Wednesday, March 26, 2014

Dear Abby, think again.

I mean, I guess it's progress of sorts when ADHD makes it into a nationally syndicated advice column. Even if you don't totally agree with the advice given.

A high school student (I'm assuming high school, no age given) wrote to say that their ADHD medication was suppressing their appetite, and so they didn't eat any lunch, and well-meaning teachers and friends have been pushing them to eat, not knowing the situation. The student didn't want to tell anyone, because some of those friends make fun of people with ADHD.

Abby (okay, "Abby") says to inform the teachers about the medication, but added this:

"It's a shame they would tease someone who has ADHD because it's a condition that so many students and adults share. However, because you feel it would make you a target, you're wise to say nothing."

No, no, no.

I wouldn't call it "wise" to hide a significant part of yourself away in hopes that no one will laugh at you for it. That suggests that people are right to laugh at it, and no they are not.

Also, frankly, if you're different, people pick up on it, and if they're so inclined, they'll make fun of you for it even if you pretend that difference doesn't exist.

Really. Just ask every kid in grade school who made Jew jokes about me.

You have to turn it around. Why is it on you to convince people not to pick on you? Why isn't it on them to try harder not to be jerks?

You should never be ashamed of who you are, and anyone who would try to make you ashamed is not someone who deserves the privilege of sitting next to you in the cafeteria.

At no point have I hidden kiddo's diagnosis from anyone. His family knows. His teacher knows. The other moms know. His karate sensei knows. Because I am not ashamed of him, and because figuring out what works and doesn't work with him is sometimes a group effort. It takes a village to tackle ADHD.

And because of that openness, other people are open with me; they talk to me about their special-needs child, or ask where to go for an evaluation. It's good to know other parents deal with the same issues.

Even if I wanted to, I'm not a good enough liar to pretend I have some sort of Stepford-perfect son. I'd rather be honest, with other people, with kiddo and with myself. I don't want kiddo to grow up thinking he needs to hide his ADHD from people. I want him to be proud of who he is -- all that he is.

Just my two cents, Abby. Carry on.

Wednesday, March 19, 2014

The experiment begins

Because the psychiatrist, who'd meant for us to be using the generic medication all along, was nice enough to call the pharmacy and say so. The medication may not work, but at least we won't go broke finding out.

He's only been on it for a couple of days. He's a bit extra tired, but that was supposed to happen. As for any improvements ... hard to say. He's still not listening at school, and not completing his work. He had a full-on meltdown the other day, in the middle of a birthday party, in front of the other moms, because I wouldn't buy him a toy. I played it off as, "Yeah, he's tired," as I tried to peel him off the floor, just because it's easier than saying, "Yeah, he does this a lot, he has utterly no emotional coping skills, the slightest bother or disappointment makes him collapse and he's not really a brat, even though he's coming off like one right now. So anyway, what were you saying about the weather?"

Amazingly other people never seem too bothered by the meltdowns. I don't see how that lasts, though. He just looks too old to be having them.

I think we have to give the medication a few weeks to see if it makes a difference. And if not, I suppose we see what's behind Door #3, and whether it comes in a generic version.

He did score really well on some sort of reading assessment test the other day. So, there's that.

Also, he had fun over the weekend at our joint pre-birthday hibachi celebration with friends (great idea, M.), and apparently also at the St. Patrick's Day parties at school. I don't quite get the St. Patrick's Day parties. Mainly because 1. we're not Irish, 2. the holiday as celebrated in America has very little to do with the actual holiday and 3. still not Irish. Although I do like soda bread.

But he came home talking about the leprechaun that snuck into the classrooms and did mischief, or something like that, and I sincerely hope we're not expected to keep up that whole business at home, because keeping track of Santa's sled and remembering the cookies and milk and the carrots for the reindeer is about all I can handle. Jewish holidays never involve invisible magical creatures, unless you count the prophet Elijah at Passover, and all you have to do for him is leave out a cup of wine. Which he never drinks, because, I'm guessing, he doesn't like Manischewitz wine either.

Our next event will be kiddo's official birthday party, for which he has so far wanted a Lego cake, a Minecraft cake and possibly a Paw Patrol cake, unless that was kiddette, who has been placing her pre-order way too far in advance. Such indecision. Just imagine if I were ambitious enough to make the cake myself. (Not a chance.)

Tuesday, March 11, 2014


So kiddo's psychiatrist suggested we try another medication, as the one kiddo is currently taking appears to be -- what's the technical term? -- doing jack squat. Well, OK. I'm not especially interested in hopping back on the merry-go-round of medication hoping to find the right one, but a lot of ADHD families go through this, so it was maybe an inevitability.

I did veto stimulants, because they're notorious for causing appetite suppression. As in, the kid loses his appetite and refuses to eat. That's a freaky enough prospect in itself. Kiddo, however, really can't be losing weight. I'm not saying he's skinny, but he might conceivably blow away in a stiff wind. I can't imagine how he could get any skinnier and I'm not interested in finding out.

