Monday, December 30, 2013

Whew.

I think the children have been out of school for so long that they've reverted to their natural state, which can best be described as "gleefully off-the-wall." They're bouncing about. They're chasing each other around the house. They're crawling on all fours and pretending to be the hero doggie characters from "Paw Patrol." (Actually that's just kiddette.) They got everything they wanted for Christmas, they got days and days with Grandma, they've eaten Christmas log and apple pie and chocolate and candy canes and ice cream. They had a playdate at the museum and a playdate at their friends' house. Right now they think life is fabulous. Oh, the culture shock when they go back to school. Homework! Healthy food!

Fortunately we've managed to convince them to nap nearly every day, just so we can breathe. What I mean of course is that kiddo naps every day. Kiddette pretends to nap for about five seconds and then grabs a bunch of books from her bedside table and pretends to read, because technically speaking, she can't yet. I'd get annoyed, but I've been reading in bed for just about my whole life -- my parents even installed a wall lamp and a mini-bookcase on the wall next to my upper bunk bed so that I could have easy book access. I figure kiddette is just proving we're genetically linked.

I hope kiddo doesn't look for naptime after he's back at school. I don't think first grade offers a naptime period. Though I've been long convinced that everyone would benefit from a naptime period. Especially me, at about 2 p.m.

So far we have had no issues with his "bomb gun." Which may be because when he asked Santa about it in NY, in his little holiday hut, Santa also told him not to point it at people. He was quite the perceptive Santa. And then he went and made a Jersey joke. We told him where we were from, and he said, "Santa says, what exit?"

Ho ho ho, Santa. You're a card. Hey, you know what Jersey has that the North Pole doesn't have? Summer.

Kiddette loves her purple cat and I can't wait to see what sort of purple animal she dreams up next year. Maybe she'd like a purple giraffe or a lemur. I suspect at some point I'm going to just start bringing generic stuffed animals to my dry cleaning and alterations guy and saying, "Please, make it purple!" He could do that, right? 

Anyway, next weekend I imagine we'll begin the impossible task of packing up all the holiday things and putting them away, and maybe in the process we'll figure out which box has the holiday books, so that next year we can read the kids "The Latke Who Wouldn't Stop Screaming" as well as "The Grinch Who Stole Christmas." Also, maybe next year I'll remember we own an Advent calendar, sometime before Dec. 15.

As for this year, it seems to be ending on a pleasant note, even if the house does look like several small tornadoes have blown through and dropped toys everywhere, which they have. The price of having fun, I guess.

Sunday, December 22, 2013

My continued annoyance

I'm still irked at the last Times story. (I know, C. I know.) Just once I'd like a major news outlet to report some aspect of ADHD other than, it's overdiagnosed and kids are drugged-out zombies. It amazes me that the Times is only capable of finding 1. now-grown kids who say they were wrongly diagnosed or 2. parents of now-grown kids who say they were wrongly diagnosed, as opposed to, say, someone who was correctly diagnosed, benefited from the diagnosis and even benefited from the medication. But that wouldn't fit the reporter's predetermined narrative, I think.

I would also like to think that the whole process of diagnosing and treating kids has changed in the last 20-30 years or so -- being that there's more potential for physical evidence of it (hence the federal approval of this brain wave test), and more awareness of the disorder generally (in that no one is calling it minimal brain dysfunction anymore). So why the Times is insisting on solely reporting about cases 20-30 years ago is beyond me. Kids and adults are dealing with it now. Maybe the Times would like to pay attention to that? Or is that too much of a ... distraction?

I love my son, but I don't always love the cascading series of meltdowns over being asked to get dressed, brush his teeth, put his shoes on, put his coat on, get his backpack, walk in the direction of the door, every day, when the idea of doing any sort of routine thing ever clearly hurts his brain so much he'd rather hide under the couch cushions. I could probably do without his being the only kid in the entire restaurant to wear his cloth napkin on his head. (OK, admittedly a little funny.) And I'd kind of like it if he could get through one lunch period at school without getting too overstimulated and goofy, and getting in other kids' faces and roughhousing too much, because a crowded, noisy, unstructured cafeteria is going to ping his hyperactivity/sensory issues/social skills issues. And yet kiddo's story isn't anywhere to be found in the Times, and I think if the Times is going to continue to rant about ADHD that they should make sure to tell all the stories.

Incidentally, since I was mainly doing a little flamethrowing last week (admittedly something I enjoy), here are two other responses to the Times article that are better than mine: One from ADDitude magazine and the other from the Child Mind Institute.

And now I swear to quit snarking on the Times until after Christmas. That's only three days, you say. It still counts, I say.

Kiddo has been pretty consistently demanding a "bomb gun," i.e. a gun that shoots some sort of harmless ball things, which he's wanted ever since seeing one at a friend's house on a play date. So, serves me right for giving him a social life. I'm not wild about toy guns. I don't feel like guns should be used for play. And if you think I'm overthinking it ... well, you must not watch the news much.

But. being still new to this Santa business, I felt I was in a conundrum. Does Santa ever say no? Does he ever not bring a kid the specific thing the kid asked for, on moral grounds? And if kiddette gets the thing she asked for (a purple cat, in case you were wondering, and I'm not sure why she thinks the entire world should come in purple, but at least it's not pink), how is kiddo supposed to feel if he doesn't?

I finally told him that Santa and I talked about it, and that if Santa were to bring him one, he would have to promise never to point it at any person, ever, or he would lose it. I don't know if that's the right solution. I do know I'm holding him to that promise.  And I hope that that's good enough.

Man this Santa thing is complicated. It's like another layer of bureaucracy to think about.

At any rate, Merry Everything, and may your holidays be lovely and may you continue to be full of wonder at the world around you, like kiddette, who today discovered that she really, really likes carrot cake.

Tuesday, December 17, 2013

The Times reports

that the overbearing direct marketing of ADHD medications to neurotic parents and clueless doctors is the reason for the jump in ADHD diagnoses over the past 20 years. The Times also seems to think that ADHD drugmakers are the only ones guilty of such a thing, and no other drugs for any other malady, disorder or issue have ever been over-aggressively marketed to the public. Also, the Times thinks that the only parents or kids worth asking about the subject are the ones who disagreed with the diagnosis and hated the drugs in the first place.

But really, the Times says, it's a real disorder. Really, we believe that, we swear. Sort of.

The article I'm talking about is of course this one, from Sunday. I quote:


Few dispute that classic A.D.H.D., historically estimated to affect 5 percent of children, is a legitimate disability that impedes success at school, work and personal life. Medication often assuages the severe impulsiveness and inability to concentrate, allowing a person’s underlying drive and intelligence to emerge. 

But even some of the field’s longtime advocates say the zeal to find and treat every A.D.H.D. child has led to too many people with scant symptoms receiving the diagnosis and medication. The disorder is now the second most frequent long-term diagnosis made in children, narrowly trailing asthma, according to a New York Times analysis of C.D.C. data. 

Behind that growth has been drug company marketing that has stretched the image of classic A.D.H.D. to include relatively normal behavior like carelessness and impatience, and has often overstated the pills’ benefits. Advertising on television and in popular magazines like People and Good Housekeeping has cast common childhood forgetfulness and poor grades as grounds for medication that, among other benefits, can result in “schoolwork that matches his intelligence” and ease family tension. 


I can't really speak to the advertising, because I tend to ignore advertisements, except when I'm mocking them out of sheer exasperation (I'm looking at you, giant-bow-wearing Lexus one-percenter car ads). I didn't seek treatment for my kid because an ad told me he would get better grades. I sought treatment because it was the only way he was ever going to function in a group setting. Or possibly in any setting.
It's entirely possible ADHD is overdiagnosed. I guess it's possible some people would rather get their medical info from a magazine ad than from a doctor. It's also possible that certain doctors are diagnosing without the proper medical experience or knowledge and are using the medications as the first treatment option, not the last resort. Just saying. 

Believe me, I am in no way defending the drug companies and their massive marketing budgets. I don't much like that either. I also don't like all the other medication ads I see on a regular basis, in magazines or on TV. Judging from the ads during football games, football fans all have erectile dysfunction; judging from the ads in the magazines I read, all women interested in entertainment news are severely depressed. Also, all watchers of WE tv and Lifetime have weight issues, and all watchers of, well, anything have insomnia. 

I would be perfectly in favor of all drug ads going away; for one thing, they're insulting. For another, they're inaccurate. Of course they're inaccurate. They're selling something. Even cereal ads make misleading or false claims to make the sale. Medication, naturally, being of greater concern than Frosted Mini Wheats.

The Times again:

 
Companies even try to speak to youngsters directly. Shire — the longtime market leader, with several A.D.H.D. medications including Adderall — recently subsidized 50,000 copies of a comic book that tries to demystify the disorder and uses superheroes to tell children, “Medicines may make it easier to pay attention and control your behavior!”

Profits for the A.D.H.D. drug industry have soared. Sales of stimulant medication in 2012 were nearly $9 billion, more than five times the $1.7 billion a decade before, according to the data company IMS Health. 


Yeah, I've got a bunch of books that try to "demystify the disorder." "Shelley the Hyperactive Turtle." "Cory Stories." "Eddie Enough." Pretty good books. In all of them, the main character, at some point, begins taking medication. I don't love that, if only because people can and do manage without it. But all the kids I know with ADHD take something or other, because they needed to, or because their parents tried every other option first and decided this had to be the next step. Like us. So honestly, if that's in the books, so be it. Those books don't appear to have been subsidized by any drug companies, dear Times -- is that all right by you?
Believe me, if a kid has ADHD, they know they're different. They know they have trouble with things their friends can do with no problem. If the best way to explain to that kid what's going on is to use a book, or a comic book, is that really so objectionable?


