The point about diabetes/high cholesterol brings up another thought of mine wrt ADD. Many of the new cases of type II diabetes are not directly caused by genes but instead by the kinds of food we consume in this society. Could it also be possible that ADD is not strictly genetic, but instead is “sparked” by exposure to our increasingly fast-paced society? To quote Thomas Szasz, perhaps ADD is a “problem with living” instead of a strictly gene/brain structure based disorder. And if that is the case, if it is not a problem with the individual but instead an incompatibility between certain types of brains and modern society, then that brings the issue of medication even more into the light. Because if we fail to alter our society in order to make it compatible with people on the ADD spectrum, then that means people with ADD will never get better (i.e. off medication), and more people who are on the “borderline” will eventually get diagnosed with ADD and the cycle will just keep on perpetuating itself. I think that when there is an epidemic out there, and I do think both diabetes and ADD are becoming epidemic, we should look at the possible environmental factors and try to figure out how environment plays into a disorder. After all, if thousands of people were dying from the flu, you wouldn’t look at flu victims and say “well, just pump them full of drugs and send them on their way.” You would seek to find the cause and contain it.
That’s not to say there can’t be physical causes of ADD in some cases. I just think that all too often we ignore the possible environmental factors. Why are we so eager to point the finger at the individual who is suffering, and so reluctant to hold the mirror up to our society and figure out why it is that so many people are suffering.
Understood- but don’t assume that just because switching schools got the child’s grades up means that they don’t have ADD.
My wife had so many problems with grad school that she had to take a year off rather than flunk out; she just recently took a battery of tests which have diagnosed her with mild dyslexia and ADD, and hopefully once she is on good medication and receives compensation from the school for her condition, she will actually be able to do grad-school level work.
However, she maintained a 3.8 GPA in college and graduated summa cum laude. And never had any particular problems there.
The difference is one of structure and focus- in college, she could rearrange her classes so that she could work on her own schedule, and not take too many classes at the same time which required rote memorization (which she has problems with, and takes a great deal of time to do). In grad school, she was forced onto a specific class track, and not allowed to arrange classes to best fit her studying needs.
Even if switching to a different school helped your friend’s son, your friends should investigate whether he has ADD or not. Because it might be a different school environment that is all he needs; or it might be that the new school environment allows him to compensate for the problems that ADD causes… and therefore will run right back into the same brick wall once he enters a school or work environment that doesn’t allow him to compensate in those same ways. In addition, he might be forming a very flawed opinion of himself based on what he thinks he can or can’t do because of ADD. My father- who has an IQ of 138- still thinks of himself as an idiot. Why? Because he has severe dyslexia, and therefore could read only at a very slow pace and with major retention and comprehension problems- and because there was no popular understanding of dyslexia back in the '50’s, my father was labelled by teachers as “stupid” or “lazy”. A definition he continues to apply to himself even though he now knows he is dyslexic.
In old fashioned classroom education where the whole class is taken through subject matter at the same speed, children who cannot keep up can get rowdy and frustrated, and difficult to control. But this goes almost double for children for whom the speed is far too slow and who get terribly bored. They can develop to become a real nuisance. Combined with some of the more hormonal fases in a childs development, I do believe these symptoms can be confused with ADD as may have been the case in the example you give above.
I remember what I was like before I was treated (end of first grade, beginning of second). It was a nightmare. I literally could not sit still, or concentrate. When we were standing up at the front of class, I would be pacing the floors, talking to myself. I was constantly in motion. I couldn’t concentrate on anything. It was horrid. I was miserable, my family was miserable, and my teachers were miserable. As for switching schools-I attended a private school, with small classes and strict discipline (it was a CATHOLIC school, for crying out loud!)
I was much happier when I started treatment (Ritalin AND counseling!). Even today, I can definitely tell the difference when I’m off my meds.
Excuse me, but I resent the FUCK out of it when people claim that meds “stifle one’s personality.” Bull-fucking-shit! If being obnoxious and not being able to get anything accomplished is a personality trait, then I’ll GLADLY “stifle” it.
A teacher did not make the suggestion that I had ADHD and off I went to get Ritalin. No, what happened initially was that Sr Frances Ramona (God rest her sainted soul!) called my father, concerned because I was misbehaving in class. My parents at first thought that I was merely acting out because my sister had just been born. Then my cousin was diagnosed with ADHD, and my mother asked my aunt for some of the information, which she took to our doctor, AND to a child psychologist. I went through an entire battery of tests and counseling sessions before being diagnosed. It started when I was in first grade, and I didn’t even start on medication until mid-way through my second grade year. My grades shot up, my behavior vastly improved, and I was much much happier!
