Pills vs. Talking (Dad may be charged for taking son off Ritalin)

[RamboLiberal]

http://abcnews.go.com/sections/Living/US/mental_illness_treatment_kids_040607-1.html

When Chad Taylor noticed his son was apparently experiencing serious side effects from Ritalin prescribed for attention deficit hyperactivity disorder, he decided to take the boy off the medication. Now, he says he may be accused of child abuse.

In February, 12-year-old Daniel began displaying some symptoms that his father suspected were related to the use of Ritalin.

"He was losing weight, wasn't sleeping, wasn't eating," Taylor told ABC News affiliate KOAT-TV in New Mexico. " just wasn't Daniel."

So Taylor took Daniel off Ritalin, against his doctor's wishes. And though Taylor noticed Daniel was sleeping better and his appetite had returned, his teachers complained about the return of his disruptive behavior. Daniel seemed unable to sit still and was inattentive. His teachers ultimately learned that he was no longer taking Ritalin.

School officials reported Daniel's parents to New Mexico's Department of Children, Youth and Families.Then a detective and social worker made a home visit.

[Name removed]

1. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Ilsa]

2. Good god. Charging child abuse

for looking after his son's best interests? Would they have also charged him when he died from malnutrition? What a lose-lose situation for a parent.

And the disruptive behavior just isn't at school. It continues on at home, so I'm sure it would have been easier for the parent to keep him on the drug.

On edit: the doctor should have offered some alternative medication if he thought it was in the child's best interest to keep him on an ADD med. Is the state going to force parents to pay for some of these drugs? They can get very expensive. My son's twice-day dosing of strattera runs $200 a month.

[Jackpine Radical]

4. Or an alternative TREATMENT such as neurotherapy,

which doesn't involve drugs.

[juajen]

21. That's expensive

My grandson is on concerta. It is only $90 a month and we love it. Why is straterra so expensive?

[Ilsa]

23. Concerta is methylphenidate, same as Ritalin,

maybe longer lasting. My son has tried several stimulant drugs and none worked for him: lost appetite, no sleep, irritability, etc. worse than the ADD and hyperactivity which has been labelled as pretty severe.

Strattera is a nonstimulant anti-ADD drug. It is relatively new and the only one in its class if I'm not mistaken. That's why it is so expensive. Also, my son takes two different doses each day, which may be why his meds are more than your grandson's.

[Jackpine Radical]

44. So why not neurotherapy?

It usually works, it's a one-time cost for a course of treatment, there are no adverse side effects, and the child is off the drugs for life.

[Ilsa]

47. Where can I get that?

I don't know of anyone offering it. I'm in texas and live in the sticks. (Can't change that right now.) Also, how much does it cost? Does insurance ever cover it?

How does this therapy affect the neurotransmitters in the brain or affect their levels in the synapses? Is it selected transmitters? Also, have they been able to do this with children who are only partially (or minimally) verbal like my son?

[Jackpine Radical]

70. Where can you find a neurotherapy provider? Here's how:

A good place to start is with www.bcia.org , who have a list of certified providers on their website. Also EEG Spectrum has a list of people they've trained, and www.isnr.org wold have a list of their members who are providers.

Insurance may or may not cover the treatment. There have been studies demonstrating the effectiveness of the method, but insurance companies are often under the collective thumb of Big Pharma, and Big Pharma hates neurofeedback. Treatment may involve from 20 to 50 or more sessions, but the sessions may be short. Many practitioners will work with you on a sliding scale.

The treatment can be administered to minimally verbal clients, and has been used successfully in treating autism-spectrum disorders. The feedback can be given in a very gamelike, very visual and intuitive was so that not much verbal instruction has to occur.

Re: neurotransmitters & all that--what actually happesn in the training is that various areas of the brain are taught to normalize their activity levels. Cortical areas are selected for treatment based on their function & on observed EEG activity rather than by neurotransmitter type, but the end result is much the same. For example, the frontal areas tend to have a lot of serotonergic and dopaminergic neurons, and that is a common general area for EEG training. One reason that meds cause unwanted side effects is that they affect neurons of a given neurotransmitter type in areas of the brain that serve some untelated function and are uninvolved in the problem you're trying to treat. That doesn't happen with neurofeedback.

