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Source: (consider it) Thread: Purgatory: ADHD and Ritalin
Emma Louise

Storm in a teapot
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I was going to post something but i forgot what it was and hten i got distract....
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leo
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# 1458

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quote:
Originally posted by mgeorge:
I had a bad experience with ADHD perception. I have a very active child, and was often subject to glares from people during church because he would actually make noise and have trouble keeping still during a worship service. I would take him out frequently so as not to offend anyone--but I would also point out at the time that our church did nothing to get children more involved or interested, either.

We have an ADHD child in our congregation - sometimes his parents csame the church in shifts - alternate Sundays without him - not we all know about the situation. Sometimes he creams ther place down or runs around the altar. When people tense up arpound him, it seems to make him worse. Consequently, wheh I am leading worship, I slow down the pace and have some more 'silence' and this seems to have a calming effect on him and, more significantly, the other kids who he 'sets off'.

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My Jewish-positive lectionary blog is at http://recognisingjewishrootsinthelectionary.wordpress.com/
My reviews at http://layreadersbookreviews.wordpress.com

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Rat
Ship's Rat
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quote:
Originally posted by musician:
I've long suspected that diet's a contributory factor in a number of today's ailments.
It's about the only thing that might explain the exponential increase in autism and all the language disorders. Schools are now so much better at identifying them, but they are increasing beyond that.

I agree that diet does seem to be a factor, especially the odd perception some parents seem to have nowadays that children can't eat what adults eat in smaller portions but must instead be fed solely on chicken nuggets, smiley face things and chips.

On the other hand, I seem to see a lot of children nowadays spending an awful lot of time in structured, supervised activities (or inactivities). A great many of the kids round here seem to go from breakfast club to school to after school club to some organised extra-curricular class. Any spare time left is spent in front of the TV, on the computer, or doing something rather tame in the back garden. They seem to have very little of what my generation had in abundance - time to just go out and play with other kids. Most of our time that wasn't spent in school was spent messing about on bikes, trying to catch newts with on a bit string tied to a stick, roller skating, making up games, having fights, making up again, grouping and regrouping and fighting again. Nowadays we'd all have ASBOs slapped on us.

I don't want to romanticise my childhood more than I can help, but it seems to me certain sectors of society put a far higher burden of concentration and structure on children, for a far greater part of the day, than ever happened before. To the detriment of unstructured phsyical and social activities that used to make up the bulk of non-school life. I wouldn't be at all surprised if that imbalance had a bad effect on concentration and behaviour during school hours.

I don't deny that there are people with ADHD who respond well to medication and need it - but when people start talking about epidemics and exponential increases and 40% of children needing medication (which I'm sure I remember seeing quoted somewhere) then I'm suspicious that we're lumping in a lot of people who don't qualify into that subset, and that we should start thinking seriously about whether environmental and societal factors, or just unreasonable expectations, have some part to play here.

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It's a matter of food and available blood. If motherhood is sacred, put your money where your mouth is. Only then can you expect the coming down to the wrecked & shimmering earth of that miracle you sing about. [Margaret Atwood]

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ken
Ship's Roundhead
# 2460

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quote:
Originally posted by musician:
I've long suspected that diet's a contributory factor in a number of today's ailments.
It's about the only thing that might explain the exponential increase in autism and all the language disorders.

No it isn't. There is no real evidence that such things are increasing at all. And ss you say "Schools are now so much better at identifying them". Which is not, as far as I know, the case in all countries.

Also we now demand more of people than we used to. There are mpo jobs for people whose brains don't fit, and no places in societty for people without jobs.

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Ken

L’amor che move il sole e l’altre stelle.

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daisymay

St Elmo's Fire
# 1480

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quote:
Originally posted by Emma.:
I was going to post something but i forgot what it was and hten i got distract....

[Cool]

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London
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mgeorge
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Cool, Leo. On behalf of many parents:

[Overused]

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Spong

Ship's coffee grinder
# 1518

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quote:
Originally posted by leo:
When people tense up arpound him, it seems to make him worse. Consequently, wheh I am leading worship, I slow down the pace and have some more 'silence' and this seems to have a calming effect on him and, more significantly, the other kids who he 'sets off'.

My wife organises several events for children with autistic spectrum disorders, and notices the same thing. The reason for organising a special visit for parents and children to a bowling alley, or the cinema, or a sports centre, is that parents often won't go to such things on their own with their children because when they do they inevitably have a hell of a time as the child misbehaves. Here everyone will understand. But paradoxically there is actually very little bad behaviour, and she thinks one of the main reasons is that the parents are more relaxed so the children don't pick up on the tension and kick off.

Spong

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Spong

The needs of our neighbours are the needs of the whole human family. Let's respond just as we do when our immediate family is in need or trouble. Rowan Williams

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Telepath
Ship's Steamer Trunk
# 3534

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Originally posted by Rat:

quote:
I agree that diet does seem to be a factor, especially the odd perception some parents seem to have nowadays that children can't eat what adults eat in smaller portions but must instead be fed solely on chicken nuggets, smiley face things and chips.
Mmmaybeee... OTOH I ate better as a child than most people I know have ever eaten in their lives. My mother fed me on, y'know... food. All the other kids were drinking artificial powdered neon stuff instead of orange juice, and I was the odd kid out in ways that made my life difficult for extended periods of time, because I wasn't allowed to eat that ersatz chemical shite.

Maybe I just needed more additives.

Originally posted by Rat:

quote:
40% of children needing medication (which I'm sure I remember seeing quoted somewhere)
Could we have a better citation? I have never heard of any credible study which suggests that 40% of children need medication.

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

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daisymay

St Elmo's Fire
# 1480

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This information site about ADHD & ADD is quite useful in explaining clearly. It's reasonably up to date.

This other one is also informational.

And NHS Direct adds to it.

They all mention a low proportion of people who have been diagnosed, nothing like 40%! They also bring up ideas about medication, behavioural help and food.

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London
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Moth

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# 2589

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quote:
Originally posted by Rat:
I don't want to romanticise my childhood more than I can help, but it seems to me certain sectors of society put a far higher burden of concentration and structure on children, for a far greater part of the day, than ever happened before. To the detriment of unstructured phsyical and social activities that used to make up the bulk of non-school life. I wouldn't be at all surprised if that imbalance had a bad effect on concentration and behaviour during school hours.

