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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 11 to 35 of 35. Go back in thread:
Posted by weatherfreak on August 24, 2010, at 22:49:05
In reply to Re: Need advice, posted by ed_uk2010 on August 24, 2010, at 16:28:23
ADD has turned into a catch-all diagnosis for people who can't concentrate for as long as they would like to be able to concentrate for ie. most people.
>
>
LOL Ed, I wish that was the case but I really think it rings true for me. I struggled big time as a child and managed to get through high school somehow. The diagnosis was only just being used for extreme cases when I was a child.
Posted by ed_uk2010 on August 25, 2010, at 14:12:33
In reply to Re: Need advice, posted by sigismund on August 24, 2010, at 17:41:05
>There's not much of that here.
It doesn't happen here either, stimulants aren't generally used in adults.
Posted by ed_uk2010 on August 25, 2010, at 14:15:36
In reply to Re: Need advice » ed_uk2010, posted by weatherfreak on August 24, 2010, at 22:49:05
>LOL Ed, I wish that was the case but I really think it rings true for me.
I wasn't referring to you :)
It seems to me that the ADHD diagnosis is profoundly overused in the US. Symptoms such at 'difficulty concentrating on schoolwork' are essentially normal behaviour. A lot of kids don't like schoolwork, why should they like it? Not everyone was designed to be academic!
Posted by ed_uk2010 on August 25, 2010, at 15:39:54
In reply to Need advice, posted by tensor on August 24, 2010, at 8:07:13
>Why do I get tired from dopaminergic drugs like bupropion and modafinil?
Hi Mattias,
I'm not sure that bupropion *is* dopaminergic, or modafinil for that matter. The mechanism of action of bupropion isn't really understood - it is an extremely weak dopamine reuptake inhibitor but that may not account for much. Hmmm.
Have you ever taken a stimulant such as methylphenidate?
Posted by emmanuel98 on August 25, 2010, at 19:25:11
In reply to Re: Need advice » weatherfreak, posted by ed_uk2010 on August 25, 2010, at 14:15:36
I think the issue is that, back in the bad old days before medication, children who couldn't sit still and concentrate on school work -- i.e, high-energy, boisterous children not academically inclined, were whipped, beaten with rulers, set to work in factories. The energy was basically beaten out of them. Now we are more humane and have outlawed child labor, corporal punishment in schools and frown upon child abuse in the home. So we medicate these children instead.
Posted by chujoe on August 25, 2010, at 19:46:01
In reply to Re: Need advice, posted by emmanuel98 on August 25, 2010, at 19:25:11
I have no doubt that ADHD is over-diagnosed among children in the US & I don't disagree with the idea that stimulants are the "more humane" way of beating the energy out of some youngsters. As an educator myself, I honor and value that energy and even occasional craziness. BUT I'm also an ADD sufferer who might well have been a happier kid if I had had some really humane intervention and understanding and perhaps medication. I'm nearly 60 years old now & I take 30 mg of ritalin every day. It has made me more productive, happier, and has allowed me to put some of the energy that flies around in my brain to creative -- as opposed to distracting -- use.
Posted by violette on August 25, 2010, at 22:08:51
In reply to Re: Need advice, posted by emmanuel98 on August 25, 2010, at 19:25:11
I don't agree with the lack of disclipline.
Some of you might be interested in this historical narrative outlining ADD within a social/political context:
https://facultystaff.richmond.edu/~bmayes/ADHD_Mayes_Rafalovich_HistoryofPsychiatry.pdf
I have mixed feelings about prescribing potent drugs to children whose brains are not fully developed (front lobe not fully developed until about age 20)...In addition to growth defects associated with use of those drugs. If such growth problems are obvious-what is not seen?
My psychiatrist said parents, not doctors, gave their children pure amphetamine salts at the turn of the century for children with these traits (this article does not mention that).
It would be ideal if schools would design programs to harness the positive traits of ADD type thinkers; but schools are not individualized, most are designed for the most common cognitive 'types'.
While they do have special ed programs, they are nowhere near the quality of programs for gifted children, and ADD children with above-average intelligence, in those special ed programs, do very remedial-level work. They surely do not reap the benefits from the special ed as gifted children-those who are already at an advantage yet are placed in intensive special programs designed to bring out their full potential.
The special ed programs for those with ADD who perform poorly in classes might even bring out the worst. The kid is singled out in a negative way; secondly the kid is bored with remedial work, and those programs are not designed with any creativity in mind. (Only my experience at my school district-and this was an upper-middle class school).
