Beth A. Kaplanek, R.N., National Board President November 30, 2000 Children & Adults with Attention Deficit Disorders--CHADD 8181 Professional Place Suite 201 Landover, MD 20785 Dear Ms. Kaplanek, I testified in the Colorado State School Board of Education hearings of November, 1999, also in the U.S Congress Committee on Education and the Workforce, hearing entitled "Behavioral Drugs in Schools: Questions and Concerns," of September 29, 2000, and in the Texas State Board of Education Hearings, November 3, 2000. In all three of these hearings, as well as in the November 16-18,1998, NIH, Consensus Conference on ADHD, I testified that there was no evidence in the scientific literature to support the claims by CHADD, and virtually all within psychology, psychiatry, and mental health, that ADHD is a disease, having a confirmatory, characteristic, physical or chemical abnormality. Absent such proof, claims that it is a disease, and that children said to have it are diseased/ abnormal, are fraudulent. In none of these hearings, did representatives of CHADD, psychiatry or any field of medicine provide references to articles in the scientific literature which constituted proof that ADHD is a disease. Their failure to have done so is due to the fact that no such proof exists. Whether ADHD is a disease or not is the pivotal question. Until this question is settled we cannot, logically proceed to a discussion of treatment. If it is not, as I know to be the case, and as was reaffirmed for me by Dr. Stephen E. Hyman, of the NIMH,in a letter to me of 9/28/00, the children are normal and there would be no justification for their treatment with drugs that are not only potent, but are addictive, dangerous, and, at times, death-dealing. You, as a nurse, do not have the preparation or credentials necessary to participate in the debate of this question; you must depend on the physician members of CHADDs professional advisory board (as of October, 2000) those qualified, and responsible, for making such determinations. They are J. Biederman, P, Jensen, D. Kessler and T. Wilensall M.D.s. Several Ph.D. members of your PAB regularly write and speak on this point without having had medical training and without having practiced or participated, otherwise, in determining whether people have a disease (any disease) or have no disease. Surely you defer to your physicians advisors on this point. In so doing, it might be of assistance to one and all seeking answers here, if the advisors (from the PAB) you quote or cite would be specifically identified or if they, themselves, were to produce whatever it is that they regard as evidence that ADHD is an actual, diagnosable disease. Having participated in the Texas State Board of Education Hearings, I have taken it upon myself to answer your letter of objections of November 22, 2000 to Mr. Chase Untermeyer, Chair, Texas State Board of Education. My responses to points in your letter are to be found within brackets as follows [Fred Baughman Jr., M.D.:].
CHADD Letter to the Texas State Board of Education November 22, 2000 Mr. Chase Untermeyer Chair, Texas State Board of Education William B. Travis Building Austin, TX 78701-1494 Dear Mr. Untermeyer: As National Board President of CHADD, the nation's leading advocacy organization serving people with Attention Deficit/Hyperactivity Disorder (AD/HD), I am writing to express grave concern over the resolution recently passed by the Texas State Board of Education. While we certainly applaud the attention the Board has given to the issue of responsible use of psychotropic medication among children and adolescents in school settings, we are offended by statements within the resolution that clearly are inconsistent with the established medical science.
[Fred A. Baughman Jr., MD:
What statements did I , Dr. Carey, or Dr. Breeding make at the
hearings that were contrary to medical science? (Please let us know who
is doing the replying)]
According to every major federal agency and professional association which has studied AD/HD, including the Surgeon General of the United States, the National Institute of Mental Health, the Centers for Disease Control and Prevention, the American Medical Association, and the American Academy of Pediatrics, Attention Deficit/Hyperactivity Disorder is a severe neurobiological condition that affects approximately three to five percent of school age children.
[Fred A. Baughman Jr., MD:
CHADDs saying ADHD is a neuro-biological condition implies that
there is an abnormality of the biology of the nervous system, i.e.,
brain of children said to have ADHD. To date, no such evidence exists,
and no test for ADHD exists which demonstrates a physical or chemical
abnormality of any sort within the brain or body of children thus
labeled. Because such children (labeled ADHD) have no demonstrable
abnormality (abnormality = disease) there is no medical indication or
justification to (1) diagnose them or (2) to treat them with drugs that
are known to be addictive, brain- and heart-damaging and sometimes death
dealing.
