Discussion Post #3: Too Quick to Label?
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Holly Susan
Feb 14, 2011, 5:31:14 PM2/14/11
to Foundations of Special Education 541
Greetings Class,
I'm so pumped up from the last discussion! The respectful, honest,
and thoughtful community you all have built has me extra excited about
the questions you all will post for your final discussion forum
(remember to check out the shiny new revised syllabus if you haven't
already).
For our third discussion, we will take on the significant issue of
over-diagnosis of disabilities. To get started read the 2007 article
listed on the Google site from the Journal of Attention Disorders that
lays out the case for and against the over diagnosis of ADHD labeled.
Perhaps you've heard in the press statements that suggest that ADHD,
Asperger's Symdrome and other high frequency disabilities are over
diagnosed, or mis-diagnosed. For example, some say that boys, who may
be seem inattentive and over- active are too often diagnosed and then
much too promptly put on medications like Adderall or Ritalin. What
do you think? Are we too quick to use medications to help students
focus? Are medications too widely available? Is the diagnosis of
ADHD overused? Or are we at a point where are finally recognizing the
needs of students with a real disability and providing the supports,
both medical and educational, that are needed? Are more parents and
student open about their disabilities?
I'm looking forward to reading your posts (due 3/14).
Warmly,
Holly
I'm so pumped up from the last discussion! The respectful, honest,
and thoughtful community you all have built has me extra excited about
the questions you all will post for your final discussion forum
(remember to check out the shiny new revised syllabus if you haven't
already).
For our third discussion, we will take on the significant issue of
over-diagnosis of disabilities. To get started read the 2007 article
listed on the Google site from the Journal of Attention Disorders that
lays out the case for and against the over diagnosis of ADHD labeled.
Perhaps you've heard in the press statements that suggest that ADHD,
Asperger's Symdrome and other high frequency disabilities are over
diagnosed, or mis-diagnosed. For example, some say that boys, who may
be seem inattentive and over- active are too often diagnosed and then
much too promptly put on medications like Adderall or Ritalin. What
do you think? Are we too quick to use medications to help students
focus? Are medications too widely available? Is the diagnosis of
ADHD overused? Or are we at a point where are finally recognizing the
needs of students with a real disability and providing the supports,
both medical and educational, that are needed? Are more parents and
student open about their disabilities?
I'm looking forward to reading your posts (due 3/14).
Warmly,
Holly
Tiffany (india) Starke
Feb 16, 2011, 4:29:00 PM2/16/11
to Foundations of Special Education 541
How come I can never get directly to the articles when I sign in? They
are never posted here and there's no link to click that will take me
whereever i need to go.....talk about frustration! SOMEBODY HELP!
are never posted here and there's no link to click that will take me
whereever i need to go.....talk about frustration! SOMEBODY HELP!
elizabeth hagan
Feb 16, 2011, 5:26:51 PM2/16/11
to foundations-of-spe...@googlegroups.com
i have screwed it everytime, i am not the one to help here...
Emily Brooks
Feb 17, 2011, 6:08:27 PM2/17/11
to Foundations of Special Education 541
I am so torn about this issues—and spend lots of time thinking about it
—because I have four students who are diagnosed with ADHD (all boys),
two of which are on medication and two of which were retained in 2nd
grade. One boy, Christopher, since he started on medication has grown
exponentially in term of his academic ability and ability to
concentrate and focus and push himself. Within one academic year his
reading level grew over 2 years--he went from reading at a middle of
1st grade level to an end of 3rd grade level. He is one of my most
able math students. In school, he went from crawling under desks
during reading time to passionately reading for over 30 minutes
straight. It is clear his medication has allowed him to learn and
better access materials.
I know this is just one anecdotal story, and although I think it was
an amazing decision to medicate Christopher, I do think that
overmedicating children is problematic. Again, I find the issue so
complex.
I was diagnosed with generalized anxiety disorder and was on
medication for years. I also have friends and family members who are
on certain medications for similar reasons because their brains and
bodies are hardwired a certain way or produce too much or too little
of a certain chemical etc. Basically everyones bodies work and react
in different ways. Medication can supplement these imbalances. They
will most likely be on medication their entire life because it is an
imbalance that is neurological. My anxiety, however, was a product of
my environment and I no longer need medication. I’m trying to say for
children who conclusively have ADHD and whoes families want to
medicate them, then I support that. It is a disorder that is in our
bodies and if we can do something about it to make their educational
experinces more enriching than I say go for it.
But, since the article discusses that the diagnosis of ADHD is
possibly overused, I think the prescriptions of medicines needs to be
better regulated and the diagnosis process needs to be more definite.
“For example, difficulty sustaining attention may be a characteristic
of stress, depression, or anxiety. In addition, some features
associated with ADHD (e.g., noncompliance) may also be prominent in
other disorders like conduct disorder or oppositional defiant disorder
(APA, 2000; Barkley, 2005). This overlap complicates diagnosis and,
without a comprehensive assessment, may increase the likelihood of an
incorrect ADHD diagnosis (Barkley, 2005; Cotugno, 1993; Kube,
Petersen, & Palmer, 2002; Milberger Biederman,Faraone,Murphy,& Tsuang,
1995)” (pg. 108). If a diagnosis is to be made, their needs to be
comprehensive assessments and conclusive evidence.
Sometimes, I feel like I have ADHD ! Clearly, I don’t, but there are
so many distractions in our world and lives that everything can become
foggy and confusing. “The core symptoms of ADHD are present, to some
extent, in most children. Consequently, people may question the
legitimacy of the ADHD diagnosis in the first place.” (pg. 111). If
it is so hard to pinpoint if someone really does have the disability,
and it is alarming prevalent in schools across our nations, we
shouldn’t be so quick to medicate. I am not against medication; I am
against the overmedication of students who may not conclusively have
the disorder.
—because I have four students who are diagnosed with ADHD (all boys),
two of which are on medication and two of which were retained in 2nd
grade. One boy, Christopher, since he started on medication has grown
exponentially in term of his academic ability and ability to
concentrate and focus and push himself. Within one academic year his
reading level grew over 2 years--he went from reading at a middle of
1st grade level to an end of 3rd grade level. He is one of my most
able math students. In school, he went from crawling under desks
during reading time to passionately reading for over 30 minutes
straight. It is clear his medication has allowed him to learn and
better access materials.
