ADHD causes and diet article fork?

I have noticed that the section involving the causes of ADHD and diet has become quite long. It's all well sourced and seems like notable info but it is overwhelming the causes section. I think it might be a good idea to fork it out for the following reasons:
1. The section is often expanded, but new information added is frequently gutted to the bare minimum since it is large already large.
2. The section creates an undue weight issue since genetics accounts for 70%, but the amount of writing dedicated to genetics is much less than diet.
Good idea or not? Comments and Concerns? Sifaka 02:11, 22 July 2009 (UTC)

Agree spliting off into a sub page is a good idea. Just a point on the genetics however. A recent well done paper showed that it is impossible to divide the effects of multifactorial conditions into what percent of the condition is due to the environment and what percent is do to genetics. The reason being that one gets many feed back loops. Therefore these are not linear conditions but non linear conditions and as such one cannot get hard numbers but only probability ranges out of the equations.--Doc James (talk · contribs · email) 13:21, 22 July 2009 (UTC)

This is also being discussed on another thread . Roughly a quarter of ADHD has been attributed to environmental factors, and of that total smoking and drinking appears to be the major cause. It is neither majority or minority opinion that diet is the cause of ADHD. The information should be deleted or moved. This is an undue weight issue.--scuro (talk) 13:55, 22 July 2009 (UTC)

Scuro, the section nor the refs say anything about deficiencies are the cause of ADHD in most cases. The evidence shows that a proportion of children, be it 10%-25% or whatever respond very well to dietary changes, this is not fringe, nor minority. Your position which seems to be only amphetamines work and if we discuss anything but amphetamines for children then we are being fringe really is bogus. Also nutrients are utilised by the brain and body and are important to neurotransmission, it is basic biology and not up for debate. Please stop attacking the article with original research.--Literaturegeek | T@1k? 17:20, 22 July 2009 (UTC)

Lead paragraph

These two sentences basicall say the same thing: Currently, there is little active debate within the research and medical communities about most issues. and Most healthcare providers accept that ADHD is a genuine disorder; debate in the scientific community centers mainly around how it is diagnosed and treated. Would recommend that we combine them.--Doc James (talk · contribs · email) 16:06, 22 July 2009 (UTC)

npov fact check tag added

I've added a npov fact check following the NPOV dispute guidelines. WP:NPOVD. Several recent points brought up in talk demonstrate that there is disagreement in talk about undue weight on several issues. See above.--scuro (talk) 15:04, 22 July 2009 (UTC)

I do not think this is needed just because there is diagreement. And thus it should be removed. Envolvement of WP:MCOTW should hopefully bring more eyes and thus neutrality to the page if this continues to be a concern.--Doc James (talk · contribs · email) 16:08, 22 July 2009 (UTC)

I disagree. I'm pretty sure that the tag should be kept because there is disagreement on its neutrality. The tag should theoretically alert outside editors to help balance it out (but, alas, the backlog does not help...)--Unionhawk 16:52, 22 July 2009 (UTC)

1. Silver, Larry B.Attention-deficit/hyperactivity disorder.American Psychiatric Publishing, Inc.; 3 edition (September 2003) ISBN 1585621315; Online:http://books.google.com/books?id=gjojY1WoIOIC&pg=PA4&lpg=PP6&output=html July 20, 2009
2. Sim MG, Hulse G, Khong E (2004). "When the child with ADHD grows up" (PDF). Aust Fam Physician. 33 (8): 615–8. PMID 15373378. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
3. Schonwald A, Lechner E (2006). "Attention deficit/hyperactivity disorder: complexities and controversies". Curr. Opin. Pediatr. 18 (2): 189–95. doi:10.1097/01.mop.0000193302.70882.70. PMID 16601502. {{cite journal}}: Unknown parameter |month= ignored (help)

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