Monday, December 30, 2013


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 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.