I am pleased that the Minister for Health and Children, Deputy Cowen, has come to the House to deal with the issue of attention deficit hyperactivity disorder. My motion asks for the Minister to undertake a prevalence study to interview the parents and sufferers of ADHD as part of a representative survey.
As a member of the Joint Oireachtas Committee on Health and Children, I have been given permission to have research conducted on the level of services available for the treatment of ADHD in the UK, the USA and Ireland with a view to publishing the findings and recommendations. I am asking the Minister to undertake stage two of that objective — the prevalence study.
Even though ADHD has been treated for over 30 years in most parts of the world, it is still a relatively new phenomenon in Ireland. While it is generally accepted that early assessment and treatment are important, the reality is that many people are only hearing about ADHD in their adolescence and adulthood. This is why it is important that we conduct further research.
As a teacher I probably taught ADHD students but did not recognise their condition. I possibly would have thought they suffered from dyslexia or from social or behavioural problems. We now realise that those children may have suffered from ADHD. It is interesting that the reason this came to my attention was that two former pupils of mine are now the parents of ADHD children. They approached me some years ago because they knew there was something wrong with their children but could not say exactly what it was. Mothers instinctively know that it is not just speech difficulties, disruptive behaviour or learning difficulties — there is something inherently wrong. Many parents have spent a fortune going from psychologists to psychiatrists without getting the treatment they require.
ADHD is accepted internationally as a medical condition of brain dysfunction. We held a seminar last Saturday week in the Mary Immaculate College of Education which was attended by over 300 people. There were eminent speakers at the conference, in particular Dr. Kewley and the headmaster of a school for children with special difficulties in the UK. It was a riveting and intense seminar attended by psychologists, psychiatrists, parents and teachers. The attentive nature of the audience was uncanny, given that ADHD patients suffer from a lack of attentiveness.
The Minister will be aware that the brain dysfunction relates to the left lobe of the brain and that a sufferer cannot take responsibility for his or her actions. ADHD is marked by a lack of sustained attention, impulsivity and hyperactivity.
There is no class distinction among ADHD sufferers. ADD is another form of the disorder marked by introversion rather than hyperactivity and more common among girls than boys. It is very sad to see people sitting in another world because they are not able to tune in to the reality of the situation around them. The children do not necessarily come from disadvantaged areas but they are at risk of being early school-leavers; in some cases they turn to substance abuse and become juvenile offenders. In the past, parents were accused of being soft, middle class parents who spoiled their children. Psychologists may have advised them to do a parenting course to help them deal with their children and they were sent away with the impression they were failures when they instinctively knew that was not true.
ADHD occurs in 3 to 5 per cent, or 105,000 to 175,000, of the general population. It occurs in 10 per cent of boys and 5 per cent of girls at primary level, 80 per cent having the disorder as adolescents and 65 per cent still symptomatic as adults. Those statistics are very stark. This issue will not go away. I have case studies relating to the trauma the condition inflicts on entire households. I know people who have separated because the mother was able to tune into the child but the father was unable to stick the strain. Siblings become so irritated at the level of attention being given to the sufferer that family disruption occurs.
In regard to comorbid conditions, 43 per cent of those with the disorder suffer lifetime anxiety disorders, 30 per cent have oppositional defiant disorders, 20 per cent suffer conduct disorders, 10 per cent suffer antisocial personality disorders, 27 per cent suffer alcohol related problems, 18 per cent develop drug dependency and 28 per cent of those with the disorder suffer separation and divorce as opposed to 15 per cent of non-ADD people.
There is a desperate need for services for adolescents and adult sufferers of ADD. The seven support groups in the country collectively estimate 30 to 40 phone calls per day from people seeking services for assessment, diagnosis and treatment. Our Lady's Hospital cannot take children over 14 years of age and, in spite of the fact the service has only been available for six months, has an eight month waiting list. There are no available services for adolescents or adults and many families seek treatment in the UK. If the services were available here, savings would be made in regard to the cost of sending people abroad.
Medications commonly used to treat ADD and ADHD in adults in other countries are not approved here because of restrictions set by the Irish Medicines Board. This must be investigated and addressed. Ritalin is not approved for adults in Ireland and most doctors are unfamiliar with medicines used to treat the condition.
There is currently no known comprehensive training programme for medical and educational professionals in the country. There is an urgent need for a national task force on ADHD/ADD and related conditions which would include representatives from INCADDS, the Irish National Council of ADD Support Groups. We need a national co-ordinator to organise research, professional training, assessment and treatment services across the country. We need funding for the national and local support groups, designated ADHD centres in Limerick, Dublin, Cork, Galway and Waterford, where action committees are already in place and senior psychologists who would train psychologists already working in hospital and health board positions and student psychologists. We need a consultant adult psychiatrist, child psychiatrist and paediatrician in each health board with special training and expertise in the condition and related conditions and we need training for registrars. We need a research programme which would include a national prevalence survey, an assessment of ADHD among children in care, a survey of ADHD sufferers among those incarcerated, particularly among those under 30 years of age, and a proposal for specially adapted Youthreach/FÁS vocational programmes which can be combined with psychiatric services in multiplex sites.
Liaison would be required with the Departments of Education and Science and Justice, Equality and Law Reform to develop a course with practical classroom experience which could be incorporated into basic teacher training programmes at university level. Training programmes for the recognition and classroom management of ADHD children should be provided for current teachers and local screening committees should be set up to screen children prior to eight years of age and to train teachers in identification and management strategies. An integrated approach to the problem is required. A figure of £30,000 would be required to carry out the prevalence study; that is not a major cost. The other issues which I have addressed would have to be incorporated into a comprehensive programme further down the line.
