Monday, April 15, 2013

The Times is concerned

about the jump in ADHD cases and the corresponding rise in medications. Because obviously the real problem is crappy parents medicating their kids into submission, I assume. Anyway, from the article:

The figures showed that an estimated 6.4 million children ages 4 through 17 had received an A.D.H.D. diagnosis at some point in their lives, a 16 percent increase since 2007 and a 41 percent rise in the past decade. About two-thirds of those with a current diagnosis receive prescriptions for stimulants like Ritalin or Adderall, which can drastically improve the lives of those with A.D.H.D. but can also lead to addiction, anxiety and occasionally psychosis.
“Those are astronomical numbers. I’m floored,” said Dr. William Graf, a pediatric neurologist in New Haven and a professor at the Yale School of Medicine. He added, “Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy.” 

Or, possibly, there are a lot of kids out there who should've been diagnosed in the first place but weren't because people think ADHD isn't real? Sorry, just speculating wildly.

The article says:

While some doctors and patient advocates have welcomed rising diagnosis rates as evidence that the disorder is being better recognized and accepted, others said the new rates suggest that millions of children may be taking medication merely to calm behavior or to do better in school. Pills that are shared with or sold to classmates — diversion long tolerated in college settings and gaining traction in high-achieving high schools — are particularly dangerous, doctors say, because of their health risks when abused.

Yeah, and when I was in college it was Red Bull, and/or NoDoz. (Or in my case, coffee.) Sharing pills with classmates is essentially becoming a drug supplier to drug abusers and should be treated accordingly. But it's a misperception that the drugs are designed to give kids better grades. They're designed to help the kids focus long enough to get their own good grades. Because ADHD kids tend to be smart and creative thinkers whose easily distracted brains go wonky when they're loaded down with busywork and test-by-memorization.

Kiddo isn't on medication for his grades. He's in kindergarten. Do they even get grades in kindergarten? Is it smiley faces or something? He's on medication because occupational therapy, behavioral therapy, behavior charts and a social skills group weren't enough to help him keep his hands to himself or prevent meltdowns over things he didn't like or couldn't control. Emotionally, he isn't 6; he's more like 3 or 4. That's part of the disorder. (Believe me, at home it's like we have two 3-year-olds, not a 3-year-old and a 6-year-old.) I'm hopeful, long-term, that he'll catch up emotionally and the medication won't be a permanent thing. But it's working right now and right now is good enough.

The Times also said this:

A.D.H.D. has historically been estimated to affect 3 to 7 percent of children. The disorder has no definitive test and is determined only by speaking extensively with patients, parents and teachers, and ruling out other possible causes — a subjective process that is often skipped under time constraints and pressure from parents. It is considered a chronic condition that is often carried into adulthood.

Funny, I don't remember the "subjective process" being skipped. I remember a two-month wait to see a pediatric neurologist at the county hospital. I also remember her conducting actual tests, of reflexes and motor skills (ADHDers tend to have issues with fine motor skills), in addition to going over the surveys.

Also, "historically"? This generation of kids growing up now is probably the first to even have access to medical and educational experts who knew anything about ADHD or what to look for. So what historically are we talking about? Because historically, what I remember from my own school days is that kids who couldn't do the work were written off as lazy or stupid, not as potentially having cognitive or behavioral issues that might be getting in the way. When you're talking about a disorder that right up until 1980 was still known as "minimal brain dysfunction," of all things, there is no historically. There's now and in the future.

So what's the result of all this hand-wringing by the Times? Comments like this.

As a school psychologist I have watched the rise in ADHD being diagnosed in children for the last thirty-four years. The diagnostic criteria for ADHD could be well termed: “Things that children do that annoy adults.”

And this.

Helicopter parenting and all that it entails, is one of the greatest factors in the ruination of their children. I have seen parents wanting their children to be labeled, to have a personal ed plan, so their children can have more time on tests, both classroom and standardized. Medicating the kids so that they can get better grades certainly makes these parents preen.

And this.

The problem is self created, we don't provide quality time to our kids, and that's what they are all craving for. 

Because it's always the parents' fault, right? And stories like this just confirm people's preconceived notions.

The Times, of course, was not done. They offered an editorial on the matter a day or two later, concluding thus:

The increase in reported cases, experts say, has been fueled by awareness of the disorder, drug company advertising, and parental pressure on doctors to prescribe drugs to help children focus. With the growing concern that many young people may be sharing or abusing these drugs, it is crucial that parents and doctors are vigilant about overmedication. 

 And by "experts" do we mean all two of the ones you interviewed for the last article?

Look, I agree that there likely is some overdiagnosing, and some unnecessary medicating, going on. I honestly don't think general-ed practitioners or pediatricians should be doing the diagnosing, unless they have significant experience in ADHD and other mental disorders. There's so clearly a general lack of knowledge and understanding in the general population that I'd only want to (and did) deal with a specialist. But I don't think any of that should take away from the many legitimate diagnoses out there, the many kids and adults who benefit from finding out exactly how their mind works and how to properly deal with it. 

Just once, I'd like the Times to interview someone who has ADHD, or the parent of an ADHDer. (Some non-celebrity, that is. They have, tangentially, interviewed Andres Torres and Michael Phelps about it.) Not to sound the alarm about drug abuse. Not to declare that all these kids can't possibly have this disorder. Just so they can tell their readers what it's really like to deal with ADHD. Because that alone would convey the idea that the Times says ADHD is real. That would be a powerful thing.

And then maybe I wouldn't feel like the most powerful paper in the country is taking potshots at my parenting decisions.

1 comment:

  1. The Times is a shitty paper with extremely slanted articles. I wouldn't wipe my ass with it. Kiddo is doing amazing. Scott and I were just saying that.