If you have further questions, please PM me & I'll do what I can to help.

[drdtroit]

50. You need to take your child

off of those drugs. The whole ADD and subsequent drug prescription matter is just ridiculous.
It is a known fact that most geniuses and creative minds are tilted toward ADD (whatever that cop out label is supposed to mean). I prefer to think of it as an aggravated brain.
Peace Out

[HuckleB]

53. It's a known fact?

Please show us what studies prove this "fact."

Thank you.

[Gildor Inglorion]

3. Interesting about ADHD....

it seems to be a brand-new phenomenon. There was no such thing when I was in elementary school. And, no, our teachers were not evil monsters. We just knew to behave ourselves and not be disruptive. It saddens me to think of a generation of zombie-like children staring blankly at their teachers because they're all drugged. Surely there's a better way to impart discipline than this "better living through chemistry" s***. On the other hand, I have no children and I'm not a teacher, so I really have no dog in this fight.

[Jacobin]

5. Interesting studies in formative stages blame

excessive TV viewing.

Lots of anecdotal evidence for it. Kinda makes sense. TV bounces around and trains your brain to have NO patience and constant need for action/violence.

[HuckleB]

33. More study is definitely needed on the environmental factors at play.

Even educational programming uses the bounce around method to teach kids. Top the TV with computer games, a lack of sitting down to read and write, and any number of other factors in our "entertain me" society, and one does wonder if the increase in ADHD is largely environmental. Are our kids brains being "programmed" to develop in a way that precludes long-term concentration by living in environments from the beginning where no long-term concentration is ever needed or developed?

It's definitely something that needs more investigation.

Good point.

[Ilsa]

42. Inadequate sleep is another problem that makes it worse.

Anyone with little children has probably observed that if they don't get enough rest, they tend to get hyperactive. That's why the first step in controlling ADD/ADHD is to work towards getting better sleep. So the first meds are usually off-label uses of drugs (like anti-hypertensives) as mild sedatives (Clonidine or Tenex) to see if that helps.

[Ilsa]

6. Sorry to tell you this, but there

really is hyperactivity and ADD. Some kids respond well to dietary changes, some do not. My son has both as part of his autism spectrum disorder. He has autism and ADD and Hyperactivity, all of which requirement treatment.

Maybe when you went to school children with disabilities were not there because IDEA did not exist?

[KittyWampus]

9. Graduated High School In 1980. Not Only Was There No ADD

there were no kids highly allergic to this, that and the other thing.

Well, maybe a few kids who were allergic to bee stings or had hay fever.

Maybe one or two had asthma.

I think the toxins (this includes television) in our environment are beginning to effect our children's health.

[HuckleB]

25. Uh huh.

Sorry, but that's simply not true. You just didn't know.

[proud2BlibKansan]

38. I agree

I started teaching in 1980. ADD kids have been around for a long time.

I remember really hyper kids when I was in elementary school in the 1960s.

[KittyWampus]

41. Then Why Didn't I Notice The Behavior From Fellow Students?

neither did either of my parents who were both teachers 30+ years on Long Island.

My father says there may have been the occassional problem kid... but for a long time, they didn't seperate out the "special" kids or the "gifted" kids.

Dad taught them all together. Gifted kids did extra work, helped in office, graded papers and tutored slow ones.

Slower learners or problem kids got special attention from their peers.

[HuckleB]

51. Yeah, sure, you betcha.

Why did the rest of us notice them?

Why did the studies notice them?

Why were they separated to other schools?

Sorry, your story doesn't match history.

[trixie]

27. Oh, I beg to differ..

I have been a librarian in many different cities with different economic neighborhoods. My unscientific findings are that it is strange that only middle class and upper middle class children are diagnosed. Could it be that those are the ones whose parents have health insurance and/or could afford the drug. It was funny to note that school districts with hard nosed diagnosis were also the ones doing business with the drug companies. You do know that schools gets kickbacks (put in a nicer way of course) from drug companies doing business in their districts.

When I worked in an economic deflated area the kids diagnosed were extremely minute. Probably the indicitive number of true add/adhd. I worked in a very wealthy area and viola.....lots and lots of kids diagnosed and medicated through the schools. How very strange.

