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
Please familiarize yourself with our Code of Conduct and Terms of Use before posting your comments.
My brother started taking Ritalin when he was in elementary school in the early 90's. However, he hasn't taken Ritalin in years and when he tried to join the Navy last Fall he was rejected because his medical history reported that he was previously prescribed Ritalin. What about this medication or its side effects would result in him being rejected from the Navy because of a prescription when he was in grade school?
i would like to know about the link between food allergies and add and adhd. it does exist. my son is living proof of it as well as the success of treating food allergies before medicating.
i sent an mail about this. - susan long island, ny
I love your show today Diane!
I have a daughter who have had a lot of bhavioral issues. She is very active, jumps and run constantly at inapropriate times. She was even suspended from pre school programs for hitting and choking other kids. She also has odd fixations, and sensitivity to sound. I suspect that she may have a nurological disorder but I don' want to medicate her right now atleast until she can concent. Please let me know what types of behavioral programs or other intervention I could try. Would occupation therapy help? How do I get her to a behavioral therapist etc?
I have a 5 year old daughter who does not have an ADHD issue as far as I can see, but she does have hyper moments. Several other parents have commented to me that allowing her to eat food containing red food die causes hyper activity. Can you guests comment on the effect of food dies on behavior in children?
Thank you.
Scott
Are your guests familiar with Ode Magazine's issue of April 2010? The cover article is entitled "Your Brain is a Rain Forest" and raises awareness that "disorders" may be accompanied by positive traits? It's a wonderful article that suggests that we need to be comfortable with our differences!
I am wondering about giving coffee (beginning with very little amounts and increasing if necessary) to children too young to medicate. If parents recognize positive changes in their children's behavior, they might know that a stimulate is helpful.
CHADD is available as a resource for parents of younger ADD diagnosed children--they usually have lists of psychologists skilled in behavioral approaches, whi can train and counsel parents.
I will add though that as the parent of an ADD child, diet, exercise, & behavioral interventions are not enough by the time the child has more autonomy (middle school) and especially as they begin to experience greater academic pressure and peer shunning. ADD children are frequently shunned for their difference, including the fact that parents are crazily managing their behaviors & schedules.
At that point, paradoxically, meds are the route to independence and adult autonomy.
Psychologizing ADD is fine with me... but remember the genetic susceptibility makes these children unusually vulnerable to stressors.
And no, Diane, respectfully sugar does not cause ADD. It can aggravate symptoms slightly.
I am a long time educator in the visual field especially. There has been a lot of discussion in the education field about modern media itself playing a huge role in ADHD & it's pandemic expansion. Put another way, if you look at TV, (Toxic Vivisection), Ads on TV and even computers, Movies, especially previews, you will notice that the mode is of very fast digital frames per second, with a staccato, hypnotic-like effect, boom, boom, always in motion, with loud noise and sound in a continual invasive manner. As a society, we seem to be conditioned to this very fast, disruptive type of visual and audial fabric that it makes you wonder WHY is this a media mode at all.
If you can project your own perception as to a very young person, wide and innocent, receiving such abusive and invasive 'hitting', which travels unfiltered, straight to the optic nerve, it's a wonder that young persons, or adults, for that matter, can have any grounded, wholistic receiving thoughts at all. It's a kind of scrambling of the nervous system, brain, and emotional content. This also leads to a type of addiction to constant stimulations,
via focus on sensation, as well as content being the mode of delivery. This could also a very good way to slip subliminal information into one to whom you want to condition as what to purchase, think, believe. wm. schaaf, gainesville, fl.
For all of your listeners who say they don't know where to go for advice, I would refer them to the school psychologist. As a retired school psychologist, I helped a myriad of parents and students with this disorder. They need to know how to navigate the medical system as well as having someone knowledgeable of the disorder to explain things to them.
Its def a link with food allergies. my son is allergic to dair, wheat, egg, soy. once eliminated from the diet, within 72 hours he was calmer and able to focus and complete a puzzle, draw a picture, sit in the classroom!!
before medication, children should be allergy tested!
I am a pediatrician, a parent of a teenager with attention issues, and I also have some of the features of ADHD(as do many physicians). I do believe there is a role for medications. My child has taken them. I prescribe them.