When federal guidelines were loosened in the late 1990s to allow the marketing of controlled substances like stimulants directly to the public, pharmaceutical companies began targeting perhaps the most impressionable consumers of all: parents, specifically mothers.


Says you.



A.D.H.D. patient advocates often say that many parents resist having their child evaluated because of the stigma of mental illness and the perceived risks of medication. To combat this, groups have published lists of “Famous People With A.D.H.D.” to reassure parents of the good company their children could join with a diagnosis. One, in circulation since the mid-1990s and now posted on the psychcentral.com information portal beside two ads for Strattera, includes Thomas Edison, Abraham Lincoln, Galileo and Socrates.

The idea of unleashing children’s potential is attractive to teachers and school administrators, who can be lured by A.D.H.D. drugs’ ability to subdue some of their most rambunctious and underachieving students. Some have provided parents with pamphlets to explain the disorder and the promise of stimulants. 


(OK, seriously, Psychcentral, you can't diagnose someone a century or two after they're dead. You couldn't just go with Michael Phelps or Ty Pennington or Jeff Kinney? People who are still living?)

Also, teachers and school administrators should not be advising medication, because that is out of their area of expertise, and they could be courting legal trouble. It just figures the only parents the Times could find to talk to for this article are parents whose school officials acted inappropriately.



Insurance plans, increasingly reluctant to pay for specialists like psychiatrists, are leaving many A.D.H.D. evaluations to primary-care physicians with little to no training in the disorder. If those doctors choose to learn about the diagnostic process, they can turn to web-based continuing-education courses, programs often subsidized by drug companies. 


Soooo, maybe the answer is that insurance plans should provide coverage for psychiatrist visits? Oh wait, that doesn't come up again, because the point of the article is to rail against the drug companies. 

Look, I'm not necessarily saying the article is bad. It's just, if the only time you're going to write about ADHD is because college kids are abusing the drugs and dying, or because the drug companies have played hardball in selling their products, you're still implying the disorder isn't real. Especially if you don't talk to a single parent of an ADHDer, or adult ADHDer, who has good things to say about medication.

I'm all for enforcing truth in advertising, but can't we also have some actual truth?

Monday, December 9, 2013

... and then a yellow belt

Things did not start out well on Sunday. In fact things had not started out well for several days. Kiddo has gotten increasingly bouncy and has had some issues at or after lunch -- though frankly I think being in a crowded cafeteria for any length of time is going to ping his hyperactivity/hypersensitivity to surroundings/sensory issues. He loves being with his buds, but it sends him into this giddy, goofy frenzy in which he does everything they do, except more so, and gets in trouble. The school has been pretty understanding and they're looking for ways to help him, not threatening to suspend him (have I mentioned the official who did that last year has been reassigned? I don't know why, but I'm frankly glad of it). But still. So his pediatric psychiatrist changed up his medication slightly. The result so far: It's nearly impossible to get him out of the house in the morning or in bed at night because he melts down and collapses on the floor whenever you ask him to do something he doesn't want to do, like say, wash his hands for dinner or brush his teeth. I've been researching ADHD for a year and a half and such things are still maddening. I don't think they ever stop being maddening.

No word on school behavior yet, but no news is good news?

Anyway. The shiai -- that would be a karate exhibition, involving several of the area dojos -- was on Sunday, and kiddo's sensei, who's quite a nice guy, always has his students and families back to the dojo afterward for a big party. Kiddo was looking forward to it. At least he was until we told him it was bathtime, and we made him get dressed, and we made him quit looking at the book to finish getting ready, etc., etc. There were so many blowups and meltdowns I finally started taking my coat off and telling him we would stay home. That got him moving.

Here was the problem. When kiddo first started karate, we already knew a few of the families there, so he had buddies in class. They've since moved on to other sports. So when we walked into the high school gym, and he was supposed to join his school on the floor, he didn't know anyone and he flipped out. I had to walk him over to his sensei, who cheerily waved him in the right direction (and tipped me off which side of the gym to sit on for a better view), but as kiddette and I turned to walk back to the stands, I felt a tug on my other hand. Kiddo refused to go. I stood there in a sea of white-uniformed people, keeping kiddette in tow, trying to convince him to rejoin his group, finally resorting to "then I'll go get my money back and we'll go home right now!" Which I'm not proud of. I'm even less proud of what I did next: I left. I said, "You need to go over there," and guided kiddette toward the stands, not looking back.

I have no idea what I was supposed to do in this situation. Relaxation exercise? Taken my place next to him and done some front-leg kicks? (Says the person who just got a steroid shot for her herniated disc.) Gotten my money back and gone home?

Somehow, what I did worked; by the time the shiai started, he was sitting with the other kids, exactly where he was supposed to be. He got up when he was supposed to, he went through the routine of kick-punch-kick, side-front-side just like all the others. And he looked pretty good. The only downside? He spotted me in the stands and kept waving, grinning widely. This was fine the first two or three times. By the 10th or 11th time, other people in the stands were starting to turn around to see who he was waving to, and the official serving as MC genially said into the mike, "You don't need to keep waving, they know you're here!"

I want to note here how goshdarn nice everyone is in karate. No angry competitive people. No screaming parents. Everyone in the stands claps for everyone. The moment that got just about the biggest applause was when the MC stopped everything to run over and retie a little boy's belt, which had fallen off. (I can empathize. It took a few tries before I got the hang of kiddo's belt.)

By way of contrast, one of my mom friends recently pulled her kid out of football because, in part, of the angry parents cursing out the kids for screwing up. And people wonder why I don't like football.

There was no sparring this time around, but the various schools offered short performance pieces instead. For instance, the karate routine choreographed to "Wind Beneath My Wings." Or the mock fight between Snow Miser and Heat Miser, broken up by a surprisingly spry (and thin) Santa. I'm aware how all this sounds, but it was rather charming. Also, the kids on the gym floor found the Santa thing pretty hilarious.

And after all that, kiddo was promoted from yellow novice to yellow belt. Hooray!

So I think it's good that he's stuck with the classes, and that he stuck it out at the shiai. Success breeds further success, or something like that. Do I expect him to practice karate for the rest of his life? Who knows, but probably not. We'll see how far he takes it.

The one problem? I can't get "Wind Beneath My Wings" out of my head.

Monday, December 2, 2013

The week in ADHD news

Well, apparently there is hand-wringing about baseball players on Adderall. The Los Angeles Times says Major League Baseball players received 119 exemptions for ADD medications last season (incidentally, dear L.A. Times, the preferred term these days is ADHD. You might want to make a note of that), which is apparently a record number. Also, seven players were disciplined for unauthorized use of Adderall; the exemptions became necessary as of the 2006 season, when MLB banned amphetamines. The number of exemptions has risen every year.

The Times says that according to the MLB's numbers, one in 10 players has been diagnosed with ADHD (not ADD), which it calls "at least double the incidence of ADD in the general population." Uh, for real? Because literally just last week, the CDC said more than 1 in 10 U.S. kids has been diagnosed with ADHD, per a 2011 survey. That's just kids, not adults -- and plenty of adults have been getting diagnosed for the first time in the past generation or so, after spending their whole lives wondering what was wrong with them. (Don't believe me? You go read the posts on the ADDitude boards.) I'm no statistician or math whiz or even remotely comfortable around numbers of any sort, but if the CDC is correct, then how in the world is the MLB number double the general population?

I think what the Times is getting at is that players are scoring legal methamphetamines so that they can, well, score. And field the ball, presumably. Except here's the thing. It's not unrealistic for an athlete to have ADHD, any more than it is for a singer/actor/writer/artist. Exhibit A: Michael Phelps. Exhibits B and C: Shane Victorino and Andres Torres. ADHDers tend to have ridiculous amounts of energy and a need to burn it off. They tend not to do well in very rigid surroundings. They'd much rather be moving about than, say, filling out TPS reports.

As always, don't take my word for it. Per ADDitude magazine:


Many experts say a connection between ADHD and athletics makes sense. "Having ADD can actually be an advantage in certain sports for ADHD children," says Mike Stabeno, author of The AD/HD Affected Athlete. "While some activities require intense concentration, that's not always the case with athletics. Everything happens instantaneously. You're in there for 10 minutes, you've got five people trying to take your head off, three referees, four teammates. You need to take in everything that's going on all at once. That's how people with ADD go through life. So it makes sense that they thrive in this field." 

So 119 out of 1,200 baseball players having ADHD doesn't sound unrealistic to me.

Sure it's possible some of those diagnoses are specious, or made on a snap-judgment basis, or made for the access to medications. Of course it's possible. Is it possible that every single diagnosis is bogus? Again, not a statistician, but I don't think so. I think the real issue, again, is this assumption that ADHD itself is bogus and people just get diagnosed so they can get the meds. And that assumption will never stop irritating me. We've spent the past year and a half doing occupational therapy, behavioral therapy, social skills classes, pediatric psychiatry and classroom accommodations, not to mention the money we've dropped on a weighted vest, compression shirts, triangular pencils, etc. You think we're doing all this for a bogus diagnosis? I assure you: No.