[HuckleB]

35. Huh?

I'm not sure where you came up with an assessment that only middle- and upper-class kids are diagnosed, but that's sure not my experience.

Also, could you pass on an article from a legitimate source regarding these purported kickbacks to school districts from drug companies? Thanks.

[Ilsa]

40. I do know there are alot of people

who think they ought to be in the business of telling a parent whether or not their child should be medicated based on anecdotal information. It's tiresome to hear about such advice when they aren't the ones living with the child, seeing the differences drugs can make, etc.

Of course there is the potential for abuse. But who is going to be the one to tell another person "It's you that's unnecessarily using this drug." Everything is on a case by case basis, and while I appreciate the input of my son's teachers, it between my husband and me and my son's doctors.

Another possibility: I have read where adults with ADD can be very driven and effective on their jobs if they can overcome the difficulties with focusing, and use their hyperactivity for the benefit of more energetic work, leading to greater opportunity for promotion and success. If ADD/ADHD has a genetic component, perhaps that is one reason they are more prevalent in wealthier areas: they are the children of successful adults with ADHD. It's a possibility for a small sector of those kids that cannot be dismissed.

Geez, I wish my kids' school could get some of that money from a drug company. Our schools are desperately needing other sources of funding.

[jayfish]

7. Oh, Yes You Do Have A Dog In This Fight.

It's you. If they can force parents to force their children to take mood altering drugs to prevent disruptive behavior, how long until they make you take them as well. "Look beyond what you see..."- Rafiki

Jay

[Beatrix]

8. Uhhh they already do

Ever been to a mental hospital? Go tell a doctor you are hearing voices that tell you to go kill people and you are thinking about listenting to them. The state will have you on anti-psyc meds pretty damn fast whether you like it or not. (thank god) That's been the case in this country for the past 50 years.

[el_gato]

13. oranges and apples

this kid was squirming in his chair just like all kids do

[jayfish]

15. Dementia Is A Wee Bit Different Than "Disruptive Behavior"

Dementia being objective and "disruptive behavior" being subjective in nature. Also, while the state may prescribe medications, I'm not sure (and I'm sure someone will correct me if I'm wrong) they can force you take them with out committing you or "proving" that you are a danger to yourself or others, hence you would probably be committed anyway.

Jay

[Beatrix]

20. Well I've been to a hospital actually

Yes, you have to be comitted. Also - there is NO burden of proof. If a single doctor says you are a risk to your self or others then that's it. A doctor can get a court order to committ you in a matter of hours. You have the right to a hearing, but by the time it's scheduled you'll have been on a med for a long time.

[shanti]

10. just because it wasn't named back then

doesn't mean it wasn't around. compare this to the current catholic priest "thing", and you get the idea.

[el_gato]

12. that doesn't mean it existed either

and couple this with the fact that the pharmaceutical companies are making billions and you get an even better idea

[struggle4progress]

16. Teacher can't cope with the kid? Call the kid ADHD!

[Eurobabe]

30. ADD and ADHD are a joke, parents check your kids thyroids!

there is recent medical literature that suggests many LDs may be thyroid related. Doctors just don't seem to check this.

[HuckleB]

32. Umm.

I don't know any practitioner who would prescribe a psychotropic before checking thyroid levels. If you run into those who don't, run away as fast as you can. Checking them prior to prescribing is standard procedure.

[HarveyBriggs]

11. Didn't Lucas Make a Film About This? THX 1138

The government forced people to take drugs in order to be docile.

Jeez, Brave New World we live in, huh?

Harvey

[GreenArrow]

62. skip the 722

[UpInArms]

14. most disturbing from this article

Taylor is among many parents facing a dilemma over whether to medicate children who suffer from mental disorders. A recent study by Express Scripts Inc., a medical benefits management company, found antidepressant use increased 49 percent among consumers younger than 18 between 1998 and 2002. Preschoolers up to age 5, the study found, were the fastest-growing users of prescription antidepressants.

preschoolers up to 5??????

:wtf:

[Eurobabe]

31. this REALLY pisses me off

why are we tampering with brain chemicals that we really have no flipping clue about? and using children as guinea pigs?

you watch, I guarantee within the next 2-3 yrs. there is going to be a huge backlash against the anti-depressant pushers, the most vile offenders, pushing pills on the young.