However, I also reassure my patients and child regularly that this is a personality trait that has both strengths and weaknesses. A world without ADHD would be very organized; but would we have as many inventors, artist, scientist, entrepeneurs.
some of us have trouble paying attention. some have trouble relaxing
some of us have trouble sitting still. some have trouble getting off the couch. Wouldn't the world be boring without the variety.
ADD or ADHD is one of the most over diagnosed personality disorders ever. Methamphetamine causes brain damage and should not be used in children. This is most definitely a behavioral problem in most cases. For those parents who have used meth (Aderol etc...) to treat their children and seen improved academic success, so has every college student who used it to stay up and cram for finals.
My son is 7 now and off ADHD medication for 6 months now. From birth he had trouble sleeping and demanded our time far more than other babies demanded of their parents. At age 5 we began medication. It did calm him down but it also curbed his appetite significantly. We also learned the medication can lead to or trigger other behavioral/mental disorders as he gets older. We found an Occupational Therapist who used music therapy with our son treating underlying sensory processing issues (SPI or SID). This therapy proved to be effective treating his more extreme reactions to environmental stimuli. In the middle of first grade at a public school we chose to transfer him to a private school that focuses on building community through relationship with peers and teachers as well as plenty of time learning through play and interaction with others. As a result we have taken our son off of medication. It went very well but there was a short time we allowed for our son to learn how to listen to his body and regain control. Our son is very intelligent according to both the public school and his current teachers at the private school. He excels in science and can read at a fifth grade level. My opinion is these special, wonderful children can refocus us as parents and maybe a society to the importance of taking time to slow down and focus on the needs of those closest to us.
jjblum,
Have you ever read The Out-of-Sync Child? My daughter was misdiagnosed with ADHD for years and she actually had Sensory Integration Disorder and required specialized Occupational Therapy. The symptoms of the two disorders overlap quite a bit so misdiagnosis is quite common. She made a lot of progress once we had the correct diagnosis.
Good Luck!
Jason from Flint, MI
My grandfather (Dr. John W Streff, O.D.) was a pioneer in vision therapy and through the use of lenses and visual training he was able to help many children with ADD and ADHD. Kids that were once dependent on drugs were able to go completely medication free and live a normal life. It really is an amazing to see the results soon after vision therapy treatment begins. For more information: http://www.add-adhd.org/vision_therapy_FAQ.html
It is truly a shame that there are not more educators out there like you. This has NOT been our experience with our Public School system. We have received very little or basically no help at all.
God Bless you for what you are doing for these families!
My 12-year old daughter is gets As and Bs in school, makes friends, and never gets in reprimanded at school. However, at home sometimes she throws fits when she doesn't get what she wants or when she needs to study and doesn't want to (especially on weekends). She throws things, breaks things, and even hits me, occasionally. She also gets very excited --- "hyper" --- after happy social situations with her peers, such as attending a game out of town, and can't stop moving and talking. A house guest recently described her as a "little bumblebee". Does this sound like ADHD? How do I get her tested? She is not in the public school system, and her Catholic school has no counselor on staff.
I missed a good bit of the show this morning, so hopefully my question/comment will be seen. I was diagnosed with ADHD- Inattentive Type and a LD in Mathematics when I was a senior in college. The revelation that there was actually a medical condition that explained my behaviors was extremely helpful. With medication and modifications to my day to day activities I have been able to graduate from college and excel in my profession. I was wondering if there is, or should be an effort to explain to children with or without ADHD, what exactly ADHD means. I feel that if ADHD had been explained to me earlier in my life, I could have at least asked someone if I exhibited any symptoms.
Thank you for saying what I was thinking! seriously if less sugar & more sleep was the answer don't you think we would have already tried all of that!?!
