Do you think ADHD is real and/or over prescribed?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm going to get flamed for this, but here goes...some of the most misbehaved children I know are diagnosed with ADHD. Interestingly enough, their parents are the most ineffective, passive and permissive adults.

I've yet to meet a child with ADHD who's raised in a strict but loving, disciplined household with firm limits, consistent boundaries, a set schedule and a healthy dose of the word n and benign neglect as needed. We're raising self-centered, entitled brats.

Go ahead, tell me that you are raising your child this way and he/she is gifted, healthy, quirky, etc. but despite your loving interventions...

We've gotten so afraid of blaming Mother or accusing the parents of neglect that experts tend to gloss over or claim the home environment is relevant.

You know, a lot of kids with ADHD have PARENTS with ADHD. The ADHD in the parents is frequently undiagnosed and untreated. The parent have difficulty organizing herself and difficulty organizing her child. That doesn't mean ADHD isn't real. It means both parents need treatment. Both the parent and the child could benefit from medication in that situation.

http://www.additudemag.com/adhd/article/9569.html

http://www.additudemag.com/adhd/article/2539.html

I think it's over medicated. I know kids with ADHD whose parents were diagnosed after their kid was. Just my experience but the parents went to Harvard, Yale, Cornell and U. of Michigan law schools and did well enough to get federal appellate clerkships: All without medication or accommodations during their schooling where they obviously did very well.
So their ADHD was mild and they learned to compensate for their slow processing and executive functioning skills. I think for SOME kids with ADHD, people (and schools) are too quick to medicate instead of working on organization and coping skills.

+1

[Anonymous]

As others have said before me, ADHD is overdiagnosed and underdiagnosed. Many people rush to a pediatrician and beg for help for very real problems a child is having in school and, in the absence of a better form of treatment, not having any way to enforce parenting changes or a behavioral plan, pediatricians often prescribe medication. This happens all over the country. However, it is not the ideal way to have ADHD diagnosed and not the way many do it. Everyone I know in my middle to upper middle class circle of friends and acquaintances gets very thorough, and very expensive, evaluations such as neuropsych exams. This is a much more accurate way to diagnose.

For those of you who don't think it is real... I don't know what to say. My husband and I are highly organized people who were both very successful in school and have been successful in our careers. We have three boys, only one of whom has severe ADHD. The other two are totally fine. My child with ADHD is in third grade and, though he has the combined diagnosis, is not hyperactive the way people may imagine. He fidgets and slouches and wiggles but he doesn't get up or move around or bug people. He does not get in trouble, ever. I would say his activity level is totally average--of course, ADHD has absolutely nothing to do with being an "active boy" so this isn't surprising information. He gets excellent grades ... at least at this point... and does advanced academics. However, it is unbelievably hard for him to regulate his attention. In school, he needs every set of instructions repeated or he misses 100%. If he is reading a book, you have to tap his shoulder or shout at him to get his attention--he doesn't hear you otherwise. If he is playing a sport, one-on-one, he is very skilled, while on a team he is totally helpless. He can have a great conversation with one child or one adult but if there are more people in the room, or noises, or other distractions, he can barely answer a simple question. I am probably not giving an accurate sense of the extent to which he can not shift his attention or process more than one thing at once. The effects of his ADHD on his development, especially social, and on his self-esteem have been major and affect him constantly on a daily basis.

I am not a perfect parent, not by a long shot. I will say that I am above average in my efforts. I go to parenting classes. I read books on ADHD and executive function and difficult children. I go to therapy and of course take my child to all his therapies. I run a highly structured household and am very strict about our schedule. I have changed my house around and switched careers all to address my child's very significant needs. I try hard to be consistent and patient, though I fail more than I would like. Do I look like a great parent to others?? Probably not because, I have to tell you, it is extremely hard to be that with some of these kids. I have neurotypical kids, too, who have their moments like all kids but they learn eventually... even easily, they're flexible, they grow in predictable ways. I think people have no idea how much more effort it can take to teach a child with ADHD.

Anyway, I am not looking for pity, but the suggestion that it isn't real is just so bizarre to me. I wish it weren't real.

