I lived with a child who was a prenatal cocaine exposure, big time! This poor guy had NO self control at all. Whatever went through his mind, he did. No matter what.
Ritalin helped him tremendously. His was still susceptable to suggestions from other kids (Why don’t you…) but the difference was incredible. His Dad is probably ADD, too, giving the kid the double whammy.
Quote: “I’ve seen the Ritalin kinds and the “Stepford Wives” aura they exude is frightening. I wouldn’t trade my
brilliant, creative, distracted little girl for a million of these kids.”
Neither would I.
But in my family’s case, Ritalin helped us realize that our little girl was indeed “brilliant [and] creative.” Putting her on the medication certainly did not make her into a flat unemotional robot, half-asleep and joyless. It didn’t change her basic personality at all. What it DID do was allow her to attend to something for long enough to gather some real enjoyment from it.
At the age of almost seven, she could barely sit still long enough to draw a stick figure; with the medication, she drew fascinating, multi-colored pictures and began to see herself as a real artist. Similarly, she’d always enjoyed fantasy play and drama but couldn’t sustain it for more than a few minutes before moving on to something else; this was a major turnoff to other kids. With Ritalin, she stuck with it and became quite successful at this kind of play, both because of other kids’ reactions and because it was really enjoyable to her. The drug brought out what was already there, just made it possible for her to show others–and most importantly herself.
In my experience as father, teacher, and more, if a kid is really robotic under Ritalin then the medication should not be continued. Some are. Many aren’t.
It is also possible that Ritalin is both overprescribed and underprescribed. In my community there are a couple of psychologists who students of mine have been to, psychologists who would find ADHD in a rock. But at the same time I have had a few students in my classes over the last ten or so years (primary grades) who have exhibited some of the classic symptoms–and who were suffering from it. I remember one family in particular: the parents, recognizing that something was wrong, said they might be willing to consult with the medical establishment, but no way in the world would he be taking Ritalin. (I had not brought Ritalin–or ADHD–up; I’m not a doctor, don’t diagnose.) The many non-medical interventions we tried were not really very successful, and the kid did not have a good year. Maybe Ritalin wouldn’t have worked at all, maybe he wasn’t ADHD, but I can’t help thinking it might have been worth a try, and I was disappointed in the parents’ attitude. In my book it’s never a good idea to sacrifice a kid in the service of ideology.
Yes, the criteria for diagnosing ADHD are subjective. Welcome to psychiatry.
Most of the shrinks I’ve worked with will say that ADHD is not exactly overdiagnosed in general, but is overdiagnosed in certain groups–namely, middle-to-upper-class white males. This could be ascribed entirely to the fact that those kids’ parents are more likely to take them to the shrink.
Why is it overdiagnosed? Because, despite what Montel Williams, Dr. Laura, and Peter Breggin will tell you, Ritalin is a very safe drug. The common side effects are tolerable and temporary. It’s completely gone from your system in a few hours. That being the case, it’s OK to have a low threshold of treatment.
The only real reason not to take Ritalin is the stigma against taking medication. I can’t agree with this view. I often compare it to eyeglasses–when people first started wearing them, people probably said, “You’re not going to go around all the time with THOSE on your face, are you? Can’t you get by without them?” And the truth is that yes, you could. You might not be able to read anything, or drive, or get around on your own, but you could get by. Even so, no one thinks twice about getting glasses for someone who needs them, and no one goes around talking about glasses being “overdiagnosed” and that a lot of those kids wearing glasses don’t need them.
I could get by without Ritalin, and I really only use it anymore when I really need to focus. However, I would have long since flunked out of medical school without it. Coping mechanisms, such as the ones that got me through undergrad, can only go so far.
I could write a book on this subject–and I intend to do so within the next few years.
