Monday, February 24, 2014

I never thought I'd say this

but I liked a story about ADHD in the Times.

Heavens! Down is up! Up is down! Dogs and cats living together! Mass hysteria! (OK, sorry, couldn't help it. Harold Ramis, RIP.)

The Times, forgoing its usual "clueless parents and incompetent doctors have been brainwashed by drug ads into overmedicating children" meme, chronicles instead how child psychiatrists are teaching pediatricians and general practitioners how to properly diagnose -- not overdiagnose -- ADHD, and to not rush to medicate.

The story confirms what I suspected:

Because the disorder became a widespread national health concern only in the past few decades, many current pediatricians received little formal instruction on it, sometimes only several hours, during their seven years of medical school and residency. 

In other words, pediatricians right now don't have the background or experience to be making diagnoses. Which is what I've said about 50 million times here.

Various medical experts quoted in the story admitted they didn't have very in-depth knowledge:

Harriet Hellman, a certified pediatric nurse practitioner in Southampton, N.Y., who is licensed to make mental-health diagnoses, said that there were times she would identify the disorder through mere instinct, a “hair-on-the-back-of-your-neck feeling.”

So I'm glad that this seminar exists and I wish there were lots of others like it. Because the biggest problem with ADHD is the lack of information -- not just among doctors, but among the general population, who still think that the disorder is a made-up thing to justify lousy parenting. 

And just when I'm sort of OK with the Times comes this op-ed arguing that universal pre-K might lead to an epidemic of ADHD diagnoses. To quote:

Introducing millions of 3- to 5-year-olds to classrooms and preacademic demands means that many more distracted kids will undoubtedly catch the attention of their teachers. Sure, many children this age are already in preschool, but making the movement universal and embedding transitional-K programs in public schools is bound to increase the pressure. We’re all for high standards, but danger lurks.
Right, fellas, the key is "many children this age are already in preschool." Except it's probably private preschool, it costs parents lots of money and if there is a problem -- as was the case with my son, who got in trouble basically every day for a year at two different preschools before he was diagnosed -- there are no experts on staff and no resources available to assist. We yanked him out of day care entirely the summer before kindergarten and kept him home with a nanny because the school setting was so difficult for him -- and that was after he was diagnosed. But the school wasn't equipped to deal with him, period. (This was all pre-medication. Something else the writers rail against.)

My point? Sure, it's possible overdiagnoses might result. It's also possible that legitimate cases of ADHD will be caught earlier and treatment plans, behavioral or otherwise, begun earlier, thus preventing a lot of anger, angst and heartache for those families.

So I'm a little dubious about this op-ed, and annoyed at the Times all over again. It was nice while it lasted, right?

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