I know this is just one anecdotal story, and although I think it was
an amazing decision to medicate Christopher, I do think that
overmedicating children is problematic. Again, I find the issue so
complex.
I was diagnosed with generalized anxiety disorder and was on
medication for years. I also have friends and family members who are
on certain medications for similar reasons because their brains and
bodies are hardwired a certain way or produce too much or too little
of a certain chemical etc. Basically everyones bodies work and react
in different ways. Medication can supplement these imbalances. They
will most likely be on medication their entire life because it is an
imbalance that is neurological. My anxiety, however, was a product of
my environment and I no longer need medication. I’m trying to say for
children who conclusively have ADHD and whoes families want to
medicate them, then I support that. It is a disorder that is in our
bodies and if we can do something about it to make their educational
experinces more enriching than I say go for it.
But, since the article discusses that the diagnosis of ADHD is
possibly overused, I think the prescriptions of medicines needs to be
better regulated and the diagnosis process needs to be more definite.
“For example, difficulty sustaining attention may be a characteristic
of stress, depression, or anxiety. In addition, some features
associated with ADHD (e.g., noncompliance) may also be prominent in
other disorders like conduct disorder or oppositional defiant disorder
(APA, 2000; Barkley, 2005). This overlap complicates diagnosis and,
without a comprehensive assessment, may increase the likelihood of an
incorrect ADHD diagnosis (Barkley, 2005; Cotugno, 1993; Kube,
Petersen, & Palmer, 2002; Milberger Biederman,Faraone,Murphy,& Tsuang,
1995)” (pg. 108). If a diagnosis is to be made, their needs to be
comprehensive assessments and conclusive evidence.
Sometimes, I feel like I have ADHD ! Clearly, I don’t, but there are
so many distractions in our world and lives that everything can become
foggy and confusing. “The core symptoms of ADHD are present, to some
extent, in most children. Consequently, people may question the
legitimacy of the ADHD diagnosis in the first place.” (pg. 111). If
it is so hard to pinpoint if someone really does have the disability,
and it is alarming prevalent in schools across our nations, we
shouldn’t be so quick to medicate. I am not against medication; I am
against the overmedication of students who may not conclusively have
the disorder.
Tiffany (india) Starke
Feb 18, 2011, 1:15:14 PM2/18/11
to Foundations of Special Education 541
Title: OUTBREAK or OVERDIAGNOSIS........you choose!
Discussion #3
Defining ADHD-
Attention-Deficit it Hyperactivity Disorder (ADHD) is a developmental
disorder, neurological in nature; affecting part of the world's
population. The disorder typically presents itself during childhood,
and is characterized by a persistent pattern of inattention and/or
hyperactivity (overstimulation), as well as forgetfulness,
impulsivity, and distractibility.
You know…it's highly unlikely to turn your head in a school these days
without playing an internal game of “I SPY A CHILD WITH……” on a bunch
of kids labeled with/suspected of having attention deficit
hyperactivity disorder (ADHD) or some other quickly diagnosed label
that rewarded them with free transportation on the DCPS, yellow cab
AKA the cheese bus.
If a commercial was made for diagnosing children with hyperactivity
and other similar quirks, it would probably read something like this….
“If your child is out of control and you're not able to deal with
their unwanted behaviors, then ADHD may be the diagnosis you’ve been
looking for. No need to fear, Ritalin and Adderall are here!”
There are many drugs and treatments for ADHD and other high frequency
disorders that would instantly solve your problems……. Got a bad kid?
Give them medication and Problem solved! But, are these medications
“the be all” in modern medicine? Are the side effects worth the quick
fix?
SIDE EFFECTS OF ADHD MEDICATIONS
The following stimulant medications are often prescribed for the
treatment of symptoms of ADHD. The most common are: methylphenidate
(Ritalin, Concerta), dextroamphetamine (Adderall, Dexedrine). These
medications have many side effects.. Some can appear within the first
few weeks of taking medication. These include:
Loss of appetite
Headache
Stomach upset or nausea
Weight Loss
Problems Sleeping
Anxiety, nervousness and mood changes
Chest pain, irregular or fast heartbeat
Increased blood pressure
Joint pain
Skin rash
Uncontrollable tics
Fever
*NOTE- Ritalin and Concerta can also cause bruising
An over diagnosis of ADHD is often done to solve the problems of a
difficult child. The bias in this diagnosis has affected/could affect
as many as one million kids or more. Yes, it would make it much easier
for parents and for teachers if the problem children just stopped
being a problem. (On the contrary, I must acknowledge the many genuine
cases of ADHD who are truly suffering from this disorder can often
benefit from medication.)
Perhaps teachers and doctors who are so quick to suggest and diagnose
ADHD are perhaps, suffering from attention deficit and the side
effects of the prescribed narcotics used to treat the “disability.” '.
It could be that if we paid more attention' to the individual child
and concentrated on the possible deficit' in the classroom, or in the
practice of over-medicating', we would better serve our children
(maybe).
Each one, who reaches one….teach one!
On Feb 16, 4:29 pm, "Tiffany (india) Starke" <teacherzp...@gmail.com>
wrote:
>
> - Show quoted text -
betsy hagan
Feb 20, 2011, 11:15:18 AM2/20/11
to Foundations of Special Education 541
Good thoughts Tiffany and Emily! I too have spent a lot of time
thinking about this issue. I currently have three students in my
class under evaluation. Their 1st & 2nd Grade teachers concur but
because our school is often reluctant to do any testing and their
parents have been unable to come to meetings on a regular basis or
show up to sign forms, I am not sure we will see anything result in
this school year for these struggling students.
This article was an interesting read on many levels. First, I find it
fascinating that the American Psychiatric Association’s authoritative
guide can give a ball point figure of 3-7% of American children
meeting the criteria for ADHD and then the media can create a circus
about over-diagnosing and over-medicating children when the facts just
don’t line up. We may in fact be under-diagnosing girls!
I have to say, for many years I have sat back in this debate and just
watched. I have seen families struggle with this and while the
children were very ‘busy’ indeed, I was never quite sure they should
be medicated and whether or not all this was even legit or not. I
always wondered if parents had some how been too indulgent etc. We
all grew up with a few friends who had boundless energy, were always
in trouble and then sat very close to the teacher’s desk every school
year.