And it is rather sexist that those with borderline personality organizations-mostly women-are often not afforded treatment payments by insurance companies; "borderline" is very much related to neurological problems (temperment) much like ADHD-overactive nervous system/hyperarousal, emotional dysregulation, impulse control issues, etc. They share very similar traits. Much like those from orphanages who end up with PTSD. The majority of those diagnosed with ADD are males.
"Very hyperactive, restless, and inattentive children have been identified by clinicians and
medical researchers dating back to at least 1902. Since then, upwards of 20 different diagnostic
labels have been used to categorize children who exhibit these problematic behaviors."
Posted by sigismund on August 25, 2010, at 22:24:03
In reply to Re: Need advice » emmanuel98, posted by violette on August 25, 2010, at 22:08:51
Kids probably shouldn't be in the schools we have.
Something medieval would be better....apprenticeships in the right field.
It's no wonder that they react to the destruction of promise in the way they do. They should be helping sail boats around the world. They get to be 20 and know bugger all, largely because of the way it is presented.
Posted by tensor on August 26, 2010, at 2:07:16
In reply to Re: Need advice, posted by ed_uk2010 on August 25, 2010, at 15:39:54
> I'm not sure that bupropion *is* dopaminergic, or modafinil for that matter. The mechanism of action of bupropion isn't really understood - it is an extremely weak dopamine reuptake inhibitor but that may not account for much. Hmmm.
>
> Have you ever taken a stimulant such as methylphenidate?Hi Ed!
No, I have never tried stimulants. Although modafinil works great most of the times it almost always make me yawn. It's like I'm tired and alert at the same time.
Regards,
Mattias
Posted by ed_uk2010 on August 26, 2010, at 13:42:28
In reply to Re: Need advice » ed_uk2010, posted by tensor on August 26, 2010, at 2:07:16
> > I'm not sure that bupropion *is* dopaminergic, or modafinil for that matter. The mechanism of action of bupropion isn't really understood - it is an extremely weak dopamine reuptake inhibitor but that may not account for much. Hmmm.
> >
> > Have you ever taken a stimulant such as methylphenidate?
>
> Hi Ed!
>
> No, I have never tried stimulants. Although modafinil works great most of the times it almost always make me yawn. It's like I'm tired and alert at the same time.
>
> Regards,
> MattiasDo you have Concerta in Finland?
Posted by ed_uk2010 on August 26, 2010, at 14:56:47
In reply to Re: Need advice, posted by emmanuel98 on August 25, 2010, at 19:25:11
>I think the issue is that, back in the bad old days before medication, children who couldn't sit still and concentrate on school work -- i.e, high-energy, boisterous children not academically inclined, were whipped, beaten with rulers, set to work in factories. The energy was basically beaten out of them. Now we are more humane and have outlawed child labor, corporal punishment in schools and frown upon child abuse in the home. So we medicate these children instead.
I don't think the demise of corporal punishment is in any way related to the increased use of medication :)
Corporal punishment has been banned because it is thought to be wrong, not because children are now on meds. Here in England, only a small minority of children are medicated, but this doesn't mean that we need to use corporal punishment.
In my opinion, a large proportion of children are not academically enclined. They don't like school work. It bores them to tears. They find it difficult to concentrate and so they feel restless. This shouldn't lead to a diagnosis of ADHD. This is not a mental health problem, it is normal behaviour. We need to accept that school is not actually a suitable place for many older children. Rather than prescribing drugs and encouraging such children into further education, we should allow children to leave school faily early (eg. at 14) and get them into work. Apprenticeships would be fantastic for a lot of young people. Some kids are practical, not academic. If they were able to do something useful instead of messing about at the back of the classroom, this would surely be beneficial to everyone.
Posted by ed_uk2010 on August 26, 2010, at 15:21:15
In reply to Re: Need advice, posted by sigismund on August 25, 2010, at 22:24:03
>They get to be 20 and know bugger all, largely because of the way it is presented.
Well yeah, school is great for those who are interested in academic subjects. I did well at school. I'm not a practical person, but I was quite good at school subjects.
At the moment, we force all children through the same education system regardless of whether they are suited to such an environment. The result of this is that a lot of kids are reaching the age of 18....and they haven't learnt anything or done anything useful. For those who prefer physical and practical activities to reading and studying, school is bound to be a waste of time (beyond the age of say, 14). If a child prefers manual work, there's not a lot of point forcing them to study French. Why not get them into an environment where they can learn to be a builder, or something similar?
