Mumsnetters aren't necessarily qualified to help if your child is unwell. If you have any serious medical concerns, we would urge you to consult your GP.

ADHD

(113 Posts)
Hopandaskip Sun 01-Apr-12 17:03:24

AIBU to think that if up to 16% of kids in one US state are diagnosed with ADHD that ADHD isn't a syndrome, it is normal?

It seems crazy to me the number of children who are being medicated with mind altering drugs. Up to 10% of school age boys in the U.S?

No normal would be the majority have it. Never has 16% been a majority.

AgentZigzag Sun 01-Apr-12 17:06:56

If anything I thought it was an underdiagnosed syndrome?

Got any research to back up your claims?

MagsAloof Sun 01-Apr-12 17:07:09

It is a very tricky area. Yes, ADHD very definitely exists. Yes, it is often inaccurately.

I would urge anyone without expertise not to make big pronouncements.

catgirl1976 Sun 01-Apr-12 17:07:14

I agree with you that it seems that things like ADHD are over diagnosed, however I don't have any direct experience of the issue so am not qualified to think that, its just a feeling and my opinion and I don't want to minimise the issue.

I think you might get a flaming on here though.

MagsAloof Sun 01-Apr-12 17:07:20

Often USED

AgentZigzag Sun 01-Apr-12 17:08:03

And I mean peer reviewed journal research rather than the Daily Mail.

catgirl1976 Sun 01-Apr-12 17:14:03

There does seem to be a fair bit, going off a quick google and skim read

here

Although the first page of stories all relate to the same study done very recently and without reading it, it would be hard to assess how robust it was

amothersplaceisinthewrong Sun 01-Apr-12 17:16:51

My son had/has ADHD and it was my experience that medication (Ritalin in hsi case) was offered only when all other avenues had been exhausted and by a psychaitrist and quite reluctantly at that. But wow it works! GPs can't prescribe Ritalin over here. Believe you me if you have a child with ADHD, thye can push you to the absolute limit - their behaviour is NOT normal. Thins are not made any easier by the fact that many people think the child is just badly behaved and badly brought up.

MrsKittyFane Sun 01-Apr-12 17:17:20

Abat Approx 1 in 6. Not a majority but a significant minority.

I see what the OP is saying. I have blonde hair. Perfectly normal but only a small % of people have blonde hair. I know very little about ADHD but have work with young offenders, lots of whom had a diagnosis. From what I saw a lot of them benefited from small class sizes, different styles of learning, better nutrition, massive amounts of exercise and so on. Very few were medicated.

I live in North America and the answer to everything is meds. Can't sleep, meds. Feel sad, meds. Can't self-motivate, meds. Possibly seeing ADHD as a normal fluctuation in behavior would help people to manage it rather than to medicate it solely.

MrsKitty - Still not normal though.

MrsTerry - x posts re the normal.

catsareevil Sun 01-Apr-12 17:30:48

The DSM criteria for ADHD include the condition that the symptoms have "persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level"

The need for symptoms to be inappropriate for the developmental level should mean that if it is being diagnosed correctly then it shouldnt be regarded as 'normal'.

The US does use psychotropic medication much more than the UK.

Just as an example this study from 2008 states that in Texas 34.7% of children in foster care were prescribed psychotropic medication.

jemsgem Sun 01-Apr-12 17:35:50

there have been a few studies that say that its over diagnosed.

i suppose its easy to fling a label around, saves having to sort out the real causes

MrsKittyFane Sun 01-Apr-12 17:37:50

Abat Not normal??

God yeah cos i diagnosis is sooooo easy to get. hmm

MrsKittyFane Sun 01-Apr-12 17:38:48

Depends how you define 'normal'.

nenevomito Sun 01-Apr-12 17:39:37

I don't know how it works in the US, but certainly in the UK its not easy to get an ADHD diagnosis (note, not label, diagnosis) and medication is only used as a last resort.

OP said it was normal, i don't think one in six is normal but Mrsterryprachett explained why it could have been said.

molepom Sun 01-Apr-12 18:31:07

Here here amotherplaceisinthewrong.

cronsilksilt Sun 01-Apr-12 19:12:37

In the UK getting a dx of ADHD certainly isn't easy.
When Louis Theroux did his documentary about medicating children with ADHD in America, his views shifted after spending time with the children and their families from being very negative about meds, to not being able to dismiss their value.
I really hope that this thread doesn't upset anybody. It is very challenging to parent a child with ADHD.

Lougle Sun 01-Apr-12 19:26:34

Why? Just.....Why?

What makes children with SN such an easy pop? A bored Sunday afternoon....Oh well, let's talk about the fake 'ADHD'.

DD1 is 6.5. She has been under a consultant Paed for 3 years. She is still no closer to a proper diagnosis, yet her difficulties are pronounced enough that she goes to Special School.

At her Paed appointments:

-we have to lock the door of the consultation room to stop her escaping
-she tries to force her way into the Paed's drawers (he has paperclips there)
-she climbs up on his couch and overextends herself to try and get his otoscope down (despite having poor balance).
-she has climbed up to try and get out of a window.
-she repeatedly turns the taps on full blast
-she tries to get copious amounts of soap from the dispenser
-she takes his stethescope, examination light, telephone, etc.
-she pulls his handgel bottle to try and get some - it's attached to his belt!

The list goes on.

She doesn't have an ADHD diagnosis. The Paed feels that some of her behaviours may be explained by her cognitive level, so she doesn't get diagnosis.

It is incredibly hard. She is a delight, but her behaviours and frustrations at home make it unsafe when I'm home alone with her and her siblings, so Social Services provide support on 2 evenings each week (we have Homestart on 1 evening and DD1 attends Kids Club 2 evenings).

If you are interested in ADHD, volunteer with children who 'have' it. Don't just make a kneejerk assumption that it's an easy card to play.

I know that people who have kids with these type of needs feel that everyone is having a go. I don't think saying that it is quite common and that it seems to be part of the 'normal' range of behaviours is being mean. It may be quite common and we can argue about normality but that doesn't mean that anyone on this thread thinks it's easy. Far from it. I spent a few hours a week with the young people I worked with and it was fucking hard work. And, I could go home.