Even today I still experience it, hell even here on the SDMB. Some people have noticed that sometimes I start posting willy-nilly on stupid stuff, annoying myself and others. Once I start noticing myself doing this, it’s time to step back and get focused. If it’s a part of my “personality”, it’s not a good one.
Are meds for ADHD and other disorders a “crutch”? Hell yes they are! Is that a bad thing? If you saw a man with one leg walking with a crutch, would you yank said crutch away from him and scream, “Walk on your own-it’s a crutch, man!!!” :rolleyes:
Just to support Hentor’s take on this: I have worked with not only several psychiatrists, but also three different clinical psychologists on the subject of ADHD, both personally and professionally. They all agreed that ADHD is best attacked with a two-pronged approach, best summed up by one of them as
1.) Structure, structure, structure, and
2.) take the damn meds.
The particular psychologist who offered that summary was one who was often frustrated by primary physicians who liked to throw meds at conditions best addressed by therapy. However, he and all the others I have worked with have all agreed that one prong of this approach just rarely works without the other: the meds alone won’t help, but all the imposed structure in the world won’t help much without the meds, either. My continuing review of the literature bears this out. (BTW, thanks to Kiminy for the cites on zinc and iron; I will review these.)
I understand your point, but to be honest, I am not “served” in this particular debate one way or another. All due respect to the various mental health professionals here (and various sufferers), but I do have knowledge and experience in this area. Any bluster you have seen is a result of being attacked from multiple directions at once. Good or bad, the response you see is pretty much a core part of MY personality.
I have tried to provide enough background so that people can tell that I did not just wander into this debate from the cornfield. I do not have the time, nor the desire, to try to list every book I have ever read or experience I have had in this area. There are people could be helped by what I know. And I have shared a great deal of information about myself and about the sources of my knowledge and opinions. I am NOT so strongly motivated to help anyone that I am willing to submit every statement I make to the kind of ridicule and animosity that I have faced so far. Think of me as the guy who says, “Hey, if you keep going that way, you’re going to walk off a cliff.” A bunch of people jump up and say, “You can’t prove that.” And I say, “Fine. Walk off the cliff.”
At one time, I almost decided to pursue a Ph.D. in psychology. I did not. I now have an MBA. My field is Supply Chain Management. In the more than 10 years since I witnessed the veritable miracles being achieved with both “troubled” kids and “normal” kids using the techniques of Direct Instruction, our schools and our approach to teaching children have changed in exactly the way I predicted at the time: In no way whatsoever, except drugs like Ritalin are getting more and more popular. It was clear to me then that between the bureaucrats, the teachers unions, and various versions of mystical-thinking psychiatrists that the brilliant work of these psychologists would continue to be treated like withcraft.
By dipping my toes into this thread, I have, if nothing else, reminded myself of the conditions that led me to decide that this was not the field for me. Even so, I will say again what I have said before: There exist behavior mod techniques and training methods that make it possible to help and teach ALL of these kids that are currently treated as “disordered” WITHOUT the need for all of this medication. Parents who uncompromisingly want the absolute best for their kids should seek them out. It is to them that my message is addressed. To everyone else, I say that you have my sympathy and I wish you the best of luck.
As far as I’m concerned, the mental health professionals who are posting here should be answering the question of how they have the time, given the absolutely deplorable state of mental health care in the modern world. I avoided the field because I knew I would burn myself to cinders trying to fix it. Those that have joined it and feel no duty to try to fix it, I don’t have any idea how to identify with.
In order to properly use behavioral techniques to address the issues being discussed here, you pretty much have to be dedicated to them. When we were working with that autistic child, we were focused on having him practice asking for things. We were dedicated to achieving repetitions of “I want a cracker” or “I want a cookie”. It took almost a week of modeling this before the child said it once. I spent weeks breaking crackers and cookies into tiny pieces. We said, “Tell me what you want” literally thousands of times. There was no major breakthrough or epiphany. There were small advances and then accellerating improvements. Gains made one day might appear to be lost the next. And for the record, in no way was this child cured of autism, but he made progress that I, and probably every psychologist/psychiatrist you personally know, would have never thought possible. In the course of one year, he went from completely noncommunicative to engaging in instances of spontaneous speech. He learned to ask for things before barrelling through every thing between him and the object of his desire. His tantrums got shorter and less frequent.
The techniques my wife and I used to eliminate Daughter1’s tantrums took months. If I had ever at any time given my wife the impression that “it might not work”, we would have been sunk. I am not talking about a simple change in discipline around the house or having a “special conversation” with a child. I am talking about an approach to training a child that requires discipline, dedication, consistency, and time. When I try to learn a song on the piano, I have to play it hundreds of times. When we taught my daughter a better way to get the things she wanted, it took hundreds of repetitions.
