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The Boundaries of Attention Deficit Disorder
Mark A. Epstein
Mark A. Epstein is currently a Clinical Fellow in Pediatric Epilepsy at Miami Children's Hospital, Miami, Florida. A graduate of Harvard University and the Mount Sinai School of Medicine in New York, he completed his pediatric training at Yale-New Haven Hospital, New Haven, Connecticut, and his pediatric neurology training at the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Sally E. Shaywitz, MD
Sally E. Shaywitz, MD, is associate professor of pediatrics and child study at the Yale University School of Medicine. She received her training in behavioral pediatrics at the Albert Einstein College of Medicine in New York. She is the founder and director of the Learning Disorders Unit at the Yale University School of Medicine. Dr. Shaywitz has a long-standing interest in the epidemiology and nosology of learning and attention disorders. She is currently co-director of the Center for the Study of Learning and Attention Disorders at Yale and the principal investigator of an epidemiologic, longitudinal study of learning, now in its eighth year. She also serves as a consulting editor to the Journal.
Bennett A. Shaywitz
Bennett A. Shaywitz, MD, is professor of pediatrics, neurology, and child study at the Yale University School of Medicine. He received his MD degree from Washington University and completed his training in both pediatrics and neurology at the Albert Einstein College of Medicine in New York. Currently, he serves as director of child neurology at the Yale University School of Medicine and as director of the recently-NIH-funded Center for the Study of Learning and Attention Disorders at Yale. Dr. Shaywitz's research interest centers on the neurobiological mechanisms underlying learning and attention disorders and on the psychopharma-cology of stimulant medication.
Joseph L. Woolston
Joseph L. Woolston, MD, is a graduate of Yale University and completed his medical training at University of Pennsylvania School of Medicine. He currently is medical director of the Children's Psychiatric In-Patient Service at Yale-New Haven Hospital and is associate clinical professor of pediatrics and psychiatry at the Yale University School of Medicine. He is interested in eating and growth disorders of infancy and early childhood, and also the phenomenology of psychiatric disorders in childhood. Address: Sally E. Shaywitz, Department of Pediatrics, Yale University School of Medicine, PO Box 3333, New Haven, CT 06510–8064.
This report examines distinctions and interrelationships among attention deficit disorder (ADD) and two closely related conditions: learning disability (LD) and oppositional/conduct (O/C) disorder. To evaluate our hypothesis that some of the difficulty in resolving the relationship between ADD and, particularly, O/C may reflect the consequences of selective referral patterns, we studied groups of children diagnosed as ADD from different referral sources. Results suggest that referral bias does exist and that children referred to mental health settings differ from those referred to pediatricians, child neurologists, or psychologists. Because of the nature of the subjects referred to mental health services, nonrepresentative associations may emerge. Rather than being considered as prototypical of all children with attention disorder, children referred to mental health facilities may represent simply an extreme of the continuum of ADD. Evidence suggests that many children with ADD will be represented by those referred primarily for attentional deficits and learning problems, rather than those with inattention, hyperactivity, or aggression referred for child psychiatric evaluation.
Journal of Learning Disabilities, Vol. 24, No. 2,
78-86 (1991)
DOI: 10.1177/002221949102400204
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