RaspberrySheep Sun 01-Apr-12 19:51:31

My son has ADHD, he is 9 yrs but I count ourselves as 'lucky' as he was diagnosed at 5 after just a couple of weeks in school. It's not easy, he also has Dyspraxia. He is medicated and with a controlled drug, which is locked away in the pharmacy until I collect it. I have to sign for it and declare who I am when I pick it up. He also has to have checks once every six months to check that the medication isn't affecting his height and weight. There is something very difficult about giving your child medication that is treated with such caution.

But what is the alternative? Without the medication, people make judgements and can not see past the 'crazy' behaviour. The school say that without his medication, it's like 'flicking a switch'. We find the medication keeps my son calm enough to allow his wonderful personality shine through.

We are so dependant on it now, which is a worry. If we spend time together for the day, I don't medicate him (as a one off) however I don't let him play out with friends or socialise without his medication and it's hard to accept that my child has to take a pill in order for his behaviour to be acceptable. I just want him to be the same as everybody else. I'm worried that when he gets older he will forget to take his tablet and of the repercussions this may have on him and others around him.

I am a single mum and he has never needed much sleep (awake at 4:45am and will not sleep until 10pm) and the excercise he takes is relentless!! I know I have it easy compared to other parent with SN children and above everything that I have rambled on about above, I love him so much and totally unconditionally. I just want the best for him but I understand that social stigma and a little ignorance about the condition means that for now, we wil continue to medicate him and hope that the long term effects on his health, if any, can be overcome.

So sorry for such a long post and thank you to the OP for getting a discussion going on ADHD, I will read this thread with interest.

Lougle Sun 01-Apr-12 20:00:21

1 in 11 children in the UK has Asthma Asthma UK That's 9.09%. Does that mean it's normal?

Of course, lots of people think that Asthma means 'a little bit hard to breathe sometimes'. They don't realise that some children really struggle.

1 in 5 children in the UK has Eczema The National Eczema Society. That's 20%. Does that mean it's normal?

Of course, lots of people think that eczema means 'a little bit of dry skin which gets a little itchy'. They don't realise that some children really struggle.

Think.

Don't let the newspapers inform you about something like ADHD. Nobody wants their child to have ADHD. Everyone would rather have a child who could sit still and concentrate instead of an ADHD tag. In fact, ADHD is not even that useful as a diagnosis to get help.

The link that catgirl gave was helpful, because on it showed the difference in a brain of a patient diagnosed with ADHD and one without.

OP- Unless you and others on here are neurological specialist, then really it is well out of your sphere of understading. In the organic sense.

sheepgomeep Sun 01-Apr-12 21:14:22

All you doubtful people can volunteer with my adhd son then. Diagnosed since he was six his lack of concentration and inability to control himself and his temper has led to increasingly violent outbursts and physical violence towards me.

I dont doubt he has other problems and he is still waiting for an autistic assessment but his life and ours have been blighted by this condition.

I do get pissed off when people have a pop at adhd. Try living with it.

Without meds my 6 year old with ADHD would be dead because of his poor impulse control.

Prior to medication he attempted to hurl himself down flights of stairs, jumped into a deep pond and went under and attempted to hurl himself into traffic. Now he can be physically restrained. That won't be the case in a couple of years.

People can flap their gums in ignorance about the evils of Ritalin but sometimes there is no other option.

cronsilksilt Sun 01-Apr-12 21:39:35

where is the OP?
Why start a thread about such an emotive subject and then not comeback to it?

MummytoKatie Sun 01-Apr-12 22:32:47

Actually I think having eczema is normal. At least I don't see myself as abnormal just because if you (currently) pull up my right sleeve you might have a bit of a shock.

There are far more unusual (and interesting) things about me than my over-reacting immune system.

But severe eczema on a child needs treating, or the child will suffer.

Eczema is a medical condition, just as ADHD is.

Just because something needs treating, doesn't mean it's not normal.

I don't think people are saying that some children don't need medication. I know I'm not. Some children absolutely need medication. What I'm saying is that there is a general problem with people being over-medicated and nothing else. I live in Canada and one of the fastest growing drug addiction problems is that of children taking inappropriate prescription medication. Twice, when I have had a cough, I have been offered a prescription for codeine. Codeine FFS, it's an opiate and one which my medical records state I am allergic to. There was no attempt to find the cause of the cough. In one case, I was already in hospital and asked for "something for my cough". I meant a cough sweet or maybe some Benelyn, not an opiate. People here all drink coffee until 11pm, then take sleeping pills. I hope the UK is very different.

I also think that medication can sometimes be used by medical professionals instead of other treatments. So, if I present as depressed, I am offered anti-depressants. Not counselling, not groupwork, not CBT, just meds. Here, I get the impression that this is sometimes the case with ADHD. I am not saying that meds can't be useful but they should be one tool in a very big arsenal.

I'm really sorry if I gave the impression that I don't think that the parents of children with ADHD are working really hard. I really feel for you and hope that my contributions to this thread have not been insensitive.

Hopandaskip Sun 01-Apr-12 23:40:36

"I see what the OP is saying. I have blonde hair. Perfectly normal but only a small % of people have blonde hair."

"I live in North America and the answer to everything is meds. Can't sleep, meds. Feel sad, meds. Can't self-motivate, meds. Possibly seeing ADHD as a normal fluctuation in behavior would help people to manage it rather than to medicate it solely."

YES, exactly, everything should be fixed with a pill! Drives me wild about the U.S.

I wasn't being mean, what I think is if this is a normal thing for humans (like being blonde or left-handed or some other minority trait) and our kids aren't being well received by society and schools (at least here in the U.S.) then perhaps we (as a culture) need an attitude adjustment.

There are famous and successful people, e.g. CEO of Jetblue that credit having adhd as what has helped them become who they are. There are many that want to focus on the positives of ADHD. Society seems to have a problem with that, they want the brilliance, the speed, the creativity without having to deal with a more exuberant person, someone that has more drive. Why can't we value people with these traits more?