[Jackpine Radical]

17. Have a look at these 2 papers:

Attention Deficit Hyperactivity, Disorder:
Neurological Basis and Treatment Alternatives

Arreed Barabasz and Marianne Barabasz

Recent research indicates a neurological basis for attention deficit disorder, specifically, right frontal lobe dysfunction. Traditional treatments for ADD/ADHD, such as stimulant drugs, behavior modification, and cognitive-behavior therapy have had limited, short-term success and many drawbacks. Neurotherapy (or EEG feedback) which addresses the frontal lobe dysfunction, has shown significant, long-term results, by teaching patients to normalize their brainwave responses to stimuli. When Instantaneous Neuronal Activation Procedure (INAP) is used in adjunct to neurotherapy, treatment time is significantly reduced without losing long-term effects of the therapy. INAP was developed on the basis of research on hypnotic phenomena.

Attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) are characterized by the inability to self-regulate focused attention. Children with hyperactivity are impulsive and behaviorally disinhibited. The condition is developmentally disabling which, if left uncontrolled persists into adolescence and adulthood. This biologically based behavioral disability has a pervasive negative impact on a wide range of adaptive functioning. Although under diagnosed in the past, such is not the case today. Diagnoses are on the rise as public awareness increases. "Its ADHD's time in the sun and they are getting it" (Edwards, 1995, P.44).

http://www.snr-jnt.org/journalnt/jnt(1-1)1.html




A Comparison of EEG Biofeedback and Psychostimulants
in Treating Attention Deficit/Hyperactivity Disorders

Thomas R. Rossiter and Theodore J. La Vaque


The study compared treatment programs with EEG biofeedback or stimulants as their primary components. An EEG group (EEG) was matched with a stimulant group (MED) by age, IQ, gender and diagnosis. The Test of Variables of Attention (TOVA) was administered pre and post treatment. EEG and MED groups improved (p < .05) on measures of inattention, impulsivity, information processing, and variability, but did not differ (p > 0.3) on TOVA change scores. The EEG biofeedback program is an effective alternative to stimulants and may be the treatment of choice when medication is ineffective, has side effects, or compliance is a problem.


http://www.snr-jnt.org/journalnt/jnt(1-1)7.html

[Mnemosyne]

18. this child should be checked for mercury poisoning etc.

We have all been poisoned to one extent or another by mercury in the environment. Until several years ago thimerasol {a mercury based preservative} was used in most vaccines. Also anyone vaccinated in the 50's or early 60's may have also been exposed to sv-40, simian virus, used to manufacture polio vaccine and causing many to later develop cancers.
Anyone with "silver" fillings in their teeth has been misled and poisoned to some extent, 50% mercury, 35% silver, 15% other. The ADA claims no danger, but it is sent to dental offices as hazardous material and is disposed of as hazardous waste.
I have been being treated as a psychiatric patient since I was 13, I'm 46 now, and have recently been diagnosed with severe mercury poisoning. It causes many psychiatric symptoms and has come close to killing me, endocrine system is failing.
Mercury is second in toxicity only to plutonium on this Earth.

[LizW]

19. sigh

This sounds horribly familiar. We've been resisting medicating our son for about two years now. No one has threatened us or reported us to any agency, but there's just this subtle disapproval.

I have no bone to pick with parents who do choose medication. Every child is different and every case is different. But I am not convinced it is the best thing for my child at this point.

We're probably not coming under as much pressure as other parents do because our child doesn't have hyperactivity. He has the form of ADD that makes it hard for him to get focused on a task, but once he does, he's super-focused and it's then hard to get him off that and transitioned to something else. He NEVER hears instructions the first time, because his brain is always still deeply involved with the previous task. When he was a toddler, I was absolutely convinced that he had hearing loss until every test came back normal. Every year when we change teachers, they think this too, until I show them that he's tested normal.

As long as my child is succeeding in school (and he is, he made A's and B's this year) I intend to resist medicating. You all may see me in jail soon, if this is the way of the future.

[Ilsa]

22. It's the parents', not the govt's, or the school's decision.

My god, I don't know what we'd do without my son's meds, or if someone came along and said we were abusing him by medicating him or not medicating him. He couldn't focus long enough to make it to the toilet before we put him on Strattera. His finally getting potty-trained at age six relieved me of big burden and his attention span at school increased significantly. We tried every behavior management solution we could find before starting him on drugs.

