I like using 'executive function' in the name. It covers more of the issue and gets rid of the idea that it's just about 'naughty' boys by eliminating the misleading 'hyperactive' label.
Re lazy parenting - most parents are forced to accept substandard schooling for their children, which caters for a small minority of children while labelling the rest deviant and blames them for their 'failure'. I reject any idea that parents are to blame for medicating their children so they can get through the nightmare that is modern schooling. And I reject the notion that parents are 'lazy' if they medicate their children. I wish my own parents had been 'lazy' enough to go to the doctor and find out what was wrong with me instead of labelling me lazy and stupid.
To the bolded - why? Are parents never lazy? Are parents always acting in the best interests of their children? (The answer is no.)
The chronic, non-stop parent blaming in our society is out of control. I won't argue, and have commented on it many times, myself. That doesn't mean parents are always right, never to blame, or always doing their best. Sometimes, they're really not doing any of that.
These parents flat out said that they put their daughter on medication, because she was "a bit blah". She doesn't have ADHD. They don't even think she has ADHD. They thought she was "blah". That's a pretty poor reason to put someone on serious medication, with known serious side effects (such as the fact that it had already caused one of their other children to hallucinate).
I tend to agree about school. School was a non-stop nightmare for me (starting about 4th or 5th grade). I medicated myself (mostly pot, but a hefty dose of alcohol at times, as well) to get through it. But, my problems went way beyond being "a bit blah". And, the picture of Quintn really, really disturbed me. I knew kids at school who were smoking pot regularly, doing coke occasionally, dropping acid semi-regularly, smoking cigarettes and drinking to excess, and none of them looked that wasted. That boy looks as though he hasn't slept for a month.
Quentin isn't on a stimulant though, he is on an atypical antipsychotic which is pretty sedating. Not sure why they chose that--he has to have issues beyond ADHD in order to have dr. use that medication. Usually prescribed for children with anger issues that are way over the top.
Here is info on the use of disorders of executive function alongside ADHD.
[QUOTE]And, the picture of Quintn really, really disturbed me. I knew kids at school who were smoking pot regularly, doing coke occasionally, dropping acid semi-regularly, smoking cigarettes and drinking to excess, and none of them looked that wasted. That boy looks as though he hasn't slept for a month.[/QUOTE]
The picture on the front is supposed to make you feel like that. And the quotes are supposed to make you feel like that. It is possible that the article is a true representation of these few parents. It's also possible that they've been misrepresented.
However, what is the article saying? Isn't it just doing exactly what most of us hate? It's continuing the out of control non stop mother blaming (almost always mothers, though occasionally fathers too.) We should be shouting about the article, not the parents in it - whom we have never met and should not be judging based on a biased article.
All it would take is a photographer to take a picture of a kid half way through a blink to get a 'druggie' look in a child. I take the article with a pinch of salt. I'm not disputing that there are some parents who do this to their children. I'm FAR more concerned that there are hundreds of thousands of kids going undiagnosed because doctors and parents have this attitude that it is a made up problem - caused by this sort of article.
Quentin isn't on a stimulant though, he is on an atypical antipsychotic which is pretty sedating. Not sure why they chose that--he has to have issues beyond ADHD in order to have dr. use that medication. Usually prescribed for children with anger issues that are way over the top.
Of course there's no way to know without actually knowing the family, but the article said he was put on it after the Adderall caused him to have delusions. While that makes no effing sense whatsoever, I've personally witnessed more than enough cases of "prescribe a drug to treat the side effects of another drug" in my life to find it completely believable.
[QUOTE]And, the picture of Quintn really, really disturbed me. I knew kids at school who were smoking pot regularly, doing coke occasionally, dropping acid semi-regularly, smoking cigarettes and drinking to excess, and none of them looked that wasted. That boy looks as though he hasn't slept for a month.[/QUOTE]
The picture on the front is supposed to make you feel like that. And the quotes are supposed to make you feel like that. It is possible that the article is a true representation of these few parents. It's also possible that they've been misrepresented.
Yes - I'm sure the picture is supposed to cause a certain emotional reaction, but it's still a picture. Do you think it was photoshopped?
However, what is the article saying? Isn't it just doing exactly what most of us hate? It's continuing the out of control non stop mother blaming (almost always mothers, though occasionally fathers too.) We should be shouting about the article, not the parents in it - whom we have never met and should not be judging based on a biased article.
