Thread: Purgatory: ADHD and Ritalin Board: Limbo / Ship of Fools.


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Posted by Bishop of Stortford (# 5653) on :
 
I've just come across this scandal, and I wondered whether anyone else had heard of this. I might not have believed it but I've trawled the internet, and it's reported all over the place. British and American children are being labelled with a mysterious disorder called "ADHD", and given mind-altering drugs to fix them. All because they won't sit still when they're told to. Or that's how I read all of this.

Have any other shipmates heard of this scandal, or perhaps got personal experience or expertise in the field. Is it really happening, or is it just a very pervasive scare story?

[ 14. February 2006, 03:43: Message edited by: Duo Seraphim ]
 
Posted by Zorro (# 9156) on :
 
As far as I know it's almost certain that ADHD is an actual medical condition. It's also true that ritalin has been prescribed for it, and is, at least in the UK, the subject of some controversy.

It's been known for Ritalin to lead to withdrawnness, depression and apparently sometimes suicide. It has also been suggested that it is partly to blame for the taking of drugs in later life.

ADHD is also a lot more than "not being able to sit down when they're told to," it can be a serious problem, and people with it can struggle enormously at school.

Thats about all I know on it I'm afraid.
 
Posted by Gracie (# 3870) on :
 
I read several articles on this last year, but don't have the references to hand at the moment. It would appear to be true. In France at any rate the same technique is used on adults too, and has been dubbed the 'camisole chimique' or 'chemical straightjacket'.
 
Posted by TrudyTrudy (I say unto you) (# 5647) on :
 
I think it's like anything else. It's like people saying that anti-depressants are over-prescribed for people who just need to pull themselves together and cheer up. Yes, there is a real set of behaviors described as ADHD, and yes, some people who exhibit these behaviors are helped by Ritalin. But all behavior exists on a continuum and it's not always easy to judge what's "normal childhood" and what's something diagnosable and needing treatment. And even if you've established that the behavior is beyond the parameters of "normal" and needs treatment, there's no guarantee that drug treatment is the best or only option, or that it will work, or that the side-effects won't be so severe as to make it a bad idea. It's just an immensely complex question that is never easy to call. Ritalin probably is being overprescribed by some doctors, in some places, as an apparent "quick fix" to problems that may have a host of other possible solutions. But that doesn't necessarily make Ritalin A Bad Thing in and of itself, any moreso than any other medication.
 
Posted by mrmister (# 10850) on :
 
I'd just like to point out that I got flamed for criticising M.E.!
 
Posted by tessaB (# 8533) on :
 
I think that some few doctors are very quick to prescribe drugs for children that display "difficult" or "challenging" behaviour.
We were having difficulty with our autistic 10yr old,( basically he was not sleeping well and so of course neither were we) and had approached the consultant to see if we could get some Melatonin to help him. The consultant was very happy to write a prescription and asked if we wanted some Prozac for him as well. We were horrified as the consultant had not even seen him.
A friend has a daughter in a home for adults with learning difficulties and noticed a change in her behaviour. She then found out that her daughter had been prescribed very heavy doses of drugs used to treat schizophrenia in order to keep her quiet during the day. The home had recently cancelled the trips to day centres and were having problems amusing the residents.
 
Posted by Spong (# 1518) on :
 
It's the Torygraph, to begin with, which is not going to be the first paper to accept the idea that children who are 'misbehaving' aren't just naughty boys who would all be sorted out by a good flogging.

I don't know much about ADHD except that there is sometimes a link with autistic spectrum disorders (which I know about as a parent) and with dyslexia. But I have heard some genuine case histories about living with ADHD, and no, it isn't living with a 'naughty child', it is (or can be, anyway) living with a child who is literally incapable of concentrating on one thing for more than a minute or two at a time, and who has to forever be zooming around smashing into things. There appears to be a good FAQ here .

There's a separate issue over whether some children are being labelled ADHD who are just boisterous, and over whether drug treatment with Ritalin rather than diet management is always the best approach. But for all of these disorders, one of the things that you get really annoyed at, as a parent, is being told 'all boys are like that'. All boys may do something that looks vaguely similar to an outsider, but there is a huge difference between them and those with a disorder.

Spong
 
Posted by Mousethief (# 953) on :
 
Being someone with ADHD who has profited from Ritalin, let me say:

1. ADHD is real, and
2. Ritalin works.

As CS Lewis said, the proper response to misuse is not disuse but proper use. Sure there are some people who don't really have ADHD who are diagnosed with same; sure there are people who are prescribed Ritalin who don't need it. This doesn't negate either of my two points.

I don't mind carefully controlled studies which indicate that there is overdiagnosis and overprescription. I can't stand reckless assholes (aresholes) who loudly proclaim it's all hokum. If the shoe fits.
 
Posted by leo (# 1458) on :
 
I've taught several kids (mostly boys) with ADHT - when their behaviour was awful, it was because they hadn't taken their pill or they were close approaching the time when it was due. The pill made a lot of difference, though I couldn't help thinking it was a form of mind control and that it was the school system's expectations, not the individual behaviour, which was 'mad'.
 
Posted by Lamb Chopped (# 5528) on :
 
More of the same. Yes, there is such a thing as ADHD (shudder). It runs in my family. It is VERY different from a normally boisterous child, and even from one hyped up on sugar or from going to Disneyland. And it's not the child's fault (or the parents').

Ritalin helped my family. I've known others who found simple caffeine enough to calm the symptoms. But if you have a child with real ADHD, you'll take help wherever you can find it. Not a chemical straitjacket--more like glasses or a hearing aid. Something that allows you to be yourself, more yourself, maybe for the first time, without distractions.
 
Posted by Mousethief (# 953) on :
 
quote:
Originally posted by Lamb Chopped:
But if you have a child with real ADHD, you'll take help wherever you can find it. Not a chemical straitjacket--more like glasses or a hearing aid. Something that allows you to be yourself, more yourself, maybe for the first time, without distractions.

[Overused] Yes! Exactly!
 
Posted by Custard. (# 5402) on :
 
I'm a teacher, and my experience is that every pupil I have taught who has shown the standard symptoms of ADD/ADHD has had a very poor diet (mainly chips).

Speaking to such children, the issue is not that they cannot pay attention - they are fine with films, etc. It is that they do not want to pay attention. Ritalin seems to make them a bit quieter, but not much more motivated.

I have also heard that the support groups for parents of such children tend to be funded on the quiet by drug companies.

That is not to say at all that there is not a medical problem with some people for which Ritalin might be very helpful. But I rather suspect the drug companies know they're onto an easy earner here.
 
Posted by Fool on the hill (# 9428) on :
 
quote:
Originally posted by TrudyTrudy (I say unto you):
I think it's like anything else. It's like people saying that anti-depressants are over-prescribed for people who just need to pull themselves together and cheer up. Yes, there is a real set of behaviors described as ADHD, and yes, some people who exhibit these behaviors are helped by Ritalin. But all behavior exists on a continuum and it's not always easy to judge what's "normal childhood" and what's something diagnosable and needing treatment. And even if you've established that the behavior is beyond the parameters of "normal" and needs treatment, there's no guarantee that drug treatment is the best or only option, or that it will work, or that the side-effects won't be so severe as to make it a bad idea. It's just an immensely complex question that is never easy to call. Ritalin probably is being overprescribed by some doctors, in some places, as an apparent "quick fix" to problems that may have a host of other possible solutions. But that doesn't necessarily make Ritalin A Bad Thing in and of itself, any moreso than any other medication.