And the next poster will say, well, your child has autism, that's different. Frankly, I don't think it's any different than the problems other parents have faced if they've tried every other course available to them. For all we know, many of these diagnoses could be related. Not everything is a discipline problem. Yes, maybe these things were caused by environmental problems and we need to clean up the environment, but finding the cause doesn't always mean you have a solution if permanent damage has been done. Therefore, we still need the meds.

As for the labs and doctors that do the testing for environmental contamination, I've heard plenty about them and their greed as well. That testing doesn't come cheap and it's not all confirmed as being sound.

[damnraddem]

24. Ritilin works for some ADHD kids, not for others.

Parents should keep on top of it all and make the decision -- and they should be supported in their decisions.

[tom_paine]

26. Jesus Christ, and the Sovietization of Amerika continues

How much longer until enforced medication awaits us, indeed!

Stuff like this, which admittedly is sort of a Leftist Ideal, this trust the psychologists to medicate our troubles away, makes me wonder if ANYTHING can stop the Sovietization of Amerika.

[Cronus Protagonist]

28. If I had a child, he wouldn't have been on Ritalin from day one

I would never submit any child of mine to that drug or any other behaviour or mind altering drugs from pharmaceutical companies in the first place.

I'm glad the man is standing up for his child now, and I commend his courage. I also wish he had done so at the beginning and never allowed the "diagnosis" in the first place.

Did I mention that I think ADD an ADHD and all the new "variants" are about as real as Unicorns? (yes, I've read a lot of research on the topic)

Click here for "BLAME BUSH FIRST", and other fair and balanced yet stunning buttons, magnets and stickers

[HuckleB]

29. Yeah! Yeah! Yeah! Yeah! Yeah! Yeah!

Just because a med is overprescribed due to a completely messed up health care system that limits the abilities of practitioners from getting to the bottom line diagnosis doesn't mean there's ever anything wrong with the brain. No way, man. The brain is perfect in everyone. Always. And don't believe that crap about mental retardation. Those kids are just plain lazy! Oh, and people with autism are just anti-social! It's all an excuse!

[proud2BlibKansan]

37. Spend just one weekend with an ADHD kid

and you will be begging for a way to calm the kid down.x(

[Beaverhausen]

34. Follow the Money - eom

[HuckleB]

36. High-tech tools focus on ADHD

High-tech tools focus on ADHD

http://www.newsday.com/news/health/ny-dshealth3825685jun01,0,1338326.story?coll=ny-health-big-pix

The 9-year-old girl stares at a bird on a computer screen and focuses hard to make it fly. As her attention locks onto the bird, it wings its way across the screen, going higher and higher. When the bird slows or drops a few inches, the psychologist at her side makes her aware that she is tapping her hand and fidgeting. When she stops moving, she regains her focus on the bird and it soars once again.

Kenneth Kaufman, a psychologist at the Institute for Behavioral Health, a private practice in Commack, is banking on this new technology to help patients with attention and behavior problems learn to focus and complete a task. The program, called Play Attention, is new technology based on work by NASA scientists to help astronauts strengthen attention span. It comes with hardware and software that allow the client, who wears a helmet lined with electrodes that record brain waves, to move objects on the screen with only the mind's eye. Better focusing completes the task faster.

Studying the technology

Several small studies in Germany and Italy, as well as at an attention deficit hyperactivity disorder clinic in Endicott upstate, have tested the technology, called EEG neurofeedback. The studies have shown it was as effective as ADHD drugs in reducing symptoms of inattention and impulsivity. But some ADHD experts say these studies test people waiting for nondrug treatments who are predisposed to want the technology to work. They say more rigorous studies are needed.

While such studies are under way, companies have started selling machines that record and analyze brain waves to help verify a diagnosis of ADHD. The quantitative electroencephalograph (Q-EEG) produced is based on findings from 2,600 people with and without ADHD."

[Jackpine Radical]

45. Thanks for posting this.

Also see my post above for other research besides what's reported here.

And QEEGs are often (usually) not necessary before beginning the treatment. Check out BCIA (Biofeedback Certification Inst. of America; www.bcia.org ) for a list of providers.

