The question stands. Why not throw drugs at the problem? an adult has admitted self control in the face of being frigidity.
My point stands. It’s possible to regulate such behavior on some level. Which draws the conclusion that prescribing brain altering drugs should be made with great care. Why there is any push back on this makes no sense.
In fact, your point falls flat on its face.
You personally can walk thirty miles to get to work every day, and thirty miles home again. Therefore that’s a good idea. My point stands. You should have to prove that you have no legs before you can get a driver’s licence or a car.
what? As in WTH? Are you drunk?
5% of children are estimated to have ADHD. 11% are being medicated. We’re medicating twice as many kids as necessary.
On top of that only 1 in 3 get the proper behavioral modification therapy that should go along with it.
It’s mind boggling that people are arguing against properly medicating children and want to argue against the idea of behavioral therapy.
Behavioral therapy is great. Behavioral therapy without medication is often useless and can be counterproductive. However, it does fool gullible parents and teachers into believing they have accomplished something/discharged their duty in the matter. And if your aim indeed is empty feel-good platitudes aimed at parents and teachers plus no results or negative results for the kid, I guess you have a point.
I should add that I had lots of behavioral therapy without medication. It sailed right over my head because I wasn’t capable of following along with what was happening, but the teachers felt like they were helping so it must have been a smashing success.
“OK, you have a serious attention disorder. Now pay attention while I show you how someone without an attention disorder would fix that.”
I have to agree that some of the diagnosis provided today may be driven by a want for special attention. My now adult son was diagnosed with an autism spectrum disorder by “the” doctor for this type of situation. During the course of this procedure, his mother and I were basically asked whether we wanted this diagnosis and, shazaam, he became autistic
My point is that I suspect that many of the children described as having ADHD are just rambunctious and hard to handle with parents who cannot or will not cope.
I think that in many cases diagnoses like that are given, because the only way to get treatment for somebody who is troubled is to label them with something that insurance, the school, etc. will treat. The real answer from the doctor might be, “it kind of looks like autism, but doesn’t have all the criteria.” That might not have been adequate to get your son any help.
The other side of it is that labels are things that have been made up by people. There is no rule that autism or ADHD has to actually map perfectly on to a single disorder. Genetic evidence suggest there might be multiple disorders which are all called schizophrenia. That is, brains can be broken in different ways and for different reasons, but all look like the thing we call schizophrenia. People like to put things in categories, but that doesn’t mean that everything is going to fit neatly into our categories.
This is all a long way around to say, I would be very surprised if many doctors are handing out ADHD diagnoses to otherwise completely healthy children. I would not be surprised if sometimes kids get diagnosed with ADHD because nothing else fits very well either, and that one seems like a good place to start. I also would not be surprised if sometimes kids get diagnosed with ADHD, but it turns out to be something else.
I think that may be truer for autism spectrum and mental health issues than it is for ADHD. If you have ADHD and you are medicated, amphetamines are a world of difference in terms of making your brain work. If you don’t - amphetamines don’t help - AT ALL. And since this is pretty darn consistent (although it can take a couple tries to get the medication right), medication is usually the first step - because as David has been saying, you can’t learn behaviors to pay attention if you can’t pay attention. And if things get worse on medication, well, you probably have disproved the diagnosis.
I’m not saying it never happens - I am absolutely sure that there are parent driven ADHD diagnosis in order to get the attention in school that every kid deserves, but we have “lack of funded” and “metric’d” out of existence, however, the treatment protocol for ADHD does involve schedule II drugs so probably shouldn’t be the first diagnosis for “we want this kid to get an IEP” by a doctor who actually is trying to help. I’d shoehorn in an anxiety diagnosis before I’d shoehorn in an ADHD one.
There are degrees of ADHD as well. It’s possible that someone who is mildly affected might be able to manage with coping skills learned in therapy (especially CBT with someone very experienced with pediatric ADHD cases); however, more severe cases cannot be managed without medication.
It’s also possible, due to the law of very large numbers, and the fact that Magiver may have gone to a small school in a small town where there wasn’t much movement in and out, and a lot of people were related (ADHD runs in families), that he really did not encounter anyone with a severe case during his childhood. It’s not just a mistake, though, but an actual logical fallacy, to generalize from a very small sample to essentially everyone (at least, “everyone” being the US, which is a pretty big place).
He also doesn’t seem to be able to settle on what he is arguing. I can’t figure out whether he is saying that AD(H)D is altogether a myth, a false label for bad behavior that results from improper parenting, or a real disorder that is being over-diagnosed. He claims to believe the last, but all his arguments seem to be directed at one of the other two. If he really believes the last, I actually also think there was a time when that was true-- that time was about 1995-2005. I don’t think it’s happening much anymore.