I do know about kids that get into everything. I was the mom with the furniture bolted to the walls because my 12 mo old could climb anything and did while I went to the loo. He had to go to the playground every day after school to spin and hang upside down for at least an hour or I would be crying by 5pm. The week he started playing water polo (about the hardest sport there is IMO) his teacher asked if I had medicated him. No, he was finally out of energy. I have one kid being assessed right now. His school thinks he has ADHD, I suspect he is just a high energy kid with lowish impulse control (like many boys) who is bored silly and acting out. He copes just fine, just is a bit of a handful and marches to the beat of another drummer, he is improving and will do just fine in the long run IMO.

As for 'normal' even when something is normal it might be on the far end of normal. Someone has to be at each end of a spectrum of normal. We should recognise this as a culture.

I was asked for some sources. I'm assuming the U.N is considered a valid one?

"The United Nations released a report in February of 1996 expressing concern over the discovery that 10 percent to 12 percent of all male school children in the United States currently take the drug" (from http://www.pbs.org/wgbh/pages/frontline/shows/medicating/readings/publicinterest.html )

My data also came from the CDC (government health organisation)
http://www.cdc.gov/ncbddd/adhd/data.html

BTW some studies are now suggesting that most ADHD medications have at most a 2 yr life span.

Mrs- the OP needed to confirm if she was talking about the UK or US.

If something is classed as a medical condition, it isn't 'normal' or typical.

A cough isn't a medical condition, it can be a response to a medical condition, iyswim.

ADHD isn't a symptom ,it's the cause, the cause is being treated, in this case and as a result the symptoms lesson and allow the patient to function better.

However the OP needs to return to the thread.

Hopandaskip Sun 01-Apr-12 23:46:35

Oh and where was I, well I'm in San Diego and this is the middle of our day. My son was competing at a kayak regatta.

Look, I don't doubt that SOME people diagnosed with ADHD struggle and really need help. I don't think that ALL people do. My son's bf has a diagnosis and does not need medication, he does fine without it.

"But severe eczema on a child needs treating, or the child will suffer.

Eczema is a medical condition, just as ADHD is."

and just like eczema not everyone who has it needs heavy duty medications. Some need a little hydrocortisone from time to time or a diet change or whatever works for them. My son had it as a baby and almond oil worked fabulously for him and he was prescribed it. My older son and I both have asthma, yeah, I think that is pretty normal too now. Some people with asthma have huge problems with it and some do not at all. My son hasn't needed his inhaler for over a year even though tests have shown definitively that he still has it.

Hopandaskip Sun 01-Apr-12 23:48:09

"Mrs- the OP needed to confirm if she was talking about the UK or US."

Both of my two sentences in my opening post said that I was talking about the US. I think that was pretty clear. Should I have bolded and underlined it too?

Can you find data that isn't 16 years old?

I could drag out data that considered ME to be yuppie flu etc.

I think that in most cases the parents are the best judge, not random strangers on the internet.

I personally think that more adult research is needed as some doctors link ADHD with forms of bi polar and this isn't funded enough.

ADHD doesn't go away at 16 years old, but ritalin stops.

Arana Sun 01-Apr-12 23:56:11

I have ADHD - it has taken 25 years to get a diagnosis and treatment. For the first time in my life I am not panicking at every moment that I'm going to lose my job for doing something unprofessional.

DS is 4, and is showing all the signs of ADHD as well as some ASD symptoms too. It breaks my heart to think that he's going to have to go through all the shit that I've gone through. If a diagnosis and medication can help him, then I will gratefully accept it.

Walk a mile in someone else's shoes is all I have to say.

Hop-not all children with ADHD are medicated in the UK.

If your thread is about the US then i will leave it because that is a completely different arguement.

I don't think that ALL people do

I don't think that with MH or whatever you want to call it, statements such as "i think" can be used ,it needs to be well researched and evidenced based.

Not just a pondering thought.

EyeOfNewtToeOfFrog Mon 02-Apr-12 00:06:00

I get what you mean, OP. To overdiagnose ADHD (or ASD, or eczema, or even the flu) makes it much harder for the people who genuinely have the condition.
Sure, some kids are very impulsive or have high activity levels, etc - doesn't mean all of them have ADHD, and even if they do, prescription medicine isn't the right answer for all of them. Just like every socially awkward person doesn't have an ASD condition. And not every rash is eczema you get the picture!

Btw, isn't there a huge regional difference in the rate of ADHD meds prescription in the US?

Hopandaskip Mon 02-Apr-12 00:10:30

ok well I know that not ALL people diagnosed with ADHD need medication because as I stated, I personally know someone with that diagnosis that copes well with school without medication. His mum is one of my best friends.

Not sure why a social conversation on a parenting board needs to be "well researched and evidenced based" though.

As for more recent evidence, the CDC one is more recent. I'm sure there are more recent ones but if I wanted to work that hard I would do it as a job. This is my time to relax because my kids are reading and the washing up is done.

However, there are experts who do agree with me. One is cited in this Guardian news article, but there are others. http://www.guardian.co.uk/education/2010/may/11/ritalin-adhd-drugs

Hopandaskip Mon 02-Apr-12 00:14:08

thank you EoNToF, its nice that not everyone is making me out to be some evil child hater because I'm proposing that we be more accepting of different kinds of behaviour and not expect all children to be quiet and placid. It should make it easier for someone with severe adhd if every Tom, Dick and Harry with a wiggly bottom wasn't immediately diagnosed, not harder, so I'm a bit non-plussed as to why I'm the bad guy here.

EyeOfNewtToeOfFrog Mon 02-Apr-12 00:36:49

Ah, well, you know what the AIBU on MN is like. It's useful for illuminating the depth of ignorance of most people have on most subjects..... grin But in-depth conversation on a serious topic? Ermmm...... blush

I think the issue is that parents of children with ADHD have to fend off idiots people who think they are bad/lazy/stupid parents. A certain amount of defensiveness is completely understandable.

IMO a lot of MH conditions are a spectrum rather than an on/off switch. Having more and more sensitive tests for conditions means that people will be 'caught' by the system more. This can be a good or bad thing. I have worked with people who received information about things in their adult life (dyslexia in one case, ASD in another) which could have really helped them receive help in their childhood. It would have been great for them to know sooner. If the tests get more and more sensitive and the medication becomes more and more what is used to manage it, then I think there is an issue. I think this tipping point has been reached in North America but it sounds like it hasn't in the UK.