Yes, what she said.

From a mother of a child described as "ADD, inattentive type".
 
Posted by Lamb Chopped (# 5528) on :
 
Well, one kid doth not a syndrome make, but the ADHD kids in my family had Excellent diets (says she, who suffered the healthy food along with them!) and were highly motivated (which is how they managed to get to the amazing places they are now in their lives). They just couldn't concentrate, couldn't settle, couldn't sit down and stop jiggling long enough to do Anything--even something they wanted to do.
 
Posted by Hazey Jane (# 8754) on :
 
No personal experience of ADHD/Ritalin here, but I did read a lot about it for a science policy essay. I think I concluded from what I understood that it is a genuine condition, Ritalin can be greatly beneficial. I also suspect, however, that there are cases where a diagnosis is given when it shouldn't be, and that the root cause lies elsewhere in those instances. That is not to detract from the very real problem that many do experience. But I think the hike in prescriptions may have something to do with this. Although better recognition of genuine cases would also presumably make up a proprtion of the rise.
 
Posted by Bishop of Stortford (# 5653) on :
 
quote:
Originally posted by mrmister:
I'd just like to point out that I got flamed for criticising M.E.!

No, but seriously MrMister, I'd really value the opinions of an Oxbridge trained medic on this one. (Can't guarantee how the rest of the ship will treat you, mind.)
 
Posted by TrudyTrudy (I say unto you) (# 5647) on :
 
quote:
Originally posted by Lamb Chopped:
Well, one kid doth not a syndrome make, but the ADHD kids in my family had Excellent diets (says she, who suffered the healthy food along with them!) and were highly motivated (which is how they managed to get to the amazing places they are now in their lives). They just couldn't concentrate, couldn't settle, couldn't sit down and stop jiggling long enough to do Anything--even something they wanted to do.

See, that seems to me like the kind of case where it's relatively easy to determine that something's wrong (although it may not, in fact, have been easy in your case...I don't know, obviously). When ADHD symptoms are combined with a good supportive family background, good diet and general health, high intelligence and motivation ... then it should be at least relatively easy to pinpoint where the problem is.

Unfortunately, in the situations that many teachers and school counsellors see, the ADHD-type symptoms may be combined with (choose any of the following): poor diet, other health issues, family problems, self-esteem issues, mental health problems, history of violence/abuse, learning disabilities, poor cognitive skills, etc etc etc ... to the point where it is difficult to unravel the "cause" of the problem much less figure out the best treatments.

Add in the fact that the behaviors may be presenting themselves in a classroom with up to (or over) 30 other students, and it's not hard to see why some children are mis-diagnosed or mis-prescribed.
 
Posted by Mousethief (# 953) on :
 
Strictly speaking, in this country at least, ADHD is meant to be a rule-out diagnosis, in the sense that you have to rule out every other possible cause of the symptoms before you can say "this child has ADHD" -- some (many?) doctors are far too lazy (or something) to go through the work to make sure that some other reason for inattentiveness, fidgetiness, etc. isn't present before proclaiming a case of ADHD. And it doesn't help anybody, least of all the patients improperly diagnosed.

I know this from personal experience as my son, who has Asperger's Syndrome, was first diagnosed as having ADHD by an over-hasty doctor.
 
Posted by Rat (# 3373) on :
 
When my mum worked with children with disabilities, she detected a tendency for identical behaviour to be diagnosed as ADHD (or some other behavioural disorder) in middle class children but treated as just plain badness in working class children.

I don't think she'd deny the existence of ADHD and similar disorders, but her observations do seem to raise the possibility that some proportion of middle class children may be misdiagnosed and medicated unnecessarily, while some less priveledged children with a genuine disorder don't get the treatment they need.
 
Posted by Spiffy da Wonder Sheep (# 5267) on :
 
I have what used to be called ADD and is now called ADHD Inattentive or something... can't be arsed to keep up with the changing names since I can't afford the 'new treatment' and am one of the lucky ones who usually uses caffeine as medication.

I'm also a teacher (sometimes). I think parents are now a lot more informed about the attention disorders and are starting to question whether or not medication is the do-all and be-all. I hate to say it, but scare articles like this are a great help in making parents think about it before they put their kids on potentially dangerous drugs. Meds just make it easier to focus, they don't cure the underlying problem, which is a lack of skills to cope with the world (seriously, I didn't learn the concept how balancing my checkbook corresponded with how much money I had in the bank until my early 20s).

I'm also in the middle of a seriously bad struggle with my ADWhatever that's keeping me from advancing out of monkey office work into teaching, and I'm considering a short term round of prescription medication to help me get back on my schedule and get me off the tornado ride.

[ 02. January 2006, 19:04: Message edited by: Spiffy da Wonder Sheep ]
 
Posted by Hazey Jane (# 8754) on :
 
quote:
Originally posted by Rat:
When my mum worked with children with disabilities, she detected a tendency for identical behaviour to be diagnosed as ADHD (or some other behavioural disorder) in middle class children but treated as just plain badness in working class children.

I don't think she'd deny the existence of ADHD and similar disorders, but her observations do seem to raise the possibility that some proportion of middle class children may be misdiagnosed and medicated unnecessarily, while some less priveledged children with a genuine disorder don't get the treatment they need.

Interesting point. It's worth also taking into account that it might not just be a social prejudice on the part of the medical profession - there is also the issue of awareness and education regarding the condition. So whilst one family might not have heard of ADHD, and slip through the net of the educational profession who might pick it up, another family might be aware of ADHD and take their child to the Doctors and push for a diagnosis. It's a complex issue.
 
Posted by Mousethief (# 953) on :
 
quote:
Originally posted by Spiffy da Wonder Sheep:
Meds just make it easier to focus, they don't cure the underlying problem, which is a lack of skills to cope with the world

Yes and no. From one point of view, the underlying problem is chemical imbalance in the brain, which the meds help with directly. But it wasn't until I started taking the meds that I was able to learn to undo some of my unhelpful coping mechanisms, and replace them with more helpful ones.

This is a learning process which is lifelong, but after a time I was able to stop taking the meds because I had built up a large enough "tool box" of useful coping skills during the time that I was on them. Meds themselves didn't make this happen -- counselling and reading and peer support groups were very important. But the meds ALLOWED it to happen.
 
Posted by CrookedCucumber (# 10792) on :
 
quote:
Originally posted by MrMister
I'd just like to point out that I got flamed for criticising M.E.!

With respect, you did not.

You got flamed for writing in a way that implied that the group of human beings that have the problem we label `ME' were undeserving recipients of publicly-funded help and support.

Nobody here, as far as I can see, is suggesting that the group of human beings who have the problem we label `attention deficit disorders' is undeserving of help and support.