My son was diagnosed with ADHD last spring. In the years leading up to this diagnosis, we took advantage of a variety of different behavioral modification, diet, relaxation and physical activities to help with his hyperactivity and focus issues. It was ONLY after determining that these non-chemical methods were not the answer did we turn to medication. It was the most difficult and emotional decision we have ever made. However, with much love and much research, we have found a balance using both chemical and non-chemical methods that has helped minimize the "negative" ADHD attributes without taking away any of those "positive" attributes. My son is now focused at school, but retains his charming personality. He is full of exuberance, but is better able to regulate it according to time and place. He can focus on his own work rather than being distracted by other classroom activity. He is off all meds on weekends, holiday and over the summer, as the ONLY reason he is on the meds is for the 6 hours a day he spends in school. All the other methods are utilized when he is not in school, and while that can sometimes challenge the limits of my and my husband's patience, it is the best approach for my son. It is his well-being that comes first. For our family, the difference has been dramatic.
My granddaughter was gifted and we could see behavior differences at early age. She talked at 2 like an adult, she understood concepts behind words. As she developed she voiced how she felt different. She was shy. At preschool she did not like confusion, noise. We noticed sensitivities to environment, touch, and she developed over reactions to what she perceived as dangers. At age 4, she was not able to enjoy a one tent circus for fear the tent would fall on her. Her anxiety grew to anger, biting and pinching herself.
None of this behavior would be exhibited outside the family group. As she got older she knew she had problems concentrating, got frustrated, and was embarrassed by her behavior.
I began reading about ADHD, mental issues, and Bi-Polar children, and Anxiety Disorders in children. Most books say these issues are genetic, many are cross over issues, and there is no one genetic marker, but a combination of many. One interesting thing is that the medications for ADHD are counter indicated in children with Bi-Polar disorder. This can be a problem since it is hard to tell at a young age whether there is just ADHD or a spectrum of issues. The foremost experts on Children with Bi-Polar disorder, Demitri Papolos, M.D. and Janice Papolos, authors of The Bipolar Child, estimate a large percentage of ADHD children are misdiagnosed.
If your child has ADHD and a spectrum of issues, you may want to read the Papolos' book. It addresses ADHD and many crossover issues. My granddaughter sees a psychiatrist, has been diagnosed as high level autism, anxiety and depression, and has been started on medication for anxiety (not ADHD). She is doing 100 percent better, but addressing her issues will be a life long process.
We are looking at over 2,100 kids (18 % !) out of the total school population in Nashua, NH of about 12,000 students, who are now labeled as part of the "special needs" population. MOST apparently are ADD & ADHD labeled.
The ADD and ADHD labeled students also generate HUGE AMOUNTS of Federal dollars for both their parents AND THE SCHOOL SYSTEMS. That can be monthly checks from Uncle Sam of over $600 per month per student! That is the really deep dark secret most are not aware of, and it has become a BIG BUSINESS! It is tens of millions of Federal Dollars paid out all across this country TO these parents and school systems. BUT WHAT ARE WE GETTING FOR THE MONEY?
Is the MONEY being generated by Federal Programs for students with these "attention deficit" issues being used FOR THESE NEEDS or just thrown into the general school budget?
You can't run a business or have a country with 18% of the population labeled as "special needs," in my opinion. Frankly, my view is MANY of this population are being labeled ONLY to get the Federal Dollars, I'm told almost ANYONE can get a Doc to certify a kid as ADD or ADHD. Who among us has not "lost concentration" or been a bit unsettled on any given day in school, or as we live our lives?
So we should put them ALL on "medications"? Big winners here are then drug companies and some Docs. NOT MOST OF THE KIDS! My view is this is mostly JUNK SCIENCE, and mostly about THE FEDERAL MONEY! And if there is some small percentage of students who apparently have real issues, it can not be 18% of the students, who are then "labeled for life!" !
I just don't believe those numbers! Let's start talking about this issue Nationally. Is it the food? Water? Parenting? Genes? Let's have some frank discussions here of the real issues and problems, instead of just medicating kids and grabbing the money! Being PC will NOT EVEN START TO SOLVE THIS PROBLEM!
