As it was explained to me, there are two axises to ADHD - the Attention Deficit part and the Hyperactivity part. You can have just one or you can have both. My daughter didn’t have the hyperactivity part - but she’s a huge daydreamer. So not disruptive and less likely to get diagnosed.
My Son is a sophomore in high school and one of his class mates has been diagnosed with both Autism and AD/HD. This boy is mainstreamed in the school, but also has a chaperone that accompanies him all day everyday. Surprisingly enough, he is somewhat popular and many of the school rules regarding clothes etc. do not apply to him. For example, he wears sunglasses and pimps his way down the hallway {much to the amusement of the other kids}.
He does have serious self control issues and has blurted out on more than one occasion “Sit down you dumb niggers” when black kids were being disruptive in the cafeteria. My Son is concerned that he will act out physically one day and I believe him…
Sorry to be off topic, but the boy {as my Son describes him} definitely needs meds.
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That sounds more like Tourette’s. But, some kids with both ADHD and ASD have impulse control issues; however, with autism, at least, and unlike Tourette’s, it is easier to replace a very unacceptable behavior with a more acceptable one. For example, if something is unsanitary, like spitting, or unsafe, which blurting the n-word could be, for a white kid, you can replace it much more easily than you can eliminate it. We had a kid once who was pinching himself hard enough to bruise, and we replaced it with snapping his fingers, and it only took a week. That was after his classroom teachers had spent a year using various techniques (mostly punitive, but some involving rewards for going a certain amount of time without doing it), and couldn’t extinguish it. The snapping was still a little annoying, but he was no longer hurting himself.
With Tourette’s, behaviors usually happen because the person is afraid of doing exactly what the compulsion is. In other words, if the person thinks the n-word is the worst word he could possibly say, that’s what he blurts. Replacing it with something else won’t work. The only things possible are to reduce general anxiety, or use medications that improve impulse control. Some people are lucky, and get good control with antipsychotics, but they don’t work for a lot of people, and other people find the side effects outweigh the benefits.
He probably wears sunglasses because he’s light sensitive. Meds help most cases of ADHD, but they don’t help autism. Some autistics have comorbidities, like anxiety disorders, and medication can help that, but people with ADHD often have paradoxical reactions to antianxiety medications.
The kid might definitely need help, but there isn’t a med for everything. There are good meds for something, great meds for some things, and OK meds for some things; other things, there just aren’t meds.
There is a very good chance that he’s mainstreamed because he’s ON meds.
A lot of people with Tourette’s are also light sensitive.
A lot of people with autism also have tic disorders, too.
I completely agree that it is over diagnosed. No question.
However, as the unofficial Poster Hag for ADHD, having finally been diagnosed at the very ripe age of 47, let me assure you that it is very real. Realer than real. Terrifyingly, heartbreakingly real. And when it goes unrecognized and untreated, the consequences can be genuinely devastating. (That would be me testifying.)
It’s also not nearly as simply as being hyper and distracted, it goes much deeper and wider than that. Depending, of course, on different factors. But the core of it is essentially a self-regulation problem.
Anyway, from the International Consensus Statement on ADHD:
I have two favorite ways to (glibly) describe what it is to have ADHD, one is mine that I used before I was ever diagnosed and the other I picked up from someone else:
People with ADD love to slay dragons (and are often very good at it). But they need someone else to clean up, do the paperwork, and order more dragons. (not mine, but SO true… )
And having ADHD means going through life feeling like you are Felix Unger…Trapped inside Oscar Madison. Imagine that, if you will.
A lot of things get over-diagnosed when they have been in the news a lot, due to sheer numbers pf people presenting themselves for diagnosis. When hypoglycemia was in the news, that was overdiagnosed, and there is a test for it. But with huge numbers of people wanting the test, false positives were higher than usual. Before it was in the news, probably 90% of people given the test had it, and you got 5% false positives and 5% false negatives. After the publicity, you had maybe 60% of people given the test actually having it, and you still had 5% false positives and 5% false negatives. But in the first instance, that meant that out of 100 people, 90 had the disease, and 85 got correctly diagnosed as positive, 5 incorrectly diagnosed as negative; 1/2 a person misdiagnosed (actually, it would be one in every other group of 100). Since the diet didn’t hurt the people incorrectly diagnosed as positive, and they’d probably be retested in a year, and the incorrect negatives might get retested, or prescribed a diet anyway when the symptoms persisted, there wasn’t much problem.