Dr. J
I think one thing that leads to it’s being misdiagnosed that even in the cases where it’s not chemical imbalance, just lack of structure at home, parents who just left their kid in front of the TV, the Ritalin still helps. Stimulants change the way you think, even if you are perfectly normal chemically. So these products of working parents, daycare, and the cartoon channel get misdiagnosed and they become easier for Mom and Dad to handle. The long term effects of this are still unknown.
This is good… there seems to be a good flow, and it’s all orderly discussion in here…
I wish it were that way at home.
My 4 year old girl is ADHD… we have struggled with her for 2 years, trying different disciplining techniques, different schedules, different everything… no help. The only thing that seemed to calm her down at all was starting preschool… and then, during the last few months, it got to the point where we were getting at least 1 call a week to come get her, she’s out of control and disrupting the class.
We talked to her doc, and she’s on Ritalin now. It has made a drastic change… she’s still a little wild, which I don’t mind, but now she can sit and do her work, and get through class, and color, and sing songs, and play… before, she couldn’t stay focused long enough to go the bathroom without getting distracted… she would come out of the bathroom naked, playing with the toilet paper roll, then drop it and run upstairs…
It’s made the difference.
However, her grandpa on mom’s side any time we mention it, just barks “Take her off it, it’s all bullshit!” and then gets grumpy… ah well. Mayhaps, in a few years, we can truly try to explain it all to him.
BTW… my daughter is on 10mg 3 times a day. How 'bout you guys? What’s the average dosage for doper’s and their kin?
dragonlady, haven’t “they” now determined that prenatal cocaine exposure doesn’t seem to harm the fetus?
My thoughts on ADHD: I think what causes many people (including me) to struggle with its validity is that there doesn’t seem to be a bimodal distribution on the “focus” scale - it seems to be a normal, bell-curve distribution of kids, and the ones on the low-focus end get an ADHD diagnosis.
With most other diseases/disorders, you’ll have a group of kids in a “normal” range, and then a few distinct outliers who are away from the rest of the crowd. It’s easy to consider it a disease in cases like this.
But with ADHD, we’re just labelling the ones who have less-than-average focus capabilities as having the disorder, and give them a drug. The drug improves their focus skills and probably makes them happier people, so it’s not all bad. But why don’t we give it to anyone who wants it? It could improve their focus skills too. Put it in the school’s water!
And another thing that’s bothersome is that it’s not clear what causes it. It seems to many of us (me) that how the kid was raised has large effect on his focus skills. Are we just using a drug to make up for poor parenting?
I don’t doubt that many people have trouble focusing, and they’re really helped by Ritalin (or “Focusin” in the Simpsons episode), but there are some things about it that bother me.
Curt C
there is a huge bump in the stats with ADHD with highly gited + kids. I am sure a lot of those kids are misdiagnosed and with a better academic placement, the symptoms would go. But many of these kids are genuinely ADHD as well.
My brother was diagnosed with ADHD in 1966 – it was just called ‘hyperactivity’ then. I have no doubt that this disorder exists and Troy is the classic case. As a kid, he had such a short attention span that he could barely watch a TV commercial let alone a whole 1/2 hour TV show. To say nothing of reading a book. He also had major impulse control problems and a level of energy that was off the chart. He was put on Ritalin at age 7 and it did help some. However, at that time the dosage given was standard (although adjusted for body weight and age) and it did flatten him out something awful. My mom hated it and always took him off the drug on the weekends and vacations. It did help him at least sit through class quietly, although it didn’t do much for him scholastically. At that time special education for LDs was in its infancy and Troy received almost no academic help other than the drug (and remedial reading classes – charmingly called ‘dummy classes’ by his fellow students). His elementary school years were hellish – a constant round of teasing and bullying. It was enough to break your heart. Fortunately, we moved to a different town about the time he started middle school. The kids at the new school didn’t know him as ‘Dummy’ and he was able to make friends. His grades were always lousy, though. He did manage to graduate and finally achieved some acedemic success with his Navy ‘A’ school – he was top in his Hull Technician class. I came upon my mom crying like a baby after his first phone call home from the Training Command. He had told her, “Mom, I guess I’m not a dummy after all.” The way they are treating SDHD now is much better – drug therapy combined with teaching strategies for dealing with the disorder.