Note what I said: We did not “extinguish” a behavior. We taught her a better way.
My second daughter threw tantrums out of frustration. I decided that this was preferable than some other frustration behaviors that she might try (pulling out her own hair, biting herself, destroying things, hurting her sister, etc.). So, I taught her that, when she wanted to throw a fit, she should do it in her bedroom, and that she would get no reward or punishment of any kind. Every now and then, she still runs to her room to cry. Come to think of it, so do I.
As soon as you adopt the approach of, well, I’ll try this for a while, and if it doesn’t work, then I’ll consider medication, you have predetermined an outcome. While it may make sense for knowledgeable professionals to be working that way, it cannot be the attitude of actual parents doing the work, or they’ll never manage it.
Remember, I am talking specifically about the behaviors that are associated with ADHD. I am not suggesting that the same techniques can be used to cure profound brain disorders. I AM suggesting that if the child in question is capable of learning AT ALL, then the child is capable of learning to behave in ways that are a) less distressing for his parents and peers, and b) do not lead him to feel imcompetent or outcast. You cannot teach the blind to see, but you can teach a child how to “appear attentive”. You can teach them how to use the brain they have to its best without the need to try to change it chemically.
It is not the use of the label I have a problem with. However, if we start medicating “introverted” kids out of hand, then you WILL see me proclaiming that there is no such disorder.
If we label a TV as “on the wrong channel”, we can talk about how many TV’s are “on the wrong channel” and we can talk about which TV’s are “closer to the right channel”. I don’t have a problem with these labels either. But if we start acting as if TV’s that are “on the wrong channel” are defective and we start hitting them with hammers, I will be equally as dubious.
I can talk about improvements right now. I can also talk about better ways of dealing with ADHD. I have used them successfully wth my own children. You want proof, I am telling you that it is already out there. Key words “Oregon” and “direct instruction” should get you started.
I am NOT going to waste a lot of my time trying to convince you–or anyone else–that certain TV’s just need to be changed to a different channel. This work has already been done, and the fact that almost NONE of the mental health or education industries are aware of it is not evidence of a shortcoming on my part.
You are absolutely–and obviously–correct. Nonetheless, I stand by my statement, and here is why: When I was in school, a great many people tried to figure out ways to make me “behave” or “sit quietly” or “attend to the lesson”. No one spent ANY time trying to teach me to “make friends” or “not hurt people’s feelings” or “talk to girls without being completely and utterly terrified”.
Do you see the distinction I am making? The diagnostic criteria and treatments for “ADHD” are focused on behaviors that annoy others and on ways of making a child’s behavior more acceptable. They are NOT focused on teaching a child skills that he needs in order to be happy.
I say these things the way I do, not because of a shallow understanding of the difficulties of kids, but because of the shallow approaches being taken on their behalf.
The whole nature vs. nurture debate, believe it or not, still rages. Amazingly, there are still people who cannot recognize that damn near everything that makes a person who he/she is is a result of BOTH.
However, I have been trying to point out that, though clearly different children have different aptitudes, this does not mean that there is something wrong with them. I was not born with an aptitude for social interaction. This does not mean that I was incapable of it; it means that it was harder for me to learn. For instance, I still, to this day, do not really understand why people say “Hello” to each other in many of the circumstances where they do. I have learned that if someone says “hello” and I don’t both respond and act pleased/surprised to see them, they will get their feelings hurt. As strange as this may sound, this was very hard for me to learn. Not hard for me to learn in a “knowing” sense, but very hard for me to learn in a “this is important and don’t forget to do it every time” sense. I also do not really “get” how you know when to shake hands with a friend. Nevertheless, I have learned some general rules to go by and I have learned to react very quickly to some body movements that precede a handshake. Also, my friends have learned that I rarely touch them (pat on the back, etc.), and they have learned that it doesn’t mean anything wrt friendship.
Do you believe that I have a disorder? That I need medication to make up for my different aptitudes? I think it’s a trade-off. You could attend a class every day, take copious notes, read all the assignments, etc. On the night before the test, you could hand me the book and tell me which chapters are covered on the test, and I could probably do as well as you on it. Give me a few days, and I could probably do better (as long as it’s not math). If the test is multiple choice (and in English), I could probably pass it without seeing the book at all (I notice patterns in the questions, and I notice that some answers are given by subsequent questions). Does that mean that you have a disorder?
Some people are amazed by the speed at which I can acquire and understand information. I am amazed by the speed at which some people learn to play musical instruments or learn and “internalize” rules of social interaction.