It's kind of fascinating, the skinniness, because right now this is what we hear every morning after breakfast: "I'm still hungry. Can I have another food?" I try to pack him extra food at lunch so he can get through the day. I have no idea where he puts it all.

So the psychiatrist prescribed a non-stimulant, saying basically, let's see if this one helps. OK. She knows I like to use as little medication as possible, so she said we should be halving the dose with a pill splitter. Fine.

Not fine. The pharmacist said that particular pill should not be split, on orders from the manufacturer, because splitting it releases the entire dose. Naturally, it was Saturday night when I learned this and we couldn't do anything until today.

So I called the psychiatrist, who never called back (I hate when doctors don't call back), and the pharmacist, who reported that he'd gotten through and the psychiatrist said to use the whole pill, and I could come pick it up whenever. Oh, OK, so actually the full dose was fine all along? Gosh, how convenient.

I went to pick it up and discovered that it was pricey. By which I mean the co-pay is $40, for two weeks' worth of pills. Two weeks? So we're supposed to drop thousands of dollars on a medication that might not even work, whose proper dosage appears to be in doubt?

It's bad enough that ADHD parents have to deal with 1. the ADHD and 2. the various amounts of ridicule and contempt from total strangers who think they're horrible parents for medicating their children. Dealing with this nonsense on top of it all is a bit much.

I did not buy the medication yet, because I want to have a serious talk with the psychiatrist first and I will be happy to call as many times as it takes for that to happen. At least we still have some of kiddo's current medication ... for whatever that's worth.

Saturday, March 8, 2014

Part 2: Information

Yes, I am aware that a two-part post should really be on successive days. It's been that kind of week. Next week I should be back to my Monday-post schedule.

Anyhow. Two things happened of note: I read an article on ADHD that didn't make me seethe, and I heard Dr. Edward Hallowell speak.

First the article, regarding the new book “The ADHD Explosion" by Stephen Hinshaw and Richard Scheffler. I believe I trashed a Times op-ed by them a few weeks back, so it is much to my surprise that I found the article interesting. Their hypothesis: The rate of ADHD diagnoses varies wildly by state -- from under 5 percent of school-age kids in some states (like my state, for instance) to more than 10 percent in others. That correlates with states that passed No Child Left Behind-style accountability laws linking school funding with students' performance on standardized tests. The states with those laws had the highest rates of diagnoses and medication.

From the article:

ADHD diagnoses of public school students within 200 percent of the federal poverty level jumped 59 percent after accountability legislation passed, Hinshaw reports, compared with less than 10 percent for middle- and high-income children. They saw no comparable trend in private schools, which are not subject to legislation like this.

How do ADHD diagnoses help schools at risk of losing their funding? First, Hinshaw notes, for kids who do have ADHD, it should improve their performance in school, including their test scores. Second, it may help kids who are disruptive in class settle down, which could improve scores for the whole class. Finally, in many areas, the test scores of student with ADHD diagnoses aren’t counted. So even it if it doesn’t help the child, it might help the school.

By the time No Child Left Behind was signed into law, 30 states had already passed these accountability statutes. The maps of those states and the states that have high ADHD rates look remarkably similar — mostly Southern states, with a few in the Midwest. ...

It doesn’t mean that ADHD isn’t a real thing, with a biological basis. Hinshaw and Scheffler are very clear about that. But it does underscore our worry that misdiagnoses are being handed out by doctors with little time, little training in psychiatric disorders, and a lot of pressure to do something to help kids who are failing.

I do appreciate that the authors aren't calling ADHD fake, unlike certain other "experts." But this research sounds striking. I'd want to read the book, obviously, but I do fully believe that there are doctors rushing a diagnosis because they think they're being helpful, or because they have no formal training in the matter. Hence my regular drumbeat of "general practitioners shouldn't diagnose ADHD." It's frustrating to me because rushed or false diagnoses makes legitimate diagnoses, like that of my son, seem less legitimate. If some of the diagnoses are bogus they must all be bogus, right?

Hey, you live with my kid for a week. See what you think. He doesn't run in front of moving vehicles anymore, so, you know, you'd have that going for you.

Here's the thing. I know a psychologist-to-be. (I'm being deliberately sketchy on who.) That person told me once, that if they were treating a kid coming from a lousy home life, who had trouble settling down in class because of the lousy home life, they would prescribe the kid ADHD medication just because it would help the kid settle down. Because assisting the kid with the lousy home life takes too long? I don't know. At any rate, I did already know the "just medicate the kid, whether he's got it or not" attitude is out there. Which is why what this article says sounds right to me.

If you're going to help kids, you have to help what's really wrong with them, if anything, and not just make things more convenient for you.