Over the last 10 years of teaching, I have had more of these students
in my class and it was evident they tried very hard to stay on task
and had the heart to do the right thing but something somewhere in
their brain would not let them comply. I have built solid
relationships with these students and know that they were in fact,
giving me their very best effort. Something was wrong and they could
not help themselves. I too have seen students get on medication and
the world becomes a fair playing field for them and they are excellent
students. So, ADHD does not mean a student is unable to learn but it
can mean that we need to help them get to the place where they can
learn. In the early 90’s we saw films about what an ADHD student
might see when he read a paragraph – the page and words were moving
and changing size and sentences were re-organizing themselves across
the page. I haven’t seen these movies circulated in recent years but
if there is any truth at all to this and we are able to help the brain
stabilize itself, then it seems right to do so. This is not a
discipline issue--but unfortunately it does come down to this and this
seems to me to feed the media circus.
One of the problems seem to be that many physicians fail to follow
best procedures and complete all recommended testing (108). This may
be the case and the APA should be the one to exhort its members and
the medical profession to clean up their act. Parents are often eager
for help for their children and following a protocol should be
standard operating procedure for doctors and schools.
But what about this media circus? I personally know parents who have
been influenced by this and refuse to even explore the medication
option. I had one grandmother in my class that was convinced her
grandson would become a drug addict as a result. I have friends who
eliminated all sugar and gluten from their child’s diet (which I think
it a great start!), others have opted to home school – all with some
success. I respect a parent’s decision in this when they have looked
at the options and decided what might be best for their child. But
the truth remains, for a child who is appropriately diagnosed with
ADHD, medication helps them focus and learn. And I believe the child
deserves a chance to view the world without a constant barrage in his
brain. I know that the medication process is a soft science so it may
not be completely right at first. There are risks involved but I know
many who have successfully navigated this path and their children are
healthy and happy and thriving in school.
Teachers often play a huge role in this—we fill out the forms that
chronicle a child’s behavior in our class. For me, I have to make
sure I am paying diligent attention to this student - his actions,
triggers, the times and places where he is able to be attentive and
for how long etc. so that I am not just sharing my frustrations about
a ‘busy’ or an ‘uninterested’ student. We can help the process by
pursing a relationship with our students so that they know we care
about their problems and not just about them ‘being’ the problem.
On Feb 18, 1:15 pm, "Tiffany (india) Starke" <teacherzp...@gmail.com>
thinking about this issue. I currently have three students in my
class under evaluation. Their 1st & 2nd Grade teachers concur but
because our school is often reluctant to do any testing and their
parents have been unable to come to meetings on a regular basis or
show up to sign forms, I am not sure we will see anything result in
this school year for these struggling students.
This article was an interesting read on many levels. First, I find it
fascinating that the American Psychiatric Association’s authoritative
guide can give a ball point figure of 3-7% of American children
meeting the criteria for ADHD and then the media can create a circus
about over-diagnosing and over-medicating children when the facts just
don’t line up. We may in fact be under-diagnosing girls!
I have to say, for many years I have sat back in this debate and just
watched. I have seen families struggle with this and while the
children were very ‘busy’ indeed, I was never quite sure they should
be medicated and whether or not all this was even legit or not. I
always wondered if parents had some how been too indulgent etc. We
all grew up with a few friends who had boundless energy, were always
in trouble and then sat very close to the teacher’s desk every school
year.
Over the last 10 years of teaching, I have had more of these students
in my class and it was evident they tried very hard to stay on task
and had the heart to do the right thing but something somewhere in
their brain would not let them comply. I have built solid
relationships with these students and know that they were in fact,
giving me their very best effort. Something was wrong and they could
not help themselves. I too have seen students get on medication and
the world becomes a fair playing field for them and they are excellent
students. So, ADHD does not mean a student is unable to learn but it
can mean that we need to help them get to the place where they can
learn. In the early 90’s we saw films about what an ADHD student
might see when he read a paragraph – the page and words were moving
and changing size and sentences were re-organizing themselves across
the page. I haven’t seen these movies circulated in recent years but
if there is any truth at all to this and we are able to help the brain
stabilize itself, then it seems right to do so. This is not a
discipline issue--but unfortunately it does come down to this and this
seems to me to feed the media circus.
One of the problems seem to be that many physicians fail to follow
best procedures and complete all recommended testing (108). This may
be the case and the APA should be the one to exhort its members and
the medical profession to clean up their act. Parents are often eager
for help for their children and following a protocol should be
standard operating procedure for doctors and schools.
But what about this media circus? I personally know parents who have
been influenced by this and refuse to even explore the medication
option. I had one grandmother in my class that was convinced her
grandson would become a drug addict as a result. I have friends who
eliminated all sugar and gluten from their child’s diet (which I think
it a great start!), others have opted to home school – all with some
success. I respect a parent’s decision in this when they have looked
at the options and decided what might be best for their child. But
the truth remains, for a child who is appropriately diagnosed with
ADHD, medication helps them focus and learn. And I believe the child
deserves a chance to view the world without a constant barrage in his
brain. I know that the medication process is a soft science so it may
not be completely right at first. There are risks involved but I know
many who have successfully navigated this path and their children are
healthy and happy and thriving in school.
Teachers often play a huge role in this—we fill out the forms that
chronicle a child’s behavior in our class. For me, I have to make
sure I am paying diligent attention to this student - his actions,
triggers, the times and places where he is able to be attentive and
for how long etc. so that I am not just sharing my frustrations about
a ‘busy’ or an ‘uninterested’ student. We can help the process by
pursing a relationship with our students so that they know we care
about their problems and not just about them ‘being’ the problem.
On Feb 18, 1:15 pm, "Tiffany (india) Starke" <teacherzp...@gmail.com>
Emily Brooks
Feb 21, 2011, 3:36:47 PM2/21/11
to foundations-of-spe...@googlegroups.com, betsy hagan
Tiffany, you bring a great point at the end of your post. Teachers and parents have a vision of normalcy and when we don't see or get what is normal we try to mold students to become what we want, INSTEAD of trying to create conditions for students with ADHD to thrive. Our classroom settings may have huge deficits or gaps that are further disconnecting the child from learning. You also bring up side effects. Weighting the pros and cons of medication is a hard decision and should be more involved in the conversation since the side effects are so broad and there are many.