You are right; most kids are never left to wander about the streets and parks "just playing", because (a) there is far more traffic nowadays and (b) their parents are terrified that a paedophile will come and steal the children away.

Whilst (a) is certainly true, and far too many children are killed and maimed on our roads, (b) is in fact very unlikely to happen, but is seen by many parents as a greater threat than traffic!

Hence lively, boisterous kids, particularly boys, are stuck in controlled conditions all day and then medicated so that they can endure it. Why there is no fuss about this form of child abuse is beyond me.

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"There are governments that burn books, and then there are those that sell the libraries and shut the universities to anyone who can't pay for a key." Laurie Penny.

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Sioni Sais
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# 5713

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quote:
Originally posted by Moth:
quote:
Originally posted by Rat:
I don't want to romanticise my childhood more than I can help, but it seems to me certain sectors of society put a far higher burden of concentration and structure on children, for a far greater part of the day, than ever happened before. To the detriment of unstructured phsyical and social activities that used to make up the bulk of non-school life. I wouldn't be at all surprised if that imbalance had a bad effect on concentration and behaviour during school hours.

You are right; most kids are never left to wander about the streets and parks "just playing", because (a) there is far more traffic nowadays and (b) their parents are terrified that a paedophile will come and steal the children away.

Whilst (a) is certainly true, and far too many children are killed and maimed on our roads, (b) is in fact very unlikely to happen, but is seen by many parents as a greater threat than traffic!

Hence lively, boisterous kids, particularly boys, are stuck in controlled conditions all day and then medicated so that they can endure it. Why there is no fuss about this form of child abuse is beyond me.

(my italics)

I can only imagine it is tolerated because it is done by qualified, well-educated adults. The over-diagnosis of childhood epilepsy (around Leicester I believe) is another example.

As for child abuse, I would be amazed if the family home was not the typical venue. Kids may well be safer outdoors, if they have elementary road sense (which is another problem).

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"He isn't Doctor Who, he's The Doctor"

(Paul Sinha, BBC)

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musician

Ship's grin without a cat
# 4873

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Sorry Ken, it is increasing at a rate unexplainable by statistical prediction - or whatever is used to predict the numbers.

It's also quite likely that schools now expect more of boys than ever before - most ADHD affected people are male.

In the 19th Century, school inspectors noted that in one school the girls outperformed boys in everything except euclid and maths. Plus sa change!
In the early 20th Century, another report mentions that boys had a healthy disregard for learning while the girls had a morbid interest in it. Note the adjectives for the attitude to the sexes and to academic achievement.
Most schools in english speaking countries, or in post colonial british countries, are set up roughly along the lines of english public schools. Those schools in the 19century were not expecting to produce academics and thinkers. They were the source of "muscular christians who would rule the empire".
There's a certain amount of truth in that. An ADHD fellow was probably the hero of his regiment - champion of sports etc.

We now expect boys to sit and study and for the first time their results are being closely monitored and measured against girls, who on the evidence of the school inspections have been out perfoming them for centuries in areas requiring thought and careful application to work.
Another interpretation is that schools are being feminised. A few years ago, boys outperformed girls in technology. That's now changing, but the criteria for assessment has changed.
Used to be that in, eg, woodwork, lads were taught cuts, joints etc and the final exam was to produce a piece so useless that it wouldn't even do for a proud grannie's christams prezzie, but it did use every cut, joint etc that had been taught in the course.
Now the challenge might be to "produce a piece to aid learing in nursery school". A girl might well think up a learning toy while a boy's response apparently is more likely "eh??"
I'm quoting these examples from a distinguished speaker on why boy's behaviour is "getting worse" as seen by society.
Society is changing and expecting different things.
Finland, eg, has no trouble with girls out performing boys. They don't. Neither has Finland's schools been affected by the system in the post colonial places.
ADHD is one particular area where boys are being closely studied. AUtistic spectrum disorders have also been described as the condition of "perfect maleness" - total self absorbtion, no idea how it is for other people, no wish to include other people in their lives.
The poor guys are now being critisised for being themselves.
I hate to think of how destructive this may prove to be in the future.

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musician

Ship's grin without a cat
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Another difficulty now is maybe - as Rat said - the changing social ideas on child rearing.
The aggro in teens and kids may turn out to be down to handing the baby at 6 weeks to a child minder. The child minder's not its mother, so is not responsible for the child's formation in society.
Perhaps we're now seeing the 1st generation of uncared for kids who have gone from the early nursery via childminders, a procession of family baby sitters, school with its breakfast clubs and after school care where the child meets its parents for an hour a day. Free time is in organised clubs - scouts, swimming, dance etc.
Yes, kids need opportunities to expand therir interests in the company of other kids, but they also need time to themselves. They need to learn social skills - not likely in the scouts! (sorry ex scouts!!)
Seriously, I know parents need to work to pay the mortgage, but maybe as a society we need to see children as real people. Not as a drain on finance, an entity needing looked after 24/7, and a burden. Go knows they're all of that [Roll Eyes] but they're so much more. They're a real privilege, they're Us - only a younger generation.
I worked with some kids who had been all over the world with their well off parents, but the kids had no experiences of their own. They'd never really been allowed to be children - they were taken places, given experiences, but often these were adult treats - like staying in a posh hotel (..so I imagine......wistfully...) but the children hadn't had time given to them. It was all taken in clubs, Doing Things.
Is that guilt on the parents' behalf, do they imagine it's for the best, or is it to take the children out of their hair yet again??
I don't know what the answers are, but there are a lot of questions needing to be carefully considered.

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Laura
General nuisance
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quote:
Originally posted by Moth:
Hence lively, boisterous kids, particularly boys, are stuck in controlled conditions all day and then medicated so that they can endure it. Why there is no fuss about this form of child abuse is beyond me.

There is more of a fuss than one might imagine, though it's mostly limited to decrying the fatness that results from this. But others have noticed that boys especially are not well-equipped to pay devout attention in first grade anyway and perhaps the recess and afterschool play are the only things that make this tenable.