[stevedeshazer]

39. You anti-ADD people sound like a bunch of freepers.

ADD and ADHD is for real. My kid is gifted, has been tested with ADD.

No, it's not a drug company conspiracy. He takes Adderal, which generically is good old-fashioned amphetamine.

You all sound like the teachers in his high school, who just think he is lazy, stupid, or crazy.

Learn about it, then come back and talk about it. :grr:

[KTM]

43. I wont disagree that it is real

In fact, I think it has probably been around for a very, very long time. I do think, however, that out society has become more and more willing to label a normal (albeit different) function of the body as an illness, and all too eager to medicate. Countless people made it through life just fine - often quite well - without medicating for mental issues.

I spent some time working in the psychology ward of a hospital, doing medical transcription. I was very suprised at how non-scientific the presciption of these drugs seemed - diagnoses were made, prescriptions issued... after a period of time, the doctor would decide the dose was too low, or too high, or perhaps should be switched to another drug, or try two at once... it was quite subjective, based on the reaction of the patient.

I also have a psychologist as a parent, and have discussed this topic extensively, so dont think I dont understand - I just disagree. I'll aways be dumfounded at how they can blast me for smoking pot or drinking - self-medicating, chemically altering my mind... bad, bad, bad... and then not three sentences later say "You really ought to consider xxx (pharmaceutical)"

Personally, I trust nature much more than the good folks at Eli Lily.

In this guys case, I think he has every right to not medicate his child - the "illness" is not life threatening, and the child is not in danger or a danger to others - just annoying, perhaps, and more challenging to teach - but the school and state have no business forcing a parent to medicate their children.

[stevedeshazer]

46. Can't disagree with that

Thanks for a well thought-out response.

[4morewars]

64. Good old-fashioned amphetamine ???

are you on good old-fashioned crack ???
:wtf:

[HuckleB]

66. Dexedrine and methylphenidate.

The mainline, most effective treatments could certainly be given the euphemism "good old-fashioned amphetamine."

[Kinkistyle]

48. Isn't our President the poster-boy for ADHD

I mean he definitely has an Attention-Deficit to go along with the Budget-Deficit.

[pinerow]

49. Cognitive Behavioral Therapy...

covered by most insurance companies, the only downside is that the parents actually have to take a proactive role in raising their children. Proactive does not necessarily mean taking little Johnny or Mary to soccer practice or little league. Proactive parents take an everyday interest in the activities of their children. How about slowing them down a bit...I mean do they really have to have every minute of their day programmed with play-dates and endless fund-raising for their schools. If the shoe fits, everyone of you who voted down a school bond issue or a half cent sales tax to properly fund your schools., wear it. seems like Americans are constantly looking for that little pill that Grace Slick sang about so many years ago.

[HuckleB]

52. CBT helps many, but I've seen no study of efficacy regarding it and ADHD.

And, yes, with anything, the family must adjust as well. That's a big part of the problem for many kids.

[pinerow]

54. Search..there is no easy way to become informed.

For too many Ritalin and its' cousins have been prescribed by non-professionals. A child is disruptive, teacher tells parent your child must have ADD or ADHD; said child is then taken to a pediatrician, who is not a Mental Health professional, and that pediatrician prescribes said meds. Thus we begin another cycle of dope fiends. Those children we were giving Ritalin to ten years ago are now selling their Ritalin to their high school mates, and they are crushing them up and snorting them....

[HuckleB]

56. Sorry, I've searched.

I read the literature daily. I don't believe any such study exists. If you do, please show us.

Thank you.

[pinerow]

60. Here are a few places you may wish to begin with...

http://www.remedyfind.com/hc-ADD-ADHD.asp

http://www.additudemag.com/selfhelp.asp?DEPT_NO=407&SUB_NO=3

http://www.adda-sr.org/BehaviorManagementIndex.htm

http://www.adda-sr.org/

http://www.handle.org/

http://www.addchoices.com/

http://www.addresource.com/catsearch.adhd?category=11&sub=1&name=Coaches

[HuckleB]

61. Is there even one study that shows CBT efficacy with ADHD?

It's a simple question.

Again, I am inundated with the literature. I've yet to see a study.

Is there one? If so, please give a reference. I can go to the library if it's not available online.