Betsy, I like your post and I agree what a lot of what you wrote. The decision to take medication is a huge one that involves risks. You also brought up the point that "they could not help themselves". I think a lot of times teachers or parents assume that students with ADHD make the decision to be hyperactive, when in fact their actions are not always conscious decisions that they make.
Betsy
Mar 1, 2011, 5:21:39 PM3/1/11
to Foundations of Special Education 541
Hey all, a colleague sent this out and I thought it was fascinating;
it also picks up on some of the discussion about over-medicating kids
with ADHD--and mostly on the east coast! I am curious where he got
his data! check it out! http://www.youtube.com/watch?v=zDZFcDGpL4U
On Feb 21, 3:36 pm, Emily Brooks <emily.ida.bro...@gmail.com> wrote:
> Tiffany, you bring a great point at the end of your post. Teachers and
> parents have a vision of normalcy and when we don't see or get what is
> normal we try to mold students to become what we want, INSTEAD of trying to
> create conditions for students with ADHD to thrive. Our classroom settings
> may have huge deficits or gaps that are further disconnecting the child from
> learning. You also bring up side effects. Weighting the pros and cons of
> medication is a hard decision and should be more involved in the
> conversation since the side effects are so broad and there are many.
>
> Betsy, I like your post and I agree what a lot of what you wrote. The
> decision to take medication is a huge one that involves risks. You also
> brought up the point that "they could not help themselves". I think a lot of
> times teachers or parents assume that students with ADHD make the decision
> to be hyperactive, when in fact their actions are not
> always conscious decisions that they make.
>
> ...
>
> read more »
it also picks up on some of the discussion about over-medicating kids
with ADHD--and mostly on the east coast! I am curious where he got
his data! check it out! http://www.youtube.com/watch?v=zDZFcDGpL4U
On Feb 21, 3:36 pm, Emily Brooks <emily.ida.bro...@gmail.com> wrote:
> Tiffany, you bring a great point at the end of your post. Teachers and
> parents have a vision of normalcy and when we don't see or get what is
> normal we try to mold students to become what we want, INSTEAD of trying to
> create conditions for students with ADHD to thrive. Our classroom settings
> may have huge deficits or gaps that are further disconnecting the child from
> learning. You also bring up side effects. Weighting the pros and cons of
> medication is a hard decision and should be more involved in the
> conversation since the side effects are so broad and there are many.
>
> Betsy, I like your post and I agree what a lot of what you wrote. The
> decision to take medication is a huge one that involves risks. You also
> brought up the point that "they could not help themselves". I think a lot of
> times teachers or parents assume that students with ADHD make the decision
> to be hyperactive, when in fact their actions are not
> always conscious decisions that they make.
>
>
> read more »
Eleanore Tiehen
Mar 6, 2011, 12:50:46 PM3/6/11
to Foundations of Special Education 541
Why would 76% of people polled in 2002 by CNN believe that ADHD was
over diagnosed? Is the public perception that ADHD is over diagnosed
due to bad information obtained by the media or anecdotal evidence
taken as a “truth” for all other situations? Perhaps the problem of
perception is not in the media, but in the way the public accepts
information at face value.
The information I took from the article, Evaluating the Evidence For
and Against the Overdiagnosis of ADHD by Mark J. Sciutto and Miriam
Eisenberg, was less about ADHD and more about how we think, perceive,
and process information. According the article, “Most likely, people
get their information from one of three types of sources: personal
experience, mass media coverage, or professional literature” (p.
110). Our personal experience drives how we perceive and process
information and subsequently the potential bias we take. I am
fascinated by the different forms of bias presented in this article;
including availability bias and confirmation bias.
Availability bias is based on the ability to easily recall an example
related to the topic. As teachers, I’m sure we would all have no
trouble citing specific anecdotal evidence from our classrooms
regarding students who have ADHD (or our perceptions of the
students). It is easy to take a hypothesis at face value when using
your personal experience or the news as valid information, without
using a critical eye.
According to the article, “A confirmation bias may influence people’s
judgments about a particular issue by leading them to (a) entertain
only a single hypothesis, (b) give greater weight to evidence that
supports preexisting beliefs, or (c) look only for confirmatory
information” (p. 110). The tendency regarding confirmation bias is to
focus on one piece of information and seek out similar or like-minded
ideas. I think it is important as educators and consumers of
information to accept and process information with a grain of salt.
Knowing how the mind works when processing new information and the
tendency towards bias in the news and scholarly articles, reading with
a critical eye should be a habit of mind that we teach and practice.
It is important to consider what we do with what we know.
The facts that the authors have not found any conclusive evidence,
combined with the absence of a large-scale, research study confirming
or denying the hypothesis that ADHD is over diagnosed poses more
questions than answers. How can the hypothesis be proved when a
national standard for diagnosing ADHD does not exist? Perhaps the
first step in obtaining a clearer picture regarding the real
prevalence of the disorder is creating a diagnostic test (or two based
on sex-specific norms) that is agreed upon and standardized across the
board. Would a standardized diagnostic test decrease the
opportunities for false positives or false negatives?
over diagnosed? Is the public perception that ADHD is over diagnosed
due to bad information obtained by the media or anecdotal evidence
taken as a “truth” for all other situations? Perhaps the problem of
perception is not in the media, but in the way the public accepts
information at face value.
The information I took from the article, Evaluating the Evidence For
and Against the Overdiagnosis of ADHD by Mark J. Sciutto and Miriam
Eisenberg, was less about ADHD and more about how we think, perceive,
and process information. According the article, “Most likely, people
get their information from one of three types of sources: personal
experience, mass media coverage, or professional literature” (p.
110). Our personal experience drives how we perceive and process
information and subsequently the potential bias we take. I am
fascinated by the different forms of bias presented in this article;
including availability bias and confirmation bias.
Availability bias is based on the ability to easily recall an example
related to the topic. As teachers, I’m sure we would all have no
trouble citing specific anecdotal evidence from our classrooms
regarding students who have ADHD (or our perceptions of the
students). It is easy to take a hypothesis at face value when using
your personal experience or the news as valid information, without
using a critical eye.
According to the article, “A confirmation bias may influence people’s
judgments about a particular issue by leading them to (a) entertain
only a single hypothesis, (b) give greater weight to evidence that
supports preexisting beliefs, or (c) look only for confirmatory
information” (p. 110). The tendency regarding confirmation bias is to
focus on one piece of information and seek out similar or like-minded
ideas. I think it is important as educators and consumers of
information to accept and process information with a grain of salt.