Oh and, by the way, my child is not medicated for the ADHD. We do not medicate for medical reasons. I have always been a healthy, organic mom and, before I had kids, figured I would do anything to try to avoid medication in this situation. But now, well, we do all the difficult stuff and we are getting by, successful in some ways even, but life is still really really hard for my kid. We all work incredibly hard and it is barely enough and my child is only in third grade.

[Anonymous]

<<I know kids with ADHD whose parents were diagnosed after their kid was. Just my experience but the parents went to Harvard, Yale, Cornell and U. of Michigan law schools and did well enough to get federal appellate clerkships: All without medication or accommodations during their schooling where they obviously did very well. >>

I think this is interesting. I have a kid dxed with ADHD (and a kid not dxed, but could be if i wanted him to I think). I had a therapist tell me I have ADHD and puts it on my therapy invoices. I can see why she thinks that -- at the same time, I too went to an Ivy league school and had a very successful career, all without the help of an ADD diagnosis or medication.

I'm not sure where I come out on all this. My life is a struggle and I sometimes think that if I had a ADD dx as a kid, I may have learned better skills. Obviously i made it this far, but organizationally, I'm a real mess (though I do manage to file my taxes on time, pay all my bills etc)

[Anonymous]

Anonymous wrote:I'm going to get flamed for this, but here goes...some of the most misbehaved children I know are diagnosed with ADHD. Interestingly enough, their parents are the most ineffective, passive and permissive adults.

I've yet to meet a child with ADHD who's raised in a strict but loving, disciplined household with firm limits, consistent boundaries, a set schedule and a healthy dose of the word n and benign neglect as needed. We're raising self-centered, entitled brats.

Go ahead, tell me that you are raising your child this way and he/she is gifted, healthy, quirky, etc. but despite your loving interventions...

We've gotten so afraid of blaming Mother or accusing the parents of neglect that experts tend to gloss over or claim the home environment is relevant.

gtfo.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm going to get flamed for this, but here goes...some of the most misbehaved children I know are diagnosed with ADHD. Interestingly enough, their parents are the most ineffective, passive and permissive adults.

I've yet to meet a child with ADHD who's raised in a strict but loving, disciplined household with firm limits, consistent boundaries, a set schedule and a healthy dose of the word n and benign neglect as needed. We're raising self-centered, entitled brats.

Go ahead, tell me that you are raising your child this way and he/she is gifted, healthy, quirky, etc. but despite your loving interventions...

We've gotten so afraid of blaming Mother or accusing the parents of neglect that experts tend to gloss over or claim the home environment is relevant.

gtfo.

11:54 had a problem?

[Anonymous]

Anonymous wrote:I'm going to get flamed for this, but here goes...some of the most misbehaved children I know are diagnosed with ADHD. Interestingly enough, their parents are the most ineffective, passive and permissive adults.

I've yet to meet a child with ADHD who's raised in a strict but loving, disciplined household with firm limits, consistent boundaries, a set schedule and a healthy dose of the word n and benign neglect as needed. We're raising self-centered, entitled brats.

Go ahead, tell me that you are raising your child this way and he/she is gifted, healthy, quirky, etc. but despite your loving interventions...

We've gotten so afraid of blaming Mother or accusing the parents of neglect that experts tend to gloss over or claim the home environment is relevant.

I don't agree with you that ADHD symptoms do not exist in families with firm boundaries BUT I do agree that we have become too afraid of pointing out the possibility of the relevance of the home environment. Here is an interesting study that showed the importance of parental training:

http://www.medscape.com/viewarticle/810197?src=wnl_edit_tpal&uac=123017PR

"Attention-deficit/hyperactivity disorder (ADHD) is commonly diagnosed, but we know little about the comparative effectiveness of the various behavioral and pharmacologic treatment options, especially in preschoolers at risk for ADHD because of clinically significant disruptive behavior. The US Agency for Healthcare Research and Quality has sponsored a comparative effectiveness review[1] of interventions for this group of children.

This comprehensive review examined 55 studies between 1980 and 2011. The interventions that were evaluated in these studies were parent behavior training, combined home and school/day care interventions, and methylphenidate use. Data were extracted using customized software.

The investigators found that more studies of all of these interventions are consistently documenting effectiveness, but parent behavior training interventions had greater evidence of effectiveness than methylphenidate for treatment of preschoolers at risk for ADHD."

