The Face of ADHD

Michael Ginsberg, M.D., knows what it’s like for the children who enter his office with the diagnosis of ADHD—Attention Deficit Hyperactivity Disorder. That’s because 27 years ago, he was that child.

His third-grade teacher had given up on him. He was labeled a trouble-maker, incorrigible and difficult. The principal said he was no longer welcome in public school.

“They told my parents they thought I might even be mildly retarded,” he recalls with a grimace.

ADHD wasn’t in the public’s lexicon in those days. No one really knew what it meant, or whether anything could help. “But my parents insisted I was a sweet, smart child and they never once gave up on me,” he recalls. They took him to doctors, psychiatrists and therapists, and he soon began what was then a fairly new revelation in medication: Ritalin.

It worked, although it didn’t happen over night. In private school, he received more attention from his teachers. He worked hard, but it was slow going at first.

As he improved, he became what he calls, “The Poster Child” for ADHD. His doctors took him to workshops and conventions, showing him off as a success story.

And when he was a sophomore in high school, it suddenly clicked. “I realized that if I really set my mind to it, I could follow through, turn in my assignments and really do a good job,” he recalls.

“Some parents want to try changing diet or exercise, but that’s almost never enough,” says Dr. Ginsberg. “They usually come back and by then, they’re ready to try medication.”

For the first time, he received all A’s on his report card, and scored remarkably well on his Practice SAT. He checked off the box “Send my scores to colleges,” and a few months later was stunned to receive a recruitment letter from Massachusetts Institute of Technology.

“You have to remember that I was a kid who thought he’d never go to college. They told me if I really worked hard, I might be able to do community college. But here I was at 16, with straight-A’s in one hand, and a letter to MIT in the other. It was unbelievable.”

And it didn’t stop there. In his senior year, he received acceptance letters from Brown, Yale, Dartmouth, Cornell, University of Michigan, Northwestern, Williams and Stanford.

He chose Stanford. And he made sure his third-grade teacher received every one of those letters. “I’ve made this my mission to work with kids diagnosed with ADHD,” says the pediatrician, who practices at the NorthBay Center for Primary Care in Fairfield.

“When I was diagnosed, people were debating whether ADHD even existed. There was a huge burden of guilt on parents who chose to medicate their children. They were told we were raising a nation of druggies. But I am living proof that medication can make all the difference in the world.”

Nearly 5 percent of children worldwide have ADHD. Data shows that the best therapy is medication, combined with cognitive and behavioral therapy.

“Some parents want to try changing diet or exercise, but that’s almost never enough,” says Dr. Ginsberg. “They usually come back and by then, they’re ready to try medication.”

A diagnosis is not clear-cut, he says. The best test is to listen to the child’s life story, to see if they are struggling with inattention, hyperactivity and impulsivity issues. If they meet six of nine criteria in one or more sections, they can be diagnosed with ADHD.

Most children are diagnosed between the ages of 5 and 10, once they’re in school and having trouble following directions or staying focused. “These are not stupid children. There is no correlation between ADHD and intellect,” says Dr. Ginsberg. “But for some reason the neurons in the frontal cortex of their brains just don’t fire the way they do in other children. They need extra stimulation to produce the same results.”

In many cases, medication can level the playing field and help these children exhibit more normal behaviors.

Before ADHD became a diagnosis, these children were marginalized, demonized and often abused.

Dr. Ginsberg is personally committed to making a positive difference in their lives. “I decided a long time ago that I want to work with children so I can help them realize and live their dreams, the way I’m living my dream.”

Dr. Ginsberg’s pediatric practice is not limited to children with ADHD. He welcomes all children from birth through age 18, and can provide well-child checkups, vaccinations, sports and school admission physicals and more. To schedule an appointment, call (707) 646-5500.

Facts and myths

We don’t know exactly what causes ADHD (Attention Deficit Hyperactivity Disorder),” says Michael Ginsberg, M.D., “but we’ve ruled out a lot of things.” During an Advanced Medicine Lecture Series event at NorthBay’s Green Valley Administration Center in Fairfield, he explained to a room full of parents, grandparents and children that ADHD is not caused by bad parenting, nor is it related to intellectual ability. Many were surprised to learn that sugar does not exacerbate the condition.

Figuring out what causes it has proven to be a lot more difficult. Anywhere from 2 percent to 18 percent of the population is thought to have it worldwide. While some adults report their symptoms have disappeared as they matured, 4 percent to 50 percent of children with ADHD still have it in adulthood. A diagnosis of ADHD can be determined by a physician if the patient meets at least six of nine criteria in one or both categories of inattention and hyperactivity:

Inattention

  • Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
  • Often has difficulty sustaining attention in tasks or play activities
  • Often does not seem to listen when spoken to directly
  • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
  • Often has difficulty organizing tasks and activities
  • Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
  • Often loses things necessary for tasks or activities (eg, toys, school assignments, pencils, books, or tools)
  • Is often easily distracted by extraneous stimuli
  • Is often forgetful in daily activities

Hyperactivity

  • Often fidgets with hands or feet or squirms in seat
  • Often leaves seat in classroom or in other situations in which remaining seated is expected
  • Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
  • Is often “on the go” or often acts as if “driven by a motor”
  • Often talks excessively

Impulsivity

  • Often blurts out answers before questions have been completed
  • Often has difficulty awaiting turn
  • Often interrupts or intrudes on others (eg, butts into conversations or games)

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