I find this is the case with all the blinking intolerances everyone in North America has. Practically everyone I know is either lactose intolerant, allergic to gluten or avoiding the nightshade bloody family. I know two people with celiac disease and everybody seems to think they are on the trendy food bandwagon when in fact, they have an extremely difficult life-changing condition.

MNHubbie Mon 02-Apr-12 01:18:37

"Not sure why a social conversation on a parenting board needs to be "well researched and evidenced based" though."

Because that is the minimum standard for any scientific discussion. The scientific method requires evidence to back up any hypothesis and without it any hypothesis is invalid.

It is counter productive to discuss something of this nature without evidence. It is a hard enough battle to deal with newspapers that print out and out lies, former glamour models suggesting it is better for children to die of polio than be vaccinated, education departments that refuse to use the words "dinosaur" or "evolution" because they may cause offence. MN is above that kind of thing.

ADHD is a condition that causes real heartache and whilst you are entitled to opinion (everyone has one, there are lots of things everyone has) if you are going to air an opinion that could be viewed by some as deeply offensive to their suffering you should have the common courtesy to listen to evidence based responses to your point and counter in kind.

Perhaps the American system does over medicate. I wouldn't know. I do know I would be discussing all options with my doctor and would be weighing up all sides and all potential treatments based upon evidence. It is not the doctors who medicate at the end of the day but the parents. I do know also that as with all conditions of this nature: ADHD, ASD, dyspraxia etc it is incredibly hard to get a diagnosis over here and that any treatment programme is discussed in depth with parents (and occasionally teachers) and is very carefully monitored starting with nonmedical intervention and working carefully to find correct doses if medication is started. I do also know that several studies have shown that many folks who have fallen into criminal ways have undiagnosed conditions such as ADHD but I don't have that evidence to hand so you can feel free to discount that if you wish until someone can post an appropriate link.

You could be entirely correct. You could have a valid point. Your comment against evidence based responses however is entirely inappropriate.

That is why i left the thread, whereas i could discuss the system, rights and wrongs around the UK, i couldn't across the US.

In the UK it is common to get a due/multiple diagnosis, but some do not wish to hang labels on to children and will just sum up the childs problems, such as information processing, impulsive/dangerous behaviour, rather than find a 'syndrome', which can be more helpful.

I still think that it isn't a shame that more research isn't done on adults, who were diagnosed with ADHD as children and are still suffering/managing, some aspects of the condition, such as anxiety/impulsiveness etc.

There is loads of evidence based reporting, regarding the undiagnosed and the criminal system.

informahealthcare.com/doi/full/10.3109/15622975.2011.600319

www.thementalelf.net/category/populations-and-settings/crime

www.addandadhd.co.uk › Living With ADHD

One from the US.

adultaddstrengths.com/2011/.../adhd-and-crime-ignore-now-jail-later...

NunTheWiser Mon 02-Apr-12 02:28:18

YANBU, OP because it is obviously so easy to get a diagnosis of ADHD and they hand out medication like it's Smarties. In fact, it's just an excuse used by crap mums and dads who can't be bothered to parent their vile, naughty children properly. I think a good walloping would sort them out pronto. hmm

asiatic Mon 02-Apr-12 05:24:34

YANBU, OP because it is obviously so easy to get a diagnosis of ADHD and they hand out medication like it's Smarties. In fact, it's just an excuse used by crap mums and dads who can't be bothered to parent their vile, naughty children properly.

Nunthewiser, largely I think this is true, I know in my LO's case I've been "offered" the diagnosis purely so that schools and nurserys can claim extra money, and I can claim DLA. Nursery staff in the past have even coached me in what I should say. I've always refused, because DC do not have ADHD, they are simply overactive, above average,but not excessivly so. I have no doubt they could be both sitting here with diagnosis, perscriptions,statements, benefits, if I had agreed to it.

ADHD exists, but genuine cases are rare, Look at all the research into attachment disorders, you will find it is very well documented that failure to nurture and disipline a child will result in the symptoms of ADHD. This is a conduct disorder - in other words, damage done to the child's development because of the child's environment. It is a very serious disability for the child, and it is caused by poor parenting - this is why it has such a high incidence in foster children who have been removed from inadaquet parents.

A tiny number of children are born with ADHD, and they are often nothing like the steriotype, often very quiet and withdrawn. There case is not helped by the large numbers of suspect diagnosis handed around to anyone who wants one.

(Lougle, why do you think your daughter has ADHD? nothing at all that you have said about your daughter suggests ADHD, that I can see)

nooka Mon 02-Apr-12 06:09:56

There are big issues in the States with over medicalisation. The way that the system is funded tends to lead to over use of diagnostic tests and over treatment. Nothing particularly unique to ADHD. When we lived in the States we were amazed at how often children were taken to their pediatrician for what seemed very minor issues that would almost certainly self resolve (and they always came back with some sort o treatment prescribed).

We live in Canada now, and have friends who were told to get their son on medication or he would not be accepted at school, even though his GP (and parents) thought he was NT. Luckily another school accepted him. He is a friend of my son, and whilst a little wild at times is (in my eyes anyway) a perfectly normal kid. There are some funny rules here about how children with special needs are managed at school which might be part of the reason. There has also been some recent research that showed a much larger than expected proportion of children who were young in year being identified as having ADHD and prescribed medication for it (this I thought a bit odd as schools here are fine with holding children back/advancing them).

So it is highly likely that some of the children Hopandaskip is referring to have nothing wrong with them at all, that some might be treated in different but equally effective ways and of course that some will indeed have ADHD and drug treatment will be very helpful. I think that the picture in the UK is very different - we are probably more likely to under identify if anything.

I work with someone who has ADHD and who used ritalin as a child. He is fascinating to talk to both about the disadvantages and advantages of his differently wire brain (he is very bright, very creative and a lovely bloke) and the challenges of growing up.

NunTheWiser Mon 02-Apr-12 07:42:27

Asiatic, I was being sarcastic and you are talking out of your arse.