In slightly less exasperating news, there's this article about a startup company that's launching a game next year that's supposed to improve kids' focus using a brain-to-computer interface. It's currently in testing.


The distinction of the Atentiv system, according to Atentiv founder and Chief Executive Eric Gordon, is the precision with which its technology calibrates each individual's mental circuitry and then zeroes in on electrical activity related to attention, as opposed to memory, for instance, or critical thinking. A numerical indicator on the screen gives a real-time reading of the child's attention level, the numbers fluctuating from zero to 100.

The goal of the game is to get a bird to move along a winding road and perform certain tasks that require tapping keys. But the bird speeds along, or slows down and stops, depending solely on the degree to which the user stays focused.

It's not an easy task, as this reporter found when he tried on the headband [which contains sensors to monitor brain activity]. Willing oneself to "pay attention" can bring the bird figure to a stop. The user must ignore all distractions—including the mind saying, "Focus! Focus!" 


There are a few other companies offering similar "games" -- Cogmed and Lumosity among them -- but as the article notes, there have been studies debunking the usefulness of those companies' products. Still, assuming testing goes well, it could be promising ... mainly because I think all this effort put into helping kids improve their focus has got to result in something useful, at some point. And then families have a tool in addition to, or in place of, medication -- and then maybe ADHD loses some of the stigma. So I'll be curious to see how the Atentiv testing plays out.

Sunday, November 24, 2013

He's a contradictory sort

Not that kiddo means to be contradictory. In fact being inconsistent is one of the consistent things about ADHD, because rote, routine things hurt his brain. Sometimes it's entertaining, though.

His anxiety, for instance. He doesn't like to be in a room (or a bathroom) by himself. Doesn't like scary stories or loud dogs. Will practically run the other way if someone's Halloween decorations are too frightening. ("But you're Superman!" I protested while we were trick or treating. "You're not afraid of anything!" Meantime his sister the strawberry was already at the door, getting candy.)

And then we met another family for hibachi last weekend. Now, we've done this sort of thing before, with cousin H. and family down South. And it went fine. But I don't recall there being quite the same reaction last time. By which I mean kiddo practically standing up in his seat yelling "More fire! More fire!"

"Don't you think he sounds like Beavis?" I said to DH.

Wow, did he love the fire. I think maybe the chef this time around had cranked up the flames on the table a little more than the last one. But still. Kiddo seemed to think this was his own private fireworks show and he did not want it to end. (In a complete reversal of the usual, kiddette was hiding behind me. "I don't like the fire," she said. Though she did like the food.)

The chef seemed to find our little pyro hilarious, playing little games with him, pretending to give him rice and then dropping it on someone else's plate instead. Kiddo was a pretty good sport about it, especially when the chef finally dumped a ton of rice on his plate.

As we were leaving the restaurant, DH encouraged kiddo to go thank the chef for the meal. Kiddo walked up to him and said, "Thank you for the fire!"

Can't wait to see what he does when we light the Hanukkah candles Wednesday.

Another contradiction: girls. He got in trouble last week for smacking himself in the face, spinning around and throwing himself on the ground. I heard this from the guidance counselor and I thought, Is this a tic of some sort? Is it related to the medication? Should I call the doctor? Yeah. Turns out he and another boy had been "trying to make the girls smile."

Seriously. He's 6. Aren't boys supposed to be totally clueless about girls until high school or later? Why is he trying to make girls smile? And couldn't he just tell them a knock-knock joke or something?

Also, lately he and kiddette have been making marriage plans. Kiddette is going to marry one of her little friends from school. Kiddo is going to marry a girl from the neighborhood. This is actually a step up from before, when they were going to marry each other. (I explained that that was not possible.) Kiddette's friend was not happy about the suggestion. I don't think kiddo has informed his intended yet.

And yet despite all this, when kiddo and I were reading the latest "Wimpy Kid" book and it mentioned a Valentine's Day dance, kiddo said "Ewwwwwwww!"

I couldn't help calling him out on that. "What do you mean Ewwwwww? You just got in trouble for trying to make the girls smile." He had no answer. I suspect the other boys at school told him dances were yucky. Maybe the next time he talks about marrying someone, I'm going to tell him that getting married involves a lot of dancing, and see if that puts an end to the talk.

Finally, of course, I would be remiss if I didn't mention the latest news: according to the Centers for Disease Control and Prevention, more than 1 in 10 children in the U.S. has been diagnosed with ADHD, per their 2011 survey of 95,000-plus parents. They say diagnoses have been rising since at least 1997, which may be because of greater awareness on the part of doctors and parents. Per the data (says the Associated Press), that's about 6 and a half million kids, half of whom are diagnosed by age 6. The CDC site also says this:


Although investigation of ADHD has been quite extensive over the past 30 years, the scientific process has been significantly slowed by the lack of a single, consistent, and standard research protocol for case identification. Variable and disparate findings have been noted throughout the literature even on basic issues such as prevalence. As a consequence, speculation regarding possible increases in ADHD prevalence cannot currently be evaluated.


So, they know there's more of it, but they don't really know why.

They also say:


CDC acknowledges the need for further research in ADHD. Specifically, key public health questions yet to be answered include:
  • What are the causes and risk factors of ADHD? What is the prevalence of ADHD? Is the prevalence increasing?
  • What social and economic impacts does ADHD have on families; schools; the workforce; and judicial and health systems?
  • Are ADHD and its comorbidities being appropriately diagnosed and treated? Are people with ADHD able to access appropriate and timely treatment?
  • How effective are current interventions? What are the long-term effects of drug treatments?


This all seems like they really don't want to say anything definitive on the topic, which makes me wonder why the 1-in-10 thing was a story in the first place. Dear medical science folks, we need something definitive on the topic. That's the only way people are going to stop thinking ADHD is made up. Get on that, would you?

Sunday, November 17, 2013

Deciding I'm OK with the Wimpy Kid

Because I was not OK with him before. I'd never read these books, being that I had already well aged out of the target audience by the time they came out. (In fact, the first book was published the year kiddo was born.) So I came to this whole phenomenon -- more than 115 million copies sold worldwide, per the Los Angeles Times, not to mention the three movies -- a bit innocently, when my mother bought a signed copy of the latest "Diary of a Wimpy Kid" book, and just to start us off properly, the first book too. (That's right, Mom. I'm blaming you.)

Kiddo was beyond thrilled when he saw the books, because clearly some of his buds are reading them too. He chattered about them all night -- "Haha, 'Diary of a Wimpy Kid,' I can't wait to read 'Diary of a Wimpy Kid,' when can we read 'Diary of a Wimpy Kid'" -- and when we finally did start reading one, thought it was the funniest book ever ever in the history of anything and couldn't wait to hear the next part.

The problem is, this Wimpy Kid dude is kind of a jerk.

He bonks the star of the school play on the head with an apple in the middle of the play. (He was a tree.) He terrorizes a bunch of kindergartners when he's supposed to be escorting them home, then lets his friend take the blame. He devises a game in which he tries to knock that friend off a Big Wheel while he's riding it downhill. That sort of thing.

OK, they're in middle school. Kids generally are jerks in middle school. And he generally gets his comeuppance by the end of the book. And this stuff is more silly than outright horrible. DH and I even think the book is kind of funny. It's just that it's clearly a book meant for kids, not adults, in the sense that the kids can laugh at it when the adults are not around, in that subversive way. So it's a little bit of cognitive dissonance for DH and I to be using it as kiddo's bedtime story. I feel like as the authority figures, it's our job to disapprove, or something. Eat your vegetables! Do your homework! Don't laugh when the Wimpy Kid bonks that girl with an apple!

On the other hand, I've always had these two warring impulses in me: the desire to do all my homework and get good grades and be liked by the teacher, and also the desire to sit back and giggle at the kids throwing spitballs in the back of the room. I'm a well-behaved smartass. So I can understand the appeal here.

And frankly, after reading him the original "Peter Pan," in which the pirates and the Lost Boys are doing the logical thing with all those swords and actually killing each other, and "The Secret Garden," in which Mary's parents and a gazillion other people die of cholera by about page 5, I probably don't have any right to complain.

Also, there's this one interesting fact about the author, per the Sydney Morning Herald:

Jeff Kinney, author of the Wimpy Kid series, has attention deficit disorder; he is sure of it. This explains why writing the opening pages of a new book is as excruciating as doing a tax return and also why he drifts away at the most inopportune of times.

Like last week at the Sydney Writers' Festival when he was giving a talk at the Opera House and found his mind wandering off to compose a plot for his new novel; it's as if his body, he says, is physically trapped in a space but his head is somewhere else completely - roaming the creative playground of infinity looking for the next mishap, gag or twist.

The ADD has never been formally diagnosed and he isn't interested in getting treatment; the condition has served him well - people who have it are often very creative, he thinks.

In fact, this is what he tells kids at a school assembly, per the LA Times article:

"I have ADD," he told the crowd. "Does anybody here have ADD? You do? Congratulations. You're going to go far."

How about that!

I am always on the lookout for authors/artists/athletes/actors/other fascinating people to add to my list of successful people with ADHD (thought I saw something about Jimmy Fallon recently too but can't find the article), because it's interesting, and a bit reassuring, to see people who have the disorder but have succeeded spectacularly in spite of it. Or because of it? Either way.

So consider me on the Wimpy Kid bandwagon. We've already started the other book, and I expect will eventually move on to the movies. Not to mention the rest of the books. And kiddo is back to pleading for one more entry every night at book time.