Knowing how the mind works when processing new information and the
tendency towards bias in the news and scholarly articles, reading with
a critical eye should be a habit of mind that we teach and practice.
It is important to consider what we do with what we know.
The facts that the authors have not found any conclusive evidence,
combined with the absence of a large-scale, research study confirming
or denying the hypothesis that ADHD is over diagnosed poses more
questions than answers. How can the hypothesis be proved when a
national standard for diagnosing ADHD does not exist? Perhaps the
first step in obtaining a clearer picture regarding the real
prevalence of the disorder is creating a diagnostic test (or two based
on sex-specific norms) that is agreed upon and standardized across the
board. Would a standardized diagnostic test decrease the
opportunities for false positives or false negatives?
colson
Mar 6, 2011, 1:02:26 PM3/6/11
to Foundations of Special Education 541
There’s Money in Them There Pills!
*** Personal disclaimer: I worked for over twenty years with
organizations out of Maryland in an effort to monitor and reduce the
use of behavior altering chemicals in children. Most of our work was
done in the eighties and nineties. The primary chemical monitored was
Ritalin. We monitored the swell in use of this chemical as it moved
across the country from Texas to the east coast and beyond. Our
conclusions were different from the findings in this research. ***
The primary concern that I have after reading this research is… Why?
With so many factors that clearly interfere with an honest
investigation, why would this investigation be attempted? The first
factor to interfere with a fair investigation is the lack of a well
defined definition or description of ADHD. This research acknowledges
the negative impact created because of co-morbidity or crossover
symptoms used to identify ADHD. It is stated that it is not uncommon
to find the symptoms aligned with ADHD in the average child (or
adult). I can see this as problematic.
My second concern with this research is the inability to control the
instruments for assessing the suspected students. It is stated that
the DSM has guidelines but the degree of consistency with which these
guidelines were used could not be determined. What is clear is that
methods and assessments are inconsistent. This sounds problematic.
Third: My third concern is the method for monitoring females and
males. The method was not clearly defined. There is a difference
between the frequency of males diagnosed and females diagnosed. The
reason for this may be the method of assessing. It may also be based
upon the difference in the male/ female body chemistries. This feels
problematic.
Lastly, we must deal with the profit generated by the sale of these
drugs. The Bazillions of dollars from the sale of these drugs increase
the profit margin of many different businesses exponentially. If we
have not learned anything else this year, we have learned about the
power of capitalism. The desire to “make a dollar” is stronger than
our desire to support the holistic development of our children. It is
painfully clear that we can not legislate human emotions – greed, lust
(for money), and selfishness.
I believe there is a serious problem in America with the over
diagnosing of students with ADHD. The amount of chemicals distributed
to treat a broad range of symptoms is scary. There is an enormous
amount of inconsistency in assessing, distributing, record keeping,
monitoring, and accountability. These are children younger than two
years old through eighteen (older) years old. There is still a need
for research on long term and short term effects of early introduction
of chemicals into developing bodies. We are the advocates for our
children. We must be fair and honest in our actions and if there is a
gray area in our research it must be in support of the whole child. It
should not be the dollar value of the chemical.
*** Personal disclaimer: I worked for over twenty years with
organizations out of Maryland in an effort to monitor and reduce the
use of behavior altering chemicals in children. Most of our work was
done in the eighties and nineties. The primary chemical monitored was
Ritalin. We monitored the swell in use of this chemical as it moved
across the country from Texas to the east coast and beyond. Our
conclusions were different from the findings in this research. ***
The primary concern that I have after reading this research is… Why?
With so many factors that clearly interfere with an honest
investigation, why would this investigation be attempted? The first
factor to interfere with a fair investigation is the lack of a well
defined definition or description of ADHD. This research acknowledges
the negative impact created because of co-morbidity or crossover
symptoms used to identify ADHD. It is stated that it is not uncommon
to find the symptoms aligned with ADHD in the average child (or
adult). I can see this as problematic.
My second concern with this research is the inability to control the
instruments for assessing the suspected students. It is stated that
the DSM has guidelines but the degree of consistency with which these
guidelines were used could not be determined. What is clear is that
methods and assessments are inconsistent. This sounds problematic.
Third: My third concern is the method for monitoring females and
males. The method was not clearly defined. There is a difference
between the frequency of males diagnosed and females diagnosed. The
reason for this may be the method of assessing. It may also be based
upon the difference in the male/ female body chemistries. This feels
problematic.
Lastly, we must deal with the profit generated by the sale of these
drugs. The Bazillions of dollars from the sale of these drugs increase
the profit margin of many different businesses exponentially. If we
have not learned anything else this year, we have learned about the
power of capitalism. The desire to “make a dollar” is stronger than
our desire to support the holistic development of our children. It is
painfully clear that we can not legislate human emotions – greed, lust
(for money), and selfishness.
I believe there is a serious problem in America with the over
diagnosing of students with ADHD. The amount of chemicals distributed
to treat a broad range of symptoms is scary. There is an enormous
amount of inconsistency in assessing, distributing, record keeping,
monitoring, and accountability. These are children younger than two
years old through eighteen (older) years old. There is still a need
for research on long term and short term effects of early introduction
of chemicals into developing bodies. We are the advocates for our
children. We must be fair and honest in our actions and if there is a
gray area in our research it must be in support of the whole child. It
should not be the dollar value of the chemical.
kande9un
Mar 13, 2011, 9:55:53 AM3/13/11
to Foundations of Special Education 541
Great thought-provoking questions Holly, and great responses so far.
Before I respond to the article and your questions directly, I would
like to respond to a few colleagues.
Ellie,
I definitely see where you are coming with your perspective and take
aways from this article. It is very disconcerting that 76% of people
surveyed believe that ADHD is overdiagnosed, where after reading the
article, it doesn't seem like there is enough evidence to support that
sentiment. With that said, I don't want to make the same mistake that
you are mentioning in your post, which is the way "the way the public
accepts information at face value." I think this is an article that
clearly supports that disclaimer. Thanks for bringing up that point
of view!
