Thursday, August 16, 2012

Medicating children for ADHD too rash?

http://timeopinions.files.wordpress.com/2012/02/a6229-000044.jpg?w=290&h=193&crop=1
Attention deficit hyperactivity disorder, (ADHD) is one of the most common childhood disorders and can continue through to adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity. There are so many controversies from all over the world about every aspect of the disorder ranging from the symptoms to the type of treatment including medication or interventions, and some even question the genuine existence of the disorder. I, myself, don't doubt that there is a disorder but I think that there are some valid points in the social construction theories. Psychiatrists Peter Breggin and Sami Timimi oppose pathologizing the symptoms of ADHD. Sami Timimi, who is an NHS child and adolescent psychiatrist, explains ADHD as a social construct rather than an objective 'disorder'. I think there are many alternatives to medicating children and their under developed minds.The most common medication used on children are stimulants that are supposed to calm the child down. These stimulant medications come in different forms, such as a pill, capsule, liquid, or skin patch. Some medications also come in short-acting, long-acting, or extended release varieties. The most commonly reported side effects are decreased appetite, sleep problems, anxiety, and irritability. Some children also report mild stomachaches or headaches. Most side effects are minor and disappear over time or if the dosage level is lowered. According to several reports, long-term stimulant use can slow physical growth by 1.2 cm per year and slightly increase blood pressure and heart rate. Stimulant use among preschool children is greater in the US than anywhere else: 0.44% of preschoolers in the US are prescribed stimulants, compared with 0.05% of preschoolers in the Netherlands, 0.02% of preschoolers in Germany, and 0% of preschoolers in the UK. In conclusion to these statistics, I can't help but wonder if the initial causes of some cases of ADHD are bigger than just one child's home or school life, it extends to the habits and developmental stages the children are raised into in America. Could it really be all the stimulating technology and easy conveniences we have as Americans that influences children's behavioral mishaps? Children these days are glued to their game systems, hand held games, and also a lot more television because of the lack of imagination and parents lack to stimulate the imagination and create an assertive, controlled environment for children. It is said that teachers are in a lot of cases the first one to consider if a child has ADHD by how that child behaves during school. Well could it be possible that the teachers handle so many children that their idea of what a "normal behavior pattern" could be too narrow cut? I think so. Anthropologist Sara Harkness cited studies she and child psychologist Charles Super have conducted comparing Dutch and American parenting styles: "The Dutch parents we studied were very closely attuned to their children's state of arousal and self-regulation, making sure that the child got plenty of sleep and that the environment was not overly stimulating. For Dutch parents, this was just a normal aspect of good parenting, whereas for American parents this approach might seem somewhat extreme, called for only when the child is really out of control."
What can parents do for their children as an alternative to medication?
Parents should keep a close watch on the child and could start by changing and monitoring the sleeping and eating habits to see if that brings about a change. The next step should be classroom intervention where the child works with both their teachers and parents for extra help before resorting to different medications.




Works Cited:

The National Institute of Mental Health (NIMH) is part of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services
http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/how-is-adhd-treated.shtml

Social construct theory of ADHD
From Wikipedia, the free encyclopedia
28 July 2012 at 02:22


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2637252/?tool=pmcentrez

Diagnosis and treatment of Attention Deficit Hyperactivity Disorder
NIH Consens Statement. 1998 Nov 16-18
http://www.ncbi.nlm.nih.gov/pubmed/10868163

Attention-deficit/hyperactivity disorder: A selected overview
Department of Pediatric Psychopharmacology Research, Massachusetts General Hospital, Harvard Medical School
http://www.ncbi.nlm.nih.gov/pubmed/15949990







Wednesday, August 1, 2012

Misdiagnosis of ADHD in children?


My attention and curiosity heightened about the back and forth controversy about Attention Deficit Hyperactivity Disorder, or ADHD, when i sat down to see a bigger picture and thought about how many children i know, evan in my own family, that are diagnosed and are medicated for this disorder. My nine year old niece is on medication for ADHD and i can recall so many instances when she has cried to to me that she doesn't like how her medicine makes her feel and she doesn't believe she needs it and also that people around her, mostly her older sister, uses her medicine as a sort of hurtful attack against her when she does something wrong. At the time, i just didn't understand enough about the disorder to understand exactly what the facts were.