"Hey kiddo," I said the other day at breakfast, "the man who wrote these books has ADHD like you do."

"Cool!" he said.

Yeah, it is.

Monday, November 11, 2013

... And here we go again

"Perhaps parents of children with ADHD shouldn't have sinned so much in their youth. Western medicine can't solve your problems now, only the lord can."

That enlightening statement was provided in the comments section of a recent Washington Post article (not the Times, C! Don't yell yet!) describing one mother's struggle with her son's possible ADHD, and putting it in the larger context of how it can be difficult to diagnose -- and how people can still so blithely choose to disparage the diagnosis. Like, say, the above commenter. 

For the record, I wouldn't have described myself as a "sinner" per se. I pay my taxes. I serve jury duty. I give blood. I have a thing for cheesesteaks, but that really just makes me a bad Jew.

The article itself is fine enough, though maybe sketchy on some details:

[ADHD] is far more prevalent in boys than in girls. Among those given the diagnosis, a small minority suffers extreme symptoms, and in those cases, diagnosis is fairly straightforward. Children with extreme cases tend to have trouble staying engaged in tasks, even those that they enjoy, for any length of time and find it impossible to stay still, particularly in classroom settings.
  
Really, if that were kiddo's only problem that would be lovely. This leaves out the sensory issues that frequently accompany ADHD, not to mention the issues with social skills, inability to recognize personal space/facial cues, developmental delays that make it near-impossible for kiddo to process emotions sometimes, delayed motor skills that make writing anything a struggle for him (though he's getting better at it). Not to mention the almost physical pain he seems to be in when asked to do a routine task that doesn't interest him (like, say, picking up his toys. Yes, that's fun to deal with). And he's lucky, in that his brain actually shuts off so that he can sleep; other ADHDers have to resort to medication just to get sleep. Also, other disorders frequently co-occur with ADHD -- Tourette's, dyslexia, dyspraxia, Asperger's, etc. So yeah, the sitting still in class? Kind of just the tip of the iceberg. 


“There is no line” that defines who does and does not have ADHD, says Lawrence Diller, a behavioral developmental pediatrician and an assistant clinical professor at the University of California at San Francisco. Except in the extreme, diagnosing ADHD is a “judgment call based on subjective opinion,” he says.


Well, maybe for you it is. I watched the pediatric neurologist run tests on my son -- physical and cognitive. That plus the questionnaires from his teacher and from us, which happened to match up pretty closely. Didn't strike me as a subjective judgment call.


Many doctors and some schools rely on the Vanderbilt Assessment Scale, a questionnaire meant to flag symptoms of ADHD and identify other underlying conditions. It includes general statements — such as “Is distracted by extraneous stimuli” and “Is forgetful in daily activities” — and asks the person completing the form to rank how often each applies to the child throughout the day.
 
But the test does not provide the necessary insights into a child’s home life — discipline patterns, inadequate learning environments, familial difficulties — Diller says. “If the behavior crosses the threshold on these forms, the parent is likely to be told the child has ADHD, even though there can be a host of other reasons why the kid is acting that way.” The child may also have other problems that have little to do with attention but result in ADHD-type behaviors.
 

Um, actually we were questioned about our home life too. And the questions on symptoms we answered were more precise than those above. So, different questionnaire then?

The one thing this Diller guy says that I agree with is using the book "123 Magic," which has come in handy for us. Even now, when we don't rely on the technique regularly, if I want to get the kids' attention I'll say, "That's 1." Generally it works.

The article does touch on recent studies showing that low dopamine levels in the brain might be associated with ADHD symptoms, and that stimulant medications increase levels of dopamine. So there's that.

The writer concludes that her son seems to be doing fine in school, so they'll take a wait-and-see approach with diagnosing. Which is totally fine. Great, in fact. But I do kind of wish the writer had put more information into the article. Because I know there have been studies other than the ones she's citing, I know brain imaging as a way of diagnosing ADHD is slowly gaining credence, and if all you read was this article you'd think there were scores of neurotic parents wringing their hands over giving Johnny meds just because he wiggles around in his seat at school. Incompetent teachers! Bad parents! Blah blah blah ad nauseum.

Why do I get so exasperated by these articles? These comments on said articles.

"These newly-invented alphabet-soup "disorders" serve one purpose, and that is to sell expensive and debilitating proprietary medications. Maybe kids would pay attention more, and generally behave better, if they were allowed to bring peanut butter and jelly sandwiches for their school lunch. Meanwhile, school administrators are incapable of making normal, common-sense decisions without first looking up the "correct" (i.e., absolutely inane) response in their little red rule books."
 
Soooo, the real solution here is that my kid should endanger his classmate's life by sneaking peanut butter into school? Hey thanks, man, you totally nailed it.
 
(Why is it that kids are so completely cool with the idea of no peanut butter because it's dangerous, and adults get so ranty about it? You want a PBnJ, you make one. Cut the crusts off and everything. Have a blast.)
 
Also, according to the National Institutes of Health, the earliest known reference to an ADHD-like disorder was by a physician named Sir Alexander Crichton in 1798. Yes, I said 1798. That only counts as "newly invented" if the commenter grew up during the Roman Empire.

"I taught for many years in an elite NYC private school.
Many of my students were taking Ritalin or some other drug if they were not getting A grades.
The parents would not accept that their child was not an Einstein.
That the child was not an A student in every course must [since the child was obviously a genius] be because the student had ADHD. ...

There is a reason in the lower grades boys are more often misdiagnosed with ADHD than girls.
Elementary school teachers are not hired because of their knowledge of the subject matter.
It is not hard for a boy to know more arithmetic than his [usually female] teacher. ..."

So you're 1. male, 2. kind of a misogynist, 3. extrapolating your elite New York experience to the rest of the planet? Because I feel pretty confident in saying that New York is not like anywhere else on the planet. 

Also, I can't emphasize this enough: The medications are not designed to give the kids easy A's. They're designed to help the kids feel comfortable and not overstimulated in a group setting, or improve their executive function skills, or help them build in that "pause" so they can stop and think before taking a potentially harmful action. 

I'm perfectly willing to believe that ADHD is overdiagnosed. But if all you read is articles suggesting (or saying outright) that ADHD is overdiagnosed, then you doubt all diagnoses. That's the part I don't appreciate. Don't make my job harder. Don't make me  wonder what kind of reception kiddo is going to get in a world that seems to largely believe his disorder is a great big lie.

Sunday, November 3, 2013

Halloween: A Postmortem

Superman and the strawberry had a fine time. They each got parades and parties at their respective schools, and then came back here and dragged me halfway around the neighborhood, and then had pumpkin macaroni and cheese for dinner (sounds odd but is good), and eventually we were able to get them to bed.

I took a half-day from work to catch kiddo's parade and to handle trick or treat duties. (There was no way I could make both parades unless I skipped work altogether, but skipping work altogether seemed like a bit much. DH and MIL attended kiddette's parade.) I'm always kind of fascinated by what the neighborhood is like during the day, when I'm not there. It's like a glimpse into the stay-at-home moms' world. Although actually there were quite a few dads at the parade too; either they all work two minutes away from the school, or they skipped work.

At any rate there was a crowd of adults lining either side of the sidewalk outside the school along with MIL and me, and then "Monster Mash" blasted out from the speakers and out came the kids. ("Monster Mash" continued to repeat, scratchily, for the entire parade. If there's one song you shouldn't listen to 10 times in a row, this is probably the one.) Kindergarten first, then the first-graders, and as I was frantically fumbling with the camera to capture Super-kiddo I heard a happy shout: "Mommy!" And hearing that made the whole half-day worth it.

Trick or treating went ... well, pretty much as I should've expected. Kiddo refused to go up to one house at all because there was a fake dead guy in the driveway. He was nearly scared off a couple other places because of dogs. (We are clearly never getting a dog. Okay by me, since I'm more of a cat person.) He insisted I walk him up to all houses after that, holding his hand. The irony of a kid in a Superman costume acting less than brave was not lost on me. I pointed this out to him, but it didn't help. I guess dogs and scary decorations are his kryptonite.


One of our neighbors was giving out whistles instead of candy. I'm sure she thought she was helping break the candy cycle, or something. I'm also sure her house was soundproofed. Because throughout the neighborhood, you could tell which kids had been to her house by the piercing sounds echoing through the streets. Kiddo, adorably, thought they were all sending messages to each other via the whistles. Sure, and the message was: "All I got was this lousy whistle so I'm going to break some eardrums!"

Really the kids around here are pretty nice, though. They all say thank you when taking candy and they ask before taking extra (I always let them). At one point when kiddette was coming down the steps of one house, she slipped (it had been raining) and fell. One of the older boys passing us stopped to ask if she was okay, and helped pick up her dropped loot. Very sweet.

(Incidentally, I was totally kidding about parents driving the kids from house to house in the rain, but I swear some parents were doing just that. It wasn't even raining that hard. Wusses. Work for your candy.)

I managed to more or less keep the kids together until we visited a family we're friends with, and then fell in with the son and all his buds as they went back out. Bunch of boys together, running ahead of their parents, and you can guess what happened next: Kiddo ran off with them, kiddette and I were three houses behind, it was getting dark and I started to panic because I couldn't see him. There was a point where I was in the middle of the street, kiddette at the house behind me, kiddo at the house across the street in front of me, and I wasn't sure which one to go after. That was when I finally hauled him out of the group, and we headed back shortly after.

