Treating Young Children for ADHD
http://thedianerehmshow.org/shows/2011-10-19/treating-young-children-adhd
Earlier this week the American Academy of Pediatrics released new guidelines for treating and diagnosing ADHD. The disorder, often characterized by hyperactivity and an inability to focus, is thought to affect about 8 percent of all kids. The new guidelines aim to help pediatricians identify ADHD in children as young as four. Previous recommendations applied to children six and up. Many pediatricians agree that attention deficit problems can be apparent in preschool age children, but there is debate over what treatments, if any, are appropriate. Join us to talk about diagnosing and treating ADHD in young children
Guests
Dr. Mark Wolraich
professor of pediatrics, University of Oklahoma Health Sciences Center
lead author, ADHD clinical practice guidelines
Dr. Mark Batshaw
executive vice president and chief academic officer, Children’s National Medical Center; professor and chairman, Pediatrics, George Washington University School of Medicine and Health Sciences.
Rick Ostrander
associate professor and director of Pediatric Medical Psychology, Johns Hopkins School of Medicine, Department of Psychiatry and Behavioral Sciences.
Dr. Claudia Gold
pediatrician and author of "Keeping Your Child in Mind"
Comments
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Darrell from St Louis -
On a previous show, some people called in regarding the benefits of meditation for adult ADD. Are there any studies on the use of mindfulness or meditation with ADHD kids? If so, what are the findings?
I have 2 boys, now 25 and 21 that are ADHD and ADD. Having witnessed this condition from birth, I can testify that you can tell the difference between normal 4 year old behavior and abnormal 4 year old behavior. The condition does not disappear at 18, it just morphs into adult behavior that can be just as destructive, especially when medication may be refused.
Diane,
I had a question about medication. I've been on serval different types of ADHD meds and was curious to know if there were any longterm health issues when taking ADHD medication for an extended period of time?
Extended period of time being serval years.
Thank you!
John
Research Triangle Park, NC
My 11 year old son has a diagnosis of ADHD. He is managing his impulsive and distracted behavior with medication. He also has sensory issues including aversion to specific noises, some touch and light. He has high social anxiety as well. We are currently working with a cognitive therapist to address these issues. Can one of your guests comment on some of these symptoms with ADHD?
We had issues with our oldest daughter and her ADHD, so much to the point that we sought help from the human resources...which was a huge mistake...they separated us from her into two different rooms and tried their best to convince her that we had been physically abusing her at home....Wow, so much for CPS..they are nothing but Evil whose main intent are to separate children from their parents, not help, but that's another program.
I am very concerned about these types of changes to ADHD guidelines. As a pediatric occupational therapist I see many children exhibiting characteristics that present in a way similar to ADHD. These behaviors potentially have underlying sensory causes. Children with low or high thesholds to sensory information react and behave differently in their environments. Children under 6 years old need intervention, however the options presented today do not treat the underlying sensory issues and there are avenues for parents and for children that do not have anything to do with medication and behavioral management. Sensory Modulation Disorder does have treatment and there are clinically proven results.
When our son was 4 1/2 he was diagnosed with ADHD. He had been in the preschool director's office daily for impulsive, disruptive, uncooperative behavior. His hyperactivity was a problem in all parts of his life. Within the first week he began taking Ritalin he could write his name, color a picture, work a puzzle, build with blocks, sit through a meal, participate well in circle time, and play well with others. He was able to participate in church and sport activities. His teacher said he was a joy to have in class. Preschool and kindergarten were very happy years for him. He experienced success, made good friends, and didn't get in trouble at school.
Although in second grade we learned that ADHD was not our son's only issue, it continues to be a primary diagnosis for him at age 17. We are thankful that it was diagnosed when he was 4 1/2, so that he didn't experience constant failure and develop additional negative patterns due to that.
Diane and guests,
Thank you for important work in the field of ADD/ADHD research and education.
Could your guests please address a critical issue in treatment for children with ADHD:
Given that ADHD is a highly heritable condition, a significant number of children with ADHD have parents struggling with adult ADHD. Effective management of childhood ADHD depends, among other things, on providing structure, consistency, and maintaining long term strategies. Parents who have ADHD themselves very often struggle with these very issues, doubling the challenges within a family. Parents often have no oxygen mask to put on first.