Bless you, my friend.
Also, things like “paying attention”, “getting along with others”, etc. are learned behaviors, just like “reading”, “writing”, and “rithmatic”.
It’s funny how many people are comforted by structure. I had a teacher once who claimed that sociopaths make model prisoners (and enjoy prison) because prison provided the “structure” that they did not receive from their own consciences. I didn’t buy it, but I did think it was an interesting theory.
I have tried many times to explain to my wife that kids actually like having consistent rules and understanding what they are (as opposed to arbitrary, unevenly-enforced rules). It makes them feel competent. They know how to achieve what they want (or avoid what they don’t). When we’re talking about hard-to-manage kids, there are things that are expected of them that they don’t really know how to do. Certainly, structure can help with feelings of lack of control, but don’t you think that the more urgent need is to train them in behaviors that will better achieve the results they (and their parents) desire?
and I was waiting for the discussion to turn in this direction. Exactly so. But here the analogy may be best made with those biologic mechanisms that help us gain weight and encourage us to eat even in times of plenty. Very adaptive in ancient times (overeating now and storing fat might help you survive the next period of unavailable food) but clearly maladaptive in our modern society - over 30% of US adults are now obese, almost 5% extremely obese and almost two thirds are at least overweight - with significant health consequences. Likewise the processing style that gets labelled as ADD might have been more adaptive in past days, but dysfunctional for today’s world. Hey, if I’m living in a tribe I don’t want everyone so focused on grinding the grain that no one is distracted by the tribe coming over the horizon with spears drawn, or noticing the herd of animals off in the other direction. How much focused attention for prolonged times did paleolithic life really need, compared to say surviving a math class? There are sometimes advantages to the ADD cognitive style too. They are parallel processors - rather than focusing all of their resources on one cognitive stream at a time, they tend to be splitting resources in several directions at once, sometimes flitting between each being the main event because they are all getting some sizable spotlighting. Sometimes they see connections between the streams that others won’t see. But in today’s world we are expected to stay focused on one thing for much longer times than in ancient days while having many highly stimulating distractions around us constantly. There is less room in today’s world for the easily distractable high energy child to bounce around in. What was once functional has become dysfunctional.
So what to do? Carpet the world or wear slippers? Some of us have the resources to pay for private schools that provide so much one on one attention and structure that at least those with mild to moderate symptoms can do just fine. Some do not. Few can excercise the option to apprentice to a tradesman early on anymore (which I am sure some did in years past). Just bemoan that the world has changed or perform the pharmocologic equivilant of wearing glasses?
I do believe that we pediatricians and mental health professionals are a bit apt to overlabel though (even though I have no data to prove it.) There is a simple explanation. We went into our business to help people. Convince me that I have a tool that can help people with condition X and I will look for people with condition X to help. If condition X gradually blends into normal, then I’ll identify many more people with condition X knowing that I have something to offer than if I did not. The same has occured with autism and the related spectrum of autism spectrum disorders. I now believe that early identification can make a difference and identification gets services; guess what? I’ll find kids who fit that label now than I did a decade or so ago. Sure the same kids wouldn’t have been labelled as autistic back then but the label is still not incorrect. I’m just not as rigid in defining symptom severity needed for the diagnosis than I once was. This is not a conscious choice; it is just human nature when you want to help.
Frankly, my dear, I don’t give a damn. We’ve had a couple of posters here say quite definitively that medication for ADD, even if you claim it was done ‘to help their parents’ or for whatever other motivations you find unacceptable, was entirely necessary for them and helped them a great deal. I find this runs contrary to your complaints that parents are medicating their children selfishly and only to help themselves.
You have evidence for this? You made an assertion, back it up.
I’m honestly unclear what you are saying here. Are saying that DoctorJ and others only have the time to post here because they are either incompetent and misguided or because they heartless and don’t care how messed up the field is? Or, have I misread this paragraph entirely?
To paraphrase ‘Here’s another paragrpah about an experience I’ve had that is irrelevant to the subject of this thread.’
So the alternative to I’ll try this to a while, and if it doesn’t work, I’ll consider medication is what? I refuse to consider medication, regardless of whether this works or not?
And unless that kid can actually pay attention, and think, “appearing attentive” ain’t worth shit.
Do you have any evidence whatsoever that ritalin etc are harmful enough that comparing them to bashing a TV with a hammer isn’t ludicrous?
It’s your argument. Bring your own cites and links. It’s not our job to search for your evidence.
Huh, I got plenty of help with those things.
To paraphrase ‘Here’s some tangenitally related information. By the way, I’m really smart.’
To paraphrase ‘I’m really smart. But musically inept.’
