NY Times More than 10,000 American toddlers 2 or 3 years old are being medicated for attention deficit hyperactivity disorder outside established pediatric guidelines, according to data presented on Friday by an official at the Centers for Disease Control and Prevention.
The report, which found that toddlers covered by Medicaid are particularly prone to be put on medication such as Ritalin and Adderall, is among the first efforts to gauge the diagnosis of A.D.H.D. in children below age 4. Doctors at the Georgia Mental Health Forum
at the Carter Center in Atlanta, where the data was presented, as well
as several outside experts strongly criticized the use of medication in
so many children that young.
The
American Academy of Pediatrics standard practice guidelines for
A.D.H.D. do not even address the diagnosis in children 3 and younger —
let alone the use of such stimulant medications, because their safety
and effectiveness have barely been explored in that age group. “It’s
absolutely shocking, and it shouldn’t be happening,” said Anita
Zervigon-Hakes, a children’s mental health
consultant to the Carter Center. “People are just feeling around in the
dark. We obviously don’t have our act together for little children.”
Dr.
Lawrence H. Diller, a behavioral pediatrician in Walnut Creek, Calif.,
said in a telephone interview: “People prescribing to 2-year-olds are
just winging it. It is outside the standard of care, and they should be
subject to malpractice if something goes wrong with a kid.”
Friday’s
report was the latest to raise concerns about A.D.H.D. diagnoses and
medications for American children beyond what many experts consider
medically justified. Last year, a nationwide C.D.C. survey found that 11
percent of children ages 4 to 17 have received a diagnosis of the
disorder, and that about one in five boys will get one during childhood. [...]
This is horrifying. How can any physician claim he has accurately diagnosed a 3 or 4 year old with ADHD? They're all hyper. Know what? They're also all biopolar. That's because at that age such behaviour is NORMAL!!!!!
ReplyDeleteNot quite – years ago I saw a video clip taken by parents of their out of control toddler – so that could get the right help. The comments I always here – who can't control a 2-3 year old ! Until you see it – only then you realize there is a big problem and exercising power over the kid just escalates the problem. Medication has become a option which parents try to avoid at all costs, but sometimes this is the last hope. Ross Greene has been using collaborative problem solving with 3 year olds and those who are not so verbal he uses pictures. Mindfulness , calming and soothing techniques can be used with toddlers too . Diet, good sleep and making the environment less stressful also helps . Sometimes kids need meds so that they can benefit from help . The med route is not a happy merry-go-around
DeleteWhat you fail to mention, is the involvement of the drug companies, their profits, and the staggering numbers of those diagnosed. If my memory serves me right, the number of those diagnosed with ADHD rose 4000% between 1994 and 2004. This means where 1 child was considered that "out of control" to need meds for his behavioral "issues". Ten years later that number jumped to 40. That didn't happen by accident. Nor was there any natural disaster causing major changes in children's behavior. It is a conspiracy between the drug companies, the therapists, the special education schools, and the unfortunately gullible or lazy parents. Follow the money, stupid. This is the ugly truth.
DeleteThere is another angle here, and this comment will probably drag the rest of the comments here to the well known Ritalin debate, pro vs. anti.
ReplyDeleteThe diagnosis of ADHD is complex, and the use of medication in its management is also far from simple. I am a professional, and my opinion on this subject is the result of training and experience. Yet, I flatly refuse to adopt an extreme position on this, since the subject matter contains a good bit of science, and I won't refute that. Now the beef. Just how many kids are placed on medication by pediatricians? Answer - probably most. That's one place where overmedication is rampant. Pediatricians do have some training on ADHD and meds, but most lack the expertise to hit the diagnosis accurately and make a fully educated guess on the best regimen of medications. Then why are these kids going to the pediatrician for that? One - insurance coverage. Two - stigma of going to a child psychiatrist. Three - cost of going to a psychiatric specialist. Finally - four - the recommendation for medications predates the evaluation and diagnosis - it is made by caregivers (often school personnel) who have zero training, and want to make their lives easier. Some of these kids who are difficult to manage have issues that need to be assessed and treated, but the pressure placed on parents to keep their kids out of yeshiva until medicated is immense, unfair, and actually criminal. Ask your pediatrician just how many requests for meds have been relayed by parents under pressure from schools.
Is there a place for medications? Absolutely. Who should prescribe? Who should evaluate? If we answer these questions, most of the problems referenced in this post will disappear.