Also I HATE standardized tests. I hated them when I was the one taking them. I hate them now. I call them "multiple guess tests." They don't prove anything, except how well you take standardized tests. They have nothing to do with true intelligence or education. And I was a "gifted" kid, an honors student, in the top 10 of my graduating class in high school, and I'm saying this. I'll teach my kids to do as well as they can on such tests, because it's part of the school experience, but I'll also teach them the value of independent, critical thinking, which carries a lot more weight in life than "fill in answer A, B, C or D."

... and on to Dr. Hallowell. He gave a talk at a nearby high school and you would not believe how many parents showed up. At first I thought, are these all ADHD parents? because I forgot Hallowell is also a general sort of parenting expert, not just an ADHD expert who also has it himself. (Read his book "Driven to Distraction" if you want a good overall view of the disorder.) This was a more general sort of talk, based off his book "The Childhood Roots of Adult Happiness."

He's a good public speaker, should you ever get the chance to see him -- resonant voice (he said he had a cold but I didn't hear it), good sense of humor. For instance, he described his family background in New England as the "WASP triad" of "alcoholism, mental illness and politeness."

His contention was that $1,500-an-hour (!) tutors to help a kid get from a B-plus to an A aren't necessary (this is some sort of New York thing, apparently?) and that helping a kid grow up to be happy doesn't mean getting them straight As or being their buddy or getting them the best of whatever, but teaching them confidence, initiative, responsibility; keeping them connected to their family, their community and their spiritual tradition; and giving them time for unstructured play. "If we could just have an attack of sanity," he pleaded.

It all sounded pretty sane to me. But then DH and I can be a bit old-school in our parenting. We don't want to be our kids' friends, though they're lovely people. We want them to grow up to be mature, responsible adults who contribute somehow to the larger society. We don't much care if they don't get straight As. You know how much that matters once the child graduates? It doesn't.

I think DH and I can afford to take the long view because we were both "gifted," both in honors/AP classes, and having gone through it, neither of us entirely liked the attitudes that went along with it. There's a difference between getting good grades and actually being smart. We prefer the latter.

This is a roundabout way of saying that I agreed with what Hallowell said and was a little surprised, I guess, that people need to hear it from a professional. I did enjoy the speech, though. I would've bought his book, since he was doing a signing, but they'd run out. Should've bought it before the speech.

Since I do think he has many common-sense things to say, I'll include a link to his website here. Peruse at your leisure.

Thursday, March 6, 2014

Part one: Exasperation

I'm breaking this up into two posts because I've been short on time this week. Just catching up.

Kiddo has the occasional off day, when his hypersensitivity is extra-sensitive or he can't stay in place for more than a nanosecond or he stomps around in an evil mood because his understimulated brain craves the drama. So that might have been his problem this past weekend. Or he was acting out because DH was out of town for work. Or the 6 p.m. birthday party he went to threw off his sleep schedule (though he did have a blast at it). Or who knows. But he spent most of Sunday being thoroughly whiny and unpleasant and having those tantrums in which he collapses to the floor and wails. Something you'd expect from a 3-year-old, maybe not an almost 7-year-old, but ADHDers tend to be behind their peers emotionally and behaviorally. I can handle two or three of those fits, but when it's more like seven or eight within two hours, yeah, I'm done. Especially when one is in the middle of church.

Actually one was in the parking lot outside church, because I wouldn't let him bring his noise-making Angry Bird toy inside, on the grounds that it might make noise. It got to the point where I walked kiddette back to the car and started strapping her back in, because I didn't think he would make it inside. After that was the tantrum inside church, when he darted off toward the snack table again, I darted after him and grabbed him away (the kids had literally just had their own snack) and he collapsed on the floor. In front of everyone. It's probably just my imagination that we instantly became the center of attention. Right? It is not my imagination, however, that one of the adults announced jokingly, "It's the RE eater!" Oh good, thanks for the nickname. Appreciate that.

Some of the other adults -- as in, the ones who have kids -- tried to help, telling kiddo he needed to listen to me and such. But I still ended up dragging him to the other side of the room to start getting the kids ready to go. At which point one of the other kids, clearly sent over by a parent, brought him an apple slice. Which was nice. Really. But also entirely defeating the purpose of my dragging him away from the snack table in the first place.

I'm feeling like maybe we need to reconsider this church thing.

That wasn't the end of the tantrums, of course, because he threw a few more during the post-church playdate, about sharing toys and cleaning up, at which point I hauled them both home and quit attempting the model-parent act, being thoroughly angry and growly, and made them both take naps. Kiddo was out like a light, proving that what I really should've done was skipped church entirely and sent them to bed for half the afternoon, but the other mom and I have been trying to schedule a playdate for a month-plus. I want kiddo to have a social life, but what if he keeps getting in his own way?

And why does kiddette keep having to suffer indirectly from her brother's wrath? I honestly don't know what to do about that.