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  1. #11
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    AMM, MNDad and MrsLOLCat, I'm with you all about the "real" ness of ADHD. The side effects of not having my ds on meds would be huge - for him and for everyone else that cares about and spends time with him. (We found a non-stim that helps him - doesn't do enough for the focus/attention, but makes a big difference and avoids the adverse side effects he got from the stim med trials).

    But here's what I found interesting about the book (the article just sort of touches on his main arguments):

    He says ADHD does not exist, but what he means (the title is meant to be attention grabbing) is that what we call ADHD is just a group of similar signs/symptoms/resulting troublesome behavior. And kids/adults with those signs and symptoms likely have many different causes for them. He thinks we should be looking for root causes of those particular symptoms. His list of "real" underlying causes (some of which are also complex and multi-causal and not completely understood) is long and varied:

    vision problems
    hearing problems
    sensory processing issues
    asperger's/autism
    learning disabilities
    giftedness
    OCD
    bipolar disorder

    And so forth. There's a lot more.
    He does not say don't medicate. It's not an anti-medication book. He says go down a list of common causes for the displayed symptoms more systematically and medicate where needed, but not indiscriminately.

    I think this part is dead on and I wish there were more practitioners willing to take the time, read the research and work on ruling out systematically a list of common or likely (b/c of patient hx/family hx/etc.) root causes with every new patient.

    So here's where I'm puzzled/not fully convinced. I'm not sure his list addresses every ADHD kid. The ones who've always had the impulsivity/inattention/hyperactivity/lack of emotional control (for their age).
    That would be my DS. Does his list cover all those kids too? IDK...If it doesn't then what are we left with if not "ADHD"?

    He also doesn't even address some of the good, recent research on ADHD that shows that kids with that label have different brain scans in common that are different than "normal" kids. Or the many observations of ADHD kids that seem to "grow out" of it, suggesting (combined with the brain studies research) that for some this might be a developmental delay (maybe also permanent disability) in the brain areas (prefrontal/frontal cortex) that are involved in attention, processing, impulse control, emotional control, so called "executive functioning".

    The first time I read the brain scan research news article it made me laugh out loud. ADHD kids' brains are under-developed in impulse control and over-developed (or advanced) compared with their age peers in motor coordination. That explains a lot! DS scaled our 8-foot block wall at 4 (with the help of a grill that we had to find a new home for). He had incredible "gross motor" skills and practically zero impulse control. He was more than 5 yo before I could walk across a parking lot without a death grip on his hand. I still have to remind him to look where he's going/watch for cars.

    So I think his book is awesome for bringing up the possibility that there is a lot more going on than we know with reasons for the ADD/ADHD symptoms. And for insisting that we can chip away at it and do a better job of helping kids with these issues. And help some kids avoid unneeded meds with big time adverse effects.

    But it leaves me with a lot more questions...no one has answered why we've seen such a rise in ADHD (overdiagnosed or not)/autism. His book doesn't either....

    Ok - this is long. I must confess, I have interests in "science studies" - sociologists/anthro/geographers with this interest study the social/cultural/institutional factors that influence science/medicine research and practices. ADHD/Autism is a big interest area. And like a lot of y'all I've got a huge interest in helping my own DS make his way in the world successfully despite these difficulties (which do come with great bonus aspects as well - I wouldn't want to medicate away ds' joy, enthusiasm, energy, or his ability to make creative and interesting connections).

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  3. #12
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    MrsLOLCat - that is really interesting that your DS' genetic panel thing came back 'clear'....lol at the lunch example. Totally. I've read that too about the stim working for everyone - it's not a "trial" and if it works they do have ADHD. I took DS med once so I'd have a clue how he might feel on it. It was the first stim we tried Adderall (sp? I hated it..But I could definitely see that I was 100 times more "focused".

  4. #13

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    It's real.

    There is a spectrum, and each kid goes through the spectrum (i.e., it is more intense at different times than others).

    I liken it to my brother's (very real, very life-altering) autism. At 47 he's still got the tendencies/tics...he has had a lot of time to live with them, though, to be able to manage them (or not, depending on the day). We did not have the diagnosis/training/resources for him when he was a child that a child on the autism spectrum has today.

    But today we DO have the understanding of autism AND of ADHD, and your average person has an understanding that these, at base, are neurological conditions and something CAN be done about them, should symptoms be getting in the way of a full life or between a child and learning to his or her potential. In 1970 this was not the case. It's 2014, so...we should do what we can.
    Eclectically homeschooling 8th grade dd, who likes science as much as art...