I am an adult diagnosed with ADHD very late in life. I am very fortunate that my parents did the right things to help me adjust to my different-ness. I am a well adjusted successful adult with a PhD in Bio-medicine and a MS in Electrical Engineering. For me the diagnoses was an ah-ha moment. It helped explain to me why I was so different from everyone else. Many of my co-morbid issues were explained due to the way I thought of myself incorrectly. I thought I should be like everyone else, when in fact I can't be! I am different than most people. An important point in the discussion that I felt was missing, was this. While medication is helpful to control the symptoms of ADHD, it is important to help someone to come to terms with how they are different. I'm not broke and I'm not diseased. I work and think different than most people. It's something I have to learn to deal with and cope. What is needed in addition to medication is the importance on stressing to the children and hopeful the parents as well. That you are different in a similar sense as someone who is color blind, or dyslexic. There is nothing you can't do when you get what you need to help you do it. You work different and you need to adjust to that fact. You are not limited because you have ADHD, you are blessed in a different way than most other people. Learn to deal with your difference and make it work for you. Parent can not stigmatize their children with the thought they are broke, but should help their child learn the positives and nothing can hold them back. Figure out how to stay on task, allow yourself to be distracted but return to point. Find the positive and stress that. "I love how hard you worked on that", "I love how you solve problem", "I love how you didn't accept failure and kept on trying till you got it"
Thank you Dr. Rao for your comment and for suggesting your book “The Ways of Boys”…read the whole previews in Amazon, love it !(already ordered)..I’m really in tune with your perspective of the “rushing to diagnose” society we all are part of .My son is taking Adheral , 20mm,hasn’t been effective ,just got prescribed with 40 a day(twice a day) . I’m having a hard time looking at him getting immerse in a serious world he is part of all by himself , while he is social with others but we see differences in the way he try to control his environment getting to be kind of a” bully” himself(I think you touch this point in the book, I can’t wait to read it). His enthusiasm is not the same, we know he is 13 and changing but we want to explore other alternatives .I think your book will help us to educate better and to know the size of our enemy, because I think we are fitting against a huge system that goes beyond the medical business and has been getting into our life, getting us in moments against a child that is just developing and looking for mental strategies to grow having their own parents as his very opponents , just because he does not “fit” in the little square we got from the same square, I mean the system.I would like to talk to you further.My phone number: 704-606-7299..I have some Q for you.Thank you
I am a Special Education teacher , I work with many autistic
and ADHD children. It pains me to see what these students are sent with, to eat everyday. These Sp Ed students are eating processed foods filled with preservatives, food coloring and trans fats. Our school, "The Open Classroom" has an award winning lunch program run by our amazing parents. They have the option to eat our amazing healthful lunch but continue to eat the garbage. When will these parents be advocates for the children's
health?
Why are your guests continuing to refer to it as an illness? Why not a condition?
As a speech-language pathologist I've seen both the positive and negatives for treating children with medications such as Ritalyn. I'm always concerned about the side-effects. Recently I saw on a morning show mother who instead of the medication, gives her son coffee - 1/2 cup twice daily. Reportedly she and many others have found that this to be is very effective alternative to drugs. I for one would prefer this alternative.
There IS widely available help for parents of toddlers struggling with behavior issues! Early Intervention is funded nationwide through the federal govt. and each state administers programs in every county of the country. We (I work at the South East Utah Early Intervention program in rural Utah) work in the homes of children ages birth-three who are struggling with developmental issues of all sorts. We meet weekly with the family, and the goal is to educate the parents on what may be going on and how they
can help. We interview the family carefully to help problem-solve what may be going on. We have seen great success with teaching parents to reduce overstimulation, teaching the child to calm and focus, as early as eighteen months. No medicine is usually needed! You can usually find an Early Intervention Program by calling your local health dept or school district.
As a former educator, my belief is that there are risks both to taking medication for ADHD and to NOT taking medication, especially for success in school. (The requirements at school are all the things difficult for ADHD children: sitting still a lot, attentiveness, focusing, self-control, etc.) Just like in treatments for other conditions, one must weigh both sides and determine what is best for the individual child. Behavioral intervention MUST always accompany medication. And it is appropriate for schools to do accommodations for these children.
L.C. Mitchell
Arizona
There is a national organization CHADD which is very helpful in terms of resources and information.
I feel it has been helpful to me as a recently diagnosed 54 year old, to have this identified as an illness (or condition) and not just "a lack of 'applying' myself.