(CNN) -- The following is an edited transcript of a chat with Dr. Michael Gordon, Chief Clinical Child Psychologist and Director of the Attention Deficit Hyperactivity Disorders Program at the SUNY Health Science Center in Syracuse, NY. The chat was held on Friday, September 10, 1999.

Chat Moderator: Welcome Dr. Gordon!

Dr. Michael Gordon: Good afternoon everyone.

Chat Moderator: Do you believe ADHD is overdiagnosed? Why?

Dr. Michael Gordon: ADHD, like almost all disorders, can be overdiagnosed and misdiagnosed. It's especially likely because there is no clear marker for what constitutes abnormal levels of inattention and distractibility. But that's the way it is even for medical disorders such as hypertension. It's not always easy to draw a line for a trait that follows along a normal continuum.

Question from MarcInSF: Why are stimulants such as Ritalin prescribed without any therapy to accompany them? Are there risks in prescribing Ritalin to prepubescents?

Dr. Michael Gordon: In many cases, the stimulant therapy is sufficient to bring the child's behavior within a normal range. There is no evidence that stimulants will effect normal growth or other developmental processes, at least as judged by ultimate attainment of height.

Question from AMDubbin: Do you believe that it is a serious matter to pump up children’s dopamine levels at such tender ages?

Dr. Michael Gordon: For children who are truly impaired by ADHD symptoms there can be justification for trying to adjust neurochemical functioning.

Question from MarcInSF: Are the SSRI's effective in treating ADHD?

Dr. Michael Gordon: Unfortunately, SSRI's (such as Prozac and Zoloft) have not been studied extensively, unlike the stimulants. At this point, most clinicians see the antidepressants as an option only if stimulants don't work or cause problems.

Question from Doris: Dr. Gordon what do you think about Adderall for treatment of ADHD?

Dr. Michael Gordon: Adderall is a medicine that combines various types of stimulants with the hope of a better treatment response. Again, the data on this drug is limited. However, in some cases, physicians report that this drug can provide a smoother and longer lasting effect.

Question from SirAxe: My son was recently switched from Ritalin to Adderall, which seems to be working better. Do the drugs have different side effects?

Dr. Michael Gordon: According to a recent study, the side effects (if any) are about the same

Question from AMDubbin: Are you aware of any substantial long term chemical changes that could be caused by amphetamine therapy as the patient ages to maturity? How about the possibility of depression in the later years?

Dr. Michael Gordon: To date, no convincing evidence exists of long term chemical changes as a consequence of stimulant therapy. This may be due to the fact that the stimulants are metabolized quickly. Also, depression has not been demonstrated to result from the medication, per se. However, it can be very depressing to have ADHD, which, aside from the medication, can be manifest.

Question from Lucy: I know someone who uses marijuana for his ADHD. His doctor is aware and hasn't objected. What's your opinion of this?

Dr. Michael Gordon: People will self-medicate in many ways. Whether the physician should condone this practice is more an ethical than ADHD-related issue.

Question from Phranque: Is there a scientific way to test and diagnose ADHD instead of having the doctor just guess on the diagnosis?

Dr. Michael Gordon: Unfortunately, most diagnoses (psychiatric and otherwise) involve a degree of clinical judgment. While there are systematic ways of assessing the disorder there is no magic measure that can instantly provide a diagnosis.

Question from RosenJMU: Are the chances good that young adolescents will become physically addicted to Ritalin?

Dr. Michael Gordon: At doses prescribed for ADHD, adolescents will tend not to become addicted to the medication, as it does not produce a "high."

Question from AnnD: My grandson was on Ritalin for 6 years. This is his first year off drug therapy, and he is doing fine (age is 13). Is ADD something some children just grow out of?

Dr. Michael Gordon: ADHD symptoms generally persist over time. However, not all children diagnosed with ADHD will continue to exhibit problems. Anywhere from a third to a half of youngsters will adjust. Much depends on the severity of the problems and the extent to which an individual finds a niche that minimizes the impact of these traits.