[Anonymous]

Anonymous wrote:As others have said before me, ADHD is overdiagnosed and underdiagnosed. Many people rush to a pediatrician and beg for help for very real problems a child is having in school and, in the absence of a better form of treatment, not having any way to enforce parenting changes or a behavioral plan, pediatricians often prescribe medication. This happens all over the country. However, it is not the ideal way to have ADHD diagnosed and not the way many do it. Everyone I know in my middle to upper middle class circle of friends and acquaintances gets very thorough, and very expensive, evaluations such as neuropsych exams. This is a much more accurate way to diagnose.

For those of you who don't think it is real... I don't know what to say. My husband and I are highly organized people who were both very successful in school and have been successful in our careers. We have three boys, only one of whom has severe ADHD. The other two are totally fine. My child with ADHD is in third grade and, though he has the combined diagnosis, is not hyperactive the way people may imagine. He fidgets and slouches and wiggles but he doesn't get up or move around or bug people. He does not get in trouble, ever. I would say his activity level is totally average--of course, ADHD has absolutely nothing to do with being an "active boy" so this isn't surprising information. He gets excellent grades ... at least at this point... and does advanced academics. However, it is unbelievably hard for him to regulate his attention. In school, he needs every set of instructions repeated or he misses 100%. If he is reading a book, you have to tap his shoulder or shout at him to get his attention--he doesn't hear you otherwise. If he is playing a sport, one-on-one, he is very skilled, while on a team he is totally helpless. He can have a great conversation with one child or one adult but if there are more people in the room, or noises, or other distractions, he can barely answer a simple question. I am probably not giving an accurate sense of the extent to which he can not shift his attention or process more than one thing at once. The effects of his ADHD on his development, especially social, and on his self-esteem have been major and affect him constantly on a daily basis.

I am not a perfect parent, not by a long shot. I will say that I am above average in my efforts. I go to parenting classes. I read books on ADHD and executive function and difficult children. I go to therapy and of course take my child to all his therapies. I run a highly structured household and am very strict about our schedule. I have changed my house around and switched careers all to address my child's very significant needs. I try hard to be consistent and patient, though I fail more than I would like. Do I look like a great parent to others?? Probably not because, I have to tell you, it is extremely hard to be that with some of these kids. I have neurotypical kids, too, who have their moments like all kids but they learn eventually... even easily, they're flexible, they grow in predictable ways. I think people have no idea how much more effort it can take to teach a child with ADHD.




Anyway, I am not looking for pity, but the suggestion that it isn't real is just so bizarre to me. I wish it weren't real.

Oh and, by the way, my child is not medicated for the ADHD. We do not medicate for medical reasons. I have always been a healthy, organic mom and, before I had kids, figured I would do anything to try to avoid medication in this situation. But now, well, we do all the difficult stuff and we are getting by, successful in some ways even, but life is still really really hard for my kid. We all work incredibly hard and it is barely enough and my child is only in third grade.

I like you. I really appreciate your perspective.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm going to get flamed for this, but here goes...some of the most misbehaved children I know are diagnosed with ADHD. Interestingly enough, their parents are the most ineffective, passive and permissive adults.

I've yet to meet a child with ADHD who's raised in a strict but loving, disciplined household with firm limits, consistent boundaries, a set schedule and a healthy dose of the word n and benign neglect as needed. We're raising self-centered, entitled brats.

Go ahead, tell me that you are raising your child this way and he/she is gifted, healthy, quirky, etc. but despite your loving interventions...

We've gotten so afraid of blaming Mother or accusing the parents of neglect that experts tend to gloss over or claim the home environment is relevant.

I don't agree with you that ADHD symptoms do not exist in families with firm boundaries BUT I do agree that we have become too afraid of pointing out the possibility of the relevance of the home environment. Here is an interesting study that showed the importance of parental training:

http://www.medscape.com/viewarticle/810197?src=wnl_edit_tpal&uac=123017PR

"Attention-deficit/hyperactivity disorder (ADHD) is commonly diagnosed, but we know little about the comparative effectiveness of the various behavioral and pharmacologic treatment options, especially in preschoolers at risk for ADHD because of clinically significant disruptive behavior. The US Agency for Healthcare Research and Quality has sponsored a comparative effectiveness review[1] of interventions for this group of children.

