Medicine Goes to School: Teachers as Sickness Brokers for ADHD

Public Library of Science ^ | April 11, 2006 | Christine B. Phillips

[neverdem]

Over the last twenty years, attention deficit hyperactivity disorder (ADHD) has emerged as a disorder of importance in childhood. Prescription of psychostimulants for ADHD escalated in many countries through the 1990s. Between 1990 and 1995, prescriptions of methylphenidate for young people increased 2.5-fold in the US [1], and 5-fold in Canada [2]. In New South Wales, Australia, rates of treatment for children in 2000 were nine times those in 1990 [3].

ADHD joins dyslexia and glue ear as disorders that are considered significant primarily because of their effects on educational performance. Medicalising educational performance can help children receive specialised medical and educational services; at the same time it can lead to them receiving medications or surgical therapies which may have short-term and long-term ill effects.

In the case of ADHD, there has been a complex, often heated debate in the public domain about the verity of the illness and the personal cost-benefit ratio of treatment with psychostimulant medication [4–6]. Much of the polemic for and against psychostimulants is concerned with the part played by doctors, the prescribers of medication, in diagnosing or discounting ADHD. ADHD is, however, a disorder of educational performance, and so teachers have a critical role in advocating for the illness, and its medical treatment. This essay explores the roles of teachers as brokers for ADHD and its treatment, and the strategies used by the pharmaceutical industry to frame educators' responses to ADHD.

[LauraleeBraswell]

""here is a theory about ADHD that relates it to early childhood television exposure within the first 2-3 years of life...I tend to agree with that hypothesis.""

I think television exacerbates the symptoms of ADD. And in general, it makes people inattentive, which may account for the increases in false diagnosis. But like I said, ADHD is not about simply "not paying attention." There are many more symptoms that encompass what is the disorder.

[blu]

I was team mom and manager for our sons' baseball teams for 10 years. I always told the parents at the season start meeting to NOT tell me if their kid was ADD, ADHD...whatever.I explained that baseball is not just about hitting and catching, it's about being able to do what you're told, think for yourself, and, most importantly, get along with others. If their kid wanted to catch worms in the outfield, fine. After his teammates told him a few times to pay attention, he'd get it.

I didn't want to treat anyone differently from the rest. Yes, we had some "bouncers" who couldn't sit still, so they warmed up a lot of pitchers, or were warmed up themselves (pitching-wise!)Most importantly, I tried to make sure that every team member had a good time, played to their strong positions, and was not picked on for being "different".

[Born Conservative]

[Republicanprofessor]

ping.

[grania]

Congratulations on controlling your son's ADD by diet. I knew about sugar, but the yellow food dye is new to me.

ADD amd ADHD are real. I've spent quite a few years now, in private and small-group tutoring, where the approach is to approach the focusing problems from a teaching standpoint.

Little things like using a multi-sensory approach (speaking, hearing, writing), a lot of feed back, and altering the plan as one goes along really seem to help.

For ADHD, it seems that the kids can't pick out what's important in an environment if there is too much going on. A discilplined environment and speaking directly to the student, in a calm voice, at close range, really goes a long way.

[AppyPappy]

My experience has been that many parents can't see the problems of their children. When teachers try to tell them, they blame everything except their parenting and their child. Meanwhile, the kids have to try to learn in an environment with a hyper, out of control kid.

My son is diagnosed ADHD. For us, it means the teachers, by state law, have to make accomodations for him. Sitting still for several hours is out of the question. Luckily, the school moves the kids around quite a bit. They also have to tell US (not just him) when he has projects due. They cannot let him just squeek by. They have to make him do the work. When they don't make him do the work, his grades suffer. When you ignore an ADHD or ADD kid, they fall apart. We get to pick his teachers for the most part. Luckily, he is also in the gifted program so we get a bit more leeway. We chose not to medicate because it changes their personality.

[Mrs. Don-o]

When we first adopted our son Vanya (who came to us after spending his first 5 years in an orphanage in Kamchatka) he had a lot of problems with managing frustration and anger, as well as staying on task and praying attention. This made homeschooling quite challenging at first.

At one point, very frustrated myself, I said, "Well, I don't know about you, but I have to get outta here and run around the block." So we both went out and ran.

Thereafter, whenever we got frustrated, Vanya would say, "Mom, let's run" and that solved our problems.

We came to call it "The Running Cure." Sure worked for us.

[MissEdie]

It doesn't matter whether or not they want to spend the money. The IDEA law says they have to! If you haven't contacted a lawyer about this, I would recommend you do. Not because I advocate people suing, but sometimes a lawyer is the only person a school district will listen to when it comes to making them do what they are supposed to do (morally and legally) for your child.