Question from RosenJMU: What alternatives are there in treating ADHD?

Dr. Michael Gordon: The alternatives (to pharmaceutical treatment) of ADHD are generally oriented to parent training and educational programming. In general, ADHD children need homes and schools that are unusually well structured with clear rules and immediate consequences. Various programs try to maximize the chances that the ADHD child will experience an environment in which such supervision and monitoring are high.

Question from Ebay5150: Does Ritalin cause eating disorders?

Dr. Michael Gordon: Use of stimulants (especially at the beginning) can cause appetite suppression, but has not been found to cause formal eating disorders. Usually any eating problems are managed through changes in dose times and availability of food during the day.

Question from Lucy: What side effects would a user expect?

Dr. Michael Gordon: The most common side effects of Ritalin are reduced appetite and (in some patients) difficulty falling asleep. Ironically, however, some patients actually eat better (because they sit long enough at the table to get some food in), while others sleep better, for whatever reason. Always keep in mind that these medications (like most medications) produce different reactions in different folks. Generally, though, the stimulants tend to be very safe medications as best the scientific literature can tell.

Question from Gray: My son has ADD. What alternative diet do you recommend?

Dr. Michael Gordon: Unfortunately, no diet has been scientifically established as likely to cause benefit to individuals with ADHD.

Question from StephanieCNN: What's the difference between ADD and ADHD?

Dr. Michael Gordon: Both terms are the same although some now use ADD to refer to the form of the disorder that does not involve hyperactivity.

Question from Siddhartha: Does ADHD lead to PDD/Autism or is there a connection between the two?

Question from Lucy: What is PDD?

Dr. Michael Gordon: PDD is pervasive developmental disorder that includes, among other things, autism.

Dr. Michael Gordon: No, ADHD does not become PDD/Autism. However, some children who look like they might have ADHD when they are really young are just showing some signs of the PDD. But generally the two are unconnected.

Question from DipertnI: Is ADD considered a product of nature, nurture or both?

Dr. Michael Gordon: All disorders are the product of both nature and nurture. It turns out that ADHD has a strong genetic component that has lead most of us to be impressed by the "nature" contribution.

Question from AMDubbin: Do you think that better environmental conditions and proper parental care could lead to the prevention of ADHD?

Dr. Michael Gordon: Clearly, the nature of the environment will effect the extent to which ADHD traits will become manifest. However, for children who have serious problems with impulse control and attention, even the best of environments will not prevent impairment. In fact, one of the ways we feel comfortable about an ADHD diagnosis is when we see the symptoms DESPITE good efforts at management.

Question from RosenJMU: What are the first signs of ADHD in a child?

Dr. Michael Gordon: The first signs are highly impulsive, overactive behavior in most situations and relatively consistently from day to day.

Question from RosenJMU: What new methods are being used in managing "rage Behavior?"

Dr. Michael Gordon: The "rage behavior" of most ADHD children are more temper tantrums and frustrations about the limits they find hard to handle, as opposed to the violence of children with formal rage disorders. There are no new methods for managing the anger of ADHD children, although some of the tried and true methods can work fine with effort.

Question from Annette: Thank you, Dr. Gordon, for participating in this session! What correlations have been found between epilepsy, depression, bi-polar or other "brain/genetic based" disorders? Do families have heightened numbers of these conditions? If so, are there overlapping treatments or early interventions to consider with the youngsters in these families?

Dr. Michael Gordon: There is a high degree of family predisposition to ADHD. According to various studies, ADHD rivals hair color for its genetic inheritability.

Question from Elektrik: Are the any complications that have shown up between taking HIV medications with Ritalin?

Dr. Michael Gordon: You'd have to ask your physician

Question from TonyDeF: Would you classify ADHD as a learning disability?

Dr. Michael Gordon: While ADHD can definitely affect learning, it is a disorder in its own right. A child has a learning disability when he or she can't read or do other school subjects despite adequate attention to task.

Question from Doris: Do a lot of children with ADHD exhibit low self-esteem?