We were home and he was already out of his costume when we noticed the fire truck lights outside. No fire, just the firefighters roaming around the neighborhood, giving out thick glow necklaces to the kids. (Cute, I know.) Kiddo ran back outside. I was in the middle of making a salad, but I ran out after him, minus my coat. The truck drove off and kiddo nearly had a massive meltdown, but I pointed out that it was going to stop again up the street. We were on the sidewalk and I thought it might be safe enough, so I let him run. Man, he is fast. I'm thinking we sign him up for track as soon as he's old enough. Unfortunately the truck made a bit of a rolling stop and kept going, and kiddo kept running after it, and at this point I couldn't see him and realized there was no way I could catch up to him, ever. But then the truck did stop, and he scored a necklace and came bounding back to me, like the world's most fright-inducing boomerang. I even got him to get a second necklace for kiddette, who unlike her brother had come back to the house when called. So everyone was happy, and it could've been worse, I suppose.

And my next source of worry will be the parent-teacher conference next week, because while kiddo is doing just fine academically, behaviorally, not so much. At least one incident of lying on the floor and refusing to do something or other. I suspect there have been meltdowns, since he's been having them at home. Not sure yet what we do about it.

But at least we had Halloween without any major incidents. Oh, and that salad? The kids ate it. I figure that sort of offset the candy.

Tuesday, October 29, 2013

So far so good

On the weather, I mean. No signs of any superstorms. Or snowpacalypses. There is a pretty good chance of rain this week, but do you think for a second that kids are going to let a little rain stop them? Oh no. They'll trick or treat under umbrellas. They'll wear rain galoshes over their superhero boots. They'll talk their parents into driving them from house to house. (Note: We would never do this.) We are 0 for 2 on actually getting to celebrate Halloween on Halloween, instead of sitting in the dark/sitting in a storm shelter/sitting on an hour-long gas line/sitting in a hotel room because we can't stay in our house. We will not be denied. We will have costume parades and trick or treating and ritual viewings of "It's the Great Pumpkin, Charlie Brown." Because we are Jersey Strong and we want candy.

I mean, unless the locusts show up.

Anyway there had better be trick or treating this year or I will end up eating all the peanut butter cups stashed in our pantry. Which, technically speaking, I probably should not do.

I am hoping that kiddo remembers to stay with his adult guide instead of seeing a group of kids going house to house and running off to join them.  I am also hoping he doesn't become so candy-crazed that he starts running across the street without looking first.

I'm hoping a lot of things with kiddo. I'm hoping he quits having meltdowns, because they seem to have reentered his regular emotional rotation. I'm hoping he quits blurting things out in class. I'm hoping he stops picking bedtime to be the time he hyperfocuses on his Legos and can't be budged for any reason whatsoever.

There have been some frustrating moments the past couple weeks, let's say.

But whatever. It's Halloween. Since we have the option, apparently, for the first time in three years, I want the kids to have fun on Halloween. Parades and candy and everything.
And we're guaranteed to not even get through a third of the candy because DH and I are pretty strict on treats, but the point is the acquisition, isn't it?

So, Happy Halloween to you, and may there be no snowstorms or superstorms or locusts. And kiddo ... well, he'll do the best he can do. Whatever his best happens to be. 


Sunday, October 20, 2013

Arguing the hypothesis

Kiddo was supposed to be getting moving yesterday, and getting ready for karate class. Instead he was hunting down his plastic sword so he could have swordfights with, I dunno, the air? and intently trying to build a truck out of Legos. (He has a book showing different Lego creations you can make, and he seems to regard it the way I do a recipe book -- as useful source material.) He didn't want to put his uniform on, he didn't want to pick out a change of clothes for after class, and the more DH and I nagged and warned him, the more stubborn and upset he got, until he went into full-on screamy meltdown mode and refused to even sit in the chair for time out. I had to take him by the shoulders and sit him down.

He calmed down after that, and after time out was done, he and I hugged and apologized to each other and he was able to get his shoes on and go. And he was giggling and goofing around like the whole thing had never happened. Typical. (Not neurotypical. But typical.)

He hasn't had a meltdown like that in a long time. Seeing one all over again reminded me that it has been a long time, and he's been better able to hold it together when asked to complete tasks. It also reminded me how horrible those meltdowns are, and how stressful to deal with, and how almost exasperating it can be to watch him having totally forgotten about it two minutes later. I almost expect scenes like that to have some sort of emotional aftereffect. Like a meltdown hangover, if you will. But no.

This morning at church (UU fellowship but "church" is fewer syllables), kiddo only kicked his legs against the pew a few extra times before I glared him into stopping. So that was fine. Generally the problem is after services, when I go downstairs to collect the kids from RE class and they're jumping around the room and stealing extra snacks from the snack table. This time, some of the other boys were goofing around on bongos (yes, bongos. Just go with it) and cracking silly jokes, and kiddo found this all so hilarious that he went into extra-hyper overdrive, giggling madly, bouncing around, trying to join in. Generally when he gets like that, it's Code Red for "get him out of the room before he really goes too far and hurts himself/hurts someone else/damages property." He was so wound up I practically dragged him out of the room, after several unsuccessful attempts to get him to voluntarily walk out. And then of course a well-meaning elderly lady stopped me to tell me about how when her kids -- or grandkids, I didn't really hear her -- were being just like little jumping beans, she would make them do somersaults, or something like that. I didn't really hear her because in the time it took her to stop me and tell me all about jumping beans, my kids had already run upstairs and were heading right for the parking lot. Hey thanks for the advice. You know what would've been more useful? Staying out of my way so I could more effectively keep the kids away from moving cars. Just a thought.

I mention all this as a leadup to this article in the Times, which I notice is being namechecked all over the Twitters today so people can trash ADHD as being trumped-up and fake and a big conspiracy by Big Pharma and incompetent bureaucratic schools etc. First of all, you think ADHD is fake? You take my kids to church. Second of all, that's not exactly what the article is saying.

The writer's point -- and she acknowledges up front that she has ADHD herself, which alone is some sort of breakthrough here, because generally Times stories about ADHD only talk about how college kids are OD'ing on stimulants -- is that the rise in diagnoses might be related to sociological factors as much as medical need. First of all, she notes:

Most children are given the diagnosis on the basis of a short visit with their pediatrician. In fact, the diagnosis can be as simple as prescribing Ritalin to a child and telling the parents to see if it helps improve their school performance.

Right, I agree, that's no way to diagnose. I keep harping on the fact that general practitioners shouldn't be making these calls. That's why we went to a pediatric neurologist.

The sociologists she quotes say that the policy shift making ADHD kids eligible for academic accommodations -- extra time on tests, etc. -- made the diagnosis more appealing, and linking school funds to students' test scores coincided with a jump in ADHD diagnoses in some states. 

Well, my kids are going to have to take standardized tests no matter what I think of them, so I won't go into that now. I can only speak for myself here: I didn't push to have kiddo evaluated so he would get better grades. I pushed because he couldn't function at school and he couldn't function at home. I pushed because the screamy fit he had yesterday used to be an everyday occurrence, and just being around him was mentally exhausting. Stick that on your standardized test.

A psychiatry professor she quotes offers this:

Schools used to punish kids who wouldn’t sit still. Today we tend to see those kids as needing therapy and medicine. When people don’t fit in, we react by giving their behavior a label, either medicalizing it, criminalizing it or moralizing it ...

Oh, if only kiddo's entire problem had been sitting still in class.

The problem with this article -- and don't get me wrong, I think it's generally a well-written, well-researched article -- is that it operates on several assumptions. One, that all kids diagnosed with ADHD automatically get fed stimulants. There are, in fact, no hard numbers in the article about how many of those kids actually do take stimulants. Some families can and do operate without them. Two, that the only ways ADHD shows up are in academic underachievement and fidgeting in the classroom. This completely leaves out issues like 1. inability to read social cues, 2. no understanding of "personal space" (really a subset of 1), 3. lack of "executive function" skills, 4. delayed behavioral/emotional development, 5. delayed motor skills, 6. hyperfocus (granted hyperfocus can be a bit of a plus sometimes). And none of this touches on frequently co-occurring (or "comorbid") disorders like Asperger's, Tourette's, dyslexia/dyspraxia or OCD/anxiety disorders.  

Are there not-incredibly-educated authority figures out there looking for a quick-fix solution, or a way to game a funding system? Let's say it wouldn't surprise me. But I don't think that should take away from the fact that ADHD is real and there is genetic evidence to support that (as the writer says, early on). Unfortunately, all that the commenters on this article seem to have gotten out of the article is that kids today watch too much TV and eat too much sugar and never ever play outside, and that's the whole goshdarn problem.

Oh yeah? Kiddo gets restricted screen time and loves playing outside every chance he gets. (Like today, when we were on the playground for an hour.) As for the diet ...

Me: "Hey, sweetie, we're going to have chef salad for dinner this week."

Kiddo: "Yay!"

And yet he still has ADHD. How about that.

Monday, October 14, 2013

The down and the up

So for a while I was posting on ADDitude's message boards, seeking other moms/kids/etc. dealing with ADHD, looking for the same answers we were, maybe looking for fellowship and a place to vent. And it worked -- that's how I and the other ADHD moms in our little informal group found each other. They're awesome women and all our respective kids are doing pretty well in school right now.

