<p>My son has ADD. He has always been a high aciever, with little tolerance of not doing well. We had a behavioral program in place --using a star chart and reward program and it workded well, but he was still having trouble completing things and school work took him forwever. In the 5th grade (having an older child we knew that middle school would overwhelm him) we took him to a specialist at John Hopkins. She said that he had excutive function disorder–an inablity to organize and prioritize-- ussually found in gifted males. She prescribed ritalin -we put him on a low dose. It has helped a lot–we don’t use it on weekends, vacations or non-academic days–like field trips or retreats. He now knows when he needs it and when he doesn’t. It was a hard decision–but I think it was the right one. Don’t rule it out–it might help your child succeed and feel better about himself. Structure and parental help are important–drugs can’t do it all.</p>
<p>You are exactly right Swmmer984. Proper diagnosis, and combination of medication (when indicated) and behavioral intervention is the best approach. Now, will you please go speak to the insurance industry and convince them to pay for it?? All too often Drs. appts have become “medcheck” appointments. If these kids were adequately treated, the # of accidents from impulsive, risk-taking or inattentive behaviors would drop, and the insurance industry would save $$ in the long run. OK, I’ll get off my soapbox now.</p>
<p>“excutive function disorder–an inablity to organize and prioritize”</p>
<p>Hey, sounds like me! I should be doing a paper right now 
Does that put me in that category? (Not meaning to sound conceited, but I do kind of fit the “gifted male” part…at least, the latter half for sure…)</p>
<p>I think that we’re starting to classify too many things as mental disorders. By doing this, we’re crowding out the people who really do need help with people who have troubles formerly known as “life”…</p>
<p>“If these kids were adequately treated, the # of accidents from impulsive, risk-taking or inattentive behaviors would drop, and the insurance industry would save $$ in the long run.”</p>
<p>So which of these kids are mentally ill, and which ones are just being teenagers?</p>
<p>Au contraire, tanonev. Mental illness has been, and will continue to be underdiagnosed and undertreated. But that isn’t the issue here.
You described yourself as overfocused- very common in ADHD folks. Because they are not good at filtering out background distraction, they learn to literally block out everything when they are attending to something of their liking. I used to have to stand in front of the TV and wave my arms to get my s’s attention (now it is xbox live). An atom bomb could go off and he’d still be playing, unless he lost his internet connection.</p>
<p>And we have had the teenager driving discussion many times on CC. No need to repeat it ad nauseum. Suffice it to say it is bad enough that teens have a 3000 lb piece of machinery at their disposal when their executive (frontal lobe) functions haven’t fully matured, but their hormones are in full swing…and add to that the impulsive, overactive, thrillseeker or inattentive ADHD person…you’ve got a recipe for potential trouble with a capital T. Oh, and did I forget the distraction of the cellphone?? Or alcohol? Or other substances?? Oh, to be a teen again… I couldn’t afford the auto insurance.</p>
<p>tanonev: I absolutely agree with your comment, “. . .that we’re starting to classify too many things as mental disorders…crowding out the people who really do need help…” Yes! Well put.</p>
<p>jym626: I can believe that mental illness may be “underdiagnosed” and “undertreated,” but I don’t think kids who have time management problems, or an inability to organize and prioritize, or who are forgetful, etc., are what I would classify as “mentally ill.” Give them labels and drug them if you like, but I can believe in many of these cases where drugs are given, a behaviorial change (or change in the home life/routine) and maybe a change in schools-- or simply in classes-- would make a big difference. I also think age and maturity play a role. A 14 year old–especially a boy–isn’t really all that mature. Prioritizing? I think that’s a skill one learns over time. Losing things? I lose my car keys on a regular basis; I get in the car and start driving and forget where I’m going. I’ve been doing that for years, but I never considered drugs to treat the “problem.”</p>
<p>I never said that time management or organizational problems = mental illness. And believe me, I wish more parents would take the time to learn appropriate parenting skills or provide adequate therapy for their child when it is indicated/needed. You are seriously overgeneralizing the statements above. I am in the mental health field, so I have a bias towards appropriate treatment for problems. And there are many treatment modalities. Medication, when indicated, is but one of them. </p>
<p>Now as for
you may be needing medication, now or down the road a bit… ARICEPT :)</p>