Whether ME or attention deficit disorders are `medical problems' in the same way that, say, bacterial meningitis is, may have some bearing on the best way to help and support the people that have these problems. It has no bearing on whether people need help and support.
 
Posted by daisymay (# 1480) on :
 
quote:
Originally posted by Mousethief:
quote:
Originally posted by Spiffy da Wonder Sheep:
Meds just make it easier to focus, they don't cure the underlying problem, which is a lack of skills to cope with the world

Yes and no. From one point of view, the underlying problem is chemical imbalance in the brain, which the meds help with directly. But it wasn't until I started taking the meds that I was able to learn to undo some of my unhelpful coping mechanisms, and replace them with more helpful ones.

This is a learning process which is lifelong, but after a time I was able to stop taking the meds because I had built up a large enough "tool box" of useful coping skills during the time that I was on them. Meds themselves didn't make this happen -- counselling and reading and peer support groups were very important. But the meds ALLOWED it to happen.

Yes, when we work with youngsters diagnosed with ADD or ADHD, it makes such a diference when they are taking their appropriate doses of prescribed medication.

And not all ADHD/ADD children are noisy and disruptive; some just can't concentrate but are quiet with it.

Ritalin does not usually work all on its own; it does make a big difference when someone needs it.

Adults - parents, teachers,carers need to help them cope with behaving in ways that help them to learn, behave appropriately, and get on well, healthily and happily in life.
 
Posted by Spiffy da Wonder Sheep (# 5267) on :
 
quote:
Originally posted by Mousethief:
quote:
Originally posted by Spiffy da Wonder Sheep:
Meds just make it easier to focus, they don't cure the underlying problem, which is a lack of skills to cope with the world

Yes and no. From one point of view, the underlying problem is chemical imbalance in the brain, which the meds help with directly. But it wasn't until I started taking the meds that I was able to learn to undo some of my unhelpful coping mechanisms, and replace them with more helpful ones.

Sorry, should have added "In my and my sister's experience". And as we weren't diagnosed until we were both in our 20s and in college, I think our experience is different than other people's (also the fact that back when we were diagnosed, only 4% of ADHD diagnoses were female).

[ 03. January 2006, 01:47: Message edited by: Spiffy da Wonder Sheep ]
 
Posted by ozowen (# 8935) on :
 
ADHD is real, but is also a condition on a continuum. Milder cases that may not need Ritalin or Dexamphetamine may still be treated with these drugs. Misbehaviour that appears like ADHD (milder forms) also gets treated by some GPs with these drugs. There is some danger of its use as social control. eg; I know one town where the local school has so many kids on Ritalin or Dex that the teachers have all become skilled in dispensing these medications. (which is illegal). The town is a low socio economic level town and I cannot help but think the GP and school are into a little convenience medication.
 
Posted by Primrose Path (# 9137) on :
 
I saw a good article in the Times about this - doesn't add a great deal to previous, except for the suggestion that at least some diagnoses may be pandering to our "feminised" society. We don't just sigh "boys will be boys" or use fear or physical chastisement to alter their hormonal balance anymore, worse luck:
http://www.timesonline.co.uk/article/0,,1056-1788223,00.html
(how do you get those funky links that just say "this")?

ADHD is real. My 6-year-old son's best friend was put on Ritalin last year and his grades rocketed; before Ritalin, though sharp as a tack on conversation, he couldn't concentrate on reading and writing long enough to do anything useful. He's better on the drug, but at a price; he barely sleeps, and eats very little, his appearance borders on heroin addict at times. I was chuntering about all of this to my male cousin on the phone, when he remarked casually that he'd been put on Ritalin by his mother (a nurse) back in the 60s. By high school, he only got it out for specific tasks like term papers; and I think now he gets by with just caffeine.

There is some encouraging evidence that fish oils help: see this link:
http://www.raisingkids.co.uk/todaysnews/news_180505_02.asp
Omega-3 oils seem to supply something needed for good brain connections. It may be that the increased incidence of ADHD is due in part to a drop in the consumption of oily fish (or cod liver oil supplements)compared to previous generations (although clearly there is a genetic link too).
 
Posted by AFSkypilot (# 10498) on :
 
There is at least one other medication that is out there that is not amphetamine based (Ritalin is a form of speed, after all). That is Strattera. Also Wellbutrin seems to work with some ADHD clients.

Want to know of a good way of screening to see if a cronically hyperactive kid has ADHD? Give him/her a cup of coffee (or half coffee, half milk) and observe. If the child begins to settle down within a few minutes of having the coffee, I suggest you take the child to a pediatritian to discuss the possiblity.

I think in time as we learn more about the function of the brain we will find other forms of medication that will aslo work for people with ADD.
 
Posted by Spiffy da Wonder Sheep (# 5267) on :
 
quote:
Originally posted by AFSkypilot:


Want to know of a good way of screening to see if a cronically hyperactive kid has ADHD? Give him/her a cup of coffee (or half coffee, half milk) and observe. If the child begins to settle down within a few minutes of having the coffee, I suggest you take the child to a pediatritian to discuss the possiblity.

There are other attention disorders that do not respond to caffeine, though.
 
Posted by AFSkypilot (# 10498) on :
 
Yes, and that is why I said it is only a screening tool for ADHD. I offer it in no way as a way of diagnosis, but it does give a stong hint that ADHD may be there.
 
Posted by mdijon (# 8520) on :
 
quote:
Originally posted by Bishop of Stortford:
quote:
Originally posted by mrmister:
I'd just like to point out that I got flamed for criticising M.E.!

No, but seriously MrMister, I'd really value the opinions of an Oxbridge trained medic on this one. (Can't guarantee how the rest of the ship will treat you, mind.)
Real Oxford medic reporting in. Unfortunately, I don't know anything about this area - except that it seems to me that experts and reasonable people in the area seem to disagree - so sorry. Luckily, others seem to know more about it.
 
Posted by Corpus cani (# 1663) on :
 
I've taught several children with either ADD or ADHD over the years - all boys. Two cases were severe enough to warrant Ritalin. The first boy, "Alex", changed almost immediately. His whole personality was crushed. Although he was previously a real handful, he had a very sparky character and underneath the hyperactivity was a really sweet chap. Almost overnight, he certainly became more compliant and a little more focussed in class, but he also became withdrawn, quiet and distant. It was very sad.

A current pupil seems not to be affected by the drug at all. He's still a pain in the neck!

ADHD is, of course, far more than just "not paying attention." One of the worst aspects can be the complete... inability (?) no, a complete absence of consideration of the consequences of their actions. That first case, "Alex", found that other boys were frightened to play with him because he was so dangerous. He would regularly injure his playmates by throwing sticks, stones, sand - even chairs on occasion. It was not because he was a violent chap, but just because he did not think in advance that his actions might cause harm. When he did hurt others he was always genuinely horrified at what he had done, but you could always be sure that he would do the same thing again.

Corpus

(P.S. Alex is now reading engineering at university!)
 
Posted by PeteCanada (# 10422) on :
 
My son was on Ritalin. He certainly became quieter, but the demons of depression took over instead. Perhaps this was an extreme case.