That the Surgeon General of the United States, the National Institute of
Mental Health, the Centers for Disease Control and Prevention, the
American Medical Association, and
the American Academy of Pediatrics, and others have joined in, in
referring to ADHD as something neurobehavioral, neuro-psychological,
neuropsychiatric biologically-based, or even as a severe
neuro-biological condition, does not mean that science has proven that
ADHD is a bona fide disease having a confirmatory, diagnostic, physical
or chemical abnormalityit has not! It only says something terribly sad
and tragic about the extent to which agents and agencies of the US
federal government and US medical academia have joined a for-profit
enterprise that asks them to pervert medicine and science to deceive the
parents, teachers, and all peoples of the United States. At one time or
another, I have written asking every one of the above-mentioned agents
and agencies to provide me proof that ADHD is a bona fide disease having
a confirmatory, diagnostic, physical or chemical abnormality--most
recently the American Academy of Pediatricsand not one of them has done
so. Should you wish to see copies of the any of the correspondence to
which I refer, please let me know. Even former CHADD president, Matthew
Cohen, CHADD, Professional Advisory Board Member, Peter Jensen, MD, and
NIMH Director, Steven E. Hyman, MD have failed to show me exactly where
in the peer-reviewed scientific literature the proof lies that ADHD is a
bona fide disease. You cannot go on insisting that it is with no
scientific proof, nor can you and your many allies, even if this
includes agents and agencies of the federal government, be allowed to
continue to spuriously, and harmfully label and drug entirely normal
schoolchildren where there has been nothing other than abrogation of
their informed consent rights.]
The effects of AD/HD range from mild interference with a child's ability to pay attention, control impulses and engage in appropriate activities up through and including severe impact upon attention, impulsivity, hyperactivity and learning. CHADD stands behind the recognized scientific research on AD/HD and has fought hard for recognition of this disorder in the public school system and throughout society.
[Fred A. Baughman Jr., MD:
CHADD has fought hard for acceptance of this unconfirmable,
undiagnosable unprovable, oft-reconceptualized disease because it is
essentially, the one and only reason to prescribe Ritalin, and because
both Ritalin and CHADD are both products of Ciba-Geigy/Novartis. This
is why CHADD was created. In the October, 1995, DEA Background paper
on Methylphenidate we read: "In fact, a spokesman for Ciba-Geigy stated
that CHADD is essentially a conduit for providing information to the
patient population. The relationship between Ciba-Geigy and CHADD
raises serious concerns about CHADDs proselytizing the use of
Ritalin."]
Today the U.S. Department of Education, in regulations issued under the Individuals with Disabilities Education Act of 1997 (IDEA), recognizes AD/HD in the "other health impaired" category. In short, schools must provide special education and related services to assist children in meeting academic and behavioral expectations appropriate to their grade level.
[Fred A. Baughman Jr., MD:
nor is appropriate tolegitimize in legislation a disease or
diseases that have no validation in science.]
Your resolution places such rights in serious jeopardy. Certainly we agree with your recommendation that local school districts implement appropriate policies to ensure the safe storage and distribution of psychotropic medication, but the terms proposed present a severe crisis to children attending schools in many rural settings where a medical practitioner (licensed nurse) may not be on school premises. Pursuant to the requirements of the IDEA and Section 504 of the Rehabilitation Act of 1973, schools must facilitate, rather than interfere with the administration of appropriately prescribed medications where such indications are necessary for a child to benefit from education. Perhaps of greatest concern is the implied message that AD/HD does not exist. This allegation is simply untrue and extremely harmful to the millions of children and families struggling with this serious yet treatable brain disorder.
[Fred A. Baughman Jr., MD:
There was no proof that the 1980, American Psychiatric Association
version of attention deficit disorder--ADD was a bona fide disease,
before it was changed, in committee, to the 1987, version of ADHD.
There was no proof that the 1987, version of ADHD was a bona fide
disease, before it was changed, in-committee to the 1994 version. And,
as you and I and Dr. Hyman and every member of CHADDs Professional
Advisory Board knows, there is no such proof today. Meanwhile, the
fruits of your labors have begotten the unspeakable: the labeling and
drugging of 5-6 million normal, if sub-optimally parented, sub-optimally
educated US children. I find no reason whatsoever to change my view of
this as the greatest health care fraud of all time.]
No where in the resolution is mention made of the 1999 Surgeon General's Report on Mental Health, despite testimony provided at your hearings referring to the Report's support of the safety and efficacy of several classes of medication for specific disorders, including AD/HD.
[Fred A. Baughman Jr., MD:
Nowhere in this report was an article cited constituting proof that
ADHD is a disease; children said to have it, diseased, abnormal. We
know the clear majority, assaulted with whole language to the exclusion
of phonics are less than proficient readers; many, less than
basicilliterate, disenfranchised. They were not disabled when they
started school. They were left illiterate and thus disabled by schools
that had a duty to render them literate, and thus educable, but did not.