I wouldn't know. I send my kids outside to "run it off" on a regular basis. I don't know what would remain of the house if I didn't. Their being maimed in a traffic incident seems a reasonable risk tradeoff for having *some* presentable furniture.

If we lived in London or another big city and didn't have a garden, I guess we'd have to do this at the park every afternoon, which I guess would be more of a production.

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Love is the only sane and satisfactory answer to the problem of human existence. - Erich Fromm

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Laura
General nuisance
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quote:
Originally posted by musician:
Another difficulty now is maybe - as Rat said - the changing social ideas on child rearing.
The aggro in teens and kids may turn out to be down to handing the baby at 6 weeks to a child minder. The child minder's not its mother, so is not responsible for the child's formation in society.
Perhaps we're now seeing the 1st generation of uncared for kids who have gone from the early nursery via childminders, a procession of family baby sitters, school with its breakfast clubs and after school care where the child meets its parents for an hour a day. Free time is in organised clubs - scouts, swimming, dance etc.
Yes, kids need opportunities to expand therir interests in the company of other kids, but they also need time to themselves. They need to learn social skills - not likely in the scouts! (sorry ex scouts!!)
Seriously, I know parents need to work to pay the mortgage, but maybe as a society we need to see children as real people. Not as a drain on finance, an entity needing looked after 24/7, and a burden. Go knows they're all of that [Roll Eyes] but they're so much more. They're a real privilege, they're Us - only a younger generation.
I worked with some kids who had been all over the world with their well off parents, but the kids had no experiences of their own. They'd never really been allowed to be children - they were taken places, given experiences, but often these were adult treats - like staying in a posh hotel (..so I imagine......wistfully...) but the children hadn't had time given to them. It was all taken in clubs, Doing Things.
Is that guilt on the parents' behalf, do they imagine it's for the best, or is it to take the children out of their hair yet again??
I don't know what the answers are, but there are a lot of questions needing to be carefully considered.

Right. It's the fault of working parents.

Actually, extensive studies have demonstrated that bad childcare is bad for kids, whether that's a mother who can't be bothered or an indifferent understaffed daycare center, and good childcare is good for kids. I've both worked and stayed-at-home, and my kids are well-behaved because we demand it. In fact, interestingly, the most spoiled and difficult kids I know are the ones who have stay-at-home parents who make the mistake of making the kids much too central in the family. That is, the kids think everything is about them and revolves around them, rather than that they are part of a family unit that has different needs.

I think that bit of this equation is down to parenting style and quality of care rather than daycare/ not daycare.

You also said:
quote:
Perhaps we're now seeing the 1st generation of uncared for kids who have gone from the early nursery via childminders, a procession of family baby sitters, school with its breakfast clubs and after school care where the child meets its parents for an hour a day.
This is not the first generation of non-parental care. Women have always worked (see Elizabeth Fox Genovese's "The Way We Never Were" for details) It was only for a brief period in the mid-20th century that post-war economics created a situation in which a few generations were raised with this sort of victorian ideal.

And anyway, studies have shown that 50s mothers actually spent less play-time with their children than modern working mothers, anyway. [Big Grin]

[ 04. January 2006, 12:52: Message edited by: Laura ]

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Love is the only sane and satisfactory answer to the problem of human existence. - Erich Fromm

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Telepath
Ship's Steamer Trunk
# 3534

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Originally posted by Sioni Says:

quote:
I can only imagine it is tolerated because it is done by qualified, well-educated adults. The over-diagnosis of childhood epilepsy (around Leicester I believe) is another example.

As far as I know, it's an example of overdiagnosis and overmedication of a particular disease in children. It's not another example because, as far as I can see, you haven't provided an example but simply made an assertion.

I have heard of research suggesting that over-structured and over-demanding lifestyles with insufficient time for play can overload ordinary children so that they can appear to have AD(H)D when they really don't. I could believe this was true, but I don't have a citation or any real idea of how credible or conclusive the research was.

If this is true, it still doesn't prove that qualified, educated psychiatrists and neurologists are widely abusing the diagnosis for the convenience of parents and teachers. We may all take it for granted that it's natural for doctors to do this as a matter of course, but there should be some credible evidence for it if that's the case.

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

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Rat
Ship's Rat
# 3373

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quote:
Originally posted by Telepath:
Originally posted by Rat:
quote:
40% of children needing medication (which I'm sure I remember seeing quoted somewhere)
Could we have a better citation? I have never heard of any credible study which suggests that 40% of children need medication.
Not from me...it's just a figure I'm sure I've heard bandied about somewhere by someone. Probably nonsense.

musician: it's slightly tangential to the subject, I know, but maybe kind of along the same lines you are thinking. Over Christmas at my mum's we wound up watching a reality TV programme called Beauty School about girls training to be beauty therapists - waxing, manicures and the like. And at one point the narrator commented that most of the students were confident in the practical elements of the course, but petrified of taking the final written theory exam.

I was really surprised, and wondered why we are expecting people interested in a field that seems quintessentially hands-on to pass academic-style study leading to a written exam? I'm not at all downgrading the level of skill the job requires - I wouldn't want somebody waving hot wax at me that wasn't well trained! - but I really can't see the necessity for classroom learning and exam-taking skills that they'll probably never need again in their working lives.

It does make me wonder if - in the interests of standardisation perhaps? - we're just making completely different demands of people now. So somebody who a couple of generations ago would have been an excellent hairdresser or plasterer taught on the job, now shows up in the statistics as a problem because they don't cope well with desk-based learning and written exams.

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It's a matter of food and available blood. If motherhood is sacred, put your money where your mouth is. Only then can you expect the coming down to the wrecked & shimmering earth of that miracle you sing about. [Margaret Atwood]

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Laura
General nuisance
# 10

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The very good point musician makes is that modern middle-class children are often overprogrammed, very much so. There's a real value in benign neglect that teaches children to be imaginative and solve their own problems and entertain themselves. A conclusion of a recent NYTimes article about genius kids is that teachers found that the most creative and genuinely curious thinkers as children were not dragged from genius class to class as babies, but had developed genuine intellectual inquiry and reading as habits apart from their parents.

The exception is organized sports and music, which you can really only learn as part of a team or orchestra. But we certainly shouldn't foist these things on the kids -- they should be chosen activities.