Hopandaskip Mon 02-Apr-12 07:48:23

This isn't a peer reviewed scientific discussion. I am a mom who found something that seemed crazy to me. I come here for rest and relaxation. Not to get hit over the head unless I pony up half a dozen studies on drug use across the U.S. in the recent past that don't seem to exist.

I found this ( http://www.washingtonpost.com/wp-dyn/content/article/2009/03/26/AR2009032604018.html?hpid=moreheadlines ) I have no idea if it interests anyone, hopefully it will at least one person. At this point I don't really care. Feel free to argue amongst yourselves and demonise me if you so wish.

seeya.

cronsilksilt Mon 02-Apr-12 08:39:22

'Nunthewiser, largely I think this is true, I know in my LO's case I've been "offered" the diagnosis purely so that schools and nurserys can claim extra money, and I can claim DLA. Nursery staff in the past have even coached me in what I should say. I've always refused, because DC do not have ADHD, they are simply overactive, above average,but not excessivly so. I have no doubt they could be both sitting here with diagnosis, perscriptions,statements, benefits, if I had agreed to it.'

I just don't believe this.

catsareevil Mon 02-Apr-12 08:44:07

Nursery staff dont make diagnosis of ADHD. Even if there was a referral stating that the nursery staff were all convinced that it was ADHD there would still be an assessment.

OhDoAdmitMrsDeVere Mon 02-Apr-12 09:00:01

asiatic
I find your post puzzling.

I am being polite.

OP I work in a specialist child development team. We see very few cases of ADD/ADHD. The ones we do see take a long time to be dx and very few are on medication.
Medication for ADHD is offered on the same basis as all other medications.

Drs do not prescribe morphine for a headache
No one is hooked up to a drip when they are thirsty.
Children who are a bit of a handful are not given ritalin.

I can only speak from my experience of working within a team that actually diagnoses and works with children with/suspected of having ADHD/ADD

I cant possibly match up to the 'I know a bloke whose kid has it' sort of evidence.
hmm

OhDoAdmitMrsDeVere Mon 02-Apr-12 09:00:49

I am still pmsl at the idea that nursery staff can dx ADHD.

tabulahrasa Mon 02-Apr-12 09:14:29

Asiatic - who exactly were you offered a diagnosis by?

In my LA the most common diagnostic route is through the school doctor, after it's flagged up by the school and patents, the school doctor observes the child and decides whether to refer it on. If it is referred on then a diagnostic questionnaire is sent out to the school and the parents to fill in.

If both of those questionnaires indicate that ADHD may be a possibility then a more in depth form is sent out and appointments are made with a develepmental paed and a psychiatrist. The parents and child then attend both these appointments where the child is observed and the parents questioned more in depth about their responses to the last form.

If at this point the medical experts agree that ADHD could be a possibility then observations of the child will be arranged - both at school and at the local child psychiatry unit. After these observations is the earliest that a diagnosis may be offered if every observation indicates ADHD and the school and parents both agree and the child is over 6...if there's any indication that it may not be ADHD from any of the observations or the evidence from the school or the parents or if the child is under 6 then they wait 6 months and do another round of questionnaires and observations.

It's not uncommon for it to take 2 yrs from initial referral to diagnosis.

So I find it fairly unlikely that you were simply offered a diagnosis by anyone who could actually give you one.

AwkwardMary Mon 02-Apr-12 09:21:10

I think the school system is to blame in a way...it only suits SOME kids. Others, possibly those like my DH...would be more suited to learning outdoors...in nature, and learning about performing arts, practical skills.

Sitting in a classroom for X hours a day is not good for ALL kids. The way we teach today is such a NEW thing. We've only had an education system for all for just over 100 years or so. Before that it was the lucky few who went to school.

Teaching the masses has been handled badly imo. Not enough flexibility or choice.

AwkwardMary Mon 02-Apr-12 09:22:15

MrsDevere I think it's worth noting that the OP is speaking about the USA where they medicate far more than we do.

CrunchyFrog Mon 02-Apr-12 09:32:56

WRT medication - I was offered meds for DS1, who has HFA, the first time I asked a paed for advice about his sleeping. He offered them as a first option, then presented behavioural advice as the second option (together with a short lecture about my terrible parenting, which was nice.) I chose the second option, and it worked pretty well for us. DS1 has gone from sleeping 1am - 7am to being in bed from 7.30 to 7.30 and sleeping from 9pm much of the time. It took over a year though. Some kids do need meds, some kids need behavioural modification.

I believe the same applies to ADHD. Some children genuinely cannot function without ritalin - I worked with one child whose ritalin enabled him to interact semi-normally, but still symptomatic, you could actually watch it wear off. Other children are medicated when they shouldn't be, because they can be supported to cope in other ways.

But if you get parents and professionals who don't know that, then kids are unnecessarily medicated. (another ASD example - DS1's teacher sees "no evidence of ASD, he's just odd. And quirky.<facepalm>) There needs to be support in place for all children, not just the % of kids with ADHD, every other child has their own way of learning best - classroom practice needs to reflect that. If we had decent SN training for teachers, and excellent classroom practice, and crucially, more money in schools, then the need for labels and statements would be reduced. <end tangent.>

ragged Mon 02-Apr-12 09:37:26

Hi HopandSkip
I was born & raised in SD. Welcome to MN where intellectual debate is encouraged, honesty is rife, trolls are mocked with tremendous humour & BS gets called BS. Not a kind place, but still refreshing compared to many online communities! This is mostly a UK site, though, and culture & clinical practices are quite different here. The pitfalls for you as a foreigner will be many (I am still falling in cultural bear traps after a mere 2 decades of living here).

I get what you're saying, a lot of people have said the same, I think (though not on this thread). Or at least, that many cases of ADHD may be a case of children not being allowed to be children and given meds rather than taught life-skills. I think my DS2 is at the ADHD or normal or the normal end of ADHD, which is controversial too (will get me slagged off). Because many insist ADHD is an all or nothing thing, no spectrum to it.

cronsilksilt Mon 02-Apr-12 09:38:42

asiatic isn't in the USA. She was on a thread yesterday saying that statements had been phased out. Scarily she claims to be a teacher.

themightyfandango Mon 02-Apr-12 09:52:19

My Ds2 has Adhd. Diagnosed at 3, started medication at 5, he also has ASD.