America is essentially diagnosing kids who are not suited to school as suffering from a mental health problem. A problem which is treated with amphetamines and similar controlled drugs. I do not understand how we have reached this situation. If school had been physical and practical, *I* would have found it a nightmare. Does this mean that I have a mental health problem? No, of course not, it simply means that the environment would not have been suitable.
I'm not saying that the ADHD diagnosis shouldn't be used - but any diagnosis which is used so frequently is suspect IMO.
Let's look at a few of the diagnostic criteria from ADHD.......· often fails to give close attention to details or makes careless mistakes in schoolwork,
work, or other activities;· often does not follow through on instructions and fails to finish school work, chores, or
duties in the work place (this failure is not due deliberately refusing to do it or not
understanding instructions);· often avoids or is reluctant to engage in tasks that require sustained mental effort;
· often loses things necessary for tasks or activities;
Hyperactive/Impulsive Symptoms· often fidgets with hands or squirms in seat;
· often leaves seat in classroom or in other situations in which remaining seated is expected;
· often talks excessively;
· often blurts out answers before questions have been completed;
· often has difficulty awaiting turn;
· often interrupts or intrudes on others (e.g. butts into conversations or games)
Are these not 'symptoms' of a child who is not suited to academic study? A large number of the symptoms are directly related to the school environment.
Posted by sigismund on August 26, 2010, at 16:30:31
In reply to Inappropriate ADHD diagnosis » sigismund, posted by ed_uk2010 on August 26, 2010, at 15:21:15
School is glorified child minding, isn't it?
I remember reading about an educative proposal. The idea was that kids doing the 2 years before university could investigate 4 areas, from a variety of angles. Of the 4 suggestions I've forgotten two, but the other 2 were The Marriage of Figaro and the Holocaust. Kids are most able to learn young. It's a great pity their lives are filled with such crap. Useless stuff about the Journey and the Destination in English. Mind numbingly boring. I did English, French, Chemistry, Physics, MathsI and MathsII, simply to be in a class I felt I would be left alone in. I had no idea what I was interested in and everyone else cared even less.
Posted by simcha on August 26, 2010, at 16:31:24
In reply to Inappropriate ADHD diagnosis » sigismund, posted by ed_uk2010 on August 26, 2010, at 15:21:15
Yeah, sometimes the ADHD diagnosis is over-used. However, in my job I have and still do encounter children and adults with genuine ADHD.
One diagnosis that I think is bogus is Oppositional Defiant Disorder. Basically it sounds like your average elementary school boy who just doesn't want to do as he is told. Is that really a disorder or is it annoying for the teachers/parents/administrators and that's why they have classified that as a disorder?
Posted by sigismund on August 26, 2010, at 18:51:17
In reply to Re: Inappropriate ADHD diagnosis, posted by simcha on August 26, 2010, at 16:31:24
>One diagnosis that I think is bogus is Oppositional Defiant Disorder. Basically it sounds like your average elementary school boy who just doesn't want to do as he is told. Is that really a disorder or is it annoying for the teachers/parents/administrators and that's why they have classified that as a disorder?
I was told that in the state system in Vietnam, kids who are overactive and badly behaved are required to kneel in, I suppose, front of the class.
In the private language schools they seemed remarkably well behaved for kids who are, after all, the children of the elites.
If you asked one of them to 'stand over there' they would do it without question.
This is during a language class after school.
When you walk in the room they all say 'Good afternoon teacher'.
Posted by tensor on August 27, 2010, at 2:38:18
In reply to Re: Need advice, posted by ed_uk2010 on August 26, 2010, at 13:42:28
> Do you have Concerta in Finland?
Yes, we have.
Regards,
Mattias
Posted by ed_uk2010 on August 27, 2010, at 14:48:43
In reply to Re: Need advice » ed_uk2010, posted by tensor on August 27, 2010, at 2:38:18
> > Do you have Concerta in Finland?
>
> Yes, we have.
>
> Regards,
> MattiasEver taken it Mattias?