<p>jym626: Thanks for your online medical advice, but I’m 54 and have been losing my car keys and being forgetful for decades; nevertheless, I’m content in my life and very successful at what I do. Once again, I would never take drugs (nor prescribe them–and certainly not online to someone I’ve never met), nor suggest any to a teenager who is forgetful, has trouble with organizational skills, prioritizing, or time management. Instead, I would make some changes in the household for that child. And, once again, the very first thing I’d do is haul the TV out of the house, and secondly, the video games.</p>
<p>I do think you need to return to tanonev’s original statement. Whether you see these teenage “problems” as mental illness really wasn’t the point, I don’t think. The point is that by labeling every little problem a kid has and ultimately drugging him for things like inability to prioritize, you dilute the cause of and advocacy for those who truly need help (in my opinion).</p>
<p>There are certain kids with certain issues that fit a profile that certain drugs can help bring them to a threshhold where their behaviour can be more modified. In extreme case, it is pretty clear that the drugs need to be used to even reach the kid and have a chance for counseling, patterning, behavior modification and time/organizational management to even get through to the kid. The problem comes when the problems are there, but not that consistently and not to the disaster level. At what point should the drugs be introduced? It is not a clear cut answer and is individual to the child, the family and the support system in place. For those kids where the time and efforts are minimal in getting the kid under control in his current state, medication might bring the kid to a point where the teachers and family can reach him at the level that can be maintained. It is not an easy thing to keep the structure and treatment consistent with any kid, and most of us are not so perfect. But some families can deal with more of this than others and have found school solutions that are more amenable to working with the kids than others. If the kids is having trouble and beginning to enter a cycle of misbehaviour, disorganization and other issues and cannot curb it, it may well be time to try the meds, and see if he can be reached a that level. If all it does is sedate the kid and does not get him proactive in reaching the next step, meds may well not be the answer. But it really is an option to be considered. </p>
<p>The category of mental illness is really a serious label and should not be given until a true diagnosis can be made by professionals, and even then I would look for other opinions. However, many of the techniques and meds used to treat the mentally ill can really help some who are struggling at a time in their lives over some inadequacy that they just cannot address. There is a difference between that and true mental illness. A person who is chronically depressed to a point that it is preventing him from functioning independently is a whole different story from a person who goes into that funk when some catastrophe hits, say a death of a child. But the treatment for that normal person may be similar when he is going through that period of his life and needs some help.</p>
<p>Eloquently said, jamimom. Many kids and adults respond to a variety of interventions- from tutoring to teaching organization and study skills to social skills training to coaching, etc. As you said, there is a big range between irritating and debilitating symptoms, as there is a big difference between a grief reaction to a Major Depressive Disorder. </p>
<p>ADHD is a biological disorder,though many, many people want to engage in an argument about it. I am not interested in a debate. For those who are interested, there is an excellent review article on the epidemiology, neurobiology and pharmicokinetics of ADHD written by Dr. K. Voeller (J of Child Neurology 2004; 19 (10): 798-814). If you can’t access it , let me know and I will send you a link. It is long (26 pgs) but is an excellent article.</p>
<p>And Jack. Geez buddy, lighten up. It was a joke. I’d say take a chill pill but you don’t like “drugs” 
I am sorry, but it seems that you want to argue or start a fight. Not interested. So I will bid you adieu.</p>
<p>jym626: Sorry, I guess I forgot to put my smiley face up after my statement for you. :)</p>
<p>I do think when someone from the medical field is making a case for drugs, attempting a “joke” is probably not a great idea. I have no desire to “argue or start a fight” with anyone. However, I do believe that this is an overmedicated society, and though drugs can be a lifesaver for many (those who are bipolar, for instance), I believe that too many drugs are being handed out like so much halloween candy way too frequently–especially to young people.</p>
<p>Aricept is for management of dementia memory problems. One example of a dementia is Alzheimers. Again, it was a joke.