This comprehensive review examined 55 studies between 1980 and 2011. The interventions that were evaluated in these studies were parent behavior training, combined home and school/day care interventions, and methylphenidate use. Data were extracted using customized software.

The investigators found that more studies of all of these interventions are consistently documenting effectiveness, but parent behavior training interventions had greate
r evidence of effectiveness than methylphenidate for treatment of preschoolers at risk for ADHD."

Special Needs Parents?

[Anonymous]

Shhhh!

[Anonymous]

The two previous postings --why the hate on SN parents? What did they ever do to you?

[Anonymous]

Special Needs Parents?

First of all, you realize that you posted at 10:27 pm, right? This isn't General Parenting. That's pretty late to expect a response.

Second, the link you provide requires a login/password. If you would like comment on the article, it needs to be accessible.

Third, the conclusion of the article (provided by you) indicates behavior training has greater effectiveness than medication in the preschool population at risk for ADHD.

I'm not surprised by the results. In our household, after or oldest was diagnosed was ADHD we had a lot of training that improved our discipline/structure/routine. We saw a lot of improvements not just in our DS with ADHD but our two other kids as well as my DH with ADHD (diagnosed after DS). That was fine until the demands of school (starting in K) became too great for my DS to keep up. He had absolutely no behavioral issues, his were related to learning - which behavior modification doesn't affect. It's why we turned to medication with very positive results.

Finally, there have been several studies that indicate behavior modification isn't sufficient to control the symptoms of ADHD. In fact they show the medication alone does better and there's marginal gain with the addition of behavior modification. Here's one http://www.ncbi.nlm.nih.gov/pubmed/8326053/ . I'll look for the other one later, I believe it was the MTA longitudinal study on ADHD. The researchers continue to recommend behavior modification but support use of medication as the best method to control symptoms.

Actually, maybe I won't look for the study results. I think I'm going to leave this thread. I don't need to convince anyone else that ADHD is real or that our treatment approach is the best according to current medical research. I know they are. Believe what you want to believe. Those of us who are living this and have researched it don't need your opinions.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm going to get flamed for this, but here goes...some of the most misbehaved children I know are diagnosed with ADHD. Interestingly enough, their parents are the most ineffective, passive and permissive adults.

I've yet to meet a child with ADHD who's raised in a strict but loving, disciplined household with firm limits, consistent boundaries, a set schedule and a healthy dose of the word n and benign neglect as needed. We're raising self-centered, entitled brats.

Go ahead, tell me that you are raising your child this way and he/she is gifted, healthy, quirky, etc. but despite your loving interventions...

We've gotten so afraid of blaming Mother or accusing the parents of neglect that experts tend to gloss over or claim the home environment is relevant.

gtfo.

What's gtfo? Why do I suspect it's something hateful? Why is this person being so nasty to the above poster?

[Anonymous]

Anonymous wrote:

Special Needs Parents?

First of all, you realize that you posted at 10:27 pm, right? This isn't General Parenting. That's pretty late to expect a response.

Second, the link you provide requires a login/password. If you would like comment on the article, it needs to be accessible.

Third, the conclusion of the article (provided by you) indicates behavior training has greater effectiveness than medication in the preschool population at risk for ADHD.

I'm not surprised by the results. In our household, after or oldest was diagnosed was ADHD we had a lot of training that improved our discipline/structure/routine. We saw a lot of improvements not just in our DS with ADHD but our two other kids as well as my DH with ADHD (diagnosed after DS). That was fine until the demands of school (starting in K) became too great for my DS to keep up. He had absolutely no behavioral issues, his were related to learning - which behavior modification doesn't affect. It's why we turned to medication with very positive results.

Finally, there have been several studies that indicate behavior modification isn't sufficient to control the symptoms of ADHD. In fact they show the medication alone does better and there's marginal gain with the addition of behavior modification. Here's one http://www.ncbi.nlm.nih.gov/pubmed/8326053/ . I'll look for the other one later, I believe it was the MTA longitudinal study on ADHD. The researchers continue to recommend behavior modification but support use of medication as the best method to control symptoms.

Actually, maybe I won't look for the study results. I think I'm going to leave this thread. I don't need to convince anyone else that ADHD is real or that our treatment approach is the best according to current medical research. I know they are. Believe what you want to believe. Those of us who are living this and have researched it don't need your opinions.