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Love is the only sane and satisfactory answer to the problem of human existence. - Erich Fromm

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Telepath
Ship's Steamer Trunk
# 3534

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I've also noticed a trend to blame AD(H)D on working parents. When I was a kid it was blamed on my having a stay-at-home mother and being an only child and, in general, being "spoiled".

(Okay, I don't really know this for a fact. I infer that other adults were using the word "spoiled" in reference to me, because of my best friend's shouting at me: "You! Are! Spoiled!", and I doubt that "spoiled" was a word she could have learned on her own; she wasn't very literate.)

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

Posts: 3509 | From: East Anglia | Registered: Nov 2002  |  IP: Logged
Telepath
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# 3534

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Originally posted by Laura:

quote:
The very good point musician makes is that modern middle-class children are often overprogrammed, very much so. There's a real value in benign neglect that teaches children to be imaginative and solve their own problems and entertain themselves. A conclusion of a recent NYTimes article about genius kids is that teachers found that the most creative and genuinely curious thinkers as children were not dragged from genius class to class as babies, but had developed genuine intellectual inquiry and reading as habits apart from their parents.

[Big Grin] ...and one of the cited ways my parents used to "spoil" me was in allowing me to piss about doing my own thing... [Big Grin] If only they'd forced me to spend more time doing stuff I hated, I might have lived up to my genius IQ and probably had better handwriting and been more athletic [Killing me]

I really felt sorry for one of the kids I taught French to. Her family had a whiteboard in the hall with a veritable patchwork of activities on it. Her ambition in life was to find a way to get some unstructured time for herself, to the extent that she would fake stomachache five minutes before the end of the lesson, just to get five precious minutes. Right after post-school French tutoring, you see, she would have either an hour's piano lesson (four times a week) or an hour's violin lesson (three times a week) and she was only twelve. And then there was summer school, which didn't let out until 5pm.

This kid was better at French at twelve than I had been, that was for sure. There was no way she was going to be behind in class, with or without my help. I could tell she quite liked our lessons, but rather reasonably didn't want to be forced. When her mother rang me up and said the girl was adamantly refusing any more tutoring, I said that that was her right, and I refused to get drawn into trying to persuade her to resume.

The kid didn't, however, show any signs of ADHD. And if her mother were to try anything on with a shrink or a neurologist, they would have seen through her line of B.S. in two minutes flat.

Seriously, these are great speculations and valuable observations about what's wrong with society and childrearing in general. I'm certain that these phenomena are real and make the lives of all children, and especially ADHDers, much much harder. However, when they finally pinpoint the actual direct causes of the physical disorder we call ADHD, I'll be surprised if these are among them. That doesn't mean I think these things are not happening, or that they're a good idea. I do think they are red herrings in terms of discussing ADHD.

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

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Duck
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# 10181

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I used to babysit a child with ADHD who responded very well to ritalin. Off it - or before his next dose was due - he literally could not sit still for 30 seconds - he would be literally bouncing off the walls from morning to night. He wasn't badly behaved in the usual sense - he was friendly, polite, affectionate, didn't swear, etc - but he really could not cope with class work like learining to read (he was nine and almost illiterate). Excercise didn't seem to help much - i could take him to the park all day, or running (an experience in itself given that he had no sense of danger) - and he'd still be hyperkinetic as ever when we got home. It did seem to upset him as he had trouble joining in with other kids - his total lack of planning meant he would do dangerous & unpredictable things which would be construed by the others as aggression - he just didn't work out what was going to happen.
On Ritalin, he was able to concentrate for longer - he would ask to sit & read a book with me, or do daft science experiments in the kitchen and actually concentrate for long enough for him to ask me why they worked, or play outside with friends without anyone getting hurt. He would actually ask for it to 'help me think better'. The only real problem he had on it was weight loss - but when he wasn't taking it then that was a problem too, as he just could not sit down for long enough to eat a proper meal.
Ritalin works. It helps people.

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Josephine

Orthodox Belle
# 3899

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quote:
Originally posted by Moth:
Hence lively, boisterous kids, particularly boys, are stuck in controlled conditions all day and then medicated so that they can endure it. Why there is no fuss about this form of child abuse is beyond me.

No fuss? Have you read this thread? Have you read Telepath's posts? Have you ever talked to a parent of a child with ADHD? There's plenty of fuss. Parents of kids with ADHD are told, in the media, by relatives, friends, teachers, and complete strangers, that they are lousy parents, simply trying to drug their kids into a zombie-like state, and if they'd just stay home with the child (or if they would have a life beyond their child), if they would spank him once in a while (or if they didn't use such barbaric methods of discipline), in short, if they were decent parents and decent human beings, their child would not have these difficulties. And the children are informed regularly, by all and sundry, that they are simply bad kids -- defiant, disrespectful, disobedient, rude.

And maybe that's true for some of them. I'll grant that there are children (not 40% of them, but a few) who do not have ADHD who are diagnosed and treated for it. That doesn't mean that all such children are simply spoiled brats -- Middle Son was diagnosed with and treated for ADHD for a while, before we realized that the medication and the behavioral therapies appropriate and useful for kids with ADHD were simply making things worse for him, and Littlest One had an ADHD diagnosis before we got to a neurologist who figured out that he was inattentive and impulsive because he has severe visual and fine motor impairments. But those things are less common than ADHD, and far harder to diagnose, so it's not surprising that the doctors would make that mistake occasionally.

But you'll note that the meds and the behavioral therapies did not work for them. Nor do they work for children whose real underlying problem, the thing causing the inattentiveness and/or impulsiveness, is OCD, depression, hearing impairment, bipolar disorder, or the jillion and ten other things that can cause inattentiveness and impulsiveness. Therefore, I think it's fairly safe to assume that most cases of misdiagnosis eventually get sorted, as our sons' did, and the kids get appropriate treatment.

Urban mythology aside, children don't get put on medication simply because they are boisterous males. My eldest son with ADHD is inattentive type. He's decidedly NOT boisterous, and never has been. But he has been on Ritalin for ten years, and expects to be on it for the rest of his life. He doesn't function very well without it -- not just in carefully controlled environemnts, like school and church, but even just hanging out with friends.