(National Assessment of Educational Progress).]
Moreover, the Board also ignores the National Institute of Mental Health's (NIMH) 1999 Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA) which concludes that "psychostimulant medications, including methylphenidate, commonly referred to as Ritalin, and amphetamine, commonly referred to as Dexedrine and Adderall, are highly effective in treating all the symptoms of AD/HD, including hyperactivity, inattention and impulsive behavior. In fact, the safety and efficacy of stimulants constitutes the largest body of scientific literature on any childhood behavioral disorder."
[Fred A. Baughman Jr., MD:
Nowhere in the MTA study is ADHD proven to be a disease, i.e., are
the children proven to be other than normal. Labeled, drugged, and
believed by all in their lives to be diseased they come to believe it
as well--intractably so! Just as the manufacturer and CHADD had hoped.]
Failure to recognize both of these landmark reports within the resolution is as astonishing as it is appalling.
[Fred A. Baughman Jr., MD:
It is CHADDs and the entire mental health industrys empty,
fraudulent, claims that it diagnoses and treats brain diseases, that
is "as astonishing as it is appalling".]
Rather, you have selectively cited the 1998 NIH Consensus Statement on the Diagnosis and Treatment of AD/HD. Equally disturbing, you also omitted in your selective citation additional NIH Consensus comments concluding that "children with AD/HD have pronounced impairments and can experience long-term adverse effects on academic performance, vocational success and social-emotional development which have a profound impact on individuals, families, schools and society."
[Fred A. Baughman Jr., MD:
Not an iota of proof that ADHD is a disease, that the children are
other than normal, beset with situational/circumstantial problems, was
offered at the November 16-18, 1998, Consensus Conference. I charged,
at the Consensus Conferencepublicly and without rebuttal, that ADHD was
(when represented as a disease) a total, 100% fraud. CHADD cannot
refute this allegation even today.]
Let us be clear: medication is not a substitute for the behavioral management, parent training, parent education and support and other appropriate interventions necessary in appropriately treating children with AD/HD. CHADD strongly supports a thorough, comprehensive evaluation to reliably diagnose AD/HD. For those who have been diagnosed, CHADD urges the use of multimodal treatment approach, tailored to the needs and response of the individual and under the ongoing supervision of an appropriately trained and experienced clinician.
[Fred A. Baughman Jr., MD:
I am an appropriately trained and experienced clinician, a
neurologist/child neurologist. I made disease vs. no disease
determinations daily. I discovered and described real diseases. I
have examined hundreds of children said to have hyperactive child
syndrome, MBD, ADD, ADHD, and uniformly, exactly as in all of
psychiatrys attempts to validate ADHD (by whatever name), I found no
abnormalitiesno disease. All of them were normalnormal, that is,
until drugs that are invariably brain-damaging were begun, in the name
of treatment and in the name of public education.]
To suggest that schools use "tutoring, vision testing, phonics, nutritional guidance, medical examinations, allergy testing, standard disciplinary procedures and other remedies known to be harmless" as a substitute for medication-in other words, in lieu of medication-is unenlightened at best and irresponsible at worst. Would one deny insulin to a child diagnosed with diabetes? Of course not, and the same respect must be afforded and upheld among children requiring medication for a medical condition such as AD/HD.
[Fred A. Baughman Jr., MD:
It is fraudulent of you and of CHADD, today, to say to the public
and to their schools, their legislatures and their courts that Ritalin
is to ADHD as insulin is to diabetes. Diabetes is a real disease having
a confirmatory physical/chemical abnormality--an abnormally high level
of sugar in the blood and in all body tissues. Insulin is real
treatment never begun until--patient-by-patient--that very abnormality
has been demonstrated. In the case of ADHD, 5-6 million have been put
on addictive, dangerous, sometimes deadly drugs before an abnormality
has been proven in a single one. We do not start insulin in diabetes,
before a high blood sugar has been proven. We do not start radiotherapy
or chemotherapy before there is microscopic proof of cancer. We do not
remove a breast or leg unless there is proven cancer therein. Why is it
that psychiatry and all physicians who practice psychiatry, absolve
themselves of proving the existence of confirmatory chemical
imbalances before they start the inevitable chemical balancerthe
pill. There can be no doubt of your intent to deceive, and deceive you
have, as never before in the annals of medicine and health care. CHADD
and all of psychiatry and mental health have created a illusion of a
disease in the minds of the public where there are only normal, if
troubled, mis-educated, children. They were normal at birth; they walked
and talked on time and were normal when sent by their families,
communities and country down the schoolhouse path. There, unbeknownst
to their families, behavioral/psychiatric observation and diagnosis
began, the very first day. Soon 25-50% would be suspected of having one
sort of brain abnormality or another. Soon 15 % would have an indelible
diagnostic label affixed and would be on a brain damaging drug.]