  5. #14

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    Do you have my kid, pdpele?

    My son also has a few characteristics of Aspergers and SPD, and would probably test as gifted. The lines are so blurry that it discourages me from trying to get a diagnosis. I'd almost rather deal with the individual behaviors/issues and not worry about what to call them all together.
    Mother of two monkeys...daughter age 10 and son age 11.5.

  6. #15

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    Quote Originally Posted by AddlepatedMonkeyMama View Post
    My son is chatty, active, and happy when he's on his meds (my only experience is with stimulants). He's also calmer and able to follow directions better. I wonder if stimulant meds have the same effect on someone who doesn't really have ADHD.
    After my mother's stroke, she was having a hard time speaking without slurring her words (think 'incredibly drunk' sounding individual), and her doctor prescribed Ritalin. We all pshawed it and laughed, but after just a couple of days of being on the Ritalin and then adjusting her dosage down (she was having trouble w/sleep) it was amazing how clear her speech was and how alert she was. It's been 2yr since the stroke, and I can tell 95% of the time when she's either too tired or missed her Ritalin. She sounds slurry and groggy. She has never had ADD/ADHD or anything close to it, so the Ritalin may be primarily affecting the parts of her brain that were affected by the stroke? IDK for sure. The clot was in the base of the basal ganglia, and they were able to remove most of it, but a tiny part couldn't be reached. Just based on personal observation, the Ritalin seems to be speeding up my mother's processing which leads to clarity.

    Can't say that ADHD doesn't/does exist, but I can say that I've worked with a couple of kids and knew a couple of individuals who had 'something'. To say that they were constantly pinging off the walls would be an understatement. OTOH, I can say that I fully believe the ADHD/ADD thing is greatly over-diagnosed. Pure opinion. When DD had her eval done at KKI, one of the evaluators tried to stick an ADHD label on her, and we completely disagreed with it. Yeah, she's wired and bouncing around, but she'll knock it off 99% of the time if I tell her to. An ADHD individual can't 'just stop'. She can. When I pointed out to the evaluator that my Kindergarten teacher noted on my report card 400yr ago that I had a hard time sitting still and focusing but that I was able to self-correct by the end of the year, the evaluator tried to pin an ADHD label on me. DH thought that was hysterical.

    I hate to say it, but IMO, I think ADHD and ASD are both greatly over-diagnosed. I was watching "The Bad News Bears" on the TV a couple of weeks ago; it was made in 1976. As I watched the kids in the movie, it made me sad because I could label just about every one of them with something. Back then, kids were 'just being kids' if they were hyper, chatty, nerdy, quirky, or whatever. No official diagnosis required. Now, everyone wants to stick a label on these kids and stuff them full of pills or stick them in therapy. It's depressing.
    Carolyn
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  7. #16

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    I have two kids, and both have been diagnosed with ADHD. One has also been identified with AS/ASD, giftedness, sensory-processing disorder, and anxiety disorder-nos (all except the giftedness likely due to brain trauma secondary to an underlying medical condition). She needs meds. If you met her when she was just getting up and ready for breakfast, before medicine, and then again 3 hours later you'd be shocked to be told that you'd just met the same girl twice. Barely functional vs. bright, curious and engaged. I have no question that she needs the medicine she takes, and that it greatly improves her quality of life.

    My son, on the other hand, only received his diagnosis because I consulted my daughter's therapist after multiple reports about his school behavior and lack of focus. He is of the classically over-diagnosed population: bright, energetic, male, 6. He's also a predominantly visual-spatial learner. I refused to give him medication because helping him learn some behavioral control, and changing his learning environment was all we needed to improve his access to grade level material (well, above grade level material outside of his old classroom) and let him make friends and feel socially competent.

    My thoughts on the situation outlined in the article are:
    (1) Just because it's over-diagnosed doesn't mean it's not a real disorder
    (2) Our public education system that caters primarily to a single style of learning, and most highly values quiet, calm, compliant learners, created the culture of over-diagnosis for which parents take the blame. When my son was in school the teacher, principal and other parents from the class all pressured me (and 2 other families of young boys) to "do something" and "talk to his doctor". The message was clear: A good parent, and a good member of that community would medicate my son and the other boys.
    AtomicGirl--Mom, old enough to know better
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  8. #17

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    I'm just starting to work my way through the alphabet books at the library. It was a really valuable read for me (a newbie to adhd), and I appreciated that his bias was revealed right in the title.