As a scoutmaster, I often had attention deficit kids in my troop (or pack, since I was a cubmaster as well). Many times I was given Ritalin to adminster on weekend camps. Sometimes I did, sometimes I didn't. Often Ritalin seemed to be used to help a boy in "seat work" at school. Bush camping is not seatwork, and usually they (and us also) were run off their feet all weekend. It helped to have high energy levels.

To this day (25 years later), I am not convinced of the efficacity of the drug.
 
Posted by Doc Tor (# 9748) on :
 
I work with Y5 and Y6 kids, and my own are in Y2 and Y3.

Part of it seems to be what we're asking children to do: sit still, listen, work independently on one task for long periods of time (half an hour is an eternity when you're six). Boys have a testosterone burst around six. The beginning of schooling, the style of school work and biology seem to conspire together. I wonder how it differs in say, Sweden, where kids don't start formal education until 7.

Higher up the school, the style of working doesn't change much - though I have noticed that concentration levels in some normally disruptive pupils (boys all) increase when they're interested in the subject, or have punishment/reward systems in place which really matter to them.

Having said all that, there are one or two pupils who benefit hugely from medical intervention. They're actually receiving an education rather than sitting outside the classroom. And yes, it makes the whole class function better, too.
 
Posted by Teapot (# 10837) on :
 
How much of ADHD is either diet based (too much sugar/caffiene), environment based (everything today happening at hyperspeed) or simply a criticism aimed at kids who realise most of "education" is a load of sphericals designed to create obediance and usefulness to the soulless economy?

And yes I do accept that quite a few apparently "ADHD" kids are one who hav been brought up to be thoughtlessly unpleasant and the label is simply used to hide this....

[ 03. January 2006, 11:44: Message edited by: Teapot ]
 
Posted by Corpus cani (# 1663) on :
 
quote:
Originally posted by Teapot:
How much of ADHD is either diet based (too much sugar/caffiene), environment based (everything today happening at hyperspeed) or simply a criticism aimed at kids who realise most of "education" is a load of sphericals designed to create obediance and usefulness to the soulless economy?

And yes I do accept that quite a few apparently "ADHD" kids are one who hav been brought up to be thoughtlessly unpleasant and the label is simply used to hide this....

Sorry, Teapot, but from beginning to end this post is such a whiffy, steaming pile of shit that I wouldn't even comment upon it if I had the time or the inclination. And I have neither.

Come again when you know what you're talking about, 'cos this is bollocks.

Corpus.
 
Posted by TrudyTrudy (I say unto you) (# 5647) on :
 
quote:
Originally posted by Corpus cani:

(P.S. Alex is now reading engineering at university!)

Did his personality ever bounce back? I'm curious (because of some situations with my own students) about the effect medications have on people's personalities, and whether better functioning in school is worth the trade-off that sometimes seems to occur.
 
Posted by TrudyTrudy (I say unto you) (# 5647) on :
 
quote:
Originally posted by Corpus cani:
quote:
Originally posted by Teapot:
How much of ADHD is either diet based (too much sugar/caffiene), environment based (everything today happening at hyperspeed) or simply a criticism aimed at kids who realise most of "education" is a load of sphericals designed to create obediance and usefulness to the soulless economy?

And yes I do accept that quite a few apparently "ADHD" kids are one who hav been brought up to be thoughtlessly unpleasant and the label is simply used to hide this....

Sorry, Teapot, but from beginning to end this post is such a whiffy, steaming pile of shit that I wouldn't even comment upon it if I had the time or the inclination. And I have neither.

Come again when you know what you're talking about, 'cos this is bollocks.

Corpus.

Sorry for the cross-posting, Corpus, but is Teapot's post really such bollocks? The question was posed upthread: is it the kids who are "mad," or the system? Surely if there's a huge rise in certain disorders it's valid to ask what we've changed about our society that's making these problems appear?

If part of the ADHD "epidemic" (and subsequent prescription/overprescription of drugs) is that kids aren't sitting still and paying attention in school, isn't it fair to ask about wider societal factors as well as about the individual child? Are we, in fact, asking the right things of them in school? Or have we perhaps reached the point where the divide between what's happening in the popular culture and what's happening in the school system is so deep that kids can no longer move comfortably between one and the other?
 
Posted by Real Ale Methodist (# 7390) on :
 
This may be a little foolheardy to suggest in a forum populated by people with experience of ADHD from both ends (Patient and doctor). Especially as my experience is very much second hand.

I would suggest that in a conventional sense there is in fact no real ADHD; and this is the problem. I suspect (and noone truly knows) that instead there are a whole bunch of symptoms; some of which can be dealt with in various ways. And that a lot of these often occur together and can be dealt with using Ritalin. What there is not is an ADHD Bacillus or similar - that can be wiped with targetted antibiotics or similar.

This is why there is a lot of confusion over the subject. It is hard for your torygraph reader with no direct experience to really understand what is going on here. (S)he would surely be incapable of telling the difference between ill behavior and ADHD. Add to this the very real phenomena of misdiagnosis of ADHD; and the fact that ADHD takes many forms of varying intensities; and the fact that the cure is uncertain to say the least. Then one has a mess which Mr and Mrs Smith are going to be suspicious of; and who can blame them.

What would help a lot of ADHD sufferers (acc. to one girl I used to know quite well - and who made me reevaluate my own opinions a lot) is if people had a more nuanced understanding of the condition; knowing it for what it is, and accepting that as a genuine if unconventional condition.
 
Posted by Teapot (# 10837) on :
 
quote:
Originally posted by Corpus cani:
quote:
Originally posted by Teapot:
How much of ADHD is either diet based (too much sugar/caffiene), environment based (everything today happening at hyperspeed) or simply a criticism aimed at kids who realise most of "education" is a load of sphericals designed to create obediance and usefulness to the soulless economy?

And yes I do accept that quite a few apparently "ADHD" kids are one who hav been brought up to be thoughtlessly unpleasant and the label is simply used to hide this....

Sorry, Teapot, but from beginning to end this post is such a whiffy, steaming pile of shit that I wouldn't even comment upon it if I had the time or the inclination. And I have neither.

Come again when you know what you're talking about, 'cos this is bollocks.

Corpus.

Well I can see you opinion, so well thought out and reasoned, is one I should value. Thankyou.
 
Posted by Telepath (# 3534) on :
 
I can't imagine any society in which concentration is never necessary.

Therefore I can't imagine any society in which an impaired ability to concentrate isn't an impairment to a major life activity.
 
Posted by ken (# 2460) on :
 
quote:
Originally posted by Telepath:
I can't imagine any society in which concentration is never necessary.

Therefore I can't imagine any society in which an impaired ability to concentrate isn't an impairment to a major life activity.

I can't imagine a society in which flexibiliy and unpredictibility and disobedience are never neccessary.

Therefore I can't imagine a society in which drugging kids to make them sit still and obey orders isn't a major impairment.
 
Posted by mdijon (# 8520) on :
 
Would you say the same of all discipline in schools Ken? Is teaching children they'll be punished if they don't do what the teacher says also as bad?
 