Actually, I got far more of a doctor blaming vibe than a parent blaming one, with some serious slams at the school system thrown in for good measure. You're right - the article could be entirely wrong, in which case why bother discussing it at all? If the father wasn't misquoted, these parents are whacked, imo (and please note that I'm talking about a quote from the father, not the mother). You don't give your child hardcore medication - medication that's already caused one of your other children to have delusions - for being "a bit blah" and not very social. While I'm not fond of the constant parent blaming that goes on in the media (and on street corners, in checkout lines, on blogs, etc. etc. etc. ad nauseum), that doesn't mean that all parental decisions are off limits to criticism. Deliberately medicating children for conditions they don't have isn't cool.
All it would take is a photographer to take a picture of a kid half way through a blink to get a 'druggie' look in a child.
Really? I"ve taken dozens - maybe hundreds - of crappy pictures of my kids, in the middle of a blink, strange expression, or whatever. None of them looked like that. There's a picture floating around of me, mid-blink, stoned out of my skull, and I don't look like that.
I take the article with a pinch of salt. I'm not disputing that there are some parents who do this to their children. I'm FAR more concerned that there are hundreds of thousands of kids going undiagnosed because doctors and parents have this attitude that it is a made up problem - caused by this sort of article.
How do you know there are still hundreds of thousands of kids going undiagnosed? People with ADHD not receiving the correct diagnosis is bad news, but that doesn't mean it's any worse than people being put on Adderall when they don't have ADHD. In any case, the vast majority of people in the comments who got the "ADHD is made up" vibe from this article were people with ADHD. Almost nobody else read it that way. (And, yes - I did read the entire comment thread yesterday.) I certainly didn't. Saying that it's not okay to medicate someone for a condition that person doesn't have isn't the same thing as saying that condition doesn't exist.
And, that attitude is not caused by this sort of article. It's caused by people not understanding ADHD. It's caused by people thinking their own experience is a universal truth ("I took all artificial food colourings out of my son's diet and his symptoms disappeared, therefore all ADHD would disappear if the parents did the same thing" and "my ex was to permissive, but as soon as I cracked down on our son, his so-called ADHD vanished, therefore all ADHD would disappear with stricter rules" and other stupid variants on the theme). It's caused by people mistakenly thinking that ADHD didn't exist when they were kids, because they never realized that the "troublemaker" in seventh grade wasn't just some punk with a bad home life. It comes from people diagnosing ADHD where it doesn't exist. People who don't believe in ADHD will read this article as validation of their viewpoint, but they'll read all articles as validation of their viewpoint. People who put kids on ADHD medication, when those kids don't have ADHD, do a lot more damage to ADHD awareness than the article does. Most people know at least one person who clearly doesn't have ADHD, but has been put on ADHD meds, and that tends to prop up the belief that ADHD isn't real.
This article isn't about kids with ADHD. This article is about kids who are receiving prescription medication for conditions they don't have. Their parents don't think they have it, and the prescribing doctor either doesn't think they have it, or doesn't think it exists. (I had trouble figuring out his views from the quotes - at first I thought he didn't think those kids had it, then later it looked as though he doesn't believe it exists.) I wouldn't be impressed by parents and doctors loading a kid up with prescription painkillers when they weren't in pain, or chemotherapy drugs when they didn't have cancer, or Lipitor when they didn't have high cholesterol, either. For a more apt comparison...I wouldn't be impressed if the doctor and the parents were putting the kids on steroids, so they'd have an edge in gym class, either.
Yes, i heard about this terminology recently too. I apologize for my post upthread, in that i posted without thinking or explaining myself clearly. i believe certain disorders exist, but i dont think the term adhd defines them well, and i am happy to see that changes are being made to clarify what the disorder really is. I also think that it is overdiagnosed and misdiagnosed.
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I like using 'executive function' in the name. It covers more of the issue and gets rid of the idea that it's just about 'naughty' boys by eliminating the misleading 'hyperactive' label.
ps.not to mention that the article isnt about whether or not adhd exists, but that adhd medications are being prescribed to control children rather than to help them with a medical disorder.
Yes, that's my problem with it. The press is completely skewed towards this sort of article. This just makes things harder for people whose children need the medication.
Well, I do think ADHD is over-diagnosed and there is a rush to medication when it may not be warranted, but I also do think that ADD and ADHD are real conditions that may be helped by medication. I live, like the family and dr in the article, in one of the states with the highest diagnosis of ADHD. Take a look at the CDC's own map of the prevalence of ADHD diagnosis and the CDC map of ADHD medication treatment and to me it's pretty clear that there is inconsistent diagnosis and inconsistent medication across the country. Maybe it's over-diagnosed/over-medicated in the South or maybe it's under-diagnosed/under-medicated in the West, but clearly either way it's not evenly diagnosed and evenly diagnosed in the US and it's likely that something is out of whack with that. I do think the press should report on this.
