Published: November 24, 2008
When pediatricians diagnose attention deficit hyperactivity disorder, they often ask their patients whether they know anybody else with the problem.
These days, children are likely to reply with a household name: Michael Phelps, the Olympic superstar, who is emerging as an inspirational role model among parents and children whose lives are affected by attention problems.
“There is a tremendous, tremendous amount of pride — I got the impression sometimes that some of the kids felt like they owned Michael,” said Dr. Harold S. Koplewicz, director of the Child Study Center at New York University Langone Medical Center. “There is a special feeling when someone belongs to your club and the whole world is adoring him.”
But the emergence of a major celebrity with attention deficit has revealed a schism in the community of patients, parents, doctors and educators who deal with the disorder. For years, these people have debated whether it means a lifetime of limitations or whether it can sometimes be a good thing.
Children with the disorder typically have trouble sitting still and paying attention. But they may also have boundless energy and a laserlike focus on favorite things — qualities that could be very helpful in, say, an Olympic athlete.
For that reason, some doctors are pushing for a new view that focuses on the potential strengths of the disorder. Dr. Edward M. Hallowell, a psychiatrist and author whose books include “Driven to Distraction: Recognizing and Coping With Attention Deficit Disorder From Childhood Through Adulthood” (Touchstone, 1995), says the current “deficit-based medical model” of the disorder results in low-self esteem.
“It’s not an unmitigated blessing, but neither is it an unmitigated curse, which is usually the way it’s presented,” said Dr. Hallowell, who has the disorder himself. “I have been treating this condition for 25 years and I know that if you manage it right, this apparent deficit can become an asset. I think of it as a trait and not a disability.”
The notion that a disability can be harnessed in a positive way is not a new concept. Last year, a study found that 35 percent of the small-business entrepreneurs surveyed identified themselves as dyslexic. The researchers concluded that dyslexia made them better communicators and problem solvers, more likely to delegate authority.
Dr. Hallowell says low-self esteem and low expectations result from the way the A.D.H.D. diagnosis is presented to children, parents and teachers. He tells children with attention deficit that they have the brain of a race car, and he wants to work with them to build better brakes.
“We want to tell children, ‘You’ve got a difference, but not a disease,’ ” he said. “Michael Phelps is one of any thousands of examples of mega-successful people, C.E.O.s and brain surgeons and famous writers, inventors and entrepreneurs, who have A.D.H.D.”
Other experts, however, say that while such success stories can be inspiring, parents need to know that their children face real risks. Research shows that children with attention deficit have different brain patterns from other children, and that they are more likely to drop out of school, be involved in car accidents and use illicit drugs.
“This reframing A.D.H.D. as a gift, personally I don’t think it’s helpful,” said Natalie Knochenhauer, founder of A.D.H.D. Aware, an advocacy group in Doylestown, Pa. “You can’t have a disability that needs to be accommodated in the classroom, and also have this special gift. There are a lot of people out there — not only do their kids not have gifts, but their kids are really struggling.”
Ms. Knochenhauer, who has four children with the disorder, says they too were inspired by the astonishing performance of Mr. Phelps in Beijing. But she added, “I would argue that Michael Phelps is a great swimmer with A.D.H.D., but he’s not a great swimmer because he has A.D.H.D.”
Dr. Koplewicz, of N.Y.U., agreed. “There are lots of children in the world who have chronic illnesses or disorders like diabetes, allergies or dyslexia who accomplish great things in spite of the fact that they have these disorders,” he said. “I worry when we say A.D.H.D. is a gift, that this minimizes how real it is.”
Michael Phelps’s mother, Deborah Phelps, says she has spoken openly about her son’s diagnosis because she wants other parents to seek out resources and support. Her son stopped taking A.D.H.D. medication at age 10. But today, Ms. Phelps is a national spokeswoman for McNeil Pediatrics, which makes the attention-deficit drug Concerta. (Dr. Hallowell and Ms. Knochenhauer have also consulted for McNeil; Dr. Koplewicz has no industry ties.)
Ms. Phelps, who is a school principal in Baltimore, says the qualities that often accompany the disorder are not always negative, although it may require extra effort and knowledge to help children harness their talents.
“You’ll find they are creative children,” she said. “They do have determination when you are able to work with them and be consistent. I want young parents to reach out and get assistance and not give up hope.”