Posted by Custard. (# 5402) on :
 
quote:
Originally posted by Teapot:
How much of ADHD is either diet based (too much sugar/caffiene)

I'd guess sugar (and fat) is a much bigger problem with kids (in my experience) than caffeine.

That's a lot of it, certainly.

quote:
environment based (everything today happening at hyperspeed)
Also a problem, to which I'd add the expectation of instant gratification.

quote:
or simply a criticism aimed at kids who realise most of "education" is a load of sphericals designed to create obediance and usefulness to the soulless economy?
None, in my experience.

quote:
And yes I do accept that quite a few apparently "ADHD" kids are one who hav been brought up to be thoughtlessly unpleasant and the label is simply used to hide this....
I know very few kids who have been brought up to be unpleasant. I know a fair few who haven't been brought up to be pleasant. There's a lot of difference.

Of course, there are also people for whom it is a problem needing medical intervention. It is sad that their needs are often hidden by those who just aren't being brought up correctly.
 
Posted by musician (# 4873) on :
 
There was a survey done in Sweden IIRC on kids with ADHD. The kids were CAT scanned and it was clear that an area in their brains was underfunctioning, causing the inability to concentrate and the other behaviours seen in ADHD - huge generalisation I know, but bear with me.
When ritalin - a stimulant - was administered, it kick started the underfunctioning area and the kids were able to complete tasks, baheve in a more socially acceptable fashion etc.
ADHD is NOT a convenient label, teapot, it's a real condition. OK, some kids may have shocking behaviour as well as ADHD, but they're not the same.
There's a lot of work being done on diet - as others have said on this thread. It can produce enormous changes, specially with the fish oils - Omega 3 oils.
My kids react very badly to artificial colours. No, I mean REALLY badly. One is a straight As, together fellow (OK, he's still a teenager!) but with blue, green or quinoline yellow colours, he's OFF THE WALL. Language completely shuts down, can't orientate himself in a room, acts as if he was very autistic. It's startling and scary.
(these colours can be in peas, crisps, drinks etc etc etc)
So much so that he now voluntarily restricts his own diet to exclude these colours.
We realised he was affected when he was tiny and fed him on real food without any artificial colours. Other parents were aghast - wot, no Smarties/kids cheap sweets/anything with these colours??
Yet it works.
A lad I worked in school with was similarly affected. His mum kept an eye on what he ate, but one lunchtime the school canteen had run out of white cheddar cheese and used red cheddar for the baked potatoes. When I went in after lunch, the lad was like my fellow - no language, scared of people talking to him.
Don't knock ADHD or the effect of diet on us all.
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.
 
Posted by Teapot (# 10837) on :
 
quote:
Originally posted by musician:
ADHD is NOT a convenient label, teapot, it's a real condition. OK, some kids may have shocking behaviour as well as ADHD, but they're not the same.

I have seen and heard several "parents" using ADHD as an excuse for their kid being a little s*d who has not been brought up to respect other peoples boundaries.... Not saying anything like all, or even most ADHD is this, just that is happens and its quite common.

quote:
There's a lot of work being done on diet - as others have said on this thread. It can produce enormous changes, specially with the fish oils - Omega 3 oils.
Indeed. I have first hand experience of the impact omega 3 oils (from Eye-Q) on ADHD and how they help. [Smile]

quote:
Don't knock ADHD or the effect of diet on us all.
I've long suspected that diet's a contributory factor in a number of today's ailments.

Indeed, hence it being a part of my question.

quote:
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.
For an increase in autism, I look as much to an increase in an alienated/alienating society as to diet.... There's no wonder depression/autism rates are climbing when the modern lifestyle is as close to what we are suited to as a GM mouse with an ear on its back is as close to a field mouse...
 
Posted by Wesley J (# 6075) on :
 
It might be worth pointing out that there seem to be alternatives to Ritalin, such as in the field of homeopathy, especially if one finds 'chemical warfare' problematic.

From what I hear, this remedy appears to be helpful in some cases, and as with many other homeopathic remedies, should not have any (or only very minor) side effects. It seems available only in Europe, though.

Note and disclaimer: The sole aim of this post is to suggest that there may be alternative medication as means of finding relief from ADHD. It is NOT intended to provide any medical advice.
 
Posted by mgeorge (# 10487) on :
 
Thank you for these posts, as I've had my battles with ADHD. I admit I was very skeptical at first--I thought it was a convenient label for parents who didn't want to do the work involved with raising a child. I see now that I was wrong.

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. The situation is very different now, thank God.

One parishioner who is also a therapist asked me once if he had ADHD...I think she was more concerned with having a "children should be kept quiet and out of sight" worship service than his welfare.

I chose to get my child involved with organized sports rather than putting him on drugs to keep others happy. That venue has been a very appropriate outlet for his energy rather than medication.
 
Posted by Telepath (# 3534) on :
 
Originally posted by ken:

quote:
quote:
--------------------------------------------------------------------------------
Originally posted by Telepath:
I can't imagine any society in which concentration is never necessary.

Therefore I can't imagine any society in which an impaired ability to concentrate isn't an impairment to a major life activity.
--------------------------------------------------------------------------------

I can't imagine a society in which flexibiliy and unpredictibility and disobedience are never neccessary.

Therefore I can't imagine a society in which drugging kids to make them sit still and obey orders isn't a major impairment.

In my experience, almost everyone will be disgusted with you for taking Ritalin no matter what, because doing so doesn't flatter anybody's personal view of what society should be like.

No-one really values flexibility, unpredictability and disobedience in practice, but if I let anyone know I was taking Ritalin they would wax indignant because they assumed I was trying to suppress these characteristics in myself or others. They wanted society to change and they wanted me to be the one to lead the revolution, no matter how beleaguered and beaten down by my struggle.

Conversely, anyone who'd had a taste of what my inflexibility, unpredictability, and disobedience was actually like would be far more offended that I might get off with just a diagnosis. They wanted me to pull my socks up and get some moral backbone and stop trying to pathologize my bad behaviour, because pathologizing your bad behaviour and popping pills for every little discomfort is what's wrong with society today etc, etc.

The major problem, from my admittedly egocentric point of view, is the tendency to use people with ADHD as a means to pontificate about everything people don't like in society. There's no shortage of people ready to use us as rhetorical devices and then treat us as if we don't exist and our actual wants and needs were irrelevant.

I've only really been helped by people who have treated my medical problem as just what it is - a medical problem. Not an opportunity to stand on a soapbox. The trouble is that there aren't nearly as many of the former as the media would lead you to believe.
 
Posted by daisymay (# 1480) on :
 
quote:
Originally posted by ken:
quote:
Originally posted by Telepath:
I can't imagine any society in which concentration is never necessary.

Therefore I can't imagine any society in which an impaired ability to concentrate isn't an impairment to a major life activity.

I can't imagine a society in which flexibiliy and unpredictibility and disobedience are never neccessary.

Therefore I can't imagine a society in which drugging kids to make them sit still and obey orders isn't a major impairment.

ken,
that's not supposed to be what it does; it's to help kids think, be aware, to have enough energy in their brain so that it works properly without having to be poked and prodded by the way they behave.