And I also do think that school is an artificial environment and many traditional public schools are not helpful for a kid with executive function issues. However, there are some schools that do a good job helping kids develop their executive functioning skills. As a parent of a child who is challenged in many executive function skills I know that some executive function skills can be taught and learned even though it may not be my dd's forte. She can get better w/o medication. She may never be a super organized Martha Stewart type, but her issues are such that she can learn enough EF skills to do okay. I don't think medication would be appropriate for her, but that is not to say that other kids wouldn't benefit from medication.
I actually see far more stories about medicating ADHD than I do about over-diagnosis, but that may be because I live in one of the states with the highest prevalence of diagnosis. If I lived in California maybe I'd see more of the other kinds of stories.
I will say that I am the parent of a child who I believe to be accurately dx with inattentive type ADD and married to a man with the same and I didn't get a vibe that ADHD/ADD is a made up disorder from this article. I will also say that I've never gone the route of medicating said child. We've tried alternate options. I do worry about the long-term ramifications of using stimulants on a growing brain, I worry about the studies that show self-medication in adulthood of kids whose ADHD was not treated with meds, the studies that show the same for kids whose ADHD was treated with meds.... There is just a lot to worry about and we can never know if we did it right.
I would be totally on board with a new category of diagnosis, having been in the situation so many times before: "Failure to adapt in the formal education environment". At least then the kids who are being put on meds to cope with school would have a valid reason. Just my two cents. I heard too many stories in the office about kids who were fine except in school. "Teacher says this, school counselor says this, they say I have to bring my kiddo in to get evaluated for attention" blah blah.
In the world of therapy for kids and families, I did see the occasional "real" case of ADHD (both types), but these were very, very rare....perhaps 2 in 1000. My guess is that about 200 of them ultimately got their kids on some kind of meds, though. The intake clinicians had some short-hand codes sometimes, too...."it's a parenting pill case" and that kind of thing, you know when someone would call and say "Hi, uh, I need help with my kid. He's got too much energy. I want to see about some Ritalin". Of course they had to get an evaluation first, so I got to see all kinds of parent antics during that process. It was pretty clear when someone needed a well-deserved break from a high energy kid, or when a parent was really worried, but the clincher? The kid. The kid would tell me "I want to read Harry Potter but I can't keep going after a page" and that kind of thing. That was more likely a "true" ADHD. So very many parents would bring in a kid who could manage all my fancy tests of attention just fine, look great in a live school observation, but when the parent would fill out the questionnaire, it would be "severe, severe, severe". That mismatch is when we get all parent-blamey, for sure.
I'm FAR more concerned that there are hundreds of thousands of kids going undiagnosed because doctors and parents have this attitude that it is a made up problem - caused by this sort of article.
In practice, and in my experience, this is not the case. A kid can get the rx in a 15 minute eval with many pediatricians or NPs, and if there's doubt, the kids are sent to a kiddie shrink, and if there's still doubt, a full psych eval...but most can go the 15 minute route. Most physicians are okay with the rx for the speed, since there isn't a terrible danger to "trying it", and for a long time it was "if this works, then the kid probably has some ADHD". kwim? A problem exists in pediatric psychiatry that sometimes it's a lot of trial and error. None of those drugs are really tested on kiddos, and so it's in practice that the providers get a sense for what works for this or that. Some psychiatrists have a regimen that they like, and sometimes that can mean a ton of meds. There are others who are big on fish oil and the like. There is a range, but I see more erring on the side of too many drugs versus erring on the side of not enough of them. A very rare psychiatrist will send a patient away with no drugs to treat whatever problem they bring.
Once I said to a ped friend "I think dd might be sensitive to sugar. She was a wild thing last night after m&ms!" Ped friend said "you think it's ADHD? Mood disorder?" Me: "no, really. It was m&ms. I swear."
I wonder what the geographic trends of child psychiatrists are....are they more populous in the east? That might explain some of it? Just a thought.
The misdx goes both ways. Many inattentive kids are missed by classroom teachers because they are not disruptive; parents are not aware of failings. I have talked this over with ds's neuro and psych and they say about 50% misdx kids with and without. This article reflects the intentional misdx with the hopes of changing outcomes through the laziest route possible. As I see it, the failure here is on the part of the dr. He is not doing his job. It is like giving antibiotics for a virus; it won't help, but somehow it is supposed to make the person feel better.
The misdx goes both ways. Many inattentive kids are missed by classroom teachers because they are not disruptive; parents are not aware of failings. I have talked this over with ds's neuro and psych and they say about 50% misdx kids with and without. This article reflects the intentional misdx with the hopes of changing outcomes through the laziest route possible. As I see it, the failure here is on the part of the dr. He is not doing his job. It is like giving antibiotics for a virus; it won't help, but somehow it is supposed to make the person feel better.