The medication has probably kept him from serious injury and harm (climbing onto rooftops, absconding over the school gates, running off from home on 'adventures' all before he was 5 years old, this is just a few examples of his impulsive behaviour without touching upon his hyperactivity, shouting, swearing, vocal and facial tics.)

It has also meant he has managed well at school and was able to start learning, it is what probably saved my marriage and stopped me having a nervous breakdown which means he still has two parents in reasonable mental health.

Obviously I worry about my child being on medication but the alternative scenario believe me is far worse.

We have just started on a two week medication holiday this morning to allow for assessment, the goal eventually being that he would ideally just need meds weekdays at school. I am under no illusion that this 2 weeks is going to be hellish for all of us including his 3 siblings who will bear the brunt (no we don't have anyone to help).

So anyone who wishes to judge about a condition they have no real experience of can do one as far as I am concerned or come and spend the next fortnight in my house and see how you feel about adhd then.

Btw, we don't have dla, a statement or any type of benefit attached to a dx of adhd nor has any professional suggested we could. <scoffs at DM stereotype of blue badges and free cars>.

asiatic Mon 02-Apr-12 10:51:11

I am a teacher, and child protection officer. We do see very few GENUINE cases of ADHD, but the diagnosos is used more often than not to manipulate statistics, finances and /or schools and parents.

Believe me, some school/mnursery staff know the system VERY well, and I know many parents who have taken their route, ( as another poster says, the diagnosis is quite often initiated by the school, and these "observations" are often skipped.) staff can tellyou what to put in the questionaires,

cronsilt, it is more than 5 years since a statement has been issued by my LEA

ragged and akwardmary, I 100% agree with both of you, much of this is simply about the difficulty of boys fitting into a social "Norm" and the social "norm" being unable to accomadate a normal, healthy active young boy!

Themightyfandngo, you have my sympathy, I have rasied many such teenagers as your DS, I specialised in fostering teenagers with behaviour problems for nearly 20 years, before having my own. You are doing an incredibly difficult job. This is not about ADHD though, this is about ASD, and behaviour that could be regarded as "ADHD" is commonly seen within that. This is a totally different game to the NT children labelled ADHD.

asiatic Mon 02-Apr-12 10:54:26

mrsdevere It sounds like in your area the diagnosis is used much more cautiously. This is one of the problems, there is no consistancy at all in how the diagnosis is reached, and what it means. I have known specialists say outright there is nothing wrong with such and such a child but we will need to diagnose ADHD to get the parents cooperation in disiplining and caring for them properly.

catsareevil Mon 02-Apr-12 11:00:25

Asiatic

What qualifies you to say whether an ADHD diagnosis is 'genuine' or not?

asiatic Mon 02-Apr-12 11:03:39

Decades of experience with ASD children, children called "ADHD" ,special eductaion, child protection , educational Psychology, and medical teams.

What qualifies you?

MNHubbie Mon 02-Apr-12 11:15:07

Wow Asiatic that was an interesting and deeply troubling post. Unless of course you were following up on the previous poster's sarcasm and it went horribly wrong I'm afraid I must call bullshit.

Utter, utter bullshit. People are suffering and desperate to get a diagnosis because their children are labelled as naughty or are just not having their needs catered for. It is true of ADHD, it is true of ASD and it is true of dyspraxia. We had to wait 8 years for a dyspraxia diagnosis before the school would finally start supplying an appropriate IEP for DS1 and we're still waiting for it to be followed properly. We have been waiting 5 years for DS2 to get a ASD diagnosis and his teacher claims he can't be ASD as her brother is autistic and he isn't like him... despite the experts saying it is pretty clear cut. So we're fighting to have his needs recognised alongside his behaviours being dealt with. We finally have the 3d thingy booked.

That is my experience. I know from speaking to parents of those I teach that the situation is the same if not worse for ADHD. This is an under-diagnosed issue.

How dare you belittle the suffering of hundreds. There is a significant difference between a child who is a bit of a handful and ADHD. It is clear and if you are an educational professional you'd know that.

OhDoAdmitMrsDeVere Mon 02-Apr-12 11:16:27

The fact remains asiatic that nursery staff DO not and CAN not dx ADHD.
They can suggest it all they want.
They can coach parents all they want (by the way have you reported the staff in question?)

They do NOT dx children with anything.

My great aunt Fanny can suggest I have Tuberculosis but it wouldnt get me a place in a sanatorium in Geneva would it?

I see lots of children where the nursery staff have suggested all kinds of thiings and it makes me want to bang my head against the nearest brick wall.

It happens a lot with ASD. It most often happens after they have done a course or a module. They tell the parents how concerned they are that little Johnny keeps lining his cars up. Scare the crap out of the poor parents based on something perfectly normal.

I also see lots of children where an on the ball nursery worker/team have kept a close eye on a child and have genuine concerns. More of them please, they help us enormously.

catsareevil Mon 02-Apr-12 11:17:58

Asiatic

"Decades of experience with ASD children, children called "ADHD" ,special eductaion, child protection , educational Psychology, and medical teams."

I dont think that any of that qualifies you to make a diagnosis.

OhDoAdmitMrsDeVere Mon 02-Apr-12 11:19:24

asiatic If I were in your position I would check out your LA's whistleblowing policy and I would get myself on the phone reporting these fraudulent professionals.

Do it now, before it happens again. Your union should support you.

Do you not think to ingore it is the same as colluding?

tabulahrasa Mon 02-Apr-12 11:23:29

hmm calling them "observations" instead of observations doesn't make them any less valid - I'm talking about observations by qualified HCPs...which have to be done before a case will progress to the next stage.

They can't be skipped or there wouldn't be anything to base a decision on...schools often skip their own in house processes - but they're nothing to do with diagnostics.

Of course the process is different in different areas, but any area routinely missing part of their diagnostic assesments would be leaving themselves open to malpractice claims.

OhDoAdmitMrsDeVere Mon 02-Apr-12 11:25:56

Yes tabulah I can just imagine the referral to our team from that nursery with 'we think he has ADHD' written across it.