Posted by chujoe on September 1, 2010, at 9:09:50
In reply to Re: Inappropriate ADHD diagnosis, posted by sigismund on August 26, 2010, at 18:51:17
Sig, I saw this before & meant to post something in response, but then got distracted & forgot. Anyway, I've spent a lot of time in Vietnam & lived there for extended periods and have taught literature courses at Hanoi university. I don't have a lot of experience with elementary education, so I won't say unequivocally that your information is wrong, but only that I'm suspicious of its accuracy. Vietnamese culture is certainly more authoritarian than American & European culture, but it is not rigidly so. Also, if these were after school language classes, they would have nothing to do with the "state system" of education, but would be privately run. Contrary to popular conceptions of Vietnam, there is a tremendous amount of free enterprise. One thing that is certainly true is that the Vietnamese are very serious about education & students are taught to be respectful of their teachers. In fact, it was difficult for me to get my students to ask questions because they were so used to simply being told the right way to read a story or a poem, etc. On Tet, the lunar New Year, the most important holiday in Vietnam, the first day one visits and pays honor to one's paternal grandparents; the second day, to one's maternal grandparents; and on the third day, students take gifts to their teachers in order to honor their important place in the Vietnamese value system.
Posted by violette on September 6, 2010, at 0:35:16
In reply to Inappropriate ADHD diagnosis » sigismund, posted by ed_uk2010 on August 26, 2010, at 15:21:15
Ed, your post was interesting, and thought I'd add something related to what you'd said. I read in China, they put kids on a 'track' based upon competence and natural skill that emerges during their early education-some are more inclined in math, some manual dexterity/working with tools, some artistically creative in visual arts, etc.....so after their strengths are discovered, they become 'specialists'...it truly maximizes the potential of the social capital. There are inequalities and problems..but are being smart. Here in the US, i think the public education is stupid..as policies here really need to emphasize more creativity, innovation if our human capital is to have any competition with other nations.
But I dont' think it's fair to say kids with ADD should not pursue academic routes merely because they cannot sit still....my son, for example, was highly ADHD-did poor in high school, but is now 'teaching' me about physics, doing well at the local community college...transferring to a top-rated engineering university next year on full scholarship. I did not put him on medication despite being threatened by school administrators..we had no health insurance, but also did not want to put him on medications until after his brain was fully developed. It was a tough choice to make. But now that he can pursue his interests, march to his own beat, his attention and behavior has improved accordingly.
There's a famous school system that originated in Italy that brings out the best in children; i forget the name of it..but the only thing close to how education needs to change and why:
http://www.ted.com/talks/view/id/66
(This guy could have probably said in 5 minutes what took him 20 minutes to say)...
But basically, the school system here, has not changed in 20 years..it's pathetic because one particular school in my district won a national award as the 'best' in the country; yet i had gone there, as well as my son, and through evaluating my son's education-it really hasn't changed much.
Then again, I'm all about interdisciplinarism and individualism, to bring out everyone's best potential..a bit idealistic, but i think it could work only if privatization were to happen as the politics are just too influential to make productive changes.
Posted by violette on September 6, 2010, at 0:44:18
In reply to Re: Inappropriate ADHD diagnosis, posted by violette on September 6, 2010, at 0:35:16
...so you know how they were designated the 'best' school in the entire country? In part, by placing kids like my son, who had ADD despite an IQ well-above average, in classes for children who were borderline retarded. So that they did not have to include his test scores in with the other averages...
There's a shortage of engineers in the US, now my son is exceling in the field..accepted to one of the best engineering schools in the country...go figure....
Posted by ed_uk2010 on September 6, 2010, at 14:13:50
In reply to Re: Inappropriate ADHD diagnosis, posted by violette on September 6, 2010, at 0:35:16
>they put kids on a 'track' based upon competence and natural skill that emerges during their early education-some are more inclined in math, some manual dexterity/working with tools, some artistically creative in visual arts, etc.....so after their strengths are discovered, they become 'specialists'...
I've not heard of that before, it sounds promising.
>I dont' think it's fair to say kids with ADD should not pursue academic routes merely because they cannot sit still....
I didn't really mean that. What I meant is that a lot of children who aren't suited to academic environments are diagnosed with ADHD.
>I did not put him on medication despite being threatened by school administrators....
Is this common? I've not heard of that happening here. School administrators don't have a say RE children's medication, even if their input is requested.
>did not want to put him on medications until after his brain was fully developed....
I can understand that.