    Overall, I found his tone to be very overly-simplistic and condescending. Nonetheless, he very clearly lays out some of the diagnostics that parents can and should ask for - great information.
    It has taken me down the rabbit hole that is the paediatric DSM: who wrote it, how it was written, etc. I feel like this all helps to make me a better advocate for my child.

    Otoh, I hate to think that one book could potentially provide just enough mis-information to prejudice an under-informed population against adhd diagnoses. I have a friend that is constantly bemoaning her grown son's need for medication. I finally asked her to stop talking about it - "If he was diabetic, would you ask him to 'wean off' insulin?!"

    As to the increase in diagnoses of adhd: I'd like to hear more on this too, pdpele. I personally think that schools are overcrowded/underfunded, and we are asking teachers to do the impossible. The whole sahm job being the hardest job argument- I disagree. I'd rather be a sahm than a public school teacher any damn day. I also feel that society in general is suffering from pathalogical patience-deficiency.

  9. #18

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    The school wanted my sister diagnosed ADHD in the mid-1970s. She was a completely normal kid. My parents refused. She's never been in any trouble, and she's been a paralegal for decades.
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  10. #19
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    It is real. But the causes to the behavior that leads to an adhd diagnosis are different. Helping a person with this diagnosis cope depends on the cause. Medication helps for some, but not for all. I would hope that alternative methods of treatment would be explored before medicating. The side effects of stimulants concerns me, too. We have been pushed to medicate, but I refuse to do so until my kids are at least 6 years old. I haven't ruled it out since I don't want them to be impaired from functioning in society, and if medication will help them function with day to day tasks that are easy for the general population to concentrate on then I owe it to them to keep my mind open to the possibility.

    For those who don't think it's real, come to my house for a day. My 4 1/2 yo twins have it so badly that the psychologist who did their evaluation was convinced they would qualify for disability benefits because of severity of it with them. It is not a matter of not being able to sit for 5 minutes. They can't focus on a task for more than a minute without something inevitably distracting them. They also have a special need which almost always comes with a diagnosis of adhd, so it's not like it's too early to diagnose since almost every girl with their disability has adhd.

    We have strategies in place for them to learn and thrive. And they are happy, so I see no point in medicating them this young. A four year old doesn't need to be sitting still. They can just play. They do well with one on one instruction, albeit in a very squirmy, wormy way , and this why homeschooling is such a good fit for them right now. They would not be able to function all day in a public school setting. Without a doubt, they would have to be medicated. I am happy that homeschooling allows us to keep them unmedicated for now. But as they age and if their attention does not improve, we may have to consider medicating.

    Our son has the diagnosis and I am not convinced he actually has it. He has later been diagnosed with spd, and I think that is causing more of the adhd behaviors than adhd. But we have been doing neurofeedback therapy, and the therapist said his brainwave patterns were indicative of someone with adhd since he had the slow wave brain movements. But the the therapy has helped his brain "wake up" and his brain waves are more quick now. She also said he has signs that he has some anxiety which I think is another cause to adhd like behavior. But the neurofeedback therapy has improved his attention exponentially, and I wish that health insurance covered it. They are so quick to cover stimulants but don't cover this therapy that is recommended by the apa for treatment of adhd.

  11. #20

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    One of the ways to look at this question for me is through the idea that by creating a diagnosis, you also create the people who have it. If something doesn't have a name, then it doesn't exist in a way. Before the 70's, ADHD really didn't exist at all because no one had given it any name - not any name that didn't normalize it as routine kid behavior. I think you can come at it thinking that by naming it, we've helped all these people who struggled before, who needed more support but couldn't get it. Or you can think that by naming it, we've made it "other," made people expect better (perhaps unrealistic) focus from their kids, made them less able to support kids with this behavior without marginalizing them as "having ADD." And while I would never say it doesn't exist... I do think there's a lot to the latter view that pathologizing distractability and hyperactivity and hyper-focus has made it harder for us to see as simply normal and harder for us to accept and more likely for us to "need" medication for it. Which, again, is not to say that medication can't help some people, but there are a lot of kids out there who display that behavior who really shouldn't be on medications.
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