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I appreciate Dr Ament's critique of my approach to the hyperactive or learning-disabled child. How to diagnose and treat this syndrome complex is indeed a controversial subject because we still don't know enough about the brain to fully understand these children and their handicaps. It remains for the reader to choose the treatment strategies with which he or she is most comfortable, in the absence of really definitive data.I agree with Dr Ament that these learning and behavior disorders do have a neurological basis, but the neurochemical models to explain the malfunctions are still speculative. Treatment with stimulant medication is symptomatic, even when dramatically effective. I'm somewhat embarrassed to admit that most of the 7-and 8-year-olds to whom I proudly pointed in the late 1960s as having been successfully treated with medication alone are now back to haunt me as socially maladaptive and painfully unhappy adolescents. By
Sulzbacher S. The Learning-Disabled or Hyperactive Child-Reply. JAMA. 1976;235(15):1553. doi:10.1001/jama.1976.03260410016011
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