Another plausable reason for the dramatic rise - standarized testing, aka "accountability laws"
ReplyDeleteThis from Salon
"ADHD diagnoses of public school students within 200 percent of the federal poverty level jumped 59 percent after accountability legislation passed, Hinshaw reports, compared with less than 10 percent for middle- and high-income children. They saw no comparable trend in private schools, which are not subject to legislation like this.
"How do ADHD diagnoses help schools at risk of losing their funding (for not meeting testing goals)?
"First, Hinshaw notes, for kids who do have ADHD, it should improve their performance in school, including their test scores.
"Second, it may help kids who are disruptive in class settle down, which could improve scores for the whole class.
"Finally, in many areas, the test scores of student with ADHD diagnoses aren’t counted. So even it if it doesn’t help the child, it might help the school."
Food for thought.
Why the spike in our skills?
אזוי ווי ס'גויעשט זיך, אזוי יודישט זיך
lol
source: http://www.salon.com/2014/03/01/the_truth_about_adhd_over_diagnosis_linked_to_cause_championed_by_michelle_rhee/
Another gem on this subject:
ReplyDeleteWhy American Kids Have ADHD and French Kids Don’t
by Collin Garbarino
"G. K. Chesterton wrote, “Science in the modern world has many uses; its chief use, however, is to provide long words to cover the errors of the rich.” A rich man cannot be a thief. He must be a kleptomaniac. America, the richest society in the history of the world, applies this use of science with diligence.
We apply it most diligently on behalf of our children. No red-blooded American child would misbehave. Our children have disorders.
In an article entitled “ Why French Kids Don’t Have ADHD ,” Marilyn Wedge says, “In the United States, at least 9% of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications.” In France she says the number is less than half a percent. Why don’t French kids have ADHD?
Is ADHD a biological-neurological disorder? Surprisingly, the answer to this question depends on whether you live in France or in the United States. In the United States, child psychiatrists consider ADHD to be a biological disorder with biological causes. The preferred treatment is also biological—psycho stimulant medications such as Ritalin and Adderall.
French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children’s focusing and behavioral problems with drugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child’s brain but in the child’s social context. They then choose to treat the underlying social context problem with psychotherapy or family counseling. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child’s brain.
The real question is not “Why don’t French kids have ADHD?” The real question is “Why do American kids have it?” After all, we’re the ones who are abnormal.
We really don’t have an ADHD epidemic in this country. Our brains are not less healthy than the French. Instead, we have an epidemic of parents looking for a scientific excuse for their own disappointment in their children, and we have a glut of lazy doctors willing to prescribe whatever drugs parents request.
Hyperactivity? Yes, many of our children are hyperactive. Inability to focus? Yes, many of our children cannot focus their attention on a particular task. I’m not saying that the symptoms of ADHD aren’t real. These symptoms, however, do not stem from biological imbalances that require medication. The problem isn’t our children; the problem is us. We’ve created their social context, and it’s not a place where they can thrive. It’s time to admit that parents are the problem, not the children.
Let me add that I don’t think that parents need medication either. Maybe we can learn from the French.
source:
Why American Kids Have ADHD and French Kids Don’t
by Collin Garbarino
You forget that special ed is very LUCRATIVE for schools (public and private, including yeshivot). Fed funds, not anymore on regular school budget, and completely "reumbursed".
ReplyDeleteThe drug companies are making billions.
ReplyDeleteFood is better medicine than drugs.
Cut the toxic sugar.
Meals only made and cooked from raw unprocessed food, if possible organic = minerals and vitamins
Don't give your children factory manufactured food, the best quality ingredients will never be used. Profits always come first.
Don't even buy bread, make your own with organic flour, raw honey, olive oil, and sea salt flakes.
Don't buy sugared fruit yoghurts. Buy natural yogurts, put in processor with some raw honey and fruit (organic if possible)
Bake your kids a gorgous no-sugar fruit cake with dried apricots, orange juice, wholemeal flour, mixed spice, sunflower oil, eggs, sultanas. simply yummy.
We are poisoning our kids, allowing the food manufacturers and drug companies to make billions.
A useful website to read is foodbabe.com
The other day picked up a packet of healthy looking kosher crackers. Read the ingredients which included the words genetically modified organisims.
ReplyDeleteWhat would our grandmothers say?