Dr. Michael Gordon: Yes, ADHD children (like most children with special needs) are prone to poor self-esteem. ADHD children are especially vulnerable because they tend to have poor peer relationships and difficult relationships with parents and teachers.

Question from Bebe: Is there a time when a child should stop taking Ritalin?

Dr. Michael Gordon: Yes, when he or she doesn't need it any longer to function

Question from Phranque: I may sound skeptical. I'm a nurse who occasionally spends time in schools. Such a large percentage of children are medicated. Are 50% of these children being medicated because of genuine ADHD or due to anger, poor relationships with parents, poor parenting, etc.?

Dr. Michael Gordon: You can't be blamed for a degree of skepticism since some children are medicated for the wrong reasons. However, your 50% estimate is probably high. Also, the fact that a disorder can be misdiagnosed doesn't mean it's bogus. It just means that we should all be insistent that children are appropriately evaluated.

Question from SirAxe: Can fetal alcohol syndrome cause ADHD or be misdiagnosed as such?

Dr. Michael Gordon: Maternal drinking does put a child at risk for learning and behavioral disorders (like ADHD). Parenthetically, the greatest risk factor as far as birth-related events are concerned, is maternal smoking

Question from AnnD: Since I have only heard of ADD/ADHD in the lost 20 years, could some of us in our "golden" years have had undiagnosed ADD/ADHD, or was it given another mental illness diagnosis before the term ADHD was coined?

Dr. Michael Gordon: ADHD -type symptoms have had any number of labels over the years. Perhaps during your school years kids with these kinds of problems were just considered "dunces." Other labels have been "minimal brain dysfunction" and "hyperactivity."

Question from Anatsik: I have heard of special schools for ADHD children. Is there reason to believe they are effective and how do I find them?

Dr. Michael Gordon: You can try getting more information from www.chadd.org. This is the national support group for ADHD. It may well be that special schools could be helpful. Of course, it would depend on how they are designed and run.

Question: At what age are children most likely to be diagnosed with ADHD?

Dr. Michael Gordon: Between ages 6-12.

Chat Moderator: What do you think of theories that blame food or sugar for ADHD?

Dr. Michael Gordon: Again, no solid evidence exists that ADHD is caused by food or sugar -- for the overwhelming majority of patients.

Question: Who should diagnosed ADHD, a doctor, counselor?

Dr. Michael Gordon: ADHD should be diagnosed by individuals with special training in evaluating for the disorder. It is especially important that the clinician be trained not just in the diagnosis of ADHD, but also in the diagnosis of other psychiatric disorders. This is important because other disorders can "look like" ADHD and, more importantly, most individuals with ADHD also have some other psychiatric problem.

Question from UnFocused: Where would an adult go to see if they are ADHD?

Dr. Michael Gordon: This is a tough question because not that many clinicians are comfortable evaluating for this disorder in adults. You should try 1) calling a child-oriented ADHD clinic (perhaps at a medical center) and see if they can make a referral, 2) talking with your own physician, and 3) calling a psychiatry department of a local medical center

Chat Moderator: Any final questions for Dr. Gordon today?

Question: How common is ADHD? Are there any percentages of the population available?

Dr. Michael Gordon: The typical range presented is between 3 and 5%

Question from AMDubbin: What do you think of Ritalin's illicit use as a study aid by college students in place of traditional caffeine?

Dr. Michael Gordon: Any illicit use of a drug is a bad idea

Question from Are: Are most kids with ADHD also diagnosed as learning disabled?

Dr. Michael Gordon: Somewhere between 40 and 60%

Chat Moderator: Any final comments for us?

Dr. Michael Gordon: It's always a good idea to approach the diagnosis and treatment of a disorder like ADHD with great care. I can't stress enough how important it is to work with someone who on the one hand isn't a cheerleader for the disorder (seeing ADHD everywhere) but also who isn't unfairly dismissive.

Chat Moderator: Thank you Dr. Gordon for joining us today to discuss ADHD.

Dr. Michael Gordon: Goodbye everyone. Great questions!

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