Ritalin is a drug that stimulates the brain and helps it to function more easily
in those who need that stimulation.

If someone who doesn't need it took it, it would have a different effect.

If you spoke to people who have improved their lives by taking it, as posted several times above here, you would hear that it is useful - not perfect, and as already said, when the way we think and act is efficiently learned when taking it, it can be often dropped or just taken occasionally when necessary.

This does not mean that it solves all problems that noisy kids have, whether with what they do, or what people critices them unecessarily for.

I used to think Ritalin prescription was child abuse, but having met quite a fwe people who have had it and improved their lives by taking it, I've been turned around in my attitude to it.
 
Posted by Emma. (# 3571) on :
 
I was going to post something but i forgot what it was and hten i got distract....
 
Posted by leo (# 1458) on :
 
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'.
 
Posted by Rat (# 3373) on :
 
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.
 
Posted by ken (# 2460) on :
 
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.
 
Posted by daisymay (# 1480) on :
 
quote:
Originally posted by Emma.:
I was going to post something but i forgot what it was and hten i got distract....

[Cool]
 
Posted by mgeorge (# 10487) on :
 
Cool, Leo. On behalf of many parents:

[Overused]
 
Posted by Spong (# 1518) on :
 
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
 
Posted by Telepath (# 3534) on :
 
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.
 
Posted by daisymay (# 1480) on :
 
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.
 
Posted by Moth (# 2589) on :
 
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.
 
Posted by Sioni Sais (# 5713) on :
 
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).
 
Posted by musician (# 4873) on :
 
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.
 
Posted by musician (# 4873) on :
 
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.
 
Posted by Laura (# 10) on :
 
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.
 
Posted by Laura (# 10) on :
 
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 ]
 
Posted by Telepath (# 3534) on :
 
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.
 
Posted by Rat (# 3373) on :
 
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.
 
Posted by Laura (# 10) on :
 
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.
 
Posted by Telepath (# 3534) on :
 
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.)
 
Posted by Telepath (# 3534) on :
 
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.
 
Posted by Duck (# 10181) on :
 
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.
 
Posted by josephine (# 3899) on :
 
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.
 
Posted by Moth (# 2589) on :
 
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.
 
Posted by Moth (# 2589) on :
 
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.
 
Posted by Laura (# 10) on :
 
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 ]
 
Posted by Rat (# 3373) on :
 
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]
 
Posted by Laura (# 10) on :
 
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.
 
Posted by Zorro (# 9156) on :
 
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.
 
Posted by Telepath (# 3534) on :
 
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.
 
Posted by Rat (# 3373) on :
 
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.
 
Posted by Laura (# 10) on :
 
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.
 
Posted by Zorro (# 9156) on :
 
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.
 
Posted by Telepath (# 3534) on :
 
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.
 
Posted by musician (# 4873) on :
 
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.
 
Posted by welsh dragon (# 3249) on :
 
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.
 
Posted by josephine (# 3899) on :
 
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.
 
Posted by Telepath (# 3534) on :
 
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.
 
Posted by St. Seraphim of Sarov (# 5452) on :
 
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.
 
Posted by Lookin (# 10855) on :
 
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
 
Posted by andrewschmidt (# 10822) on :
 
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
 
Posted by Mousethief (# 953) on :
 
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.
 
Posted by Telepath (# 3534) on :
 
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.
 
Posted by Lookin (# 10855) on :
 
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
 
Posted by Telepath (# 3534) on :
 
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]
 
Posted by musician (# 4873) on :
 
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.
 
Posted by welsh dragon (# 3249) on :
 
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


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

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 ]
 
Posted by Bishop of Stortford (# 5653) on :
 
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.
 
Posted by Telepath (# 3534) on :
 
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.
 
Posted by LeRoc (# 3216) on :
 
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.
 
Posted by Telepath (# 3534) on :
 
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.
 
Posted by LeRoc (# 3216) on :
 
I worked as an Activities Councillor for these children, and as a volunteer, so I would only discuss their medication if I really felt there was something wrong.

Maybe it is my issue, and I definitely don't know much about the pharmaceutical side of ADHD, but I have always felt that Ritalin is quite a strong chemical.

Like I said: it definitely helps to control the condition and to get forward for many children. But even if they are happy with it, I would always be in favour of continuing research, also towards medicines with less side effects.
 
Posted by Telepath (# 3534) on :
 
I prefer Ritalin because it's been around for so long and is so heavily researched, not to mention that I don't get any side effects and, if I did, I could reasonably expect them to be easy enough to manage and/or to go away if I stopped taking it.

There are alternatives such as Strattera, a non-stimulant. I haven't tried it as it's too newfangled for me, but I don't suppose Strattera will be the last nonstimulant treatment they ever invent.
 
Posted by christianjimmy (# 1820) on :
 
quote:
Originally posted by Telepath:

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.


As far as I remember from my Psych. degree, the reason why Ritalin (as a stimulant) worked was that effectively it over-stimulated the brain, leading to reduced levels of activity across the board. So not a paradoxical effect, rather harnessing the stimulation to smother the associated behaviours deriving from ADHD or ADD. I was quite surprised when I learnt this, and at first questioned the ethical issues associated - however that was entirely in the abstract, and since then have come across a number of people with ADHD who have been helped enormously by using Ritalin to subdue their over-activity, and my wishy-washy theoretical problems strangely disapeared...
 
Posted by Mousethief (# 953) on :
 
quote:
Originally posted by christianjimmy:
As far as I remember from my Psych. degree, the reason why Ritalin (as a stimulant) worked was that effectively it over-stimulated the brain, leading to reduced levels of activity across the board.

Except that this rarely happens with non-ADHD kids. Either the stimulant does nothing, or it sends them pinging off the walls. There's a reason stolen Ritalin prescriptions are sold on the street, and it's not because they calm people down.
 
Posted by Spong (# 1518) on :
 
quote:
Originally posted by Telepath:
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?

Or it could be genetic. As I said earlier, there seems to be some connection with autistic spectrum disorders, and they are about five times more common in males than females.

ASD diagnosis is also increasing similarly spectacularly. There's a lot of disagreement about whether this is a genuine increase in numbers or just a reduction in previous underdiagnosis. However, the 'blame it on the parents' approach does echo the 'refrigerator parenting' that was supposed to be the cause of autism thirty years ago.

Spong
 
Posted by christianjimmy (# 1820) on :
 
quote:
Originally posted by Mousethief:
quote:
Originally posted by christianjimmy:
As far as I remember from my Psych. degree, the reason why Ritalin (as a stimulant) worked was that effectively it over-stimulated the brain, leading to reduced levels of activity across the board.

Except that this rarely happens with non-ADHD kids. Either the stimulant does nothing, or it sends them pinging off the walls. There's a reason stolen Ritalin prescriptions are sold on the street, and it's not because they calm people down.
Sorry, yes, should have said, (AFAIK) it over-stimulates the brains of ADHD kids because their brains are at an already elevated level of activity, so further stimulating it sends their already heightened level of activity into overdrive, and thus smothers the effects of hyper-activity. With non-ADHD kids (with lower base levels of brain activity) it just sends them wild.