Lastly, part of the problem is that people connote the word “drugs” with street drugs and other bad bad bad stuff. These are medications, and when used wisely and appropriately in conjunction with other concomittant interventions, can be very beneficial.</p>
<p>I do agree that we have over diagnosis of ADD ( at same time we have under identification)
My daughter for instance who I had mentioned before was 10 weeks early, had gross motor delay as well as slight learning challenges attended a program intended to give those not quite ready for kindergarten more time. She was enrolled because we hadn’t been able to find an appropriate program for her, the neighborhood public school advised us against it when they found she had been reading since 3 yr, and I didn’t know of anything else available.
The 5’s program was very good for her, and she went on to 1st grade, but what we saw in the 5’s program were other children who were being “redshirted” to gain advantage in school. Kids who were just about to turn 6 who were then put into Kindergarten the next year, because the school gifted program looked at your grade and your performance, not your age. When a good portion of the kids are 6 entering kindergarten, that kicks the level of academics expected up quite a bit, and those who are traditional kindergarteners look like they are “slacking”.
With the SATs not indentifying students who had accomodations ( needing extra time) it has motivated some to be diagnosed to gain that extra ( unneeded) advantage, even though they are not expecting to use accomodations in college.
My daughter does have ADD and she does have accomodations in college- similar to what she would find on the job. ( It is a civil rights issue once you leave K-12) IF a college is put off by a student stating that they recieved extended time on SATs, and that they have ADD or an LD, then that is not where they should be attending school anyway.</p>
<p>SBMom,</p>
<p>I have not read this whole thread but I will weigh in with my opinion on this topic.</p>
<p>There are a number of students that do have ADD or ADHD in the US. However, I think it is over-diagnosed. I can’t find the reference but I think I read that in some school districts there are 20% of the boys on Ritalin/Adderall (I think it may have been embedded in a post by Mini in the past). These numbers are not found anywhere else in the world.</p>
<p>A secondary issue contributing to the over-diagnosis is that schools are not set up to take advantage of boys learning styles which tend to be more interactive.</p>
<p>This is not to say that some kids need something for ADD/ADHD, I would just go into it very carefully. Often the best path is to do nothing.</p>
<p>It is important to not generalize, maybe many are misdiagnosed but in the past many children suffered who were NOT diagnosed. My brother who has a genius level IQ had horrible problems in a rigid Catholic school because he couldn’t sit still. We have better awareness now and because of our environment many more children do have ADD and autism, it is not all misdiagnosis. That said medication is not the answer for everyone but it is helpful for some children and can make a huge difference in visual learning and focusing. Having the right support in school is important as well. I have to laugh at schools where kids who can’t sit still are punished by missing recess. If they had PE and recess and more hands on learning to begin with they would not be acting out or so disorganized. I work in the field and have experience in my family so I could go on and on. My brother was finally diagnosed as an adult with adult attention defecit disorder and is finally on medication. He is thriving for the first time in his life. He is 56 years old and is getting married for the first time to a wonderful girl, he is doing great in his career. He would have had a much easier life if diagnosed earlier as a young student!</p>
<p>jym626: Thanks. I am aware of what Aricept is.</p>
<p>One point that we may not have discussed directly, although it has been alluded to indirectly, is how the social life of unmedicated students with ADD/ADHD is impacted.</p>
<p>I teach primary grades, so my observations are of children 6-9. I am very careful, since I am once of the first teachers parents deal with in regard to their child. As I noted in a previous post, teachers MAY NOT diagnose, medicate, or tell parents to medicate, although we may be better able to help a parent put their child’s behavior in the context of the continuum of behavior seen in the classroom.</p>
