ADHD

[Hopandaskip]

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?

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.

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

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 ( 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.

'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.

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.

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.

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

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.

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.

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

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.) 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.

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.

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.

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. .

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.

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.

Asiatic

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

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

What qualifies you?

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.

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.

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.

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?

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.

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

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.