You may count that as child abuse, although that statement is as inflammatory and unhelpful as it is ignorant and false.

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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!

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Moth

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# 2589

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I wasn't denying the existence of ADHD. I have known children who have it.

I have also known parents who spend all their time trying to get their child diagnosed with something, anything, rather than admit that the child is not very academic.

I do think it is child abuse to keep a child constantly in supervised activities, rather than letting them have their own time and freedom. Yet I have been criticised for allowing my sons to catch buses on their own, play in the local park, or cycle off to see friends. "What if something happens?", goes up the cry.

I don't think it is child abuse to give a child ritalin if the need is clinically proven, and experience shows it works. I'm sure that the vast majority of parents are acting in that way. I'm just saying that some aren't. They have such ludicrous expectations of their children that any kind of inattention or falling behind at school is medicalised and treated. I can't quote statistics on this, but I've seen it with my own eyes.

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Moth

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I'm also suggesting that keeping children constantly in supervised activities might actually cause genuine behavioural difficulties, or even neurological ones. If caged animals develop "pacing" and other odd behaviours, why shouldn't young humans?

Again, I can't prove any of it, I just speak as I observe.

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"There are governments that burn books, and then there are those that sell the libraries and shut the universities to anyone who can't pay for a key." Laurie Penny.

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Laura
General nuisance
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Josephine:

I also was reading Moth to be saying that it was a form of child abuse to lock children up all day without sufficient energetic release and then expect them to behave in a class, and that this probably resulted in some otherwise normal kids being misdiagnosed. I didn't read it as a comment on real ADHD. I think we can all agree that over and under-diagnosis is a problem. I think we can also agree (as you can see from musician's post) that no matter what they do, it is the parents' fault if a child has ADHD. [Big Grin]

I'm used to child problems being blamed on working parents, myself. I seem to recall that you and Mousethief work outside the home. That will be your problem, then. My older son is a bit neurotic and perfectionistic, and that's my fault, I expect.

[ 04. January 2006, 14:17: Message edited by: Laura ]

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Rat
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# 3373

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I agree with what Moth said.

Also, while there is probably some cross over between working mums and use of breakfast and after-school type daycare facilities, I don't think I'd blame working mothers for over-programming (which is a lovely neat phrase I hadn't heard before). I don't see many stay-at-home mums round here kicking the kids out to play during daylight hours either.

Personally, I'm always inclined to blame all ills on parents not working outside the home since that's the novelty factor in the great scheme of things [Biased]

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Laura
General nuisance
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quote:
Originally posted by Rat:
I agree with what Moth said.

Also, while there is probably some cross over between working mums and use of breakfast and after-school type daycare facilities, I don't think I'd blame working mothers for over-programming (which is a lovely neat phrase I hadn't heard before). I don't see many stay-at-home mums round here kicking the kids out to play during daylight hours either.

Oops, I forgot, It's actually working mothers that are to blame. That the fathers might work 8am - 10pm to support the stay-at-home family is irrelevant. [Big Grin]

Actually, though, for certain groups of kids, they do much better in terms of behavioral problems and school achievment if they participate in pre-school breakfast and after-care programs, because the alternative is not dancing and gamboling outside with their mothers in a breezy, clean, safe park. It's being in activities at school OR playing in needle-strewn crack-den-lined inner-city streets and homes without enough money for a good breakfast.

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Love is the only sane and satisfactory answer to the problem of human existence. - Erich Fromm

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Zorro
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# 9156

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Laura, it seems like musician was really only making one point.

I'm at private school, and as it happens, I live a pretty damn grounded life. My going to that school saps nearly all disposable income from the house, and my parents are happy to do that, probably because they didn't fancy seeing my chances go down the pan as a result of the bullying I had during my state school years (P1-P7.)

But if there's one thing I know about a lot of the people at my school, the ones with very, very healthy bank accounts, it's that a very small amount are actually happy.

I can remember a dialogue with one guy, it went something like this;

ZORRO: Hey "J", how was christmas?

"J": Crap, all I got was a laptop, a pool table and a stupid underwater sea scooter (the personal yellow ones, typicall about £300 I think)

ZORRO: Man, you're kidding right? I got a P.C game, apart from the constant family stuff it was a pretty good christmas for me!

"J": Lucky you, we went to our house in the bahamas, it's so boring!

It's really sad, I think, when you see obnoxious little prats like this guy, who cause a fuss, and will do anything to get attention. The question is why do they do it? The answer, most often, is "Daddy's away running the business all the time, and mummy's at the beauty salon with her friends," so to compensate for this, mummy and daddy buy them expensive gifts which they can't use (who the hell is going to use a sea scooter aged 14, as we were then!)

I'm not saying that it's all working parent's fault, but I am saying that day in, day out, I see the effects of what that does to kids, and I find it disturbing. I find myself thinking that maybe people should consider how much time they can give to their kids before actually having them. There's nothing wrong with running the business, and going to the beauty salon, but it's not right that you expect a child to deal with that.

Furthermore, I'd like to again reiterate my point that ADHD does exist, and to say that it isn't all the fault of such parents.

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It is so hard to believe, because it is so hard to obey. Soren Kierkegaard
Well, churches really should be like sluts; take everyone no matter who they are or whether they can pay. Spiffy da wondersheep

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Telepath
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# 3534

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I certainly don't doubt that there are a lot of people without ADHD who are diagnosed as having it.

I also don't doubt that there are a lot of people with ADHD who are not diagnosed as having it, but I rarely witness any handwringing about that.

And it matters. We have no way of knowing how many people are alcoholic, in jail, or dead because they were never diagnosed or treated. Or how many more are leading lives of quiet desperation, poor or bankrupt or shopaholic or just plain struggling to keep their lives together in a tenacious holding pattern. All these people know is that they need to get a grip on themselves, and get more discipline and better standards. But that knowledge is always overshadowed by the other knowledge, that something is wrong with them, just wrong. That they are wrong. Oh sure, everyone is a unique and worthwhile human being who is intrinsically deserving of respect... but the trouble is that they are so hopeless and infuriating that it's no wonder people get fed up with them sometimes, and they're lucky anyone puts up with them at all... [Disappointed]

I think it's tragic that people are living their lives in this way, but I seem to be one of the few.