[pinerow]

63. Here are some...lets' remember nothing is 100%

Research and Clinical Practice Has Shown Well Constructed Behavior Modification Programs To Be Very Useful In The Management of ADD/ADHD:

Behavior modification programs emphasizing positive reinforcement of appropriate behavior have been useful in reducing maladaptive behavior at home and at school. Research has shown that behavior modification can improve impulse control and adaptive behavior in children of various ages (4)-Perceptual Motor Skills 1995, and (5)-Abnormal Child Psychology 1992.

The use of positive reinforcement related to daily reports from school has been found to be useful in improving task completion and reducing disruptive behavior in the classroom (6)-Behavior Modification 1995.

Some parents have been found to prefer behavioral to medical treatment (7)-Strategic Interventions for Hyperactive Children 1985.

Families are often able to succeed with their behavior modification efforts through the use of written materials only (8)-Journal of Pediatric Health Care 1993.

Cognitive Behavioral Therapy Can Help ADD Children Improve Problem Solving and Coping Skills:

Cognitive Behavioral Therapy (CBT) consists of teaching children to change their thought patterns from ones that lead to maladaptive behavior to ones that produce adaptive behavior and positive feelings. This technique can be used to help children to improve their self-esteem. It can also be used to help them improve coping skills, problem solving skills and social skills.

In one study CBT was found to be helpful in helping hyperactive boys develop anger control. The findings indicated that "Methylphenidate (Ritalin®) reduced the intensity of the hyperactive boys’ behavior but did not significantly increase either global or specific measures of self-control. Cognitive-behavioral treatment, when compared to control training, was more successful in enhancing both general self-control and the use of specific coping strategies." (12) Journal of Abnormal Child Psychology 1984. (It should be noted that CBT has not proven to be successful in all studies. The problem may be related to the fact that each study uses different strategies and measures of success).

Cognitive Rehabilitation Exercises (Brain Training) Can Improve Attention & Concentration As Well As Other Intellectual and Self-Control Functions:

Victims of strokes or head injury may have significant impairments in attention and concentration. Cognitive Rehabilitation exercises are often used to help these people to improve their ability to concentrate and pay attention. This approach has been applied to children with attention deficit disorder with some success. The repeated use of simple attentional training exercises can help children to train their brains to concentrate and pay attention for longer periods of time. (13)-Behavior Modification 1996

References

(1) Physicians’ Desk Reference. 52nd ed. Montavle (NJ): Medical Economics Data Production Company, 1998

(2) Barbaresi, W Primary-care Approach to the Diagnosis and Management of Attention-Deficit Hyperactivity Disorder. Mayo Clin Proc 1996: 71; 463-471

(3) Taylor, M Evaluation and Management of Attention-Deficit Hyperactivity Disorder. American Family Physician 1997: 55 (3); 887-894

(4) Cociarella A, Wood R, Low KG Brief Behavioral Treatment for Attention-Deficit Hyperactivity Disorder. Percept Mot Skills 1995: 81 (1); 225-226

(5) Carlson CL, Pelham WE Jr, Milich R, Dixon J Single and Combined Effects of Methylphenidate and Behavior Therapy on the Classroom Performance of Children with Attention-Deficit Hyperactivity Disorder. J Abnorm Child Psychol 1992: 20 (2); 213-232

(6) Kelly ML, McCain AP Promoting Academic Performance in Inattentive Children: The Relative Efficacy of School-Home Notes With and Without Response Cost. Behavior Modif 1995: 19; 76-85

(7) Thurston, LP Comparison of the Effects of Parent Training and of Ritalin in Treating Hyperactive Children In: Strategic Interventions for Hyperactive Children , Gittlemen M, ed New York: ME Sharpe, 1985 pp 178-185

(8) Long N, Rickert VI, Aschraft EW Bibliotherapy as an Adjunct to Stimulant Medication in the Treatment of Attention-Deficit Hyperactivity Disorder. J Pediatric Health Care 1993: 7; 82-88

(9) Donney VK, Poppen R Teaching Parents to Conduct Behavioral Relaxation Training With Their Hyperactive Children J Behav Ther Exp Psychiatry 1989: 20 (4); 319-325