[MissEdie]

I've got ADHD too, I'm not a boy either. I got it from my mom too, she was born in 1939. Wonder if it's passed from mother to daughter and from father to son? That's a perspective I haven't heard yet, how about you?

[SoftballMominVA]

Actually, he is correct. Autism IS the "disability of the moment." And it is being vastly over diagnosed.

IMO it is not truly autism that is on display here. Autism typically becomes evident around 15-18 months as a withdrawal from others. These kids have a wide range of symptoms from lack of speech, repetitive behaviors, hyper-concentration, etc. These kids come to school with a diagnosis of autism. These are NOT the ones that are improperly diagnosed.

The ones I am talking about are those that have other issues, ranging from mild mental retardation to emotional disturbance to just a good case of "SRB" (spoiled rotten brat).

What happens is this.... child does not do well in school for any number of reasons....child is brought up to a special education committee (with parent approval) and is tested. Then, the data is discussed.

Then one of two things happens. If the parent has an attorney or advocate they will focus on the "lack of ability to mimic proper behavior" as the lynch-pin problem. This statement falls under the autism spectrum.

Or the child is really MMR or ED and the school doesn't have the balls to say "your child is retarded" or "your child has an emotional disturbance" and instead says "autism" based on the inability to mimic proper behavior.

At this point, the child can receive special services under the autism label.

This type of labeling is vastly different from the traditional one that is seen in the very young. It is a cop-out from the schools or manipulation from the parents. An autism label is easier to accept than MMR, ED or just SRB.

[luckystarmom]

No they can't. A doctor has to be the one to prescribe the medication. If it is prescribed too much, then it is the doctor's fault for not being thorough.

[luckystarmom]

No they don't. It is very hard to get SSI benefits. My daughter has brain damage and she doesn't qualify to get SSI benefits.

[bpjam]

Actually, in states all over the country. The parents get an order from the school telling them to take their child on one of a handful of doctors. And if they don't put their kid of Ritalin, they are threatened with having the kid suspended. In fact, school counselors would write 'prescriptions' for students to go to a psychiatrist to get medication. The parents get the message: the kid gets doped or he gets kicked out. Its a huge industry and poor teachers are happy to see problematic kids become quite and compliant.

While you are legally and technically correct that only a doctor can prescribe a Schedule II narcotic, the kids wouldn't be seeing doctors about the drugs if the schools were pushing them there. And schools aren't going to refer to doctors who aren't playing along. Just like trial lawyers, they won't with the compliant doctors.

[oprahstheantichrist]

"Wonder if it's passed from mother to daughter and from father to son? That's a perspective I haven't heard yet, how about you?"

Nah. I passed it onto my oldest boy, and his "version" is identical to mine. I think my paternal grandfather had it, too, so I think if it exists on both sides of the gene pool, you're far more likely to have offspring with the trait.

One other thing I've noticed though, is that with each subsequent generation, the ADHD symptoms are worse, but the IQ is also proportionately higher. I have it way worse than my mom, but I'm also smarter. My kid is way worse than me, but he blows me away on math and reasoning skills.

[Spirited]

Thank you for your post. I feel as you do after training to teach and marrying a spouse identified as having the problem.

The overworked tag is a destroyer of people and the drugs are worse so far as I am concerned. Our 7 grandchildren are homeschooled so that the label and the drugs could not be attached to any of them.

I am certain that each of them will function just fine in their jobs, their world and their homes because they weren't on drugs or decimated with labels.

So far the eldest who began her science labs as a 16 year old high school student at NCState is at Oxford to further her science education. She carried a double major and added a third major once she entered University.

A brother now 17 has also been at State since he was 16 so that he could take Chinese and math courses (that he is acing). And this is the child who would stand on his head in another room (during his elementary schooling time) while his Mother read to the four children but could answer any question about the text. He is a ranked paint ball contestant. He is headed toward Physics when he enters college.

Another sister is acing German and math at a community college (whose standards are higher than NCState for entrance) as an added prep because her concentration has been on ballet and arts during her high school years.

The fourth female is 14 and has written two books and illustrated one.

Since I have been trained to test for ADD et al I will tell you that the school systems would delightedly have destroyed any of them which is why I urged their parents to go the home schooled route. And why I am eternally grateful for children who are willing to put themselves out to educate their progeny. I am just as proud of the remaining 3 who are younger and therefore not as much "proof of the pudding" but equally active and capable. What you can label at grade 3 or 4 can be mitigated by grade 11 if someone works at it and keeps away from ineptly stupid labels that only provide excuses.