Picture from saypeople.c
I started researching this topic and have found that the amount of children who are diagnosed for ADHD have massively increased from 4.4 million in 2002, to 5 million in 2010, according to a report by the Food and Drug Administration. In addition to this, i found many debates over if the diagnosis inclination is due to the rate of misdiagnosis which has been re-analyzed as sleep disorders such as insomnia, sleep terrors, nightmares, bruxism and snoring. These disorders have some very identical symptoms as ADHD such as inattention, hyperactivity, and behavioral problems, that overlap and lead to misdiagnosis of the disorder according to principal investigator Susan Shur-Fen Gau, MD, PhD, associate professor at the College of Medicine and Public Health, National Taiwan University. In reference to this, it's clear to me that mental health professionals that are conducting tests to diagnose children's problems should be more thorough and first be able to question other possible factors causing the child's symptoms, like sleep disorders, before jumping the gun by concluding ADHD. 

Another questionable factor of ADHD diagnosis is that in a report from The American Academy of 
Pediatrics, it has been decided that children can now be diagnosed with ADHD at the young age of four. Controversies about whether four is too young of an age for diagnosis or not and if it can even be considered a valid one for the underdeveloped mind and behaviors of the child, have parents, teachers, and others questioning if their children can possibly just be experiencing more than normal levels of hyper-activeness but are just acting as children. There could be numerous other reasonable factors manipulating children's actions such as diet, sleep, exercise, home life, etc. that can be mediated without medication or a label that could make a child feel inferior to other children and siblings. Dr. Claudia Gold, a pediatrician and child mental health, expert is concerned that they will lead to more over diagnosis and over-medication in the preschool group. "Once there’s the question of ADHD rather than the question 'What’s going on for this child?' already you’ve narrowed your thinking," Dr. Claudia Gold said. "If you just look at what are the symptoms and what is the label, you miss a lot. But that is the standard of care, that’s how it works, which is how kids get all those labels," Dr. Claudia Gold also stated. I found an interesting blog article written by Dr. Jay S. Winston who was diagnosed as a child and was told he needed to be medicated on Ritalin which he objected to and in turn did not take the medication, but wrote about his perception and conclusion about over diagnosing and falsely diagnosing ADHD. Here is a piece from his blog: "Do I sound like a learning-disabled person? Or might it be that I was struggling with an educational system which itself has a severe disability in terms of understanding that some minds work differently than others and allowing those minds room to flower? Alas, from what I hear, things have only gotten worse since I left high school, and any hope for change has been positively knee-capped by “No Child Left Behind.” Can there be any doubt that, as reliance on standardized testing continues to grow, the attention deficit epidemic and resulting drugging of America's youth will as well?" This is just one persons ideas and side of the issue and there are many stories on the opposite side praising the doctors for medicating their children to fix them.



For more information on ADHD and what it is check out this website: www.tappmedical.com 


Work Cited:
  
American Academy of Sleep Medicine
"ADHD Linked To Sleep Problems In Adolescents" ScienceDaily
Retrieved August 1, 2012, from http://www.sciencedaily.com­ /releases/2009/05/090501090914.html
 (2009, May 6)

Susan Shur-Fen Gau, Huey-Ling Chiang. Sleep Problems and Disorders among Adolescents with Persistent and Subthreshold Attention-deficit/Hyperactivity Disorder
May 1, 2009

Leslie Wade - CNN Medical Producer 
http://thechart.blogs.cnn.com/2012/06/18/kids-taking-fewer-antibiotics-more-adhd-meds/?iref=allsearch
June 18th, 2012
07:45 AM ET

 Elizabeth Landau - CNN.com Health Writer/Producer
"Kids as young as 4 can have ADHD"
 http://thechart.blogs.cnn.com/2011/10/16/kids-as-young-as-4-can-have-adhd/?iref=allsearch
 October 16th, 2011
12:01 AM ET 


Paul J. Frick Department of Psychology, University of New Orleans
Persephanie Silverthorn Department of Psychology, University of New Orleans
"Psychopathology in Children"
 http://www.credoreference.com.hrt-proxy.libraries.vsc.edu/entry.do?id=10692092
© 2004 Springer Science+Business Media, Inc

essay by Dr. Jay S. Winston
My Mind on Drugs - an ADHD
ADHD and More
http://adhdandmore.blogspot.com/2009/02/my-mind-on-drugs-adhd-essay-by-dr-jay.html#links
February 12, 2009 
 
Image of table used from saypeople.com