Science and Opinion

I was reading an opinion piece in the Washington Post about medicating (or overmedicating) children for a variety of psychiatric problems, including ADHD, bipolar, and Asperger's syndrome. It was written by Elizabeth J. Roberts, a child and adolescent psychiatrist in California. Her argument is that too many children are being diagnosed with psychiatric disorders when the problem is actually bad parenting.

I have several problems with argument. By far, the largest flaw in her piece is the lack of evidence. This is a common technique used by people giving their opinions on various topics. They make a variety of statements without backing any of them up with evidence. This is particularly true for those who are "experts" in their field, as if their qualifications mean we should just believe what they are saying. In Roberts's case, she doesn't even make an attempt to cite any studies suggesting what she says to be true. She uses no statistics whatsoever and has only a couple anecdotes (based on hearsay) to back up what she's saying.

Her column, most likely, appeals to readers because it addresses a subject that has become a popular sentiment in the U.S. -- namely, that we're "overmedicating" our children. This has arisen following the increase in prescribing various medications to treat psychiatric/behavioral problems, most notably ADHD. There is a problem in this logic, however. The increased prescription rate may be due (and I strongly suspect is due) to the increased availability of drugs for treating such problems.

Nonetheless, the most important piece of information on this subject is missing: evidence that children are being misdiagnosed and given medications that they should not be taking. However, such evidence is deemed unnecessary by the Post editorial board for publication of this column. Why? I suspect it is because it has become such a popular sentiment that it is now just an accepted, yet unexamined, truth. Of course, if this belief is true and we all "know" it be true, then where the heck are all these doctors, psychiatrists, school teachers, and parents coming from? If Roberts is so right, then all her colleagues must be completely off their rockers. So, according to Roberts, she's just a voice in the wilderness -- a lone beacon of truth. Yeah, right.

Somehow, despite her idiotic article's assertions, I doubt that is the case. Why in the world would her colleagues continue to misdiagnose children despite her knowledge of the "truth" regarding this? Why don't they know what she knows? At a minimum, why don't they at least follow the brilliant Dr. Roberts's advice on this? Roberts doesn't answer this question in her column. I suspect that is because, if she knows the answer, she wouldn't want to write it.

The reality is, and her colleagues probably know this, systematic studies of this issue have found the perception of overdiagnosis of ADHD does not mesh with the reality. Studies suggest that most of these diagnoses are correct. Although there are some incorrect diagnoses, these are made up for by the kids who SHOULD be treated for ADHD but aren't getting such treatment. Unfortunately, such studies don't make for interesting newspaper reading. Basically, it flies in the face of popular belief and does little to outrage readers.

As for Roberts's other diseases (bipolar disorder and Asperger's), I know very little about the overdiagnosis of bipolar -- never heard about it before as a problem in children. For Asperger's, though, I find it interesting that she mentions it once at the beginning but then never again in her article. Why? I suspect it is because there are no medications for treating it. It's on the autism spectrum of developmental disorders. So, why the heck then did Roberts include it in her idiotic article? I have no idea, though she may have been trying to broaden her article beyond ADHD (and the out-of-left-field bipolar).

So, let's see how Roberts did in her treatment of this science subject. She used all opinion with no evidence to back anything up, except for a couple random anecdotes. She mentioned unrelated diseases that don't even fall under the idea that she promotes in the article. Finally, evidence does exist on her subject matter, but it contradicts her and she chose to ignore it. I can't believe the Post wasted space in its Opinion section on her.