And yes, there is quite a market for stolen Ritalin prescriptions in certain playgrounds around the US and UK...
 
Posted by Karl: Liberal Backslider (# 76) on :
 
Which is strong evidence for the existence of ADHD - give Ritalin to someone who doesn't have it, and they become more hyper and uncontrollable.
 
Posted by Telepath (# 3534) on :
 
originally posted by christianjimmy:

quote:
And yes, there is quite a market for stolen Ritalin prescriptions in certain playgrounds around the US and UK...
So I hear, and I can't imagine anything more pathetic. It reminds me of Adrian Mole getting his Airfix plane stuck to his nose when he decides to try his hand at glue-sniffing.

Originally posted by Karl:

quote:
Which is strong evidence for the existence of ADHD - give Ritalin to someone who doesn't have it, and they become more hyper and uncontrollable.
Or they might not. They might clean off the top of their desk, sharpen some pencils, and settle down for a nice evening doing their taxes. You just don't know.

That's why it's not recommended to try and diagnose it by giving the patient some Ritalin and seeing what happens.
 
Posted by Bishop of Stortford (# 5653) on :
 
quote:
Originally posted by christianjimmy:
it over-stimulates the brains of ADHD kids because their brains are at an already elevated level of activity, so further stimulating it sends their already heightened level of activity into overdrive, and thus smothers the effects of hyper-activity. With non-ADHD kids (with lower base levels of brain activity) it just sends them wild.

[/QB]

Hmmm.. I've been reading up on this, and what I have read is that the brain of an ADHD child is not over-active. It's the body that's over-active because the part of the brain that regulates active behaviour is not working properly. Ritalin is supposed to work by stimulating the inactive brain, which allows the child to control themself. Is that correct, or not. Or is it all just a question of un-provable theories?
 
Posted by Karl: Liberal Backslider (# 76) on :
 
quote:
Originally posted by Telepath:
originally posted by christianjimmy:

quote:
And yes, there is quite a market for stolen Ritalin prescriptions in certain playgrounds around the US and UK...
So I hear, and I can't imagine anything more pathetic. It reminds me of Adrian Mole getting his Airfix plane stuck to his nose when he decides to try his hand at glue-sniffing.

Originally posted by Karl:

quote:
Which is strong evidence for the existence of ADHD - give Ritalin to someone who doesn't have it, and they become more hyper and uncontrollable.
Or they might not. They might clean off the top of their desk, sharpen some pencils, and settle down for a nice evening doing their taxes. You just don't know.

That's why it's not recommended to try and diagnose it by giving the patient some Ritalin and seeing what happens.

I understand from Mrs Backslider that this is what happens when kids without ADHD are misdiagnosed and given Ritalin. It doesn't happen that often, but when it does, that's what happens.
 
Posted by Bartolomeo (# 8352) on :
 
I am too old to have been diagnosed with ADHD although in retrospect it most certainly had to have been a major factor in my struggles in school. I remember trying to complete math tests and being the only one in class unable to complete them in the prescribed amount of time. The problems were easy enough, but I couldn't concentrate long enough to finish the test. It started in first grade and continued at least through early adulthood.

I am confident that with today's understanding I would have been diagnosed and treated, and that my life would have been the better for it.
 
Posted by josephine (# 3899) on :
 
quote:
Originally posted by Bishop of Stortford:
I've been reading up on this, and what I have read is that the brain of an ADHD child is not over-active. It's the body that's over-active because the part of the brain that regulates active behaviour is not working properly. Ritalin is supposed to work by stimulating the inactive brain, which allows the child to control themself. Is that correct, or not. Or is it all just a question of un-provable theories?

No, you're absolutely right. This article explains that the evidence base strongly supports the idea that ADHD is largely the result of having smaller and hypo-functional lateral prefrontal cortices.

This article, which is a bit more "layman friendly," says:

quote:
ADHD sufferers had less activity in the right frontal lobe of their brains than those without the disorder.

The area of the brain that is less active in children with ADHD is part of an ‘Attention network’. This network is activated by people without the disorder in order to concentrate or control themselves. The particular brain region seen to be underactive in people with ADHD normally grows and becomes more active with age. However, in children with ADHD it does not seem to mature so quickly.

The so-called paradoxical effect is a result of the fact that the part of the brain that allows you to inhibit response -- allows you to choose not to pay attention to something, not to say the first words that popped into your head, not to move when your body wants to move -- is under-active. When you stimulate that area of the brain, it allows you to inhibit inappropriate behaviors and inappropriate responses to distracting stimuli.
 
Posted by Lumpy da Moose (# 9038) on :
 
To my own peril, I'm going to post without reading all the 3 pages of postings already; I will attempt to address some of what the OP was looking for.

In my experience, I suspect that a lot of parents are looking for ways of dealing with boisterous children without having to actually assert some discipline. This is NOT always the case, but I think there is a tendency to want to medicate rather than deal.

Those of us who are ADD/ADHD and/or have children with the affliction can definitely tell you that it is NOT an imaginary disorder. I have been through it as a child, back when methylphenidate was considered a bit of an experimental treatment for the affliction. I very clearly remember hearing the word "hyperkinetic" applied to me and/or my behavior. I also remember very clearly how easily I was distracted by such seemingly simple things as the patter of classmate's shuffling feet while in the classroom; it is a memory snippet that is quite clear even today. There were other such things as hearing the birds sing, or watching the rain. I remember distinctly my exasperated boredom at having to fill out a sheet with 100 squares each number 1-100, for probably the 4th or 5th time in the first grade. I had successfully completed the task the first time-- let's move on! Most of my school years (and a LOT of my adult years) were filled with boring repetetive tasks which I already mastered easily. I had a tough time sitting still (sometimes still do, but now I can get up from the desk without getting yelled at), and was out of my seat a lot. I had an exceptionally difficult time working on things that required an extended amount of concentration and that I was not interested in such as math. I could sit and read interesting books for hours and often my folks had to make me go out on play. I do NOT remember actually taking anything for this as a child, though my dad claims I did. I asked him if it worked, and he said, "Oh yeah." It must not have been for very long term, more than a few weeks at most or I would remember it.

I saw almost all the same behaviors in my son as he grew up. This was NOT from environment, as his mom and I divorced when he was 2 and he lived primarily with her. He would spend visitation time with me, but not the ins and outs of everyday life. When he was attending a small private Christian school and had smaller classes, the teacher there tapped his energy to help with other students or get put on special projects. When he began to attend public school where such activity appears to be frowned upon, he ran into disciplinary problems. We did the whole gamut of testing and finally tried him out on Ritalin. Seemed to work OK for him without too many side effects, though he would get a little whiney or weepy when he "crashed" at the end of the day.