The thread I was posting on is still up there, and that's how another poster found me, an adult with ADHD. They asked about our group, I explained that we're all moms of ADHD kids, but that certainly we're available for anyone to vent or commiserate. The person wrote back explaining that what they really needed was a support group, because their professional and personal lives were in shambles, and they didn't know what to do anymore. (Note I'm leaving most details out, to respect the person's privacy.) I felt awful. Advise a fellow mom about the benefits of a 504 plan? That I can do. Help an adult who's got way more hand-on experience with ADHD than I will ever have? There I'm out of my depth. The person wasn't really interested in talking further, but I offered the name of my old therapist, who deals with a lot of ADHD adults, and I wished them luck. Which I think was about the limit of my usefulness.

My therapist had always said that adults with ADHD, the more severe cases, can't handle money, can't hold down a job, can't maintain relationships. What are they supposed to do? Who helps them? And what if that's my son in 30 years?

On the other hand, I was poking around the Interwebs and I found this, written by a TV documentary filmmaker in the U.K. He realized late in life that he probably had ADHD, but decided it was a gift, not a curse, because it gave him endless energy and the ability to mega-multitask.

He says:

By the age of 26, I had directed 26 plays, two operas and two TV dramas.
Then I switched to being a documentary film-maker and have made more than 130 films and studio dramas as director, producer, series producer and now executive producer.
Last year I executive-produced 13 films, and am responsible for nine so far this year.
In my 50s, I also became a writer - three books and hundreds of articles so far.


(I'm tired just reading that.)

He adds:

So I hope the parents and teachers of children with these problems, and those who have suffered from ADHD, will see beyond its drawbacks to a future of excitement and creativity if sufferers are given the chance to learn how to use their energy positively.

Well, thank you, Mr. Graef. I hope you're right. I hope we figure out how to channel kiddo's energy and hyperfocus in the right way. I hope we all don't fail this generation of ADHD kids. And I hope my ADDitude correspondent finds whatever they need to get through. 





Monday, October 7, 2013

It's ADHD Awareness Month ...

But since it's also Breast Cancer Awareness Month, I think people are probably not clamoring to be more aware of ADHD. There's only so much awareness to go around.
OK, I did find this funny.




I'm just not sure what ADHD Awareness Month is supposed to accomplish, and I think that's why I find it a little frustrating. (Also, I could swear it was just a week last year?) You're not going to cure ADHD. Frankly I'm not sure you should. There are a lot of upsides to it -- creativity, energy, hyperfocus. The ability to multitask, since an ADHDer would be doing 15 things at once anyway. Hypersensitivity to what others are saying and thinking can be damaging, but it can also lead to a sense of empathy for others, and an increased ability to "read the room" and figure out how everyone is feeling or thinking. I've seen this in action with kiddo; if someone else is upset, he's upset. That sense of empathy would be useful in all sorts of professions, and I think it makes him a better person. Getting kiddo to adulthood is going to be, at times, challenging, but I think it's going to be a rewarding effort, and I wouldn't trade that for anything.


Basically, looking at the official website, it looks like the way to raise awareness is to assume the defensive crouch and say "ADHD is real and stop calling me a lousy parent!" over and over until someone believes you. The listed events appear to be talk radio shows or seminars for people who are already dealing with ADHD, which is great, but it's not raising awareness. (That is what is known in political punditry as "the echo chamber.") Here are some of the site's suggestions for what you can do:

  • Contact organizations in your community to recognize and hold ADHD Awareness Month activities. 
(An activity is not telling people to hold an activity.)

  • Contact a State Legislator to have your State declare ADHD Awareness Month. (Google: ”yourstatename legislature”).
(Right, our politicians have absolutely nothing else going on right now.)

  • Arrange for a local library or community center display on ADHD.
 (OK, that one actually sounds useful.)
 
  • Do not feel limited to the month of October. Keep spreading the word and holding activities throughout the month of October.
(Guys, proofreading?)


I know I'm just bomb-throwing over here, but it's out of a certain amount of frustration. The years change and the conversation remains the same, and no matter what this website says, there are still going to be people who think ADHD is bogus, and they will say so in online comments on every single news story about ADHD. If you want to raise awareness -- really raise awareness -- you have to do more than put up a website. I'm just saying.

But *sigh* tell you what, I'll do my part. Here goes:

Yes, ADHD is real. No, my kid doesn't eat too much sugar. Yes, he likes fruits and vegetables. Yes, he also likes playing outside. No, he does not watch too much TV. Or spend too much time on the computer. Or have his own cellphone. No, just telling him to try harder does not work. Neither does spanking. No, the point of medicating is not to create little kiddie zombies. Or to help college kids ace their exams. Yes, medicating is sometimes necessary, not so the child gets good grades but so the child (or adult) can function. No, I do not care what your third cousin twice removed who read a magazine once says causes ADHD, unless your third cousin twice removed is a pediatric neurologist. And finally: No, I'm not a lousy parent. Thank you and good night.

Sunday, September 29, 2013

A promising scene, and a new worry

Kiddo's school had its annual PTA ice cream social last week. Basically it's a PTA meeting for about two seconds and then it's an excuse to give the kids ice cream and let them run around the auditorium, and then outside on the playground in the dark. You'd think that would be a bad idea, but there have been no reported injuries, and there's just enough ambient light that you can more or less pick out your kids on the jungle gym or wherever they are. The only problem is when you decide it's bedtime, and then your children, hopped up on ice cream and the thrill of after-hours playground time, scatter to the winds and now you have to chase after them in the dark. I think strobe lights would be really helpful in this case. Someone could flash them on selected kids as needed and then the parents could more easily grab them. Or possibly this would be a good reason to install homing devices on their hoodies. Either way.

What I liked about the social was watching kiddo (before we moved outside, that is). He fell right in with the other boys from his class. They ran around the room together. They created an ad-hoc conga line together. One sweet kid with a gap-toothed smile even came over to DH to ask if he was kiddo's dad, and then to introduce himself. Pretty good manners for a first-grader.

I've always been most worried about kiddo's interactions with other kids, because social cues are so hard for him, he has issues with personal space, he can't handle losing at anything, he's not always good at sharing toys, etc. I tend to worry about that more than his academics, although admittedly his academics are so far pretty good so that's an easy choice to make. But he's clearly getting along with other kids. They were coming over to say hi to him, to give him a hug, to get him to come play. And that's really reassuring. Also, I will be sad when they all outgrow hugging each other, because it's so adorable.

I also said hi to kiddo's kindergarten teacher, who is super-involved and always at school functions, and she said nice things about his current teacher (and about us). So that was reassuring too.

The worry, right now, is kiddette.

I have at times described her as tough, assertive, determined, not afraid of things. All of which will be really beneficial for her when she's grown up and ruling the planet. Right now, though, she's getting in trouble at preschool. She isn't listening to her teacher. She talks back at times. She's being a total disruption at naptime, noisy, throwing a book when she's done with it. We're having obedience issues at home, too.

At the ice cream social, she was the only little girl running right around with the boys, doing everything they did (including jumping right up on the stage in the multipurpose room, even after I'd told her not to), and at the end of the night, she was the one who was harder to corral for bedtime. She had a total meltdown about needing to go home.

So. Running around, not listening, being defiant, throwing things, getting in trouble at school. Stop me if you've heard this song before?

I'd say it's too early to diagnose kiddette, except that kiddo was diagnosed at age 4. She doesn't seem to have the sensory issues he does, but ... well. Either she's potentially got ADHD or she's being an unbelievable brat right now for no good reason.

I think it's probably too early to panic. But it has been a real struggle to stop myself from yelling at her on just about a daily basis. I'm inclined to take a wait-and-see approach, though in the meantime I'm going to use the techniques I use on kiddo and see if they work.

I don't think I want two kids with ADHD. That is entirely too much chaos.

Monday, September 23, 2013

The week of everything

Well, not everything. I don't remember seeing any locusts. But they're going to show up Oct. 30 so Halloween gets canceled again and we can all lose power for two weeks and wait on hour-long lines at gas stations. I don't know how locusts will make us lose power but it will happen. Maybe they'll chew through everyone's electrical cords. Schedule it now, people. 2011: Snowmageddon/Hurricane Irene. 2012: Superstorm Sandy. 2013: Locusts.

What actually happened this week was, three days of physical therapy sessions -- which I have now been doing for a month, and it's helping, but back pain still wakes me up in the middle of the night sometimes -- plus two different Back to School nights for two different children at two different schools, back to back, plus our meeting with school officials to update kiddo's 504 plan, plus meeting up with my fellow ADHD moms for dinner, drinks and commiseration, plus wrapping up the details on kiddette's 4th birthday party, which was Saturday. It is surprisingly difficult to figure out the goodie bags if you have zero time to get to a store and buy things. I ended up doing something I never do: I went to Wal-Mart. I hate Wal-Mart. But all the other stores I like better don't happen to be open until midnight.

Incidentally, there is something ... off about Wal-Mart late at night. Maybe it's the gloomy lighting, or the lack of people. Or the fact that the people who are there seem to wander like lost souls. Or maybe it was the creepy guy zipping around the store on one of those motorized store carts while wearing a Hulk mask, not appearing to do any work, not saying a word. If I'd seen that guy in the parking lot afterward I was fully prepared to throw something heavy at his head and run like hell. Although I'm not sure what I would've thrown, since multicolored plastic stencils and bags of fun size candy don't weigh much.