However, while I certainly believe ADHD is a real disorder, it is definately overdiagnosed. I have a friend with a 9 year old son who was having some behavioral problems in school – class clown type of behavior. His school wanted to have him tested for ADHD. Knowing about my brother, she called me to get my opinion. My opinion was that this kid, whom I’ve known since infancy, didn’t act anything like my brother. From the time he was a baby, they could take Danny into any setting – even a nice restaraunt or a movie and he would be perfectly calm and well behaved. I explained to her what my brother had been like and she agreed that that didn’t sound like Danny. So, she did an experiment. She told Dan she would give him $100.00 cash if he was good at school for one month. He was a perfect angel; paying attention in class, finishing his homework, not talking out of turn… It was a complete turnaround. Of course, my brother (or any kid with ADHD) would have been completely incapable of such an improvement for any amount of money. This experiment convinced Maria that Danny was having a behavior problem rather than a medical one. He’s 13 now, playing in the school band and on the honor roll. But, I can’t help but think that if he had been assessed for ADHD they might have found it… And his situation would be some different right now.
I agree that it is over diagnosed.
I believe that it is an ‘easy answer’ for the parents now-a-days that can’t be bothered dealing with children taht want to run around and play like normal kids.
1.) Kids run and play
2.) Noise is made
3.) Parent doesn’t want to deal with it.
4.) Parent had child diagnosed as ADHD
5.) Doctor gives parents drugs for the kids
6.) Kids take the drug.
7.) Kid is subdued and is no longer running around playing like a normal child.
8.) Parents problem solved.
No this is not for all cases, but IMH, I believe this is the senario for most of them today.
My 8 year old has trouble staying on task and his teacher has repeatedly “hinted” that I should have him tested. He is making good grades (A’s & B’s) and she says that he does really well on projects he’s interested in but his problem is the daily “grind”. Does this sound like ADD to anyone? I have checked out the various links and the symptoms seem to apply to all the kids I know. I think he just needs motivation but I am clueless as to how to help him. Any ideas?
Sure it sounds like ADD…so does just about everything else.
My sons teacher is sayingt he same thing…like I said in my OP, I think teachers and parents want their kids on the drug more for their own benefit than the childs. (It’s a lot easier to look after a group of kids who are doped up after all.)
Dude, I wouldn’t worry about yoyur sone if his greades are that good.
MHO.
fun2d8 -
Don’t you dare put your kid on Ritalin because he can’t focus on the daily grind - I think it’s a testament to how smart and normal your kid is that he can’t focus on the mind-numbing busy work. My mother is a psychologist and she raised 3 boys in a home school environment. I was as hyper as a young kid can get but I would do my work and do it well as long as I was able to do it when I wanted within the day and didn’t have to do anything that was tedious and timeconsuming. My parents still joke with each other that if I had been placed in public school I would have taken a mountain of Ritalin by now.
Point is - If your kid is doing well in the right areas but can’t focus on the bullshit then the class is the problem - not the kid… don’t even think about “having him tested” so they can stone him out of his gourd with Ritalin.
Don’t have a particular axe to grind in this debate. I’ve bounced back and forth in my opionons. Currrently, my take on the situation was heavily influenced by an article in The New Yorker last year by Malcolm Gladwell, called “Running from Ritalin”. Gladwell makes a pretty persuasive case that the attacks on ADHD as a diagnosis and on Ritalin as a treatment for it are overblown. He explores the most plausible current hypotheses for the neurochemical nature of the problem, with a coherent theory about why Ritalin has the salutary effects it does seem to have for some portion of those diagnosed with ADHD. I highly recommend the article to anyone who’s interested in this issue.