And as for the sexism of it all - it couldn't be that girls and women are just being left undiagnosed in unknown numbers, could it?

I can only speak from personal experience here, but I remember having my instability described as "the vapours" or being told that I "must seek help for PMS,"[1] both of which I'm pretty sure I don't have.

Could it be that wackiness, incompetence, and erratic high-strung emotionalism are seen as simply being female, only more so?

Aren't we all supposed to slap our wobbly thighs in sympathetic laughter as we identify with poor dumb Bridget Jones, who cannot do her job and is so impractical that she cannot even cook a meal? Are we not told to shriek, "that is SO just like ME!" Isn't Ally McBeal endearing, throwing shoes in restaurants and working a reference to her dysfunctional love-life into every deposition?

Everywoman is such a dizzy dame, isn't she? Maybe your expectations are too high, little girl. Your life is quite good enough for someone of your station.

You don't think, maybe, sexism might be hard on us chicks too, maybe?


[1] No, I'm not equating PMS with the vapours. I don't know anything about it. My point is that both are strictly feminine ailments.

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

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Rat
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# 3373

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quote:
Originally posted by Laura:
Oops, I forgot, It's actually working mothers that are to blame. That the fathers might work 8am - 10pm to support the stay-at-home family is irrelevant. [Big Grin]

Ah yes, but the working dads probably wouldn't believe you if you told them it was all their fault, so where would be the fun in that?

quote:
It's being in activities at school OR playing in needle-strewn crack-den-lined inner-city streets and homes without enough money for a good breakfast.
Oh yes, I'm sure you're right. Certainly I believe breakfast clubs in Glasgow have been a great success for kids many of whom who wouldn't otherwise have got breakfast at all, and there's some evidence that learning outcomes are improving as a result.

It's just that the idea of possibly being left in a school-based situation from 7 in the morning till 6 at night - which I believe would be possible here if the government met its education aims - makes my flesh creep.

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It's a matter of food and available blood. If motherhood is sacred, put your money where your mouth is. Only then can you expect the coming down to the wrecked & shimmering earth of that miracle you sing about. [Margaret Atwood]

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Laura
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quote:
Originally posted by Zorro:
It's really sad, I think, when you see obnoxious little prats like this guy, who cause a fuss, and will do anything to get attention. The question is why do they do it? The answer, most often, is "Daddy's away running the business all the time, and mummy's at the beauty salon with her friends," so to compensate for this, mummy and daddy buy them expensive gifts which they can't use (who the hell is going to use a sea scooter aged 14, as we were then!)

See, you cite working parents but then you describe neglect that hasn't got much to do with working. You describe children whose parents don't pay very much attention to them, then give them lots of crap to compensate. Mummy in your story is not, in fact, working, but chooses to spend non-working time in a stereotypically rich woman way.

People who work don't have to work around the clock, and people who don't work don't necessarily devote their nonworking time selflessly to their kids.

musician actually made a number of points, but the main two were:

1) ADHD may be a result of the allegedly first generation of children whose mothers worked outside the home a lot and

2) ADHD may also result from the overprogramming that many middle class children in such families get.

I think neither contentions are borne out by studies of such things.

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Love is the only sane and satisfactory answer to the problem of human existence. - Erich Fromm

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Zorro
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# 9156

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Laura said;
quote:
See, you cite working parents but then you describe neglect that hasn't got much to do with working. You describe children whose parents don't pay very much attention to them, then give them lots of crap to compensate. Mummy in your story is not, in fact, working, but chooses to spend non-working time in a stereotypically rich woman way.

People who work don't have to work around the clock, and people who don't work don't necessarily devote their nonworking time selflessly to their kids.

I didn't actually say that. What I said was that the father was working all the time, clearly that's related to working. I also said that the mother doen't spend time with her kids. I don't expect anyone to spend every waking moment with their kids, but I think it's fair to say that a lot of kids don't see their parents for some of the reasons which musician described, that they're either at nursery or have a nanny in to babysit, while the mother does whatever she wants and almost never sees them.

I never suggested that the "mummy," side of things had anything to do with working.

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It is so hard to believe, because it is so hard to obey. Soren Kierkegaard
Well, churches really should be like sluts; take everyone no matter who they are or whether they can pay. Spiffy da wondersheep

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Telepath
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# 3534

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Originally posted by Zorro:

quote:
I didn't actually say that. What I said was that the father was working all the time, clearly that's related to working. I also said that the mother doen't spend time with her kids. I don't expect anyone to spend every waking moment with their kids, but I think it's fair to say that a lot of kids don't see their parents for some of the reasons which musician described, that they're either at nursery or have a nanny in to babysit, while the mother does whatever she wants and almost never sees them.

That's awful, and most certainly has a great many disastrous and evil effects.

I don't see what it has to do with ADHD, though.

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

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musician

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# 4873

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Laura
quote:
Right. It's the fault of working parents.
No, I didn't say that. I didn't mean that either. "Fault" is part of a blame culture and I've no time for that.

I do suggest that the imbalance in many homes might/ may be partly down to parental working plus the Paxo* approach to kids free time
*Paxo = stuffing for turkeys - little seasonal allusion [Big Grin] )

I work full time. So does psyduck. The kids have allergies to Stuff. Thank god neither is ADHD, but I think ADHD, being provable through CAT scanning, is a brain condition. As far as I know, such is not down to working parents.
The Paxo Kids might be.
Whether it's a good trend or not remains to be seen.

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welsh dragon

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# 3249

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When I was doing an junior attachment in an adolescent unit, about 10 years ago, the (UK) consultant pretty much refused to prescribe ritalin. It is of the amphetamine family, and his argument was that we do not really know what the effects will be of heavy use during childhood or constant use during adulthood, after 2 or 4 or 5 decades.

Even then, however, it was much more commonly in use in the States.

Ritalin use has now become much more common in the UK. We also see adults coming to outpatients who think they may have ADHD and ask for ritalin, who did not have it as children.

I imagine that if I had a child with behavioural problems, who might be helped by ritalin, I would on the one hand be passionately desirous for him/her to have anything that might help his/her chances in life. On the other hand, I would have grave misgivings about dosing a child with such a medication if I could possibly avoid it.