That would have us all rushing around sorting out a dx hmm

asiatic Mon 02-Apr-12 11:40:47

MNhubbie, I am not taking about ASD or dyspraxia atall, these are totally separate, although of course dyspraxic symptoms can be part of a conduct disorder.

ADHD is 50% conduct disorders, ( damage done to children's brain by lack of nurture - genuine, but not congentital)

35% imaginary

10% part of other genuine disorders

5% real, if that.

This numbers are estimates based on a lifetime of experience, and rounded up to the nearest 5, but pretty sound.

No amount of jumping up and down screaming at me is going to change the facts.

OhDoAdmitMrsDeVere Mon 02-Apr-12 11:45:35

Wow.

Have you published your findings?

catsareevil Mon 02-Apr-12 11:46:19

You are not qualified to make a diagnosis of ADHD. Therefore not qualified to say what you think is genuine or not.

If you had a knowledge of the diagnostic criteria then you would be aware that they rely on a description of the symptoms displayed by the child. They do not require any conclusions about aetiology, so for you to try and separate it into what you see as being congenital and what you see as a lack of nuture is totally meaningless in that context.

cronsilksilt Mon 02-Apr-12 11:52:49

Conduct disorder is not ADHD
Who has told you this rubbish asiatic?

EBDteacher Mon 02-Apr-12 11:54:14

I think ADHD is frequently sometimes inaccurately diagnosed. In my county children who are struggling with their behaviour go to CAMHS and almost ALWAYS come out with a diagnosis of ADHD and/or ASD or nothing. This is partly due to lazy very, very overstretched services not looking particularly thoroughly into each case.

There is a huge cross over between symptoms of ADHD, dyspraxia, sensory intergration difficulties and some aspects of ASD (amongst other conditions) so it is quite hard to get a really spot-on dx and they just don't bother. Then there are things that might well be a more accurate dx but the psychiatrists won't stick their necks out to diagnose like CU, paediatric bi-polarism, pro-dromal schizophrenia, pro-dromal anti-social personality disorder etc etc.

It is not a perfect system. I don't think there is over diagnosis in the uk but I think there is pretty rife mis-diagnosis.

asiatic Mon 02-Apr-12 12:00:07

cronskilt I have decades of training and experience in conduct disorders, I specialised in raising teenagers with conduct disorders for 2 years, I was the regional specialist, before I had my own children and gave it up.

A conduct disorder is damage done to a developing brain by lack of nurture. Social norms do not become embedded. This is irreversible, although you can teach a child t o behave, if they want to learn, it will never become instinctive, the way it is with children brough up with love and disipline.

These conduct disorders are normally called ADHD. The child is seriously disabled and disadvanteged by this, it is an over simplification to just call it bad parenting, although to a lesser extent bad parenting does cause a lesser conduct disorder.

ADHD as a congenital condition also exists, but is rare.

Your opinion does not a fact make.

catsareevil Mon 02-Apr-12 12:00:10

EBDteacher

Have you considered returning to psychiatry to help improve that?

asiatic Mon 02-Apr-12 12:00:35

sorry, that should say 20 years, not 2 years

molepom Mon 02-Apr-12 12:04:07

So what you are saying Asiatic, is that I have damaged my childs brain through neglect? If I were you I would make syself very clear indeed before you carry on...you've just managed to piss me off no end at the moment.

No molepom it might be imaginary. hmm

EBDteacher Mon 02-Apr-12 12:09:04

catsareevil would you seriouly rather kids went around with the wrong 'label' on their paper work which meant they never got the right intervention?

For example if a child is labled ADHD but actually their symptoms are caused by Sensory Intergration Disorder they will not be refered to an OT who could really help them.

Anyway, obviously I bow to your authority on the subject.

EBDteacher Mon 02-Apr-12 12:15:09

Kids arrive with me because they have 'behavioural difficulties'. It is my job to care very deeply about what actually underlies those difficulties so we can get the support and intervention package right. Would you rather I just thought they all had ADHD because they can't sit and listen?

I don't quite understand what the axe is you're grinding?

molepom Mon 02-Apr-12 12:15:52

Oh lovely, imaginary you say....excuse me while I just wet myself laughing...

MNHubbie Mon 02-Apr-12 12:17:36

OT referral is the stage we all fight to get to. Regardless of the label that gets us there.

So Asiatic it is all bad parenting? Do you write for the Hate Mail?

Pitiful and horrific comments. I think this thread has reached the troll-filled midpoint. I await the return of sensible folk but I don't think I'll be monitoring the thread any more.

I remember now why I stopped checking Mums' net.

cronsilksilt Mon 02-Apr-12 12:18:24

Conduct disorder occurs when ODD is not treated
ODD is a condition which does not occur by itself but as a co-morbidity.
To develop ODD a child has to be neurologically wired towards it.
Children with ODD are very difficult to parent - hence the emphasis on parenting classes
I feel very sorry for any parent that came across you while struggling with their sn child

cronsilksilt Mon 02-Apr-12 12:20:07

That post was to asiatic btw

EBDteacher Mon 02-Apr-12 12:27:26

MNHubbie I hope that isn't aimed at me because my problem with the system is that some children and families are not given enough access to the specialisits who can dx, and after the point of dx there is not enough effort put in by the system to get intervention right for the child.

This is basically because CAMHS are unbelievable stretched and that situation is getting worse.

I say this from my (humble) professional experience. I have sat with psychiatrists/ clin psychs while they have argued with one another over dx enough times to know that it is not straightforward, in the sort of complex cases I work with anyway.

EBDteacher Mon 02-Apr-12 12:29:34

That is not technically accurate either cronsilksilt

KatMumsnet (MNHQ) Mon 02-Apr-12 12:29:46

Hi we've moved this into Children's Health.

EBDteacher Mon 02-Apr-12 12:33:26

Conduct Disorder

From DSM IV. No specific aetiology required for dx.

EBDteacher Mon 02-Apr-12 12:36:56

ODD

Specifically says if behaviour problems DO NOT meet criteria for Conduct Disorder.

catsareevil Mon 02-Apr-12 12:40:29

EBDteacher "catsareevil would you seriouly rather kids went around with the wrong 'label' on their paper work which meant they never got the right intervention?"