I just can't get my head around the widespread use of amphetamines in children (in the United States). I don't think it happens to the same extent in any other country. Although the initial effect of amphetamines in childhood ADHD are positive, the long term effects on the developing brain haven't received enough study to justify such widespread (and prolonged) use..... in my opinion. These drugs are very similar (or the same) as the ones which we are encouraging young people *not* to use! I am not anti-drug by any means, but I do think it's important to be extremely cautious when using potent psychoactive drugs in young children..... on a daily basis.
Posted by floatingbridge on September 12, 2010, at 13:00:32
In reply to Re: Inappropriate ADHD diagnosis, posted by violette on September 6, 2010, at 0:35:16
Violette, love the Ken Robinson link (that is his name?). Have you seen Gulver Tulley's clips on his Tinkering School?
I think Ed and you are in alignment--the semantics around 'academic' to be parsed out....
My son would be labeled Adhd in most schools if they were given the chance.
His kindergarten was Waldorf. This year
we are homeschooling and may go back
to Waldorf in the future. There are no other options for his early education here.He absorbs and processes large amounts of information while walking, biking, or other similarly 'rhythmic' activity. The an observer might assume he was merely inattentive. He identifies simple plants, not only from memory, but by using rudimentary botanical rules. Insects, bugs, arachnids. Like many boys, he has a knack for categorization.
To make a long story short, my hope is to preserve his, what can I call it? Self-sense until he is of age to define himself versus early definition by schools with their limited resources and, sadly, lack of vision. Some students are simply shut out of school because it has become so narrow in practice and short-sighted in vision.
And no way anyone will give him stimulants while his brain is developing!
A favorite story from Jackie Chan's authorized biography.
After being kicked out of at least 20 schools, his mother was at the end of her tether. In absolute desperation, she enrolled him in Chinese Circus school. He excelled. The rest is cinematic history. I adore his movies (the Hong Kong one, not the *yawn* Hollywood ones).
Posted by violette on September 14, 2010, at 20:37:46
In reply to Re: Inappropriate ADHD diagnosis » violette, posted by floatingbridge on September 12, 2010, at 13:00:32
Yes, I just didn't have anything to add to what Ed had already said...Is Tully on Ted Talks too? I will look him up...Homeschooling sounds so tough-i really give you credit for that...you're a take charge person! How was his experience in kindergarten?
> Some students are simply shut out of school because it has become so narrow in practice and short-sighted in vision.
I see that too. Here, the vision is competitive test score metrics; those who don't perform get weeded out of the aggregation through the back door.
> And no way anyone will give him stimulants while his brain is developing!
That's how i felt too.
> A favorite story from Jackie Chan's authorized biography.
After being kicked out of at least 20 schools, his mother was at the end of her tether. In absolute desperation, she enrolled him in Chinese Circus school. He excelled. The rest is cinematic history. I adore his movies (the Hong Kong one, not the *yawn* Hollywood ones).
Love it...my son's a great fan of Chan as well.
I've seen that 'catergorization' with other ADD kids...it seems sort of autistic, yet at the same time, just another way to look at things. A strength/talent that can be fostered with the right resources and vision. Mother vision. ha
Really, there are so various cogntive styles and schools are too homogenized to the most popular at the expense of a substantial number of children.
Posted by floatingbridge on September 14, 2010, at 22:32:03
In reply to Re: Inappropriate ADHD diagnosis » floatingbridge, posted by violette on September 14, 2010, at 20:37:46
Mother vision. I like that :)
Posted by mellow on September 16, 2010, at 4:23:11
In reply to Re: Inappropriate ADHD diagnosis » violette, posted by floatingbridge on September 14, 2010, at 22:32:03
I was dianosed ADHD as a child and my father respectfully told the psychiatrist where she could put her diagnosis...LOL!
My school made me repeat the first grade and then in the second grade the school made my parents get me evaluated by a doctor the school recommended. At this time another mother reached out to my parents and told them that out of the 30 kids in my class 9 had been put on Ritalin by that doctor just that year!
This was probably 1990 right when Ritalin was hot. I'm not going to say i wasn't an active child and i certainly think outside the box, but i turned out all right without drugs during childhood. There have been low moments, but my parents love and hard work carried me through more than any prescription could.
I don't think any intervention at that point would have changed the course of my life. I'd still be bipolar. I actually think introducing a stimulant at that point could have made my substance abuse issues later on in life much worse. A lot the people i started getting high with in high school were my friends who would give me their Dexedrine and Xanax.
In my opinion kids shouldn't be put on those drugs just yet.
This is the end of the thread.
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