Gifted Issues Discussion homepage Forums Twice Exceptional Giving Ritalin A Go

Actually, Ritalin has been around for decades and it's been used to treat ADHD since the 60s.

But the jury is still out on its long-term risks. The Wikipedia has a lot of well-cited information on this subject.

Obviously, ADD and ADHD are real (as I mentioned, a kid in my class had ADHD, and I've seen it up close). However, I think there's a lot of overdiagnosis, especially over the last 20 years or so as schools have become increasingly focused on worksheet-type seatwork and less focused on developing creative abilities while cutting recess. And honestly, I don't think that the type of work handed out in public elementary schools necessarily teaches concentration skills. There's too much busy work, too many short worksheets with multiple choice questions, and too little work that requires real, sustained concentration on a single general idea.

For example, how many novels do public school kids read as part of school by, say, fourth grade? By that I mean, read, discuss in class, and write about? I do NOT mean reading AR books at home and filling out a reading log and never analyzing the book. And how much time do fourth graders spend reading one- or two-page sheets with a small group of multiple choice questions used to "assess comprehension?" These worksheets teach kids how to read in units of sound bytes and how to answer questions on high stakes tests. They certainly don't teach them how to read a serious book and analyze it. I wouldn't have sat still for this, and I don't have ADD.

So it's just easier to drug some kids. Don't get me wrong. I'm not trying to claim that there's some kind of conspiracy. I just think that these labels have become popularly known and it's easy to think of them as a result. Plus, ADD and ADHD are defined loosely enough to make it easy (too easy, IMO) to justify the diagnosis.

Just my 2c.

I have never seen a worksheet with multiple choice questions in 5 years of elementary school. Not once. They're all short answer/ written response.


Several per year by fourth. We are involved with this now.


Until recently, I'd never seen this either. We have started to get assignments in RAZ Kids, which includes godawful-quality texts and inane multiple-choice questions; this has happened only in the past two weeks, as a pilot, and I am hoping it goes away again.

But in general, you've made me feel better about the quality of our school, so thanks.

As for whether ADHD meds are overprescribed: it's up to parents to be skeptical and weigh the pros and cons. We need doctors who are very careful and not beholden to drug companies. We need teachers who know it's not their role to diagnose anything or recommend meds. However, if suffering is being alleviated (those who have needed meds will know what I mean), I don't think it's for bystanders to judge whether it's right or wrong to use meds in that particular case.

DeeDee

I agree with you in a way, but in a way I don't. I think American society needs to do some serious questioning about these drugs.

Interesting: today's NY Times has an Op-Ed piece on Ritalin. It was actually worse than I thought: three million children are being given these drugs.


And:

A diagnosis of ADHD can (correctly) be made only if the problem is occurring in more than one setting. That is, trouble concentrating in school is not sufficient for a diagnosis.

Boredom in the school setting or inappropriate instruction is obviously a problem for lots of kids, and can lead educators to make incorrect assumptions about ADHD; but responsible physicians look at functioning at home and in other non-school settings, as well as at school, before making a diagnosis or prescribing meds.

In the current environment, there are lots of places where this process can go wrong and lead to incorrect diagnosis; I get that. But the current public conversation around this issue often throws out the baby with the bathwater.

DeeDee

Not sure what you mean. Are you saying that the editorial I quoted is just a case of fear-mongering?

He presented some provocative information questioning long-term benefits of stimulants in children. I'd be interested in your opinion about it.

Some interesting research on the topic:

http://newideas.net/adhd/research/functional-neurology-adhd-brain-studies/mri-stanford

http://www.psychiatrictimes.com/adhd/content/article/10168/53841

http://www.medscape.com/viewarticle/744742

This sort of brings back memories. Given a sensitive, nontraditional, Gifted parent, I've experienced the situation where school is the ONLY environment where the child shows symptoms because school is the only place where the child goes that has more than the minimum of rules, boundaries and limitations.


We have to keep in mind how much intensity and effort a gifted parent can pour into keeping a child functional when in truth the child has fallen well behind agemates. Not to mention how much energy, intensity and effort the child is pouring into holding it all together. This is a very difficult situation.

Ideally there would be a differentiated diagnostic list for every spot on the IQ curve.

shrugs and more shrugs
Grinity

Regarding the Stanford study:


So in other words, the guy in the Times pointed to exactly these limitations as being potentially serious flaws in the logic around Ritalin use.

I'm a scientist and one my greatest frustrations with my field is the tendency to draw conclusions from too little data. It has been proven again and again that a too-small sample size can lead to false-positive and false-negative findings. IMO, a study like this shouldn't be published until the authors have tested a much larger sample size.

Put another way, this is why the FDA insists that drug and device companies run Phase III clinical trials with thousands of people.

FWIW I wanted to mention an interesting radio interview I heard the other day with a local psychologist who has a clinic for kids with ADHD, anxiety, ld's, ASD, etc. Instead of medication he uses a program that sounds like video games that are programmed to get more and more interesting if the kids keep their attention and focus. Supposedly it helps to "train" the brain by rewarding the attentive behaviors.

I know nothing about the program but it sounded like an interesting non-drug approach.

Well, Alcohol is a depressant. So why is one of the stereotypes of a person under the influence of Alcohol is more talkative and sparkly at a party? Dancing on the table? Lamp shade on head?

Turns out that Alcohol depresses the part of the brain that usually is at work inhibiting us from dancing on tables and saying what we shouldn't say. Who knew? Brain is complicated, not 'What you see is what you get.'

So a stimulant activates the part of the brain that directs attention. That part of the brain helps gifted kids with ADHD-I directly by speeding up the normal parts of their brain to match their gifted parts, and indirectly by helping kids with ADHD guide their attention towards topics that the children really want to pay attention to, but aren't inherently rewarding.

Is it morally right to keep any child in a classroom that is markedly below their level to learn? No. It's just as bad to do it to academically advanced kids as it is to do to kids who get misplaced into special ed classrooms when they have normal intelligence. But that doesn't mean that no gifted child as ADHD or ADHD-I.

Is my science perfect? No. But it's better than, 'Oh, a stimulant must stimulate hand and foot movement' in the paragraph above. Brains are tricky. HG and PG kids are so far from the norm that it's really really hard for families to make these decisions.

((shrugs))
Grinity