Huh? Not sure who this is aimed at. I am 17:52 and that was my first and only post on this thread. Anyway, I was just pointing out one study that showed that parental intervention can and does help. On the topic of medication, I do believe there is a need for it in many cases BUT I also think that doctors don't adequately explain the risks and over play the benefits (this was well explained in the NYT article this past weekend (http://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html?ref=health&_r=1&). For example, you mentioned the MTA longitudinal study. IMO this study should be required reading for anyone deciding whether or not to try medication for their child. The study, after 8 years of following children with ADHD using either medication, therapy, or a combination, found little to no benefit long term. We can always find a study to support whatever position we want to take but this is the only longitudinal study of its kind and its results should be known by everyone.

From the publication of MTA study:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063150/
"Thus, although the MTA data provided strong support for the acute reduction of symptoms with intensive medication management, these long-term follow-up data fail to provide support for long-term advantage of medication treatment beyond two years for the majority of children—at least as medication is monitored in community settings."

I am NOT saying that those that choose medication are bad parents or have made the wrong decision. I do think that we are often not given a full picture of the risks and benefits. I think the following, also from the MTA study discussion, is very good advice:
"Decisions about starting, continuing, and stopping medication may have to be made on an individualized basis, avoiding untested assumptions about continuing benefit, and using periodic trial discontinuations to check for need and benefit."

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm going to get flamed for this, but here goes...some of the most misbehaved children I know are diagnosed with ADHD. Interestingly enough, their parents are the most ineffective, passive and permissive adults.

I've yet to meet a child with ADHD who's raised in a strict but loving, disciplined household with firm limits, consistent boundaries, a set schedule and a healthy dose of the word n and benign neglect as needed. We're raising self-centered, entitled brats.

Go ahead, tell me that you are raising your child this way and he/she is gifted, healthy, quirky, etc. but despite your loving interventions...

We've gotten so afraid of blaming Mother or accusing the parents of neglect that experts tend to gloss over or claim the home environment is relevant.

You know, a lot of kids with ADHD have PARENTS with ADHD. The ADHD in the parents is frequently undiagnosed and untreated. The parent have difficulty organizing herself and difficulty organizing her child. That doesn't mean ADHD isn't real. It means both parents need treatment. Both the parent and the child could benefit from medication in that situation.

http://www.additudemag.com/adhd/article/9569.html

http://www.additudemag.com/adhd/article/2539.html

I think it's over medicated. I know kids with ADHD whose parents were diagnosed after their kid was. Just my experience but the parents went to Harvard, Yale, Cornell and U. of Michigan law schools and did well enough to get federal appellate clerkships: All without medication or accommodations during their schooling where they obviously did very well.
So their ADHD was mild and they learned to compensate for their slow processing and executive functioning skills. I think for SOME kids with ADHD, people (and schools) are too quick to medicate instead of working on organization and coping skills.

I have 2 boys with ADHD, both combined, one child's is regular middle of the road diagnosis, the other has very severe ADHD. My dh is an ADHD parent diagnosed after my first child. He went to a prestigious university and has a very successful career making over 300k a year. HOWEVER, his ADHD severely affects our marriage and his parenting ability. Yes, he has learned strategies to cope at work although he always works much longer hours to complete all of his work than most of his coworkers. Having ADHD can give you the ability to have a narrow focus on certain parts of your life, such as school and work, but that focus cannot be sustained and it is often the home life that it disrupts.

Working on organization and coping skills are very important, but sometimes the brain cannot even begin to process how to do so without medication to begin with. And I say this as a very "crunchy", organic, anti meds unless absolutely necessary mom. If you knew my dh at work and how organized he is there, you would never believe the chaos of his things at home. His stacks and piles and clutter get scattered around the house. This while trying to keep a structured routine for the ADHD kids at home. It's a vicious cycle and I wish there was not such a stigma surrounding it. My in-laws still think this is something my kids will grow out of (after many years of denying there was a problem to begin with and thinking I was paranoid mom) and clearly never thought dh had a problem.

A diagnosis and medication should have been pursued for my dh as a child. He is working extra hard now to learn the life skills necessary while juggling career and family.

[Anonymous]

It's impossible to know how a lifetime of various drugs would have altered a person's brain development. It's preferable to assume utopia, but not at all realistic.