Currently, my youngest stepson has the "H" part of it real bad. He does tend to get a bit zombie-like when medicated (which I didn't notice with my own son, btw). He really is a kid out of control and no amount of disciplining works with him. He just doesn't remember being told not to do something you pointed out to him 10 minutes ago. Yet he tests as above-normal in intelligence and has an extensive vocabulary for a 7 year old. As in my oldest (and me), things that interest him can hold his attention for hours-- a good dinosaur book, cetain movies, GameBoy, whatever. Sit him down to do his homework and you almost have to shackle him to the desk, and even then unless the place is silent as a tomb anything will distract. Medication does tend to help him here, but he takes enough that it takes away his appetite and he doesn't eat much. My stepdaughter who is 11 should be taking her Straterra (and refuses vehemently to do so-- everything makes her barf, so she says) and needs it because she too is very scatterbrained and could come in the house with her books, drop them on the floor, and then claim she has "no idea" where they are-- she dosn't remember bringing them home. She also has an extremely difficult time with doing homework. The middle stepson is just now 15 and getting more focused, but he has trouble from time to time. Mrs. Lumpy is the only non-ADD/ADHD one of the bunch and I'm sure we all drive her up the wall on occasion.

I can tell you for certain about the children under my care that not one of them has been misdiagnosed or given meds just to shut them up. I know my son gets his honestly from me. I don't know my other kids dad well enough to say for sure, but Mrs. Lumpy claims that he has those tendencies as well.

As for "medicating your kids will make them drug users," I think this is a load of dung. Matter of fact, I read in one of the many books I've been through on this subject that NON-medicated ADD/ADHD kids tend more toward drugs looking for some calming effect on their restlessness. I can say this certainly resonates with me, as I would suggest that was my experience. Meditation, btw, did not work very well for me. It wasn't until I was in college for the third time that someone turned me onto illicit amphetamines and I found I could actually snap off the distractions and really dive into my work, whether it be a mid-term exam in math-for-dumb-English-majors or when putting together my term paper for my lit. class. That right there speaks volumes.

I spent many years berating myself for not being able to just do "normal work" like other kids were easily able to do. I didn't and don't want my kids to face that same issue which will follow them all the rest of their lives.

I don't doubt there are a lot of people seeking to get their kids medicated so they don't have to take responsibility for them. However, there are some who really do need the help.

And that's all I have to say about that. [Biased]
 
Posted by Telepath (# 3534) on :
 
Originally posted by Lumpy da Moose:

quote:
In my experience, I suspect that a lot of parents are looking for ways of dealing with boisterous children without having to actually assert some discipline. This is NOT always the case, but I think there is a tendency to want to medicate rather than deal.
To be pedantic, the first choice of such parents was probably to do nothing, rather than deal. It takes effort to get to the medication, after all. Why crawl over a mile of broken glass if you can tolerate just sitting in the same spot?
 
Posted by Lookin (# 10855) on :
 
quote:
Originally posted by Telepath:


To be pedantic, the first choice of such parents was probably to do nothing, rather than deal. It takes effort to get to the medication, after all. Why crawl over a mile of broken glass if you can tolerate just sitting in the same spot? [/QB]

ouch ouch ouch ...

do you seriously think thats the case?

that is seriously harsh!

I have a whole range of things I want to type in the response to that commment AND the one that was in reply to, But I am gonna be sensible, go away and think on it before I post, because I am so wound up at the moment, that people make those sort of assumptions that I would probably break the rules if I were to post right now.

Lookin
 
Posted by Telepath (# 3534) on :
 
I think it's the case that if there exist parents who medicate but do nothing else to deal with the problem, there are probably also parents who don't even medicate to deal with the problem.

It isn't particularly easy to get diagnosis, to get treatment subsequent to diagnosis, and to maintain the treatment once you've got it, and I would not be surprised if some parents chose to deal with the problem by doing nothing at all. And why should they when they're only going to get a big pile of hassle, suspicion and societal condemnation for their trouble?

The only reason to bother in the first place is if the difficulties have escalated to the point where they're forced to. Some parents' lives may never be made so uncomfortable that it forces them to act. (This is not the same as making a conscious decision to pursue no treatment of any kind, BTW, which may or may not be a good decision in any particular case.)

I don't see why that's harsh, I just think it's realistic.
 
Posted by AFSkypilot (# 10498) on :
 
I have to say that I disagree any attempts to use medication just "to control the kids."

The way I approach the problem is to try to use some simple disciplining techniques by teaching parents--and teachers--the belief behind most misbehaviors and suggesting ways to counter the misbehavior mostly by allowing the kids to experience the consequences of the behavior they chose.

Someone much earlier said ADHD is a rule out diagnosis. Not exactly. If a child is acting out many different things should be considered before arriving at the ADHD diagnosis: diet; environment; history of abuse; family history--most importantly history of alcohol/drug abuse in the family. A complete physical and psychsocial assessment should be done. If there is no other explanation for the acting out, try giving a mild stimulant, such as coffee to see what the reaction is.

Even if it is determined that a child does have ADHD and a medication is chosen, child and family therapy is still important to help the child learn to make more responsible decisions.
 
Posted by AFSkypilot (# 10498) on :
 
May I make a suggestion?

For those who might want to learn more about this disorder, go to: CHADD
 
Posted by Telepath (# 3534) on :
 
AFSkyPilot, good points, though I would like to make the point that ADHD does not solely manifest itself in misbehaviour.

I know you are not doing this, AFSkyPilot, but a lot of discussion about ADHD is couched in terms of what the observer wants and expects, whatever that is.

When you take all this away, the person with ADHD is still there, still has ADHD, and might still need help in terms of what they want, not only in terms of how they affect others.
 
Posted by Beautiful_Dreamer (# 10880) on :
 
This is to the OP

I have heard of ADHD and I can say that it is very real. It is more than just not being able to sit down when told to, it is more like not being able to concentrate on anything even if you want to. Adults can have it too. I know, I am bipolar and we have a lot of symptoms in common. If someone has ADHD, they can benefit greatly from medication and therapy.
 
Posted by josephine (# 3899) on :
 
AFSkypilot, why would you assume, if a child is having difficulties, that the parents need to be taught "simple disciplining techniques" and that the main things to consider are "diet; environment; history of abuse; family history--most importantly history of alcohol/drug abuse in the family"?

I ask because that's the sort of stuff we kept hearing, until we finally got Littlest One to an incredible neurologist who was able to identify the root causes of his behavioral difficulties. It wasn't that he was oppositional, or defiant, or making bad choices. He was refusing to do things that were, in fact, impossible for him to do, because of his complex neurological impairments. But no one at the school, and no one involved in mental or behavioral health, ever considered any possibilities other than lousy parenting and a kid who made bad choices.

Are mental health counselors taught to look for signs of sensory or motor impairments, or to consider the effects of disability on behavior?
 
Posted by Telepath (# 3534) on :
 
Well, Josephine, we've got to be clean-living model citizens because the normal folk have outsourced their Puritan guilt onto us [Big Grin] We have to do all the weight training, and the Seven Habits, and the nourishing yet thrifty menu plans, and the one-and-only one elegant glass of red wine with our organic supper (for the good of our arteries), and the life coaching, and the soothing yoga, and the wholesome family board game night, so they don't have to.

As a reward, we get to write all the beautifully penned thank-you and condolence letters that normal people don't have time to write because they have to watch telly and drive cars, and grownup stuff like that [Killing me]
 


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