Personally, though, I think some of the kids who were misdiagnosed as having AD(H)D in the period 1995-2005 (when it was a fad diagnosis) were not completely normal kids whose parents were either looking to excuse the results of bad parenting, or looking to get them things like more time on tests. I think a lot of misdiagnosed kids from the period had other problems that simply were not recognized at the time. One was high-functioning autism. At that time, anyone who had not had a language delay could not get an autism diagnosis. Another was depression. At that time, the common wisdom was that depression simply did not show up in people before puberty. Now we know that this isn’t true. Kids as young as kindergarten can be diagnosed with depression. And interestingly, it often first presents with hostility. I can see how it would be very easy to mistake the hostility of depression in a child, particularly one with no precipitating event, for the push-back sometimes seen in ADHD-- and that’s especially true if it’s the common wisdom that depression does not exist in children.
So, the misdiagnosed children were never perfectly normal-- they had something going on-- it just wasn’t AD(H)D. But there was no better label available.
You are completely missing the point of the thread. If twice the number of children are getting medicated than are necessary then the solution STARTS with behavioral therapy BEFORE moving on to drugs. And IF drugs are needed then it should be done with behavior therapy and not in a vacuum. If drugs are over-prescribed and exclusively used that means dosage is the method of adjustment. We’re just not giving the child enough. Or we need to try some other drug which may of course be true but the operative word is “try”. “Try” can be a function of not giving up until the problem is solved or it can be a spin-the-wheel of pharmacology because a doctor is experimenting on a patient. In this case a patient is a child whose brain is still developing.
And your qualification for making that assertion? You are a psychologist perhaps? A behavioral therapist? An MD or psychiatrist? A neurologist who researches ADHD brains? An ADHD patient with experience? A parent with an ADHD child who has done the research before sticking their kid on amphetamines? Or are you making an assertion about the health of others and what protocols should be used out of your ass?
Common sense. Behavior modification provides a background to work with for all those you listed.
All drugs have side affects and on a good day you’re fixing one problem at the increase of others.
Yet again, you are ignoring the premise of thread. Twice as many children are being diagnosed than necessary. put it another way, they’re harming as many children as helping. This doesn’t appear to bother you at all and I’m not sure why.
New numbers show it’s 10%, actually.
Those aren’t new numbers. It’s the whole point of the thread. 5% is the expected number. Thus, over-diagnosed. And the rates of diagnosis vary wildly by location.
So? The rates of Tay-Sachs disease vary widely by location, because it’s almost exclusive to people of Ashkenazic backgrounds, and there are more of them in some locations than others. Sickle cell is extremely rare in Caucasians, so it probably varies widely by location as well. And some cancers vary by location because they are associated by exposure to things in certain areas. Measles outbreaks happen in places with low vaccine rates.
AD(H)D is known to run in families, so it may be more common in some ethnicities. It could be associated with prenatal exposure to all kinds of things, from pesticides to noise. It is associated with prematurity, and therefore could actually be more common in places with good neonatal care, where very premature babies are more likely to survive, and it could be more common around places where fertility clinics exist, and there are higher rates of high order multiples (more than twins), because they are almost always born pre-term.
Its association with prematurity, BTW, is one reason that there were probably in actual fact, fewer kids with it 50 years ago, when you were in elementary school, because a premature baby born 60 years ago had a much lower chance of surviving than one born 10 years ago. Not no kids, though, because prematurity isn’t the only cause. (And it’s worth mentioning, not every premature baby grows up to have it. There’s an association that is strong enough to suggest an etiology in some cases, but it isn’t a determination; it’s not like being born with two copies of the the Tay-Sachs gene.)
OK then. Kids are diagnosed correctly and any statistical deviations by year, location or other metric can be explained. Close the thread.
I will now sleep better at night knowing doctors never over-prescribe anything.
Diagnoses often change dramatically around adolescence.
For a while, parents getting TODDLERS diagnosed with “bipolar disorder” was all the range (well, OF COURSE they’re rapid-cycling bipolar; they’re toddlers!) but that disorder cannot be reliably diagnosed until puberty at the earliest, and more commonly adulthood.
Magiver, I’m curious – what’s your dog in this fight? Do you have school-aged children or grandchildren? What’s it to you if more kids are taking ADHD drugs than is statistically “necessary”?
People writing out of the Harvard Medical Schools should know better than to say something like “Experts estimate that 5% is a realistic upper limit of children with the disorder”[FONT=Trebuchet MS] without giving any citations. Who are these experts? I see this article which suggests an estimate of 7.2%. As is the case with these things, always, there is no magic book we can look in that says 5% of kids (or 7.2%) have ADHD, and it’s up to psychiatrists to find that 5%. One study can say one number, another a different, and neither one is right or wrong. They both saw what they saw, with the methods that they used.[/FONT]
[FONT=Trebuchet MS]Even if the population prevalence is 5% that doesn’t mean it is exactly 5% in every group and every location. Some groups and locations may have much higher or lower rates for any number of reasons from systemic bias in diagnosis to random chance.
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