I found your article both fascinating and thought-provoking. I do however, wish to point out several issues which I feel were not addressed. First of all is the obvious lack of significant hyperactivity on Pooh's part, which militates against a pat diagnosis of ADHD. Although Pooh does present a tendency to fidget, this is not, I feel, sufficient to meet DSM-IV standards for severe hyperactivity. The various symptoms involved; including inattention, impulsivity, forgetfulness, hunny dependency, and certain linguistic difficulties arising from a rather casual attitude towards grammar and spelling do very strongly suggest an attention deficit without associated hyperactivity, or ADD. ADD/ADHD appears to be associated with an underutilization of glucose by certain segments of the brain, including the frontal and prefrontal lobes. This tracks closely with certain anecdotal evidence associating ADD/ADHD with a relentless, 'sweet tooth' which has often been misinterpreted by society to mean that sugar causes hyperactivity, when it has become more and more clear that ADD/ADHD causes the brain to feel it constantly must require more sugar which it cannot then utilize, leading to a vicious circle. I feel that this may be the cause of Pooh's fixation on honey rather than the much more complex explanation of an OCD, which I do not feel can be supported by any evidence of primary OCD symptoms, such as door-checking or hand-washing. Repetitive counting seems much more a symptom of the impulsivity and a general lack of mental stillness associated with ADD, as well as a possible presentation of Pooh's astonishing creative language skills, which are addressed below.

ADD has also been generally and anecdotally associated with higher than average intelligence, which often is unclear in the initial presentation of symptoms due to the presence of a primary learning disability, (ADD/ADHD) plus other LD's that are often seen in conjunction with the primary, such as dyslexia or dysgraphia. Pooh does present obvious dysgraphic symptoms on a number of occasions, although this could also be explainable by the fact that bears can't write. However, Pooh's strong creativity, both in his problem-solving activities as well as in his use of language, suggests that not only is microcephalia not an option, but that the Bear with Very Little Brain may in fact be a misunderstood genius. Although the article describes Pooh's attempt to disguise himself as a rain cloud as, 'poorly thought out' and a sign of impulsivity, which is correct, it is also in fact a highly creative approach to the problem. That Pooh had failed to fully see all the consequences inherent in his attempt does not detract from his extraordinary ability to visualize and attempt solutions that have never been tried by any other bears in either natural or literary history. Pooh's use of language is also extremely creative, and I believe that this creativity could well stem from an extraordinary mind handicapped by a dyslexic or other lingual/neurological disorder. This is further supported by Pooh's poetry, which although nonstandard in the extreme, is in fact quite unique and excellent. His referring to himself as a Bear with Very Little Brain suggests some extreme self-esteem issues, possibly even clinical depression, but is also an extremely strong self-concept, (as shown by his use of capital letters.) In conclusion, I would suggest the proper diagnosis for Pooh is that of ADD without attendant hyperactivity, combined with possible dysgraphia and dyslexia, which have led to clinical depression. I feel that the prescription of even mild stimulants for Pooh would be a grave error. Instead, I would suggest that an antidepressant such as Wellbutrin, Desipramine or Prozac would be much more appropriate in this case, especially combined with intensive therapy to address self-esteem issues. I feel especially strongly that therapy is needed here, as bears are known to become more aggressive as they age, and an aggressive, clinically depressed, impulsive bear presents a possible danger to those around him.

Thank you,