Now, with the post publicity group, 60% of people have it, and you still have 5% get false positives, 5% false negatives. This time, instead of correctly diagnosing 85 out of 90 people, you correctly diagnose 47 out of 50; that isn’t too bad. However, in the group of 40 who don’t have it, you have 2 false positives. False positives are up 400%. And you aren’t testing the same number of people: you are testing 130 for every 100 you used to test. There will be a feedback loop, where more and more people will present themselves for diagnosis. You will catch more genuine cases, but you will also have more false positives. Legitimate diagnoses will be up, but so will mistakes.*
Because there is a test, this will self-correct. People will be retested, and the false positives will be negative the next time (and probably pronounce themselves cured, thanks to yoga, or acupuncture, or something :eyeroll:)
Unfortunately, with AD(H)D, there is no self-correction. Some wise parents ask for trials off meds every two years or so, mindful that the results may show how necessary the meds are, but if it’s true that there finally are some objective tests, and on top of that AD(H)D is no longer the disorder of the hour, perhaps we will see fewer and fewer false positive diagnoses.
*If I got the math wrong, please contact a mod and fix it. It’s late, and I am not good at math. Plus, I made the actual totals up-- I don’t really know how many false positives glucose tolerance tests produce. I just know that I have had several, and all showed hypoglycemia, then when I was pregnant, the cursory screening showed high blood sugar, so I had to have the long test, and it showed my usual very low numbers. So falsies happen.
Yep. That was my official childhood diagnosis when I was a few months shy of kindergarten, but doctors & nurses started remarking on my high energy level when I was hospitalized just after my first birthday. Apparently it was striking considering I was a little girl.
I can think of several people I grew up with in the 1970s who were probably on the autistic spectrum. Two of them were from a facility in our neighborhood for “emotionally disturbed” children (see footnote) and there was a boy who had very severe behavior problems who was eventually sent to a state facility. We were told that he had “childhood schizophrenia” which was what severe autism was sometimes called.
Footnote: The “emotionally disturbed” kids were usually in the foster care system, and most likely had what we now call Reactive Attachment Disorder. Most of the time, we didn’t know they were from that facility until they told us, and one thing I definitely remember was that no matter what their IQ was, they were always several grade levels behind where they were supposed to be in their schoolwork.
One reason for the upswing in the numbers of people with autism in the 1990s wasn’t children being diagnosed with it, for whatever reason-- genetics, vaccines, bad parenting, heavy metal poisoning, GMO foods, leaky guy syndrome, wouldn’t have mattered a whit which or whether some or any of those were true causes, because the “new” cases were adults who had been diagnosed with “childhood schizophrenia” in the 60s and 70s, and had their diagnoses revised to suddenly “become” autistic in the 90s, and contribute to the numbers. And some mentally retarded people were also either being revised, or given secondary diagnoses, many because they were misdiagnosed in the first place with a wink and a promise, for reasons I stated above.
So while the ranks of autism swelled with new cases because people were suddenly looking for it, the reason it exploded in the 90s wasn’t JUST that people who in previous generations wouldn’t have been diagnosed with anything.
After growing astronomically for a while, the number of cases if starting to plateau. I predict it may even shrink in the future, because every time a specific gene, or other etiology is discovered, that causes a very narrowly defined syndrome, like Rett’s syndrome, that gets removed from under the umbrella of autism, and becomes a separate diagnosis.
Updating this thread:
Sorry, wrong reference. Correct one is
When I was growing up, I was likely the youngest in my class as my birthday was 9 days before the cutoff date. But that meant that I was 6 months younger than the oldest because we had two classes per year. This was eventually abandoned, eight years after I finished HS. One problem with it was that kids coming from outside didn’t fit it in well with the system and also mid-year graduation didn’t articulate well with college. But I think it was much better for the kids.
Also we had a half hour recess in the morning and nearly everyone went home for lunch. All in all there were many advantages to the system. But it really wasn’t sustainable.
20 years ago my oldest son was “diagnosed” with ADD and medicated as were half the boys in his 2nd grade class. In fourth grade a parent recommended we see a vision expert for a different issue. That Dr solved his ADD by finding and through therapy fixing his vision issues. He had trouble reading and lost interest in class because of a lazy eye. Afterwards he became an unmedicated voracious reader and solid B student.