<p>Often ADD/ADHD children have very mercurial temperaments. They frequently begin their school years as popular children, since they are animated, active, and fun to be around. However, this popularity is often compromised as the child is not able to focus on tasks or play, frustrating playmates. They may be building block towers alongside another child, decide they are done, and then knock all of the towers in the vicinity down, upsetting others. Then the ADD/ADHD student cannot understand what the fuss is about. At times they are very hard for other children to deal with. Their active personality makes them natural leaders, but frequently they do not have the interpersonal skills to be sensitive others, so this goes by the wayside. They are left alone in their ever-changing pursuits, which then becomes a frustration, and they try to get others to join in. </p>
<p>The really sad part is that the active child knows this is happening and cannot really figure out how to get back in the good graces of the peer group. We have a very strong conflict management program, which helps the other students a great deal and even gives the transgressor feedback about what went wrong and exactly how it can be fixed. Often these outbursts look like an anger management problem, and come under the purview of our behavior specialist. </p>
<p>So now, you have a child who may already feel badly about themselves because they are not achieving in school, and now no one wants to play with the child, plus they are taken out of class to talk to a behavior specialist, etc. The teacher is annoyed because they just want to teach and they are dealing with behaviors which do not go away or “get better” with interventions. It can become a downward spiral.</p>
<p>I really agree with the comments regarding TV, video games, etc. The most successful, non medicated ADHD student I had this year went from a k reading level in 2nd grade to a 10th grade level due to 2.5 hours of reading instruction each day. The instruction was not the point, though. The mom knew that the child was behind, and when she was told that his behavior was such that he was in jeopardy of being excluded from the extended program, SHE came in and sat outside the classroom so that he would know he was accountable. SHE talked to teachers daily after school and the consequences or rewards were immediate. SHE had 3 questions she asked him at the end of each day, which she then graduated to having him ask himself. If his homework wasn’t done he would come to school with a note from his mom stating that “he wouldnt’ do it” and that he should suffer any consequences the teacher deemed appropriate. The progress may have been academic, but it was all the doing of a very ADD mom who had learned to cope and who set the structure for the child so that he could succeed. Not that teachers expect this from every parent, but that is what it took for this child to succeed.</p>
<p>Okay, it is till pretty early for Alaska and I need another cup of coffee! Have a great day!</p>
<p>momof1,</p>
<p>great points.</p>
<p>You may have missed my notorious story, posted on another thread, of attending school with my son for a day back in 7th grade.</p>
<p>This was before we realized he had ADD. I had told him that the consequence for not writing his assignments down in his notebook would be I would come to school and watch him to make sure it was done. This was half in jest. But he kept not doing it so one morning, I just got out of the car & went in with him for the day.</p>
<p>Yes, parental backup and consequences are terribly important. </p>
<p>Luckily my S does not have the hyperactive/impulsive part of the ADD spectrum; he is very popular and well liked by his peers (a poll in school news paper for valentine’s day voted him the one who’d get valentines from the most people.) He won an elective office (then had to give it up due to not maintaining a B average.)</p>
<p>I want to thank everyone for their comments and for the many PMs I have received. You are a very supportive group. I am exploring many new ideas.</p>
<p>What happens to the kids who’ve had special accomodations at schools and testing sessions when they hit “the real world”?..How do they do when coworkers and bosses have no interest in their special needs? I’m not being facetious, just curious of “Phase 2” in life…</p>
<p>accomodations under a 504 are part of the Civil Rights act to insure equal access for those with disabilities. These are applicable once students leave high school ( or before)
<a href=“http://www.wrightslaw.com/info/sec504.index.htm[/url]”>http://www.wrightslaw.com/info/sec504.index.htm</a>
I am in process of getting my daughter a 504 instead of the IEP that she had for years. Actually the school did not follow a legal IEP which was mandated under the federal IDEA, and because I was wasting my time and energy dealing with the school and the district trying to get them to do so, it was suggested to me to obtain a 504 for her instead as it was more enforceable.
However, even though she apparently qualified for an IEP for specific learning disability for 8 years, now the school is saying she doesn’t need any accomodations and they are balking to sign off on the 504.
::eyeroll::</p>