I also have a lot of reservations about the idea that a) 3-4% -or more- of the general population have ADHD and b) most or all of these people should be on some variety of amphetamine. The differential diagnoses for adult ADHD are often bipolar disorder (manic depression) or personality disorder; groups of patients I would strongly advise to avoid amphetamines. I don't have any easy answers, I'm just hoping that the American National Institute of Mental Health has pulled its finger out and is doing a load of research on ritalin and its long term effects. Preferably not funded by the drug companies.

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Josephine

Orthodox Belle
# 3899

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First, Moth, I thought you were saying that giving Ritalin to a child diagnosed with ADHD was a form of child abuse. I've heard that before, so I mistakenly understood that to be what you were saying. I'm sorry for misunderstanding.

quote:
Originally posted by Telepath:
We have no way of knowing how many people are alcoholic, in jail, or dead because they were never diagnosed or treated.

Unfortunately, we do.
This annotated bibliography includes the following entry:

quote:
Rosler M; Retz W; Retz-Junginger P; Hengesch G; Schneider M; Supprian T et al. Prevalence of attention deficit-/hyperactivity disorder (AND) and comorbid disorders in young male prison inmates. European Archives of Psychiatry and Clinical Neuroscience 254(6): 365-371, 2004. (55 refs.)
Objective This study was performed to evaluate the prevalence of ADHD as well as comorbid conditions among young male prison inmates. ... Results The overall prevalence of ADHD according to DSM-IV was 45 %. ... Conclusion The prevalence of DAA/HCD or ADHD in young adult prison inmates is significantly elevated when compared to non-delinquent controls. Generally the population of young adult male prison inmates exhibits a considerable psychiatric morbidity. Of the total sample, 64 % suffered from at least 2 disorders. Only 8.5 % had no psychiatric diagnoses.

This abstract on PubMed states:

quote:
One hundred two inmates were interviewed and tested to determine epidemiological rates of attention-deficit hyperactivity disorder (ADHD) and depression in an adult male prison population. ... Diagnosable ADHD was found to occur in 25.5 percent of the inmates
This report of a study done in Norway found that

quote:
Forty-six percent of the prisoners exceeded the cutoff score of 46 for ADHD on the Wender Utah Rating Scale, and another 18 percent scored in the screening window of 35 to 45.
Given that the rate of ADHD in the general population is estimated at 3 to 5 percent, the fact that every study I have ever seen (and I've looked at bunches of them, going back many years) shows that the percentage of male prisoners with ADHD is not less than 25%, and may be more than 70% (depending on the study, which prison, and the criteria used to determine diagnosis), I think it's fair to say that the under-diagnosis and under-treatment of ADHD is a much larger social problem than the over-diagnosis and over-treatment.

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I've written a book! Catherine's Pascha: A celebration of Easter in the Orthodox Church. It's a lovely book for children. Take a look!

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Telepath
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# 3534

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Right... I guess we do know how many people are in jail with ADHD. I was aware of studies to that effect so I shouldn't have lumped the prison population in with all the other people whose lives waste away without anyone else ever noticing.

You can't be treated for ADHD without anybody knowing it, but you can be an alcoholic without anybody ever finding out, and you can crash your car without anybody ever knowing that your undiagnosed ADHD was the cause of your accident.

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Take emptiness and lying speech far from me, and do not give me poverty or wealth. Give me a living sufficient for me.

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PataLeBon
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# 5452

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I, as a teacher, don't think that parents are to blame for ADHD.

What I have seen are kids who simply don't look at things the same way as everyone else, and don't respond to the environment the same as everyone else.

I simply made adjustments on how I interacted with them and how long I expected them to pay attention to me or to what they were doing. Some of that was simply me saying, "Are you sure that you are finished? Why didn't you do {blank}?" Usually, they would go back and say "Whoops, I didn't mean to do that." and fix it. If they didn't, then usually it had to do with them simply being their age.

The one child that I remember vividly had behavior problems on top of his ADHD. I quickily figured out that he was a gifted child and simply quickly figured things out, got bored, and then moved on with or without teacher assistance (usually without and usually driving the other kids nuts!). Once I set up a system to let him do other things when he had finished his work to my satisfaction (AKA I had to agree that he was done - he often wouldn't finish because of his ADHD) we had no more problems.

But I can't blame my kids behavior on what the parents do. I know that the kids that I teach can adapt to what is going on in my room, if I remember that every child is different and give them time and space to be who they are, not what I wish they could be.

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Horatio Harumph
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I find it interesting that not much is ever mentioned about AADD (Adult Attention Deficit Disorder).

I am guessing the majority of people diagnosed with ADHD are done so at an early age, as a child or young person?

However, once your over a certain age, if your diagnosed with ADHD Ritalin is not then an option, or it didnt use to be. That may well have changed.

Why was and maybe still is Ritalin only acceptable for children to start and use as a medication, and not for adults?

My intellectual knowledge on this subject is quite poor I am afraid, but I try and am trying my best to learn as much as I can, and to make sense of the experience I have had of an older brother with ADHD, who was diagnosed as a young person, but "apparently" to late for any support to be given to our family, in any shape or form, and also the experience of supporting other adults with ADHD.

Lookin

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andrewschmidt
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# 10822

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My wife is studying to be a teacher, and I helped her type an asignment which may have some bearing, so please excuse a total lack of references, but this comes from my memory of typing her assignment whilst high on my 8th cup of coffee (instant, not percolated I want sympathy [Waterworks] ).

The subject of her paper was CAPD (Central Auditory Processing Disorder), a disorder which was 'apparantly' frequently misdiagnosed as ADHD, having as it did many of the same behavioral symptoms. her paper posited that one of the possible causes could be the modern tendancy for young people to be open to multiple media simultaniously. The treament difference was however great since this is a case in which ritalin will not work (there being no chemical brain dysfunction), but may indicate a reason for misdiagnosis.

Andrew

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mousethief

Ship's Thieving Rodent
# 953

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quote:
Originally posted by Lookin:
I find it interesting that not much is ever mentioned about AADD (Adult Attention Deficit Disorder).