Once upon a time, it was not considered a black stain on one’s character to get held back a grade, especially if it happened very early. Getting held back in K, 1 or 2 was really no big deal, and it was how schools dealt with kids who were not ready for their age-grade. They didn’t need to give them a label like “hyperactive,” or even “Mild MR” if they couldn’t learn with their age mates, especially if they did fine after being held back once. A few kids even got held back twice. According to my father, you could be held back at his school three times, and then you were referred to the State School for the Mentally Retarded. There was no official limit to how many times you could be double-promoted, which was how schools dealt with kids at the other end of the bell curve. My father was double-promoted once (second grade). Now schools have gifted & talented programs, and avoid double-promotion like the plague.
I remember working in an elementary school in the 1990s, though, and by then, parents took personal affront to the suggestion that their kid be held back-- or even wait, and restart K again the next year. Parents would be LIVID. And on the other end, parents were always wanting their kids in the G&T program, and didn’t seem to get that it had a purpose. It wasn’t a club where you got in if you were cool.
I’m 60. You weren’t ALLOWED to be unfocused or uncontrollable when I was a kid. Throw a tantrum and your butt got warmer for the effort. Misbehave in school and you got it from the teacher and then your parents when you got home.
What helped was someone dedicated to the process and that was the stay-at-home mom. It was a full time job with skills handed down from generation to generation.
That’s gone.
My mother WAS a stay-at-home parent. I went to a Catholic school, and if I misbehaved, I may not have gotten spanked, but I was certainly disciplined. (And I got spanked plenty of times at home) It just made things worse.
Guess what? It didn’t work. Nor for three of my cousins. (ADHD is speculated to run in families) You don’t beat a neurological disorder out of someone.
It helped that back then, parents and teachers presented a united front. Now, when a kid gets in trouble for anything-- or not even in trouble, but someone simply suggests that maybe a kid needs a little extra help in something-- or hell, someone even suggests that the kid has a cold-- the parent takes it REALLY personally, and gets highly offended. I’m serious. I worked in a high school and elementary school in the 1990s, and I had a son in 2005, so I see what goes on in his schools, plus, I work in a preschool now. This was starting in the 1990s, and it has just gotten worse. It is so bad now that teachers keep obviously ill kids in school rather than confront parents.
When I was a kid, if my teacher told my parents anything, whether it be that I was struggling with something, and needed extra help, or that I had an attitude that needed adjusting, my parents acted as an extension of the school, not its adversary.
I had a mother with a career back in the 1970s, and I see kids today with a stay-at-home parent-- usually a mother, occasionally a father. It doesn’t make that much difference. Something in the parent-school relationship has changed.
School days are longer now, kids get fewer breaks, and they are pushed to master concepts at earlier ages than we were a couple of generations ago. We weren’t expected to be sounding words out until about 6.25 in the 1970s. Now kids are being expected to do it about 15 months earlier. That’s a huge chunk of time at that age.
It’s normal for 3-, 4- & 5-year-olds to spend 6 hrs in the classroom everyday, with a full 3 dedicated to instruction for the 4- & 5-year-olds. They get about 20 minutes of outdoor recess out of six hours, with maybe an indoor break of the same length. We would have had 15 to 20 minutes recess out of 2.5 hours in the 70s. Going home for lunch is no longer an option for grade schoolers, and a full hour in total of recess time is not normal anymore. It’s a 1/2 hour total, if that much. There’s homework for first and second graders now, too, and even kindergartners in some places. Junior high/middle/intermediate schoolers do not get recess at all (I got 1/2 hr. after lunch). High school starts earlier now, on average, than it used to, albeit, in just the last three years or so, and few school systems have pushed back high school after some studies have shown that adolescents sleep better in the morning than the evening.
No, you don’t beat a disorder out of someone, but you also can see one in someone who would not otherwise have exhibited one with undue demands and extra stress.
I’m sure there are people who would exhibit AD(H)D under any circumstances, even the least stressful and demanding, but I’m also sure there are tons of borderline cases who were asymtomatic in the 1970s, but who would have shown symptoms under the school loads that we subject small children to now.
I worry about it.
Until an objective, repeatable, reliable test is devised for such a subjective “disorder,” I feel free to ignore any such psychiatric “diagnosis.” Kids haven’t changed, society has.