(10) Raymer R, Poppen R Behavioral Relaxation Training With Hyperactive Children J Behav Ther Exp Psychiatry 1985: 16 (4); 309-316

(11) Richter NC The Efficacy of Relaxation Training With Children J Abnorm Child Psychol 1984: 12 (2); 319-344

(12) Hinswaw SP, Henker B, Whalen CK Self-control in Hyperactive Boys in Anger-Inducing Situations: Effects of Cognitive-Behavioral Training and Methylphenidate. J Abnorm Child Psychol 1984: (12); 55-77

(13) Rapport MD Methylphenidate and Attentional Training. Comparative Effects on Behavior and Neurocognitive Effects on Behavior and Neuorcognitive Performance in Twin Girls With Attention-Deficit/Hyperactivity Disorder Behav Modif 1996: 20 (4) 428-430

(14) Myers, R Focus: A Comprehensive Psychoeducational Program For Children 6 to 14 Years of Age To Improve Attention, Concentration, Academic Achievement, Self- Control and Self-Esteem Villa Park (CA): Child Development Institute 1998

[HuckleB]

65. Thank you.

I will take your references for further review. The interesting thing I've noted regarding supposed use of CBT with ADHD, is that the "CBT" used with kids is usually simple behaviorist support rather than actual CBT. I'm not sure why there is such a need to call something CBT when it's not, as long as it works, but, for some reason, some folks do. This actually makes it more difficult for parents to understand what the therapist is doing, what their children are doing, and what they are trying to do when communicating with their children. In terms of true CBT use for ADHD, it seems to help some kids get from, say, 70 percent plus improvement via medication and/or other behavior techniques closer to 100 percent, but only once some part of the 70 percent is accomplished. However, CBT as a pure treatment for a kid in the midst of true, thus far untreated ADHD instead of behavior and/or medication doesn't offer a lot of hope, IMHO. It's an adjunct for some to get to 100 percent improvement, and, possibly, to ween off of medication as time goes on, again, for some.

[pinerow]

67. You are welcome...my objection had more to do with the hunt

for the "magic pill or wand" to make everything more better. I will agree that a combination therapy is probably best, however it has been my experience that a number of parents readily choose the medication route at the behest of school authorities and prescribed by non mental health professionals. With all due respect to pediatricians.

[HuckleB]

68. I agree.

Pediatricians should not be prescribing psychotropic medications. They do not have the time to do a true, full assessment for ADHD, depression, or any other possible diagnosis. And they certainly don't have the time to explore possible treatment options with the parents. And, yes, I say this with all due respect to pediatricians.

Don't get me started on schools, ADHD and magic solutions to behavior issues.

[pinerow]

69. Not to worry...I Won't...

nt

[drdtroit]

55. One has to wonder

what the world would be like had these ADDers been medicated into a nice coma:

BEN FRANKLIN: Disorganized and argumentative, he brimmed with endless ideas and imaginative projects.

WINSTON CHURCHILL: Before achieving political prominence, he was a bad student who couldn't concentrate.

ALBERT EINSTEIN: Another poor student, he was distracted, socially awkward, messy and infinitely creative.

[HuckleB]

57. None of them had ADHD.

Every one of them functioned quite well. Function is the key to diagnosis.

[Zolok]

58. Dunno...have a friend of the family

whose kid is classically hyperactive...and hyperactive kids are good at shutting down whole classrooms all by themselves.
There are few options here, drugs, segregating the kid....putting up with it none of them palatable.
It is a sad situation.

I had a cousin who basically bailed out of elementary school teaching because of hyper active kids. It was this whole chore to explain to the parents who were in some cases in deep denial that their kids had this problem....and that the options weren't too many..and on and on and on.
Meanwhile the class stagnates and regresses because of one kid...
Like I said it's sad.

www.chimesatmidnight.blogspot.com

[Ilsa]

59. Actually, as far as classroom options go,

if a child is diagnosed with a disability, then IDEA kicks in to protect the child's rights to a free and appropriate public education. This includes meetings with appropriate personnel at the school to design and individual education plan which might include both mainstreaming or seclusion from a stimulating class environment, how to test, what is appropriate discipline, etc.

Parents need to do what they feel is best for their children, but you are right, they shouldn't stay in denial about their child's capabilities and whether their behavior is holding them back.