Josiah Simons has just finished eating lunch at Ridgeview Elementary School and he's on his way to the nurse's office to take a pill for his Attention Deficit Hyperactivity Disorder.
Along with daily doses of reading, writing and arithmetic, Josiah, 7, gets a daily dose of Adderall, a stimulant that allows the second-grader to sit still and pay attention in class.
“You can immediately tell whether a child has taken it or not,” said Debbie Johnson, health services administrator for Oklahoma City Public Schools and the mother of a son with ADHD. “Typically they're more attentive and they can stay on task longer. There's less anxiety.”
About one in 10 school-age children in Oklahoma — and the nation — has ADHD, according to figures provided by the Centers for Disease Control and Prevention. It's a condition that makes it hard to focus and pay attention and can make it difficult for a child to do well in school or behave at home.
“You watch children struggle with not being able to get all of the successes that other kids get because they are always in trouble,” Johnson said. “They're the ones who can't sit in their chairs or get their homework done.”
Dr. William Graf, a pediatric neurologist and a professor at the Yale School of Medicine, said that over the last 20 years the percentage of people diagnosed with this disease has doubled.
He said that while it is a complicated question, he feels ADHD is probably diagnosed too frequently and too many people are taking medication to combat it.
“It's a condition that has a treatment and the treatment has helped many people,” he said. “But it's also a treatment that has the potential to be abused or misused and needs to be closely scrutinized.”
Some children with ADHD may be hyperactive or have trouble being patient. Others have trouble controlling impulsive behaviors and act without thinking about consequences.
“ADHD does not just interfere with learning, but the symptoms can also cause problems for children socially with their friends and at home with their families,” said Anne Jacobs, an Edmond-based psychologist who treats children and adolescents with ADHD. “The inability to wait your turn in a game or stop yourself from interrupting peers can gradually cost children some friendships.”
About 5.2 million children ages 2 through 17 have ADHD, including about 72,000 in Oklahoma, according to recent CDC data.
Many more go undiagnosed because they don't have access to medical care or because of the stigma attached to the disorder, said Dr. Mark Wolraich, medical director for the OU Children's Physicians child study center.
“Clearly, from past studies, there are a number of children who have the condition but are not identified or treated,” he said. “Clearly, there remain children who would benefit from treatment.”
While the Oklahoma City School District doesn't specifically track students with ADHD, Johnson said about 2 to 3 students take ADHD medication at each of the district's 55 elementary schools.
“We've got quite a few children receiving ADHD medication,” she said. “It's become more of a norm than not.”
Johnson was a school nurse for 19 years. The youngest of her three grown children was diagnosed with ADHD in elementary school and “still has a lot of issues.”
“We couldn't take him to church or go out to dinner and try to sit at a table,” she recalled. “And forget about trying to take a trip somewhere in the car. It was impossible.”
Some parents of children with ADHD are conflicted because they don't want to medicate their child but don't want to see them singled out for negative behavior that often leads to isolation, Johnson said.
“Their child is the one that others are going to stay away from,” she said. “The negative reinforcement leads to low self-esteem, which of course, causes them to lash out or they get really depressed.”
Josiah, whose father and two brothers were diagnosed with ADHD, began taking Adderall in the first grade. He takes a short-acting pill twice a day, after breakfast and lunch.
“He was restless. He couldn't sit still,” recalled Melodee Simons, Josiah's grandmother and a longtime parent liaison at Ridgeview. “If you gave him a list of three items to get, he could get two but he'd forget the third one every time.”
Josiah became an honor roll student after he started taking the medication, Simons said.
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You watch children struggle with not being able to get all of the successes that other kids get because they are always in trouble. They're the ones who can't sit in their chairs or get their homework done.”
Health services administrator for Oklahoma City Public Schools and mother of a son with ADHD