Important components to successful treatment include medical management of the treatment process and, for many, the responsible use of psychotropic medication.
[Fred A. Baughman Jr., MD:
Where no disease exists on the risk side of the risk vs.
benefit equation, the only risk to the patient is that borne by the
treatment, be that treatment a drug, electroshock, or psychosurgery]
Moreover, medication decisions should be made by medical professionals in concert with parents and feedback from schools. Schools alone should never propose nor discourage the use of medication. We therefore encourage you to reconsider the language of the resolution and resist further efforts which discourage children and families from receiving the medical treatment so crucial to managing this serious disorder. And we implore you to cease all rhetoric repudiating the scientific research that clearly establishes AD/HD as a biological disorder of the brain.
[Fred A. Baughman Jr., MD:
Here again, we encounter your fraudulent representation of ADHD as
something physically, biologically abnormal within the child. Every
physician-member of your Professional Advisory Board is well aware that
ADHD has never been validated as a disease, i.e., an abnormality within
the child or adult. CHADD, in turn, has an obligation, a duty, to all
such knowledge as is available to your PAB]
To diminish such evidence is insulting and an act of grave irresponsibility. To this end, we stand ready to work with you in educating others about the devastating effects of untreated AD/HD and ensuring that our children indeed receive the quality education so prominently highlighted within the first paragraph of your resolution. Please let us know how and where we may assist.
[Fred A. Baughman Jr., MD:
CHADDs one and only obligation to the Texas State Board of
Education and to the country, is to tell them the truth, about ADHD. Is
it a disease with an abnormality within the childyes or no? If yes,
cite the article (usually one article) describing the confirmatory,
characteristic physical/chemical abnormality by which it is diagnosed,
which makes it a real, actual, bona fide disease, the child/adult with
it abnormal/ diseased. Whether ADHD or any disease is real/
legitimate/ bonafide is not a matter of consensus, vote or belief, it is
a matter of whether or not a physical or chemical abnormality can be
demonstrated in the child said to have it. Where was that abnormality
in any of the 5-6 million US schoolchildren that CHADD exhorted us to
label and drug, before the drugging was begun?]
Sincerely, Beth A. Kaplanek, R.N. National Board President CHADD Cc: Governor George W. Bush Lieutenant Governor Rick Perry SBOE Members Jim Nelson, Commissioner of Education, Texas Education Agency Senator Judith Zaffirini Representative Glen Maxey Representative Elliott Naishtat Gene Lenz, Senior Director, Texas Education Agency Pat Pound, Governor's Committee on People With Disabilities Theresa Marvin, Executive Director, Texas Council of Administrators of Special Education Curt Decker, J.D., Executive Director, NAPAS Jim Comstock-Galagan, Executive Director, Advocacy, Inc. Matt Cohen, J.D., Immediate Past President, CHADD Board of Directors Evelyn Green, M.Ed., President Elect, CHADD Board of Directors Mary Durheim, CHADD Board of Directors, McAllen, Texas Peter Jensen, M.D., CHADD Professional Advisory Board Lynne Day, CHADD Chapter Coordinator, Austin, TX Sandy Wilbourn, CHADD Chapter Coordinator, Ft. Bend County, TX
This concludes my remarks. Sincerely, Fred A. Baughman Jr., MD, Neurologist/Child Neurologist (independent, self-supporting) 1303 Hidden Mountain Drive El Cajon, CA 92019 fax 619 442 1932 Cc: Mr. Chase Untermeyer Chair, Texas State Board of Education Governor George W. Bush Lieutenant Governor Rick Perry SBOE Members Jim Nelson, Commissioner of Education, Texas Education Agency Senator Judith Zaffirini Representative Glen Maxey Representative Elliott Naishtat Gene Lenz, Senior Director, Texas Education Agency Pat Pound, Governor's Committee on People With Disabilities Theresa Marvin, Executive Director, Texas Council of Administrators of Special Education Curt Decker, J.D., Executive Director, NAPAS Jim Comstock-Galagan, Executive Director, Advocacy, Inc.