I think the urgent need is to teach people that the two-pronged approach described by DoctorJ is far and away the best one.
Smartass, I am not sure what your understanding of ADHD is, but it is very much not autism nor tantrum behavior. The type of intervention that you allude to, as far as I can tell, in the treatment of the child you experienced during your two-semester seminar is very much alive and well and being used appropriately for children with autism. Ritalin is not being used in the treatment of autism.
The behavioral responses you describe for your children’s tantrums are fine. Tantrums are not symptoms of ADHD. Anyone recommending Ritalin for the treatment of tantrums is simply out of their depth.
But you are not. In that post, you discussed autism and tantrums, not ADHD.
Finally, perhaps I have the time to post here that I do because when I post, I do so concisely, rather than writing a thesis each time.
I can’t speak for other parents or people that have ADD and the like here, but my 6-year-old began displaying his Attention Deficit when he was three or so. I’m quite sure it’s not environmental. And maybe there are other ways to help him, however, I’ve worked with him alot on it, and so have other people, and it doesn’t seem to be something that you can correct using standard behavioral methods. Maybe I could scream at him, or beat him, and then he’d get his tasks done faster out of fear, but I’d rather not.
For those who don’t know what it’s like, here’s a sample of a typical morning:
Me: Nathan, it’s time to get dressed. Here are your clothes, put your socks on first.
10 minutes later. Me: Nathan? Are you getting dressed? Come on, we have to get going.
10 minutes later. Me: Nathan! Get dressed! Come on!
10 minutes later. Me: Nathan LastName!! Come oooon!!! We have to go! What are you doing?? You must get dressed right now!
On and on until we’re both pissed off, and I end up dressing him myself. Which is not ideal for either his self-help abilities or his self-esteem. Multiply that by eating meals, doing homework, getting in the car, etc… maybe you can begin to understand how much of a struggle it can be. His teachers and babysitters report the same problems. What would you anti-medders have me do? Neglect my other children, myself, and the chores in my home in order to “help” him with every little thing that most kids his age can do by themselves? No… that’s what I’ve been doing, and noone is benefiting from that. He knows he has this problem, and he doesn’t feel good about himself because of it. I’ll not just stand by and allow him to grow up like this.
Better living through chemistry, I always say.
Just to be clear, I understand that this forum is devoted to the kind of bickering that you want to do in this case. However, I don’t have the time for it. The only reason I have gone this far is for the benefit of those who might read this and be helped by knowing that there are other approaches out there and with some ideas about how to find them. That said, I did a cursory search on the web to try to find a few links for you guys to pore over.
When I talk about “Direct Instruction”, I am talking about a “school” of psychology focused on teaching techniques. These are practical-minded folks, and much of what you will find browsing around is about teaching reading to both “normal” and “challenged” kids.
One thing that was drilled into me is that, rather than finding ways to label kids as deficient, we should focus on better ways of teaching them all. If your teaching methods do not leave any kids behind, a lot of the “disabilities” become meaningless.
Hopefully, this is enough to get you started on realizing that when I talk about “Direct Instruction”, I am not talking about a hallucination I once had. This link will take you to a Word doc of a research paper. I did not read it. I am providing it solely for this quote:
Paul Weisberg was the professor who tried to talk me into the Psy Masters program. Hopefully, this will convince you that I did not hallucinate him, either. Wonderful man. Brilliant man. It was under his guidance that I spent 5 months working with a profoundly autistic boy. His lectures on imaginary “disorders” like dyslexia and ADD were both hilarious and enlightening. At the time when I knew Dr. Weisberg, he was battling ignorance in ways that would humble Cecil himself. And he was losing (I see that educators are still babbling about “whole language” and inappropriate animal sensory deprivation studies).
And the fundamental tenet that he taught me remains as true, to me, now as it was then: When a child is not learning and behaving in the way he needs to, you can spend all the time you want analyzing his "deficiency"or defining his “disorder”, but if you truly want to help the child, you will be more interested in working on ways to teach him the skills that he needs to know.
I have had a little more difficulty finding links where Direct Instruction folks talk specifically about dealing with hard-to-manage or “disadvantaged” kids. I guess you’ll just have to take my word for it when I tell you that the same approaches to teaching kids to read also work in teaching them how to “behave”.
Direct Instruction is not some sort of radical idea. It is a logical result of behavioral research, and the tenets of behaviorism remain as valid as they have ever been. For those who don’t know, behaviorism is the “school” of psychology that is most rigorous about using the scientific method and not theorizing about internal mental “processes” that cannot be examined or proven. Its founding father, B.F. Skinner was rigorous almost to a fault.