Absolutely not, and I agree with you that the most important thing is do get the right intervention for the child, it was just that the list of alternative diagnosis that you gave raised my eyebrows a bit. I apologise for being snippy with you.

EBDteacher Mon 02-Apr-12 12:48:46

No worries.

I wasn't suggesting that those were alternative dxs for ADHD, my apologies if it reads like that.

I was just ranting because I work with children with extremely severe and complex behavioural difficulties (for some of whom ADHD may be part of the very complicated picture) and I do get frustrated when it doesn't seem that a full range of possible causes are considered. Actually completely irrelevant to the thread grin.

OhDoAdmitMrsDeVere Mon 02-Apr-12 13:01:57

In my experience.
ADHD is one of the least diagnosed conditions in young children.

I work with 0-5.

I realise that my experience of just one borough isnt a scientific study.
Its a tiny bit more scientific than 'the teachers tell you how to get dx and get DLA' though.

Cos we all know how easy it is to get DLA for a pre schooler with ADHD (but that is a seperate thread daily mail article

DX is tricky for lots of conditions and as PP have said they tend to overlap. It is very hard to tell what is going on with a 3 year old who cant sit still, spits and hits and bangs their head when they are angry. ASD? ADHD? RAD? Brain Tumour? Abuse?

Which is why any nursery trying to dx a child out of hand should be reported

cronsilksilt Mon 02-Apr-12 13:03:34

Different classifications true - however conduct disorder is known to occur if ODD is left untreated

EBDteacher Mon 02-Apr-12 13:09:33

Please could you provide a reference for me to read about this causality?

EBDteacher Mon 02-Apr-12 13:10:25

Also, could you let me know what the 'treatment' is for ODD?

cronsilksilt Mon 02-Apr-12 13:14:30

Google oppositional defiance disorder untreated- I just did and Found lloads of references

OhDoAdmitMrsDeVere Mon 02-Apr-12 13:14:36

I understood that ODD was a co-morbid conditon that occoured when other conditions were left untreated.

Years of negative attention and needs being left unmet lead to ODD. (over simplified obviously)

Is that the same for CD?

(genuine question - not trying to stir up anything).

cronsilksilt Mon 02-Apr-12 13:22:09

Yes that's what I understood also mrsdevere
So if a child has ADHD/ dyslexia for example and has no dx or support they may go on to develop ODD

EBDteacher Mon 02-Apr-12 13:40:33

OK, I have consulted Dr Google as you suggest. There is no mention that ODD causes conduct disorder. Just suggestions that some children who do not stop displaying ODD symptoms (either as a result of some sort of intervention or because they 'grow out of it') may go on to meet the criteria for CD. This is not the same thing as causality.

Now we are saying dyslexia may cause ODD??

So, dyslexia --> ODD --> CD unless your parents engage in some parenting classes?

Were you one of the people up thread who was saying unqualified people shouldn't make assertions?

hmm

cronsilksilt Mon 02-Apr-12 13:51:08

I'm not making assertions - you asked for links So I googled quickly. My training wasn't over the internet. I'm not saying that dyslexia leads to ODD - I said that it was my understanding that undiagnosed comorbidities can lead to ODD.e.g. adhd/dyslexia with no dx and badly catered for, could lead to behaviour which the could be dxed as ODD. My point (although I can see I am not making it very well) was that ODD doesn't occur by itself, it's co-morbid with other conditions. Hence a child has to be neurologically wired towards developing ODD.

cronsilksilt Mon 02-Apr-12 13:57:31

The NAS 'you need to know campaign' quotes prevalence of ASD and ODD/CD as 30%

EBDteacher Mon 02-Apr-12 13:59:19

Yes, I agree when you put it like that.

I think the problem with all these conditions is that they are functions of neurocognitive dysfunctions that are as yet poorly understood both in terms of aetiology and impact.

Hopefully the next decade of research will bring some enlightenment.

cronsilksilt Mon 02-Apr-12 14:04:29

Yes that would be good

Lougle Mon 02-Apr-12 18:55:25

Asiatic, I didn't say DD1 'has' ADHD. Equally, as I said to her Paed, I don't care at all if she 'gets' a diagnosis of ADHD or 'doesn't'.

Why?

Because, the most important thing for DD1 is that she is in the right school with the right staff and they respond to her not her 'labels'.

The travesty in this Country is that children need diagnoses to receive the right support. So many Counties treat the label not the child.

BTW, it is of completely no interest to me whether you 'see' anything in any of my posts. I don't need your validation to know that DD1 at the age of 6.4 (tomorrow) needs constant supervision due to the combination of her inattention,no sense of danger, unstable gait, and low impulse control.

I have 3 children, DD1 is the eldest. She requires the most supervision. I know what 'normal' children are like - I have two.

1Musteatcakenow Thu 25-Oct-12 14:03:25

Good grief! Sorry to stir this up again, but oh my goodness...

I am compelled to comment and to say that research suggests that for example conduct disorder, has a genetic and environmental aetiology or underlying cause. I can well understand why some of you are jumping up and down here, because the amount of mis-information from apparent professionals is astounding!

There are areas of the brain, which in conduct disordered children and those with hyperactivity are not firing properly, or are underdeveloped. One of these areas is the amygdala and no definite reason is known as to why this is the case. It is different in adolescent onset Conduct disorder and life time persistent (which can be diagnosed from age three) the area in conduct disorder that deals with emotion and empathy is known as Brodmanns area, and can have lesions on it which impair function.

Many professionals in the field of diagnosing the many complex conditions that children can have, don't have a clue as to what they are doing. I find this disheartening, frustrating and worrying. It isn't about the diagnosis, it's about the support that a diagnosis can bring. I have a son who is over the worst of conduct disorder and didn't need rediagnosed at eighteen as having anti social personality disorder. I now foster a child who is undergoing assessments currently. It is not bad behaviour, it is not induced by bad parents (this is a factor in some cases) and it does not get 'cured'. The only medication which would be prescribed as a worse case scenario that I know of is lithium, to control violence. Ritalin for ADHD is now somewhat outdated as there are more recent medications.

I'm still astounded at some of the posts I've just read, but well done to those of you who don't take that crap lying down.

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