Question:
What are your guests' views on treating children's ADHD by also addressing challenges of the parents? Are there programs and/or research about ADHD as a condition shared within families?
Thank you, Ginette
Great topic and Thanks for discussing it. I've two questions.
1) I am interested in hearing about non drug related treatments, are their studies about these treatments and their efficacy?
2) What are the effects of ADHD as the child goes into adulthood, if they use medication initially, will they be dependent of medication for the rest of their lives?
Thanks
VS
To what extent is a child's learning impacted by undiagnosed and/or unmanaged ADHD at an early age? What are other long-term effects of ADHD?
I grew up in the 60's and 70's and none of my friends or people that I knew had any thing like what is described. I have kids who are now in their twenty's and totally normal. They were athletes and academicians Could this be something that the pharmaceutical industry is trying to promote for their gain? I also believe that activity such as sports could help control hyperactivity. What do your guests think?
I don't hear any talk about changing the diet by eliminating sugar, chemicals and processed foods. In Europe this is often the first step, and the results can be dramatic. The pharma companies are feeding US a lot of nonsense.
I don't hear any talk about changing the diet by eliminating sugar, chemicals and processed foods. In Europe this is often the first step, and the results can be dramatic. The pharma companies are feeding US a lot of nonsense.
I would like to know how a lack of adequate and challenging stimulus may factor into an ADD/ADHD diagnosis. When i was younger i was diagnosed with and medicated for ADD. No older and no longer taking medication I have found that my lack of attentiveness often has to do more with not being challenged or stimulated enough. As a young adult in college and now in the workplace I find it hard to focus on mundane tasks but given a challenging problem requiring critical and creative thinking I can be wrapped up in it for hours.
For a parent that is new to this...My 7 year old boy was diagnosed with ADD. What are the steps that I need to take to confirm that this a true diagnosis.
I have an ADHD inattentive 7 year old in special ed who also has expressive & receptive language disorder.. Ritalin did not help and gave him a facial tic that took a while to resolve after medication (Ritalin LA) was stopped. Our doctor recommended Strattera, but we are very concerned about side effects and personality changes -- we adore our creative funny child and would hate to see his personality reced even if there was some improvement in his attention span, which is causing significant learning delays. He is in second grade and struggles to read.
Sleep?
I have read that not getting enough sleep can cause ADHD symptoms. Since everyone in our society (including children are getting less sleep than people did a few decades ago, could that help explain so many children (and adults) having ADHD problems?
Could getting more sleep help children have less ADHD symptoms?
Sue from Maryland
Bruce from North Carolina -
As an adult with ADHD, I have for years managed through a work environment that was challenging, as well as structure, yoga, and more importantly; a very vigorous exercise regimen.
I am curious - now that physical exercise seems to have been taken out of the daily school life - if many of our children today are being diagnosed with "ADHD" simply because they get NO physical activity.
Even my dogs get a little whacky when they have no activity....
In addition, I would take issue with Dr. Gold on a comment she made - "something wrong..." I would suggest it isn't "wrong." It's "different." There are many, many brilliant and successful people who have made significant achievements, and contributions - while living with ADHD.
My daughter is a preemie born at 24 weeks gestation, weighing 14 oz. Because she was born so early she is more at risk getting ADHD. We were getting a great early intervention program in Illinois. Which isn't specifically for ADHD, but it is for her development. My family and I just relocated to Florida. Were the govener just changed the early intervention, we are fighting tooth and nail to get her the help she needs in OT, PT and developmental therapy. My insurance doesn't cover these services. I worry about my daughter and are so frustrated these programs are being taken away to help children.
Thank you so much for doing this show. I am the mother of an 11 year old boy diagnosed with ADHD when he was 7. I always feel judged by the world of ill advised parents who think I either am a bad parent or let him watch too much TV or fed him junk food causing his problems. Or the ones who think medication is an unnecessary step.
Every child is an individual and should be treated accordingly.
One caller, apparently a doctor, made a very important point which was apparently missed. To reiterate: it is necessary to distinguish between hyperactivity and inattention. Sometimes children are erroneously diagnosed with ADHD because then have other problems. Children with vision problems are often often diagnosed with ADHD when in fact they just can't see. True for hearing problems also. I can confirm this from my own practice.