Back to School went well, for both kids. Kiddette is fine academically. Her desire to tell everyone else in the world what to do, however, is getting her in trouble. We don't let her pull that crap at home, either, so maybe she'll settle down a little.

Kiddo is also doing well. His math and reading skills are good, he's listening, he's doing his work, he's not getting in trouble. He loves reading, his teacher noted. And right there, that would be enough to make me happy. Any kid of mine should love reading. She also said she hadn't seen any of the misbehaviors he'd been showing last year, and that he's a sweet boy. Hooray!

The 504 plan has basically been fine-tuned to reflect the change in schedule, and to encourage him to be less anxious about getting his work done perfectly, because that seems to be the issue right now: If his classwork or homework is somehow less than perfect, he gets upset and can't seem to move on from that. But really, a good meeting overall -- everyone in the room seemed to be on the same page, and to have good things to say about our boy.

Kiddette's party went fabulously (plus a delightful visit from C. and company), and the 500-decibel shrieking you heard was the sound of her reacting to all her lovely gifts. (I didn't even know they still made Lite Brite. They do.) I got her a little musical jewelry box with a twirling ballerina inside, because I had one when I was a kid, and I loved it. Both kids are fascinated with it, and let's hope that ballerina is still twirling in a week, not keeling over from overuse. Also, kiddo has been getting a little too enthusiastic about "helping" his sister open her presents, to the point where I started taking them away from him. He occasionally has this "what's yours is mine, and what's mine is mine" take on toys. Kiddette is way more patient with that than he has any right to expect, but I still need to step in sometimes.

Much of today, of course, was spent trying to make the family room look less like an entire toy store was just dumped in the middle of it. I have this thing about being able to see the floor.

So, kiddette has been well and truly celebrated, kiddo is having good school days and my back is functioning. On to the next week, in which I will not need to buy anything for any goodie bags.

Sunday, September 8, 2013

So far, so good

I mean, aside from kiddo cutting a hole in the front of his brand-new shirt on the first day of school. Apparently they were doing an arts-and-crafts thing of some sort. "The scissors you gave me were too sharp, Mommy," kiddo said. Yes, scissors have an unfortunate tendency to be sharp, since they are used to cut things. How about that, kiddo?

I can't really come down on him, though, because of the thing I did in nursery school once. Which is, I cut a boy's hair. For absolutely no reason. Just reached over with the scissors and snipped a lock off. I got in all kinds of trouble, of course, and the boy I think needed some supplementing trimming at the salon to neaten everything out. To this day I don't know what I was thinking. So at least kiddo only caused damage to his own person, and at least it was just a shirt. Which we have decided will now be his "art smock," since he already wrecked it.

Otherwise we haven't gotten any horrible reports yet. Though granted, what with Labor Day and Rosh Hashanah, he's only been in school two days so far. (I imagine he'll have many more opportunities next week to wreck his outfits.) The 504 coordinator wants to wait a week or two to see how he's settling in, then adjust the accommodations accordingly. That makes sense.

I have high hopes for his teacher, though, whom several other mom friends with older boys recommended. She's very structured, they said, and I said, perfect. A laid-back, whatever teacher would be a disaster for him.

She met us at the door on the first day, as we were doing the usual dork-parent thing and waiting in front of the school to snap a shot of him coming off the bus, then walking him to his room. The very first thing she said was to thank me for writing the letter to her, explaining what kiddo is good at and what he needs help with. She said it was very helpful. I was thrilled she'd read it, let alone liked it. That made my day.

I also shared the letter with the other ADHD moms I've been meeting up with -- our own personal support group -- and they liked the letter so much some of them were planning on ripping it off for their own kids. I am totally in favor of that. In fact I am so in favor of that that I am posting it here (with some details changed, of course). If one teacher liked it, I bet others would too. Steal away.




Dear XXXXX,

            I’m glad to know that my son XXXXX will be in your class this coming school year. I’d like to tell you a little bit about him.

XXXX has ADHD and has a 504 plan for classroom accommodations. In XXXXX class last year, those accommodations included a fidget toy, a band around the bottom of his seat and a special cushion to sit on. He has had issues with sitting still and with being physically aggressive with other children, due to sensory overload. He presents certain challenges, but offers a lot of positives as well.

He’s extremely friendly and loves to laugh. He wants to be helpful and to please adults, even if he doesn’t always quite manage to do it. He’s creative and smart, and loves to read. He also loves computer time and shows some skill with mathematics. He’s capable of a great many things, but may need extra help in achieving them.
           
We’ve found that being very clear and direct helps with XXXX. He will question instructions but given an answer, tends to be satisfied. Any opportunity for physical activity will benefit him (he does also have a weighted vest to assist with the physical stimulation, and has been receiving occupational therapy through the school). Repetitive or routine work will not go well with him, even though it’s certainly necessary. His brain isn’t stimulated enough by the activity and he will seem to find it almost painful. The occasional break, or even just a chance to stand up and stretch, should make a difference. He does enjoy any opportunity to be creative or to tell a story; you may find those tendencies helpful.
           
Other methods that seem to work are seating him close to the teacher’s desk and making him either line leader or line “caboose,” enabling the teacher to watch him more closely. We use a Time Timer at home, or the timers on our phones; sometimes the only way to get him to complete a task is to encourage him to “beat the clock.” He’s proud of himself when he’s able to do that. He does have issues with transitions; I’ve found that either using the timer, or telling him, “I’m going to count to five and then you need to do this,” is effective. (Sometimes the counting alone will work, without a stated consequence.) He also has trouble controlling his emotions sometimes, especially if he loses a game or if things don’t go the way he thinks they should. At home, we ask him to count backward from 10 to 1 and take a deep breath, which is generally effective. To ensure he’s listening to you, it’s a good idea to either touch him on the shoulder or make him repeat back to you what you said.

He’s very social and wants friends, but will unintentionally invade personal space or say inappropriate things. He was part of a social skills group last year, and I hope he is offered that opportunity again this year. We have seen some improvement in that area.
 
I hope you find this information useful. My husband and I look forward to working with you this school year. Our contact information is below; please don’t hesitate to reach out to either one of us if you have a question or something you need to discuss. Thanks and looking forward to meeting you.

Sunday, September 1, 2013

The backpack is packed.

I have no idea why kiddo needs a highlighter, but the list says he does, so there you go. I'm just not picturing him marking relevant points in his addition and subtraction workbook, is all. Also unclear on the index cards and the dry-erase board markers. But they're in the backpack, along with the folders and the pencil case and the Ziploc bags and the extra crayons and the kitchen sink. I had him carry the backpack around just to make sure he could, because it's heavy. At least most of that stuff is going in his desk once he gets there.

So the supplies are ready. I'm a little unclear on whether kiddo is ready. He's been OK this summer -- some extra bounciness in the transition from kindergarten to full-day daycare, more running around and less listening, but he more or less settled down as far as we can tell. At least we didn't get complaints from the teachers. We did the library's summer reading program, kind of, except the library wasn't open on Sundays, and if we were busy that Saturday, we weren't getting to the library that week. Once again I suspect that library programs are meant for stay-at-home parents. The killer, of course, is that we read to the kids all the time -- we just don't always get the chance to prove it by marking the minutes down on a sheet.

Kiddo seems excited, I think, though he may just be excited by the new backpack (it's Angry Birds). I'm hoping at least one of his buddies from daycare, or from kindergarten, ends up in his class, although honestly he's so uber-friendly it might not matter that much. We were at the playground yesterday, and within two minutes he was running around with a couple other boys he'd never met before, and they were taking turns spinning each other around on the giant swing by twisting the chains and letting go (pretty sure this was not an approved use of the swing but OK).


Am I ready? Well. I'm never going to react to these milestones the way a mother of a neurotypical kid would. I won't get all teary-eyed about my baby growing up; I'll worry about whether he listens well or has a meltdown, or runs around on the bus, or throws things -- most of which he quit doing last year, but still. I'll keep pushing for our first meeting with the new 504 coordinator. I'll try and figure out when to start sending the weighted vest to school. I'll obsess about trying to get extra protein into a kid who doesn't like lunchmeat and can't bring nuts to school. (At least he likes soy nut butter. And cheese. Anything cheese.)

I feel robbed, in a way, that I don't get to just sit back and coo over my brand-new first-grader, and go on with my day. But he's my kiddo and I wouldn't trade him for anything. So I'll do whatever it takes to help him get through this school business. For the first day, and all the days afterward.


Tuesday, August 27, 2013

Dear back, you are stupid and I hate you.

I mean honestly, how do I go from "hmm, my back is bothering me, I must be sitting too much, let me get a little more active this weekend" to "oh wow, I can't get out of bed without crawling"? Should there not be some sort of in-between step there? Like a warning light that comes on right before my back gives out? Some sort of computer voice doing a countdown to a chiropractor visit?

And "getting active" did not exactly mean running a 5K. Which trust me I will never in my life be doing. I picked up some plants at a plant farm, and then went to BJ's. Granted pushing a cart around at BJ's probably qualifies as resistance training for football players. But I'd done it before with no problem, until now. So much for stocking up on cereal and roasted almonds.

So I went to the doctor, started physical therapy and went back to the chiropractor. The doctor (naturally) gave me medication. The physical therapy facility has way better heating pads than I do, and they're all nice, and they have me do particular exercises to stretch out the areas that need stretching. The chiropractor did not approve of my doing gardening without a back brace, and so now I own one. A back brace. It attaches with Velcro. Perhaps I can get a walker for the next breakdown and then have the complete "I'm an Old Fart!" set.