When my wife and I embarked on dealing with Daughter1’s tantrums, I spent an evening at Books-A-Million looking for books that she would find helpful. There is a lot of good and bad to be found. For those looking for help, I highly recommend 1-2-3 Magic: Effective Discipline for Children 2-12 by Thomas W. Phelan Ph.D. I have read it front to back (only takes a few hours) and I agree with almost every word.
In dealing with hard-to-manage children, the same behavioral techniques work, but they require more rigor, dedication, and time. Keeping with the theme of Direct Instruction, I personally believe that it is important to think less about controlling behavior and more about teaching a child skills that he or she needs.
I’ll answer your question with a few of my own. I finished my Bachelor’s Degree in the spring of 1990. While approaches like Direct Instruction may be cutting edge, they ain’t knew. How is it that none of the professionals posting here have not given any indication that they have any idea what the hell I’m talking about? Why is it that, rather than embarking on an immediate search to find out what I am referring to, they have instead launched into attacks on my statements? How much of the debate here has been about my ideas and how much about attacking my character and/or credibility?
Science consists of a lot of wandering down incorrect paths. Young sciences, like our current behavioral/cognitive sciences, consist of even more of it. I maintain that a lot of the discussion about cognitive and behavioral “disorders” amounts to peforming extensive experiments on fire and doing a lot of impressive theorizing about the properties of phlogiston. If we know so much about mental “processes” like concentration and focus, why is it that we have such difficulty defining them, demonstrating their presence, and measuring them?
The behaviorists in general, and the researchers on Direct Instruction in particular, are working very hard to shine a light into a very dark area of science. They are performing outstanding research and they DO have evidence that they know what the fuck they are talking about. Regardless of how good their intentions may be, these hordes of professionals who are honing their ability to diagnose and medicate nebulous “disorders”, are not helping in this effort.
If the ONLY sort of information that you are able to appreciate is reporting of studies, you should find plenty by starting with the links above. If you are paying close attention, you might also see some good examples of being very careful not to draw conclusions that are not warranted by the evidence.
A schizophrenic cannot distinguish between reality and imagination because of profound brain dysfunction. Using all of the techniques available to us, we are not able to teach them how to do this. A child who can read a book from cover to cover, watch an entire cartoon, or play with a toy for extended period, is able to focus his attention and maintain it. If the same child is having difficulty learning math or science, claiming an “attention deficit” is absurd. If a child is able to consistently walk to a door and reach to the correct side of it in order to grasp the knob, then he is able to distinguish “left” from “right”. If the same child has a tendency to write the letter “e” backwards, claiming that he is “dyslexic” and cannot tell left from right is equally absurd.
It is not unusual for children and adults to fail to attend to things that are not interesting to them. It is not unusual for children to ignore instructions that they are given. However, to claim that a child is not doing something because he is incapable of doing it is big fucking claim–and it is astonishing in face of instances where the child may be observed doing the exact thing that they are supposedly unable to do.
The “disorders” that are called “attention deficit disorder” and “dyslexia” are riddled with instances of these kinds of claims. However, if this is not obvious by observation, I cannot think of any way to “prove” it.
Changing the chemical environment of the brain can actually change the personality of the person (ever hung out with a long-term alcoholic?). This tendency to describe a child’s traits as “disorders” is a way of making it sound reasonable to use drugs to change the personality of the child–these changes of traits can then be presented as “treatment” or a “cure”. Whether or not this does lasting harm, I am not a proponent of it.
On the other hand, if an adult chooses to modify his brain chemically, for fun or personal satisfaction or whatever, I don’t think of it as any of my, or anyone else’s, business.
When a child may be observed to do something in one instance but not in another, to claim that he is incapable of it “ain’t worth shit”, either.
No. But I have already explained why it is a risk I will not take with my own children, at least not for “disorders” that I have seen to be addressable WITHOUT resorting to these drugs. Ultimately, it is a decision that will have to be made by individual parents. Whether they reach that place through failure to properly implement other approaches or through the failure of those approaches to work in an acceptable timeframe, I would advocate that they resist it as much as they feel able to. More than that, I would never ask. And, as I have said before, for those who DO choose to avail themselves of these drugs, I sincerely hope that they are not doing significant harm.
I have already conceded that there may be cases out there where these drugs are the only viable solution. But it seems obvious to me that there are a staggering number of cases where these drugs are being used where other solutions would be preferable.
I have provided at least a start. For myself, it is less important to convince you or any other person than it is to let any parents in the “audience” know that there are other possibilities and that they are worth exploring.
I am glad for you. I, on the other hand, did not.
This is the way I communicate. I’m glad that it amuses you. Maybe you’ll decide to share some personal details and we can make fun of you, too.
