Sunday, December 7, 2008

Important Info For Parents of Children With Possible AD/HD


Rabbi Yaakov Horowitz from Project YES has some great columns for parents who are concerned that their children may have AD/HD and who may not be doing well in school:

ADD-ADHD
ADD-ADHD Assessment and Testing
ADD-ADHD Use of Medication

Here's some basic information from the 2nd column on assessment of whether a child may have ADD or AD/HD:

For example, the Washington D.C.-based American Psychiatric Association
lists 14 attributes of ADD/ADHD, of which at least eight symptoms must be
present for a child to be officially classified as ADD or ADHD. Simply review
them and check them off as you go:

___ Often fidgets with his/her hands or feet, or squirms while seated.
___ Has difficulty remaining seated.
___ Is easily distracted by extraneous stimuli.
___ Has difficulty awaiting turn in games or group activities.
___ Often blurts out answers before questions are completed.
___ Has difficulty following instructions.
___ Has difficulty sustaining attention in tasks or play activities.
___ Often shifts from one uncompleted task to another.
___ Has difficulty playing quietly.
___ Often talks excessively.
___ Often interrupts or intrudes on others.
___ Often does not listen to what is being said.
___Often forgets things necessary for his/her tasks or activities.
___Often engages in physically dangerous activities without considering possible equences.

Please note that although some of these attributes may seem
similar, they are not exactly the same. It is also important to note that
ADD/ADHD diagnoses are further broken into three (there are actually several
additional sub-types, but that is beyond the scope of this article) specific
categories, each with its specific clinical presentation that better describes a
child’s behavior:
1) Hyperactive/Impulsive Type (classic Attention Deficit
Hyperactive Disorder),
2) Inattentive Type (classic Attention Deficit
Disorder), and
3) Combined Type (a combination of inattentive and
hyperactive).


-Dixie Yid

(Picture courtesy of adhd.ca)

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3 comments:

L said...

It's unfortunate here that R. Horowitz is taking the position of the mental health industry and big pharma and coming out in favor of drugging our kids.

R. Horowitz has a reputation for openness and innovative thinking and not just taking the easy way out. Hopefully he will reassess his position here soon and recommend something more original than just parroting the industry line with minor modifications and caveats.

There is no need for the frum world to copy the mistakes of the outside world. Sometimes our relative isolation is beneficial. We don't have to adapt every fad that comes along, like ADD/ADHD and Ritalin and variants. The sad thing is that there is a rising chorus of questioning of and opposition to the ADD industry supported drugging of kids in the outside world now, but we (some of the frum world), as often happens, are lagging behind, and are still basically faithful to the discredited industry recommendations.

DixieYid (جنوب يهودي) said...

L,

It is unfortunate that you speak about things that you do not understand. I will repeat a comment I left at Mystical Paths this morning:

Unfortunately, it sounds like you are applying the bad scientific methods that you are stating were used with Risperdal to AD/HD and the various medications for that condition as well.

Furthermore, you seem to be laboring under an assumption that AD/HD medications are primarily for the purpose of making classroom or home management easier for teachers and parents, rather than for the good of the child.

It also seems as if you are confusing inability to focus, uncontrollable impulsivity and an inability to concentrate with problems with midos.

Children with AD/HD are unable to learn basic skills they need for life since they can't focus on learning to read or write long enough to learn those skills. In almost every subject in school, whether limudei kodesh or limudi chol, reading and writing are a necessary part of those subjects. If children lag behind in these, or in any other step in the cumulative process of learning, they begin to fail in school, feel like failures, and therefore act out in other areas in school, to mask their inability to function in school.

Low self esteem, a lack of friends, frustration, misbehavior, depression and going off the derech are much more serious "side-effects" than properly dosed AD/HD medication.

As Rabbi HOrowitz pointed out in his articles, as adults, these children who will one day be CEOs, communal leaders and entrepreneurs will be able to make choices about their occupations that will be well suited to their AD/HD nature. At that time, they may very well not need the medication since they will be able to channel their nature through their own life choices.

However, all children have to sit still in classes learning basic subjects that require a tremendous amount of time sitting still in a classroom setting. A 6 or 8 year old is not able to make the kind of lifestyle choices that would enable him or her to channel those AD/HD characteristics in an adaptive way. At that stage in life, the symptoms of AD/HD are almost exclusively unadaptive and have serious consequences for the child.

*Properly dosed*, and in consultation with a doctor who specializes in this issue (psychiatrists/neurologists/some pediatritians) AD/HD medications have few and minor side effects. The common side effects (like lack of appetite) are often far more minor than the sometimes catastrophic side effects of not treating this condition.

Confusing the symptoms of AD/HD as a moral problem with the child that need to be solved through midos improvement ignores the real and non-volitional aspect of the condition. Unfortunately, such an approach creates even more problems than it solves since it makes the child feel even more guilty than they already feel about their inability to succeed in school. This just exacerbates the low self-esteem and acting out that can result from failures in school.

More minor cases of AD/HD can be handled with behavioral techniques. And when this is the case, it should be treated that way. However, there are a children (and adults) whose AD/HD cannot be adequately treated by non-medical means. In such cases, it is more cruelty than kindness to deny them the treatment they need and thus subject them to all of the dangerous side effects of non-treatment.

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