Next I'll be eating dinner at 4 p.m. daily and complaining loudly about kids today.

(Side note: While DH and I lived in Florida, we for whatever reason opted for an early dinner at a restaurant -- and were the youngest people in it by about 40 years. I make early bird special jokes because they're true.)

I am starting to feel more normalish again this week, although I'm still in physical therapy. I also switched out my purse, since according to Oprah, certain types of bags are better for the back than others. If Oprah says so, it must be true. Thankfully I don't have to carry the children around anymore, as much as they would like me to do so. Still it's aggravating to have to shut down horseplaying and overenthusiastic hugging with, "Not now, sweetie, Mommy's back hurts."

Stupid back.

I was so sidelined by this that I almost didn't get to send out the letter I wrote to kiddo's new teacher, explaining who he is, what he has and what techniques work with him. I got it in the mail today. (No, school hasn't started yet here. Yes, we do start late. I agree, it is strange.) I'm hoping the letter does something -- anything? -- but we won't know until after school starts, I guess.

I also sincerely hope kiddo wasn't meant to have finished that entire summer typing program before September, because that is not happening. Mainly because he thinks practice-typing the same two letters over and over is torture. (I can see his point.) Speaking as someone who types for a living, and has worked with lots of other people who type for a living, I'm pretty sure hunt-and-peck is the preferred method anyway.

He has been typing, though. So, credit for that.

I got all his school supplies before my back gave out, so we're set there. We just need to pick out a first-day outfit, and show him his room, and hope he doesn't get overstimulated or oppositional or otherwise act out. A normal first day of school for us, in other words.

In the meantime, my old-fart back and I will continue the healing process.

Friday, August 16, 2013

I thought about being offended

when I saw this movie review which says, "If the original felt like it was designed for adolescents, however, this follow-up feels like it was made by an adolescent, one with a whopping case of ADHD." The good folks at The Wrap liked that line so much, in fact, they used it again under the headline. I thought about being mightily offended, because ADHD is a neurological condition and not a lazy slang term meaning "poorly organized filmmaking."

It's also a fairly ill-informed thing to write, in that folks with ADHD tend to be extra-creative and frequently end up working in the arts (see my previous post on that); someone with ADHD isn't necessarily going to be a bad storyteller. They're more likely to be a wonderful storyteller who forgot to pay their electric bill five months in a row. Or a genius filmmaker whose clothes never match because he can't find the clean laundry.

This is additionally a pretty obnoxious thing for someone with ADHD to read, since the condition they've struggled with for a good chunk of their life is now being played for laughs in the service of trashing a summer movie sequel. Frankly trashing a summer movie sequel shouldn't even require so much work. If the movie were any good, it wouldn't be released in August. All you really need to write is "It's August and this is a sequel. Half a star. Moving on."

(Bear in mind, I liked the first "Kick-Ass." I thought it did a pretty good job being meta right up until the end when it didn't, and I love Chloe Grace Moretz because she is the coolest and I'll even go see her in the "Carrie" remake. But not even my liking for the first film can justify the existence of the second film.)

I'm not loving the fact that my son, who can read, and who's been known to read what I'm reading right over my shoulder, could stumble upon such a sentence right up there in a movie review. What's he supposed to think, the first time he sees something like that? Or the second or the third?

So I debated being offended. I considered going into full all-out self-righteous mode and trashing the writer eight ways from Sunday. And then I considered some more.

I'm not a huge fan of some people's tendency to get hysterically offended over every little thing. I don't necessarily want to be one of those people. It's no fun to be around, for one thing. They tend to get a "cry wolf" response after a while; people stop listening to them. For another, there are definitely better things in this society/this world/this century/etc. to get worked up about than the use of a word.

It's clueless and obnoxious to use "ADHD" like it's some sort of goofy slang word. But it's also a pretty good indicator of someone who isn't worth listening to. For instance, I will never seek out this writer's movie reviews again. And I think that's what I'm going to tell my son, the first time he sees or hears something like this: Now you know not to bother listening to this person, because they are ignorant.

You can't change the ignorant people. But you can decide how to respond to them, or whether to respond to them at all. And that, in a way, is sort of freeing. 

Sunday, August 4, 2013

Catching up on ADHD news

I was on vacation. Well actually, I was on vacation the previous week and spent this past week being exhausted, because long road trips apparently wreck you when you have arthritis, even if you take your lumbar pillow with you because you have become an old fart. I'm going to have to change the name of this blog to "Angry Old Mom With Arthritis."

We went to the circus at Lake George, and then left the kids with MIL (thanks, MIL) and went to Burlington, Vt., overnight. It's a lovely place and totally crunchy. Vegan everything. Sarongs for sale everywhere. Extensively used bike parking. A ton of breweries seemingly. (I'm guessing that's a necessary thing in the winter.) We also hit up the Ben and Jerry's factory tour, and I guess we should've felt guilty about doing that without the kids, but uh, no.

Anyhow. I'd still like to weigh in on the FDA approving the first brain wave test for ADHD a couple weeks ago. The test involves an EEG and sensors hooked up to a child's head, and measuring the brain waves, which appear differently in an ADHDer. The FDA says using the test helped doctors make a more accurate diagnosis. The commenters on the Times article, of course, are saying various variants on "The FDA is ripping people off and all psychiatrists are snake-oil salesmen and parents should let their kids be kids!" (paraphrasing, of course), rebutted by the adult ADHDers and parents of ADHDers who say, "Oh yeah? You deal with this for a while and see if you think it's made up." So, the usual back-and-forth then.

Then ABC had this story about experts' skepticism about the validity of the test and their belief that they can diagnose just fine on their own, thank you very much. Sorry -- two experts' skepticism. I guess all the others were busy. Anyway one of them said this about general practitioners using the test:

"They can charge for it and it gives you a pseudo-scientific basis for the diagnosis – a piece of paper with little wiggles and you can say they're not the wiggles you expect," she said, adding that she hopes parents "understand the limitations of the test" and "realize they don't have to rely on commercial promotions."

The company that makes the test, says this article, is a tiny start-up in Georgia and they've been working on the test for seven years. The (uninsured) cost to parents for the test would be $300, it would take about an hour and the company's president said they're looking to sell it to clinicians and hospitals. He also said the ABC News article hurt, and called it misinformed, adding:

"While there are some upfront costs, NEBA is worth it because of the increase in accuracy it brings the clinician and the overall costs associated with misdiagnosis."

Here's the thing. I don't especially expect the test to be perfect. I don't have any especial need to have my son tested. (Believe me, we already know what he's got.) But I'm glad the test is around. Because if there is such a test, and it works at all, then people can't keep snarking that ADHD is made up and blame kids' behavior on lousy parents, incompetent teachers and money-grubbing psychiatrists. A test takes the emotion and knee-jerk moralizing out of it. A test puts things on neutral ground.

The other piece of this is, and I've said this before, that general practitioners shouldn't be diagnosing. They don't have the experience, they're probably not up on the research and, at least in my experience, they're way too quick to throw a pill at a problem and move on with their lives. Medicating ADHD, which I'm generally in favor of as necessary, is a fairly delicate process -- finding the right drug at the right dosage, figuring out how to handle the side effects -- and that's a specialist's job. It's such a fraught topic, and causes parents so much angst, that it shouldn't be the automatic solution. It should be the last resort after other methods -- OT, behavioral therapy, classroom accommodations -- have been tried. Yes, that takes time. So does doing anything right.

And frankly ADHD is on occasion misdiagnosed, per my various readings. Sometimes the child actually has bipolar disorder. Sometimes it's purely sensory processing issues and not hyperactivity/inattention at all. Some of the things my kiddo does, a child with Asperger's would also do, or a child with SPD. So getting to the right conclusion is crucial. The wrong diagnosis means the wrong treatment, means, most likely, the wrong medication and then a worsening of the situation. Anything that could prevent such an outcome is welcome, as far as I'm concerned.

Though I will note that $300 is a lot of money and it would be nice if that cost could be offset somehow to ease the burden on families. Offset by insurance, say.

In other news, that Charlotte Observer series appears to have reached its conclusion. And it's a lovely conclusion. The writer (actually guest blogger on the paper's website), in part, said this:

"I realized that my son John, my forever challenging son, had immeasurable gifts, maybe some as a result of his unique brain. As I reflected on his perpetual insights about people and behaviors, I knew that if I could just safely guide John to adulthood, he would do great things."

Well, yes! I think kiddo will too. He's smart, he loves telling stories, he's totally charming (he has dimples. Seriously), he builds fascinating things with Legos, he's sensitive to other people's emotions, he's wonderful around babies. He plays very nicely with his little sister, even though their "playing" sometimes consists of bonking themselves into the (closed) basement door, falling to the floor and yelling "Ow!" then giggling and doing it again. Yes, really. I figure they're not strong enough to give themselves concussions. (This is still an improvement over their previous game, in which they said to each other, "Let me smell your foot. Eww!" "Let me smell your foot. Eww!" Honestly. They are like the world's littlest fraternity, minus the beer.)

And they appear to be awake, since kiddo has unlocked the gate and I can hear them chattering downstairs, so that would be my cue to go give them breakfast.

Read more here: http://www.charlotteobserver.com/2013/07/30/4200702/life-as-a-mom-of-a-child-with.html#storylink=cpy