I suppose that would depend on what you are trying to achieve, now wouldn’t it?
I think that about covers it for me for tonight. I DO want to see some of this football game.
I want to try to address a few issues that have come up in a “lump” fashion:
Our 10yo with hyperactive/impulsive ADHD chooses medication. He prefers to have some amount of control over his choices of behavior, and Concerta gives him that control. That said, Concerta doesn’t seem to take away any of the creativeness and imagination that he has. Without the meds, he spends his days throwing fits and/or breaking toys because they won’t do what they want him to do. With meds, he has enough self-control that he can build amazing paper airplanes, or Lego models, or Hotwheels tracks. Just to put a different spin on things, if Mozart did have ADHD, one can only wonder at what marvelous music he might have been able to produce if he had been able to focus his attention more easily. If Einstein had ADHD, he might have actually been able to solve all of the problems of relativity, rather than just hinting at the solutions.
At our son’s age, and with his temperment, it is literally impossible for us to force him to take any kind of medicine. There have been a few days when he has refused to take his medicine, and HE has suffered the consequences. On days when he hesitates to take his medicine, it’s usually enough to remind him of those days on which he chose not to take his medicine. No, he’s not aware of the remotely possible long-term effects, but he is aware of the fact that it helps him get through the day without getting put in detention, without breaking any toys, and with all the enjoyment that a 10yo boy should get out of life.
Our son also does not appear to have a heriditary form of ADHD, since there is literally no one else in the immediate or extended family who has anything similar to ADHD. However, he has other symptoms of in utero brain damage from unknown causes (sensorineural hearing impairment, and low muscle tone), so there is strong evidence that his version of ADHD is due to brain damage, rather than genetics.
This was our “bible” for our first child, and I have to admit that she turned out very well, at least up to the current age of 13. She had enough self-control to realize that there were very real consequences if we actually reached the magic number of 3, and it was incredibly easy not to lose our temper with her even when we did get to 3. I highly recommend the book as a first step toward avoiding medication with a hard-to-control child.
However, for our second child, he was much more tempted to find out exactly what would happen if we reached “3”, even though the consequences were ALWAYS exacted, and NEVER good. He’s 10yo now, and we’ve been using 1-2-3 Magic for nearly eight years, but he STILL doesn’t understand that his behavior needs to get back in line before the count of 3. In fact, he interprets our counting as permission to continue the unwanted behavior until we actually reach 3. In other words, even with consistent and regular application for eight years, 1-2-3 Magic has had little to no effect on our son’s behavior.
This argument might be compelling if it carried itself through to the end. However, our son is NOT capable of watching an entire TV show (even a 15 minute cartoon), or play with a single toy for more than about ten minutes without medication. In fact, he pretty much DOESN’T watch TV at all, since he can’t focus on it, and he has never read more than about five pages in a row even for books that he claims he enjoys reading. If he plays with Legos without medication, he ends up with a five-piece construct and little Lego pieces scattered throughout the house. With medication, he builds cars and airplanes and the pieces generally tend to stay in one room.
Jumping to another “disorder” here, I DO have dyslexia. I’ll grant that it appears to be a mild form, but no one told me that I had it until I was well into adulthood, and my mother only told me then because I was complaining about how hard it still was to write letters legibly and correctly. To this day, if I see a “d” or “b” out of context, I have to really thing about which letter I am looking at. That said, I have absolutely no problems looking at a door and making a logical decision about which hand is the more logical hand to use to open the door, and finding the dooknob on the first try. Dyslexia is NOT the same as confusing Left and Right–it has to do with how the brain interprets images that the eye picks up.
My mother was an alcoholic for many years, so I think she would qualify as a “long-term alcoholic.” She really was not a pleasant person to be around during those days. However, once she started taking Prozac, her need to drink to calm her anxiety and depression pretty much went away, and now she seems to be as “normal” as most other people I know. She used alcohol as a way of using chemicals to make her life more bearable (and she did have several suicide attempts in those days, usually when she was sober), and Prozac has given her life back to her. It’s not a cure, but it’s the closest that medical science can give her for now.
ADHD meds are NOT a cure, and if there is anyone out there who believes otherwise, they are fools. However, they do make the condition livable, both for the patient and for those around them.
If your children are happy, healthy, and successful, then there is no reason to even consider doing anything beyond what you are already doing. However, in talking with other parents of kids with ADHD, I have yet to meet a single parent who used meds as their first resort. Most of us went through years of trying behavioral modification, diet modification, etc. before we went to the extreme of using meds. As easy as it might seem, meds are expensive AND hard to give to children who don’t want to take them.