Betty,
I agree with parts of what you are saying as well, especially your
point about the validity of our assessments for ADHD. It is stated
many times in this short article by Sciutto and Eisenberg that there
is not a standard way to assess for ADHD and if there is (I suppose
the DSM-IV criteria would be the best criteria to use--but not
necessarily an assessment) we (as a nation) are not assessing students
in a valid and accurate way. It is stated on page 108 that "One
potential reason for the diagnostic inaccuracy is the variability in
assessment procedures." It is very detrimental to our students if we
are not testing in a comprehensive, multi-faceted way AND it also
makes for very unreliable data about whether or not students are being
over diagnosed with ADHD or not. It seems apparent that we as
educators and administrators need to follow very strict protocols when
processing a potential case for ADHD and we must test a student very
comprehensively--and not just for ADHD but for other disorders as well
to make sure that we are not misdiagnosing. As stated in the article
on page 108, as well, symptoms that we classify as ADHD symptoms, may
be associated with a different disorder, such as ODD, stress,
depression or anxiety. I believe it is our jobs as educators to
question and play devils advocate when others are so quick to label a
child to havd ADHD.
With all that said and solely based on my short 5 year experience in
education, I do believe that many educators are quick to label a child
as having ADD or ADHD simply because of his "uncontrollable and
fidgeting" behavior--and I specifically used the pronoun "his" because
(as the article supports in a way) many people are quick to group boys
into this catergory, because by nature they are usually the ones who
are less likely to stay seated and have short attention spans. I
agree with what Tiffany and Emily mentioned about this issue, and that
was we as teachers have a specific idea of what are students should be
acting like and what mold, I think emily put, should fit into and we,
are at times, not working with students to see why they are so fidgety
or unengaged or distracted, we simply get frustrated with their
behavior and lack of focus and put the blame on them and what they are
doing wrong and jump to--he must have ADHD, we need to get him tested,
he simply can't sit still or focus on anything! This way of thinking
is very frustrating to me, as I think teachers need to be much more
reflective and proactive with their instruction. When a lesson
doesn't go well or when I notice a student is not focusing well or
seems unengaged, I always look to myself to see what I am doing wrong
as a teacher, what I could do differently to reach that child or teach
that concept differently. I think think of what other factors could
be causing this child to be distracted, what social issues in the
classroom might be causing this inattentiveness, what factors at home
are being brought into the classroom that could be hindering this
child's focus and progress--such as the cowboy example from the
article. As the article states, and as educators who deal with myriad
of issues everyday in the classroom, there are many reasons for
inattentive or hyper-active behavior, and we need to think of what we
can do to help combat that with how we teach and how we develop a
community in our classroom.
To play devils advocate (on my own thoughts yes!) I do think it is
important that we are recognizing when we have tried many different
strategies to reach and help children and we still do not see change
in behavior, and that we follow through with the correct protocols and
work with parents to help that child succeed. As I am sure there are
many students who are not diagnosed who should be and many students
who would benefit from medication. I found it very concerning that,
as stated on page 109, "more than 50% of children with mental health
needs do not receive any form of treatment". Now is that because
parents are not supporting their children and making sure they are
receiving the services they need? Or perhaps they do not agree with
special education and having their child be tested, because of
whatever history or thoughts they hold about special education? It is
an interesting question and a very sad statistic at that. It is
amazing to see the difference that special education intervention and
medicine can have on a child, if done and used correctly. I have a
child who is medicated in my class and it is very apparent the days he
takes his medication and the days he does not take his medication.
When he doesn't take his meds, he is a completely different child. He
is unable to sit still, focus, remain calm, etc. He even will come to
me and tell me "Ms. Anderson I didn't take my medication, I am having
a really hard time". And I really feel for him--he needs his
medication to help him focus and that is ok, but without it, he is so
bombarded and distracted that he gets so overwhelmed!
As with any issue, there are both sides to the coin, and what it comes
down to in this case, I think, is thorough and accurate testing, to
make sure that we are diagnosing students with the correct disorders
and only medicating those who truly need it.
Before I respond to the article and your questions directly, I would
like to respond to a few colleagues.
Ellie,
I definitely see where you are coming with your perspective and take
aways from this article. It is very disconcerting that 76% of people
surveyed believe that ADHD is overdiagnosed, where after reading the
article, it doesn't seem like there is enough evidence to support that
sentiment. With that said, I don't want to make the same mistake that
you are mentioning in your post, which is the way "the way the public
accepts information at face value." I think this is an article that
clearly supports that disclaimer. Thanks for bringing up that point
of view!
Betty,
I agree with parts of what you are saying as well, especially your
point about the validity of our assessments for ADHD. It is stated
many times in this short article by Sciutto and Eisenberg that there
is not a standard way to assess for ADHD and if there is (I suppose
the DSM-IV criteria would be the best criteria to use--but not
necessarily an assessment) we (as a nation) are not assessing students
in a valid and accurate way. It is stated on page 108 that "One
potential reason for the diagnostic inaccuracy is the variability in
assessment procedures." It is very detrimental to our students if we
are not testing in a comprehensive, multi-faceted way AND it also
makes for very unreliable data about whether or not students are being
over diagnosed with ADHD or not. It seems apparent that we as
educators and administrators need to follow very strict protocols when
processing a potential case for ADHD and we must test a student very
comprehensively--and not just for ADHD but for other disorders as well
to make sure that we are not misdiagnosing. As stated in the article
on page 108, as well, symptoms that we classify as ADHD symptoms, may
be associated with a different disorder, such as ODD, stress,
depression or anxiety. I believe it is our jobs as educators to
question and play devils advocate when others are so quick to label a
child to havd ADHD.
With all that said and solely based on my short 5 year experience in
education, I do believe that many educators are quick to label a child
as having ADD or ADHD simply because of his "uncontrollable and
fidgeting" behavior--and I specifically used the pronoun "his" because
(as the article supports in a way) many people are quick to group boys
into this catergory, because by nature they are usually the ones who
are less likely to stay seated and have short attention spans. I
agree with what Tiffany and Emily mentioned about this issue, and that
was we as teachers have a specific idea of what are students should be
acting like and what mold, I think emily put, should fit into and we,
are at times, not working with students to see why they are so fidgety
or unengaged or distracted, we simply get frustrated with their
behavior and lack of focus and put the blame on them and what they are
doing wrong and jump to--he must have ADHD, we need to get him tested,
he simply can't sit still or focus on anything! This way of thinking
is very frustrating to me, as I think teachers need to be much more
reflective and proactive with their instruction. When a lesson
doesn't go well or when I notice a student is not focusing well or
seems unengaged, I always look to myself to see what I am doing wrong
as a teacher, what I could do differently to reach that child or teach
that concept differently. I think think of what other factors could
be causing this child to be distracted, what social issues in the
classroom might be causing this inattentiveness, what factors at home
are being brought into the classroom that could be hindering this
child's focus and progress--such as the cowboy example from the
article. As the article states, and as educators who deal with myriad
of issues everyday in the classroom, there are many reasons for
inattentive or hyper-active behavior, and we need to think of what we
can do to help combat that with how we teach and how we develop a
community in our classroom.