Larry
Psychotherapist in Missouri
I have been a listener of the show for years & have never commented before today. I am a mother of four children two of the four have been diagnosed with ADHD. I really was frustrated with the way you lead the discussion this morning, you did what most people who are uninformed about ADHD, and that is focus on the diagnosing of children who are really just being children with ADHD & the medication risks. Instead of focusing on the positives of what these researchers have developed help in early diagnosis and intervention which means help for children. People talk about how OVER-diagnosis-ed this disorder is and how we are over medicating children. This has lead to creating a climate around an ADHD diagnosis that if you do have a child with ADHD you have to fight everyone just to get the help they need. People are very judgmental and skeptical of even the children that REALLY do need help. Therefore it leaves families like ours frustrated and left feeling abandoned by the public school system. I have found that I know much more about ADHD than many of the "professionals" that are put in place to supposedly help my children. I am amazed that this is the direction you thought was most beneficial for your listeners this morning. I for one thought you could have expanded and help your listeners instead you just fell into the same jargon that has been spread for years. If you have high blood pressure you take medication, if you have a thyroid disorder you take medication, and so on why is it such an issue to get these kids help when they need it without all the judgment of society!!! So you left me very frustrated & disappointed this morning.
I am 32 year old mom of a 6 year old.
Maybe looking more into social and family problems behind ADHD should be considered before putting children on treatments.
We don't know the long term side effects.
Diagnosis is very important but going into drug treatment for such young kids seems very scary to me.
Thanks,
Anna
It is proven by researchers who do not accept financial backing from pharmaceutical companies, and by those whom do, that SSRIs, antipsychotics, and other synthetic heroin and speed medications are ABSOLUTELY UNHEALTHY for children and adults with the APA's creation of ADHD, Bi-Polar, and Major Depression Disorders for children and adults. We must stop allowing America's Drug War to devastate all aspects of our lives and consequently catalyst the American and global decline!
While it is thought that 8% of all kids have said dis-ease, what is the actual percent that are being treated? I feel it is likely far greater than 8%...
I'm a behavioral psychologist with over 20 years experience helping kids, mostly boys, with ADHD. I'm very worried about the new guidelines. In particular, lowering the age to four will cast a large net, and over-diagnoses will increase. As it is, we have no objective criteria to measure or evaluate this disorder, and with rushed manage health care, less time to watch and separate ADHD from many other issues that mimic its symptoms. I've published a book around this very problem "The Way of Boys" Promoting the Social and Emotional Development of Young Boys".
Jonathan from Indianapolis-
As a recovering addict who was diagnosed with ADHD at the age of 6, I would like the guests to discuss the possibility that the drugs prescribed to children for this disorder can be gateway to illicit drug abuse and that these drugs are not a cure-all but must be used with discretion and without behavioral therapy, the effectiveness of the drugs decreases. If you would like for me to weigh in on my experience, call me at (773) 203-8651.
Diane
As a secondary educator, I offered a Program that addressed this particular student population.
These are the students whose parents are chronically left out of the loop as far as the schools are concerned, The average faculty member would rather medicate this population rather than learn how to teach.
I gave my students' parents my phone number and phoned the parents WEEKLY to keep them apprised of their child's progress and academic successes.
Antoinette Augustin
Charlotte, NC
Angela from Birmingham, AL
My husband and my two sons, ages 14 and 11 have ADHD. Both children were diagnosed around 5 years of age. It has been very challenging, dealing with teachers, managing behavior, etc.
However, I want to encourage parents with young children with ADHD to seek support - from doctors, such as child psychologists, family members, support groups, friends, etc. The caregivers really need to get the support they need so that they can be the best caregivers and advocates for their child.
In Dec 2008 issue of Current Issues in Education, an exploratory study by Groswald, Stixrud, Travis & Batch reported that the Use of the Transcendental Meditation technique to significantly reduced stress & anxiety and improved ADHD symptoms and executive function.
The 3 month study, which looked at students from 11-14 years old, found Transcendental Meditation In addition, a study reported in Health and Qualtiy of Life Outcomes in 2009 saw a reduction on negative student behavior, such as absenteeism, suspensions and rule infractions. Other studies showed increased calmness, intelligence, academic performance and self-development, and reduced depression and substance abuse.
Filmmaker David Lynch created a foundation to provide this program for at-risk students, currently working with public school districts nationwide and private middle & high schools in New York City, Washington DC, Atlanta, Detroit, Chicago, Los Angeles, San Francisco and Tucson.