I don't distinguish between any two disorders. When I say I have ADHD, the fact that I'm an adult means I have adult ADHD.

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Telepath
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Originally posted by Lookin:

quote:
However, once your over a certain age, if your diagnosed with ADHD Ritalin is not then an option, or it didnt use to be. That may well have changed.

Why was and maybe still is Ritalin only acceptable for children to start and use as a medication, and not for adults?

I didn't get any treatment as a child, except a brief trial of Ritalin when I was three, followed by the discredited Feingold diet (well, my parents said it was the Feingold diet, but they only followed the 1% of it that made sense to them (or that they could cope with and wanted to do anyway, if you ask me)). In other words, no effective treatment until I was re-diagnosed at age 25.

Anyway. Ritalin is a stimulant. Give it to a hyperkid and the kid calms down. Hey, wait a minute! Stimulants don't calm you down! That means it must be a paradoxical effect! Paradoxical effects are effects that are the opposite of the ones you'd expect, and they happen in children and the elderly. Therefore, it was assumed that Ritalin wouldn't work on teens and adults.

So, well, then I guess somebody must have given Ritalin to a hyperteen or hyperdult and found that it worked, so it must not be a paradoxical effect after all. Oh.

Anyway, it's not licenced to treat adult ADHD but there's no reason why a specialist can't prescribe it for adults anyway.

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Horatio Harumph
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quote:
Originally posted by Mousethief:

I don't distinguish between any two disorders. When I say I have ADHD, the fact that I'm an adult means I have adult ADHD.

Thats fair enough. And indeed you dont hear alot about AADD and thats why I suppose.

And Telepath, I hear what your saying, and I think there are always going to be those people who are "classed" as being plain old disruptive or whatever you wanna call it, before and if they ever are diagnosed with ADHD.

I know there were some talk about using ADHD as an excuse or diagnosing it when a person dosnt actually have it, but I think it works the other way round, that it isnt diagnosed all the time when it should be.

Lookin

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Telepath
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Originally posted by Lookin:

quote:
And Telepath, I hear what your saying, and I think there are always going to be those people who are "classed" as being plain old disruptive or whatever you wanna call it, before and if they ever are diagnosed with ADHD.
Quite so. And of course, if a person wants to be disruptive, Ritalin is hardly going to stop them. It doesn't control your behaviour for you, it only provides you with an opportunity for self-control. A truly disruptive person on Ritalin would probably just become more efficient at causing disruption [Big Grin]

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musician

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I heard a lecture from an adult with ADHD. He had grown up in (IIRC) Glasgow in the 60s. He spoke of being able to recall how many bricks were in the wall outside his headteacher's room, because he'd been sent out of class so often over the years.
He recalled being called "a space cadet" etc in those enlightened days.
He also spoke of how he wasn't paying any attention in class on account of his ability and prefered choice of activity. He was replaying a film in his head. He could remember all dialogue, scenes etc. No trouble in using his brain, just that he wasn't able to focus on the task in class.
This guy wondered why ADHD didn't mention "alternative focus ability" because many folk he knew with ADHD had it.
He also said that when his ritalin ran out ( he lived in the USA as an adult) he drank Mountain Dew. It worked so well in an emergency that his family insisted on having a spare case of it just in case.

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welsh dragon

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quote:
Originally posted by Telepath:

Anyway, it's not licenced to treat adult ADHD but there's no reason why a specialist can't prescribe it for adults anyway.

The side effects, according to the British National Formulary, include

  • insomnia
  • restlessness
  • irritability
  • excitability
  • nervousness
  • night terrors
  • euphoria
  • tremor
  • dizziness
  • headache
  • convulsions

and so on, as for dexamfetamine sulphate (that is about 25% of the list by length of that group of side effects).

Other, specific side effects include

  • depression
  • confusion
  • rash
  • various clotting disorders
and again a lengthy list continues.

The cautions for both dexamfetamine, with which it is listed, and ritalin, say

quote:
data on safety and efficacy in long term use not complete
There are also special cautions in children, listed again with dexamphetamine, re growth retardation and also

quote:
In psychotic children, may exacerbate behavioural disturbances and thought disorder

I would have thought all this was an excellent reason for a specialist to be cautious in prescribing a potentially dangerous medication off licence.

Disclaimer, disclaimer, not medical advice and all that.

[ 05. January 2006, 11:31: Message edited by: welsh dragon ]

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Bishop of Stortford
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quote:
Originally posted by welsh dragon:
I imagine that if I had a child with behavioural problems, who might be helped by ritalin, I would on the one hand be passionately desirous for him/her to have anything that might help his/her chances in life. On the other hand, I would have grave misgivings about dosing a child with such a medication if I could possibly avoid it.

Yep, well that's actually why I started this thread. And I've found the opinions and insights you've all given have been extremely helpful, so thank you to all who have posted.
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Telepath
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welshdragon, I said no reason why a specialist can't prescribe.

If I'd said there was no reason why a specialist would not fork over the speed to anyone and everyone no questions asked, I would now be saying "egad, I never thought of that."

I would expect a specialist to have thorough knowledge of the side effects and potential risks, and to have done a thorough evaluation of the patient, and to have taken the evaluations of other professionals into account, before deciding on a trial; and that, if they considered the benefits not to be worth the harm or potential harm, not to proceed.

I didn't spell it out explicitly because that is the least one would expect of a competent and ethical specialist. Mind you, I also didn't explicitly spell out that the putative specialist is assumed arguendo to be competent and ethical, since incompetent and/or unethical behaviour is a different category of problem.

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LeRoc

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I have worked a lot with children that have ADHD, and have seen that Ritalin can help. However, I think it is a very blunt instrument with rather severe side effects. Everytime I help a child taking this medicine I can't help thinking that I'm somehow feeding him poison.

I really hope that some more refined medicines with less severe side effects will be developed in the future.

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Telepath
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Originally posted by LeRoc:

quote:
Everytime I help a child taking this medicine I can't help thinking that I'm somehow feeding him poison.

If the side effects seem that bad to you, LeRoc, I'd raise it as an issue. Maybe the kid needs a different dosage, a different formulation, or a different treatment regime.

OTOH if the kid seems happy, or if you feel this way every time, it's probably more your issue than theirs.

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