To play devils advocate (on my own thoughts yes!) I do think it is
important that we are recognizing when we have tried many different
strategies to reach and help children and we still do not see change
in behavior, and that we follow through with the correct protocols and
work with parents to help that child succeed. As I am sure there are
many students who are not diagnosed who should be and many students
who would benefit from medication. I found it very concerning that,
as stated on page 109, "more than 50% of children with mental health
needs do not receive any form of treatment". Now is that because
parents are not supporting their children and making sure they are
receiving the services they need? Or perhaps they do not agree with
special education and having their child be tested, because of
whatever history or thoughts they hold about special education? It is
an interesting question and a very sad statistic at that. It is
amazing to see the difference that special education intervention and
medicine can have on a child, if done and used correctly. I have a
child who is medicated in my class and it is very apparent the days he
takes his medication and the days he does not take his medication.
When he doesn't take his meds, he is a completely different child. He
is unable to sit still, focus, remain calm, etc. He even will come to
me and tell me "Ms. Anderson I didn't take my medication, I am having
a really hard time". And I really feel for him--he needs his
medication to help him focus and that is ok, but without it, he is so
bombarded and distracted that he gets so overwhelmed!
As with any issue, there are both sides to the coin, and what it comes
down to in this case, I think, is thorough and accurate testing, to
make sure that we are diagnosing students with the correct disorders
and only medicating those who truly need it.
Drew Smith
Mar 13, 2011, 11:08:40 AM3/13/11
to Foundations of Special Education 541
Tiffany,
Thanks for mentioning the side effects. I think it is crucial to
remember how all students are going to react to the medications
differently. For some, the benefits of the medication are going to
far outweigh the negatives of its side effects. Not that we should
discount the medications, but we just need to be extremely careful
when we start medicating children.
Drew Smith
Mar 13, 2011, 11:23:07 AM3/13/11
to Foundations of Special Education 541
Great responses so far. It is amazing to think that this is something
that we consistently think about with many of our students, over or
under diagnosed. For me, I feel that it has always been easy to label
an active student as having ADHD without any real medical knowledge.
Personally, I should be offering no diagnoses when it comes to my
students, but simply my observations. It is easy to focus on a child
that is having a visibly difficult time paying attention and just as
easy to overlook a quiet student. Unfortunately though, these
assumptions hurt all types of students. Those quiet students may be
completely focused on something else in the room, while the more
active student might have had too much sugar at lunch. There is just
so much more that goes into an ADHD diagnoses then their behavior in a
classroom setting.
Since boys are often the ones making more noise we are more willing to
label them as hyperactive. These types of conclusions also lead to
the possible misrepresentation of females in the ADHD statistics. The
text suggests, “Girls with ADHD tend to exhibit lower levels of
disruptive behavior and higher levels of inattentiveness,
internalizing symptoms, and social impairment (Sciutto and Eisenberg
109). As I alluded to earlier, I do think that teachers and parents
often confuse disruptive behavior with a quick ADHD diagnoses.
An interesting point discussed in the article referred to the
comparison of false positives to false negatives. If the argument is
that we are over-diagnosing then the assessment must be flawed. With
any assessment though there is going to be mistakes and as the text
suggests, “there is a wealth of research evidence documenting factors
that contribute to false positives and false negatives in the
identification of children with ADHD” (Sciutto and Eisenberg 108). If
this is true, then there is a somewhat similar number of students over
and under diagnosed.
Lastly and as Tiffany mentioned, the medications have such a wide
range of side effects that we need to be sure that the benefits of the
medicine are going to outweigh those side effects. Since we all react
differently to particular medications it is important to remember that
even if a student is diagnosed with ADHD, Ritalin or Adderall may not
be the best method of treatment. While I have no evidence to back it
up I do feel that a majority of DCPS schools have overwhelmed and
underfunded Special Education departments. In my school I am aware of
one child that is diagnosed with ADHD and that would put us
dramatically below the 3-7% range. For these reasons, I do not
necessarily see that we are quickly putting any student on medication,
but that possibly has more to do with funding. I do feel that in many
other districts and schools they are much more quickly to diagnose and
medicate though. We are becoming more open with our needs and our
student needs we just need to continue to be diligent in defining the
correct needs for each child.
that we consistently think about with many of our students, over or
under diagnosed. For me, I feel that it has always been easy to label
an active student as having ADHD without any real medical knowledge.
Personally, I should be offering no diagnoses when it comes to my
students, but simply my observations. It is easy to focus on a child
that is having a visibly difficult time paying attention and just as
easy to overlook a quiet student. Unfortunately though, these
assumptions hurt all types of students. Those quiet students may be
completely focused on something else in the room, while the more
active student might have had too much sugar at lunch. There is just
so much more that goes into an ADHD diagnoses then their behavior in a
classroom setting.
Since boys are often the ones making more noise we are more willing to
label them as hyperactive. These types of conclusions also lead to
the possible misrepresentation of females in the ADHD statistics. The
text suggests, “Girls with ADHD tend to exhibit lower levels of
disruptive behavior and higher levels of inattentiveness,
internalizing symptoms, and social impairment (Sciutto and Eisenberg
109). As I alluded to earlier, I do think that teachers and parents
often confuse disruptive behavior with a quick ADHD diagnoses.
An interesting point discussed in the article referred to the
comparison of false positives to false negatives. If the argument is
that we are over-diagnosing then the assessment must be flawed. With
any assessment though there is going to be mistakes and as the text
suggests, “there is a wealth of research evidence documenting factors
that contribute to false positives and false negatives in the
identification of children with ADHD” (Sciutto and Eisenberg 108). If
this is true, then there is a somewhat similar number of students over
and under diagnosed.