Inattentive type kids rarely get picked up because people think ADHD is about 'naughty' kids (mainly boys).
I think the problem of brief visits to a psych and a prescription for pills is likely to be a localised one. It isn't something that happens here to my knowledge (England.) However, I do accept that there are some children who are misdiagnosed with ADHD, and ASD, particularly if they are gifted. This is a problem, but not anywhere near as common (here) as kids not being diagnosed at all through lack of understanding of what ADHD is and I blame poor press for this.
So perhaps we can redirect ourselves to talking about schools (this being the Learning at School forum and all). WHy is it that people would even feel a need to medicate their kids just so they can function in school or that they could have an 'edge' over others. THat is alarming from a cultural perspective.
An educator friend of mine that has been in the field for a very long time attributes many of the problems (with children with and without actual ADHD) to much bigger class sizes overall (than 20 years ago), and that too many children with special needs (or the need for accommodations) get placed into the same class.
Kids that have difficulty with executive functions and impulse control are known to have more problems in a larger class and also, the more children there are, the more noise, the more distractions, the less personal attention, the less likely the teacher will allow a kid to move around if needed, etc.
To me, this seems to come back to the fact that our schools are under resourced and that might be something we could effect. WHat would it take for our schools to actually be able to meet the needs of children that have difficulties with executive functions, sensory overload, impulse control?
Once when I did a school observation for a kid who was referred for attention problems, I was struck by how stimulating the 1st grade classroom was. There was stuff all over! Things dangling from the ceiling, christmas-style lights draped on things, every bulletin board was covered, the smart board had things on it, the chalkboard had things on it, then add to this cramped space around 25 kids....it was something similar to that Hoarders show but with classroom dingledangles instead. I'll be honest....even I had a hard time focusing on the classroom behavior assessment I was doing. It took twice as long. The teacher complained to me that so many of her kids this year were ADHD....it was like an epidemic. But alas, the teacher was not open to discussing how the classroom may be too much. "These are my materials! I don't get any funding for these from the school!"
When the family started shopping around for another school option, the primary goal was to find as bland a classroom as possible. And he was fine! Incidentally, I've seen a lot of EBD (special ed behavior classrooms) that are quite blank as well. Maybe that's more a safety concern in the self-contained rooms, but I think they are on to something.
I had all those problems but thrived in primary school. My nightmare schooling took place in high school.
We had a not too small class size - about 26 children - and only one member of staff. My children were in classes of 33 with 2 members of staff, but 33 was FAR too many and the rooms were too small. Our class rooms were large and we were expected to get up and move around and play.
The problems, as I see it are:
Too big class sizes.
Too much testing.
Too much 'teaching' and not enough learning.
Too heavily 'curriculum' driven and not enough exploration driven.
Too much reliance on memorising and not enough immersion.
Too much focus on reading, writing and maths and not enough on play.
Too much sit down and be quiet and not enough up and doing.
Reduction in playtimes and genuine 'free' play.
This is not a problem only for kids with SpLDs - it's a problem for most children. Children need to play and explore and they thrive on finding things out. We took topics in primary school and covered all sorts of interesting things through them - eg we made Viking shields and sang Viking songs and painted longboats and wrote letters and news reports and put on TV shows and plays. We learnt maths playing at the sinks and in the 'shop' and going round the school with measuring sticks and bits of string. We all read to the teacher individually every day and the teacher had time to let us do that because she wasn't containing our energy and trying to keep the noise down because we had our needs met.
I'm ANGRY about what is happening to education. I went to a different school and my whole life turned upside down. I had to sit and wait until other children were finished, doing nothing and expected to put up with it. Hour after hour. Day after day. Year after year. Sitting. Waiting. When I was finally given something new to learn, I'd forgotten how. I am now highly educated but I did it all in adulthood, at night school and working shifts to get through it. I'm still learning now and writing a PhD proposal, but back then I was written off as lazy and stupid. Because I couldn't and wouldn't be shoved in a corner and expected to shut up because I already knew how to do the work. I asked for work at first. I begged for it. I cried. I complained. Finally I gave up and school was about being with my friends. There's no excuse for putting children through this.
There needs to be a serious rethink. Start trusting children and their enthusiasm for learning. That would be a first step. And maybe get rid of classrooms like is happening in parts of Sweden. No more expectation to sit still, then the kids WILL sit still just like my 'inattentive' child is doing right now, reading, because he wants to.
Ooh. Where did all THAT come from?! 
That was FUN!
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