The week in ADHD news

So a study came out recently saying that the majority of pediatric specialists ignore the American Academy of Pediatrics' guidelines for treating ADHD in preschoolers. (I learned about it here; the full story is here.) Researchers at the Cohen Children's Medical Center of New York sent out a questionnaire to 3,000 specialists nationwide. The AAP guidelines, which were revised in 2011 to extend the minimum age for diagnosis from 6 down to 4 -- in other words, the age at which kiddo was diagnosed -- say behavioral therapy should come first, with medication as more of a last resort. In other words, what we did. But more than 1 in 5 specialists said they go with the drugs first.

Sigh. Any second now I expect the NY Times to weigh in on the terrible terrible overmedication of America's youth, while once again not managing to find a single child or parent actually dealing with ADHD to interview about it.


OK, why do I think doctors (and/or parents) opt for medication first? Because it's covered by insurance. Basically the reason we haven't been back to kiddo's behavioral therapist is because she dropped our insurer, and while she offered to keep seeing him at the co-pay rate, we felt like that was more of a short-term favor. Most occupational therapy facilities (and, I have a feeling) ABA facilities don't take insurance, and after our ongoing aggravation with the OT Facility That Wouldn't Quit Billing, I can understand why. They're not equipped for that level of paperwork. So what are parents supposed to do if they can't afford to pay for therapy out of pocket? They go with what's covered.

Also, behavioral therapy is a long-term time commitment. I had to come in to work late on appointment days; kiddo occasionally missed part of kindergarten. It helped, sure, and we got some good advice on dealing with him (this is most of the point). But not everyone can make that kind of commitment.

And also, I think there is such a general lack of education out there about ADHD and other mental issues/disorders that people think the meds are what you're supposed to do. Got ADHD? Oh, well, get drugs. The other (and preferable, if you can swing them) options never come up because people don't know what they are.

I do find it troubling that doctors are just throwing medication at little kids to solve the problem. But I also think doctors will just throw medication at anything to solve any problem. Case in point: Many years ago I went to my doctor looking for help and advice about my insomnia. He rolled his eyes and gave me a prescription for Ambien. I'd actually kinda been hoping for an informed discussion about what might be causing the insomnia and what I could do about it, but sure, OK, Doc, I'll just take these meds and quit bothering you. The upshot: I took it maybe three times, didn't like it and stopped. And then I had children and insomnia basically ceased to be a problem, because when you have kids you're always tired and will never turn down an hour or 15 of sleep if you can get it.

So you want doctors to stop overmedicating kids? Great. I'm with you. But how about getting doctors to stop overmedicating the entire rest of the country while you're at it?

Bringing me (tangentially) to point number 2: This is Speak Up for Kids month, according to the Child Mind Institute in New York. (And you thought it was just Mother's Day.) The institute, which helps kids with all manner of behavioral and learning disorders (and has a pretty informative website, do check it out), runs a campaign every May to inform people about these disorders and about how kids' mental health is disregarded and underserved. I can't say they're wrong. If more people (and more doctors, apparently) really understood ADHD or autism or OCD or Tourette's or any number of other issues, they'd be better prepared to help kids who have them, wouldn't they? And maybe overmedicating would be less of an issue.

Anyway, that's my four or five cents. Now I have to get back in bed so the kids can serve me breakfast. Happy Mother's Day, all.

The week in ADHD news

One of the more aggravating things about ADHD is feeling like you have to constantly convince people that it's real. And not some made-up excuse to drug a bratty kid into submission. Or a way of justifying bad parenting. Etc.

Which was why it was sort of heartening to read about this study out of Sweden, which found that teens and adults with ADHD were more likely to commit criminal behavior -- but dramatically less likely to commit criminal behavior if they were still on ADHD medication. Said a professor who's researched ADHD but wasn't involved in this study:
"There definitely is a perception that it's a disease of childhood and you outgrow your need for medicines. We're beginning to understand that ADHD is a condition for many people that really lasts throughout their life."

Probably I should be flipping out about the idea that kiddo is more prone to criminal behavior, but I'm just delighted to see an article based on the idea that ADHD is real. As opposed to wondering whether it is real, or whether it's overdiagnosed, etc.

On the other hand, there was this story, which found that the youngest kids in a class were more likely to have trouble with academics and behavioral issues, and were also 50 percent more likely than the oldest kids in their class to be prescribed ADHD medications by the time they hit seventh grade.

In other words: 1. Maybe meds are overprescribed after all. 2. The parents who obsess about school cutoff dates and holding their kids back an extra year might actually have the right idea. Although the researchers said the study might not be conclusive across the board, and could possibly also mean that ADHD is undertreated in the older kids, not overtreated in the younger kids.

So, a bit of an up-and-down week in news stories.

In more local (ahem) news, kiddo had a couple of good days this week, thus proving that it's possible for him to have good days. We restarted the star chart and that seems to have made an impression. I also, for whatever it's worth, started giving him gluten-free foods. I'm not being completely strict about it -- if I were, I would've banned all gluten from his diet for a few weeks to see if it made a difference -- but I am keeping him gluten-free at school, just to see what happens. Supposedly ADHD kids sometimes have food sensitivities -- not allergies -- to gluten and/or dairy.  If I get the sense that any of his behavior is somehow food-related, I'll modify his diet further.

There is of course the possibility that he'll be this way no matter what he eats, so I'm not being too obsessive about it.

The OT at school finished her assessment so we should have some results this coming week, when we meet with the school again. Kiddo's teacher noted that the OT said he seemed distracted during the evaluation. Again, glad they're seeing what we're seeing. The in-class observation won't happen till December -- thanks a lot, Sandy -- and we'll meet on those results in January. Progress is progress.

At any rate, kiddo and kiddette had a lovely Thanksgiving and even tried to dance along with the Rockettes during the parade. And since all of our immediate neighbors have already put up their Christmas lights, it's time to move on to the December Month of Shopping Madness and Way Too Much Sugar. Um ... hooray?