Physicians writing on KevinMD in 2014 about ADHD: how it is tested for, whether diagnoses had reached a tipping point, stimulants in very young children, foster children on antipsychotics, and whether childhood was being turned into an illness. This archive is closed; ADHD posts since then are on the mental health record. One maintained record draws on this archive: Mental health: what psychiatrists and physicians say, in their own words.
I wrote recently about getting started with an evaluation for a child who’s not doing well in school. Don’t rush to just do ADHD testing: There are many reasons for attention problems, and it’s best to not just zero in on ADHD at the start.
Still, there’s a time when confirmation and testing for an ADHD diagnosis is appropriate. What kinds of tests are available?
A clinical history is, well, talking …
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How to test for ADHD
Tom Insel, director of the National Institute of Mental Health (NIMH) in his recent blog post, “Are Children Overmedicated?” seems to suggest that perhaps more medication is in order. Comparing mental illness in children to food allergies, he dismisses the “usual” explanations given for the increase prescribing of medication. In his view these explanations are; blaming psychiatrists who are too busy to provide therapy, parents who are too busy to provide …
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Young children are silenced by psychiatric medication
I have been blogging and tweeting about ADHD a lot lately because I believe that change is in the air.
This is the worst of times for ADHD diagnosis because statistics show it is wildly overdiagnosed and overtreated. This is possibly the best of times for ADHD diagnosis because I think we have reached the tipping point and feel hopeful that the ADHD fad will soon begin to fade.
We humans are …
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Have ADHD diagnoses reached a tipping point?
A recent study, one that received relatively scant media attention (compared with a concurrent New York Times piece about a new psychiatric diagnosis termed “sluggish cognitive tempo” that may be the “new ADHD”) showed that antipsychotics are being prescribed to nearly one third of kids (age 2-17) in foster care who are diagnosed with attention deficit hyperactivity disorder (ADHD).
This disturbing statistic brought to mind a common complaint I hear from parents …
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Kids in foster care end up on antipsychotic medication for ADHD
The statistics tell us that our children are getting sicker and sicker. Attention deficit hyperactivity disorder (ADHD) has more than tripled in just 20 years: It is now diagnosed in 11 percent of all kids, and in an astounding 20 percent of teenage boys. Autism is also on a rapid rise. The latest reported rate suggests that it occurs in one in every 68 kids — 20 years ago it …
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We are turning childhood into an illness
“I know its my ADHD acting up,” a mother of three young children recently said to me as an explanation for her inability to recall a particular piece of information. My observation, in the setting of mybehavioral pediatrics practice, of increasing numbers of mothers of young children being diagnosed with ADHD is in keeping with a recent report from Express Scripts. This report, based on pharmacy claims data, showed a 53% rise in writing of prescriptions for ADHD in …
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The rise of ADHD diagnoses in young mothers
Readers have contacted me about a recent study that links acetaminophen use in pregnancy to the later development of ADHD in children. Is Tylenol yet another thing pregnant women need to avoid?
The study, titled “Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders” was published this month in JAMA Pediatrics. Dutch researchers looked at about 60,000 children born from 1996-2002. Their parents have been filling out questionnaires and …
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Is acetaminophen taken during pregnancy associated with ADHD?
A recent article in the New Republic, provocatively titled “ADHD Does Not Exist,” starts out well enough. The author, a psychiatrist with “over 50 years experience” points to the fact that ADHD describes a collection of symptoms, rather than their underlying cause. Using stimulants to control these symptoms, he argues, is analogous to prescribing pain medication for cardiac chest pain rather than addressing the underlying circulatory problem.
But my …
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ADHD and the value of uncertainty
When someone asks me what a developmental pediatrician does, I tell him or her that I treat children who have a variety of developmental problems, such as attention deficit hyperactivity disorder (ADHD). Without fail, that disclosure elicits some sort of an emotional reaction.
Many people have strong opinions about whether the disorder really exists. Parents are still being told, by family and so-called friends, that it’s “their fault,” and that all …
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ADHD: To medicate or not
Recently I reviewed my son’s high school essay on To Kill A Mockingbird. I was surprised and pleased to rediscover, or perhaps discover for the first time now that I was viewing it from the perspective of over 50 years of life experience, the profound wisdom of the book.
In one of the novel’s most famous quotes, Atticus tell his daughter Scout, “you never really understand a person until you consider things …
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Perhaps ADHD is a problem of not listening
When the American Academy of Pediatrics came out with new guidelines a couple of years ago extending the age of diagnosis of ADHD (attention deficit hyperactivity disorder) down to age 4, it seemed as if Pfizer might have been waiting in the wings. Soon after, a new preparation of ADHD medication in an oral suspension, for kids too young to swallow pills, became available.
I was a lone voice expressing opposition …
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Rising ADHD rates is a symptom of our broken health system