This is similar to a situation that my wife has had trying to get Daughter1 to clean her room. If you change the dialog to be about cleaning a room, I have heard it in my house many times. Remember, that I said that the techniques involved are not always intuitive. Also, there seems to be a parenting “reflex” that leads us to give the same instructions repeatedly and wonder what is wrong with the child that is not following them. Lastly, tackling tasks that involve multiple steps can be intimidating for children. I have watched my child gaze at the pile of toys and clothes that is her room in the same way that I have stared at complicated math problems. Determining “where to start” is a skill; believing that a task is doable may take experience and practice.
A few suggestions, on the off-chance that you are interested:
For new tasks, help the child break it into steps. “ChildName, put on your socks, then put on your shoes.” Make sure that the child has enough practice at the task that he knows what steps need to be performed.
If the child can read a kitchen timer, get one. If not, look for some sort of hourglass, like an egg timer. “ChildName, if you have your socks and shoes on before the time runs out, you will get x reward.” WATCH THE CHILD PERFORM THE TASK. If the child get sidetracked, remind him/her of the time remaining.
For some children, this sort of thing can work like magic. For others, it can take a lot of repetitions. If no progress is being made, look for ways to make the tasks smaller or to require fewer of them at one go. As proficiency increases, increase the complexity and/or number of tasks or reduce the time.
This means that, at least initially, getting the child dressed will require a certain amount of pre-planning. It also means that you may have to set aside time for these activities with the knowledge that you won’t be getting anything else done concurrently. Sorry about that.
Admittedly, giving a pill is a whole lot easier. For every child, there will be some things that are a whole lot harder to train than others. If you set out to teach me to play the piano, it will probably take a lot of time and effort. The less you tend to think of a child as having something wrong with him, the less likely he is to believe it.
Focusing on unpleasant tasks is onerous for children and adults. Most “normal” people are well into adulthood before they can sustain concentration on “work” for hours at a time. If you were to read one of the self-help books offered to students, you would learn some interesting results from research in the area: For almost all students engaged in study sessions of various lengths, they later recall only the first few minutes and the last few minutes. Normal students are encouraged to study in short bursts and take frequent breaks. Even the ones who without an “attention deficit”. I have known many “normal” college students who found that taking ritalin before studying for an exam made it easier for them to cram for longer periods and they felt they retained more. I have also known athletes who took steroids to make their workouts more productive.
Focusing on tasks is difficult for everyone. For some people, it is really difficult. This does not mean that they are dysfunctional, and the fact that a task is challenging does not mean that the person attempting it has a deficit. We are all differently abled to do different tasks. You can be committed to teaching the child, even if it turns out o be a lot of work, or you can medicate the child. For the most part, it is up to the parents to decide.
And for those who think I am nuts and want the medication for their children, I can guarantee you that it won’t take much of a doctor search to find one who will write the prescription. If, on the other hand, you have chronic pain that you would like to treat, you may be in trouble.
For anyone who likes the technique I described with the timer, it is discussed in more detail in the book I recommended in my previous post. But hey, Dr. Phelan may be as much of nutjob as I am.
So, clearly, if a person is able to occasionally laugh and enjoy life, it is absurd to say he has “depression”, even if these moments of clarity are brief periods in between weeks of suicidality and misery.
You have hit upon what I consider to be the misnomer of the condition. Yes, I can occasionally pay attention to something for a long time. Other times I am totally incapable of sustaining attention for more than a few minutes, even on something in which I am interested. I just don’t have any control over when these things happen. That’s why I think a better name would be attention control deficit disorder. Telling me that I have to pay attention to this lecture for the next hour is like telling a depressed person that he has to be happy for the next week, and just as the fact that a person occasionally has a happy week doesn’t mean he isn’t clinically depressed, the fact that I occasionally watch an entire movie doesn’t mean that I don’t have problems sustaining attention.
This is a common and understandable misunderstanding about ADHD, but not one I would expect from someone with as much to say about it as you have.
If you are indeed including me in that snide little passage: I am not a mental health professional, but a primary care physician, and I put in a very long day at it today. In fact, I spent a whole lot of that day dealing with mental health problems, primarily depression, because our local mental health system is so deplorable. So I’m not interested in a lecture about what I should be doing.
Again, Smartass, you said your daughter has AUTISM. NOT ADHD!
THEY ARE NOT THE SAME THING!!!
Those of us who suffer from ADHD also tend to hyper-focus, to the point where we concentrate soully on one miniscule detail, sometimes so completely that we lose track of everything else, and never get anything done. So basically, you can’t pay attention properly-it’s either jumping all over the place, or concentrating on the little speck on the wall.