Lastly and as Tiffany mentioned, the medications have such a wide
range of side effects that we need to be sure that the benefits of the
medicine are going to outweigh those side effects. Since we all react
differently to particular medications it is important to remember that
even if a student is diagnosed with ADHD, Ritalin or Adderall may not
be the best method of treatment. While I have no evidence to back it
up I do feel that a majority of DCPS schools have overwhelmed and
underfunded Special Education departments. In my school I am aware of
one child that is diagnosed with ADHD and that would put us
dramatically below the 3-7% range. For these reasons, I do not
necessarily see that we are quickly putting any student on medication,
but that possibly has more to do with funding. I do feel that in many
other districts and schools they are much more quickly to diagnose and
medicate though. We are becoming more open with our needs and our
student needs we just need to continue to be diligent in defining the
correct needs for each child.
Meredith Blunda
Mar 13, 2011, 9:47:05 PM3/13/11
to Foundations of Special Education 541
As with many of the issues that we have discussed in our class, I
don’t think the topic of over-diagnosing ADHD has an easy yes or no
answer. After reading the posts that my classmates have read, I have
appreciated all of the complex thoughts and feelings presented, and
agree with a lot of them. Ultimately, I am not a doctor and do not
have the knowledge to give a firm answer on this questions, so I will
instead give my opinions on the matter, based on my experiences.
Before going into education, I remember thinking that children were
overly labeled as ADHD and given medication too often. But to be
honest, I had no real basis for that opinion. I think, just as Mark J.
Sciutto and Miriam Eisenberg write in “Evaluating the Evidence For and
Against the Overdiagnosis of ADHD,” I heard horror stories on the
news, and chose to believe them without question (110). Upon entering
the classroom, I have seen many cases of the opposite. I have
encountered students who were barely functional in the classroom and
coming to the point where they hated being in school because it was so
difficult for them. It wasn’t until they were diagnosed and given
treatment that they began to see success and start enjoying learning.
It opened up a world of learning for them. Now I realize these are
just my personal experiences, but I think that people need to have an
open mind to finding solutions for students that are struggling in the
classroom. But it should be done on a case by case, student by
student, basis - not making general assumptions for students.
I think there are a few things that need to happen to remedy the
situation. The assessment procedure needs to be standardized. The
authors write that “physicians varied considerably in their assessment
and diagnosis of childhood disorders”(108). If we can improve the
system for how children are diagnosed, eventually the stigma may
lessen around ADHD and this debate may eventually not need to happen.
I also think, as teachers, we need to work to make sure that we are
making accommodations in the classroom for all types of learners. Our
students come in all different forms and come with their own
challenges and it is our duty to find ways to help them learn in the
best way they can. I think we need to explore all of those avenues
before we start down any route of diagnosis. With these things in
place, some of the worries of over-diagnosis will not be necessary.
don’t think the topic of over-diagnosing ADHD has an easy yes or no
answer. After reading the posts that my classmates have read, I have
appreciated all of the complex thoughts and feelings presented, and
agree with a lot of them. Ultimately, I am not a doctor and do not
have the knowledge to give a firm answer on this questions, so I will
instead give my opinions on the matter, based on my experiences.
Before going into education, I remember thinking that children were
overly labeled as ADHD and given medication too often. But to be
honest, I had no real basis for that opinion. I think, just as Mark J.
Sciutto and Miriam Eisenberg write in “Evaluating the Evidence For and
Against the Overdiagnosis of ADHD,” I heard horror stories on the
news, and chose to believe them without question (110). Upon entering
the classroom, I have seen many cases of the opposite. I have
encountered students who were barely functional in the classroom and
coming to the point where they hated being in school because it was so
difficult for them. It wasn’t until they were diagnosed and given
treatment that they began to see success and start enjoying learning.
It opened up a world of learning for them. Now I realize these are
just my personal experiences, but I think that people need to have an
open mind to finding solutions for students that are struggling in the
classroom. But it should be done on a case by case, student by
student, basis - not making general assumptions for students.
I think there are a few things that need to happen to remedy the
situation. The assessment procedure needs to be standardized. The
authors write that “physicians varied considerably in their assessment
and diagnosis of childhood disorders”(108). If we can improve the
system for how children are diagnosed, eventually the stigma may
lessen around ADHD and this debate may eventually not need to happen.
I also think, as teachers, we need to work to make sure that we are
making accommodations in the classroom for all types of learners. Our
students come in all different forms and come with their own
challenges and it is our duty to find ways to help them learn in the
best way they can. I think we need to explore all of those avenues
before we start down any route of diagnosis. With these things in
place, some of the worries of over-diagnosis will not be necessary.
Emily Machado
Mar 13, 2011, 10:54:25 PM3/13/11
to Foundations of Special Education 541
Keith, I think that you bring up a really good point about the
potential benefits of ADHD. Some of my students with ADHD are the
most engaged and enthusiastic learners of the class.
Sciutto and Eisenberg make a great point by emphasizing the idea that
“for ADHD to be over-diagnosed, the number of false positives must
substantially exceed the number of false negatives” (p. 108). We
rarely hear about false negatives in the media or from our special
education coordinators and principals. We are often asked to try
every possible option before referring a student for testing. To be
honest, I had never even thought about unidentified ADHD students
because I had always assumed that I would be able to clearly see their
symptoms. With all of the media attention to overdiagnosis, I also
assumed that my own beliefs about student behavior might be
overgeneralizing or overdiagnosing. However, Sciutto and Eisenberg’s
argument about gender differences was particularly informative for my
own teaching. Because girls manifest symptoms of ADHD differently
than boys, they are often missed when identifying students with ADHD.
Their argument makes me wonder whether some girls in my own classroom
could be going unnoticed with ADHD.
In terms of Holly’s question about overmedicating students, I wonder
if we would be better off debating about the identification process
for ADHD. I find it hard to take a stand on overmedication because
I’m unsure whether we are over or under diagnosing our students. If
we are indeed overdiagnosing our students and giving them medicine
that will only have negative side effects, then of course we should be
more careful about assigning labels. However, I fully believe that if
medication will improve a child’s quality of life we should give him
or her the opportunity to take it. If students are not diagnosed and
experience “social impairment” and “inattentiveness,” then perhaps we
should be more open about using medication. I have one student in my
class who is in special education for an auditory processing disorder,
but consistently shows symptoms of ADHD. She has so little impulse
control, is wildly excitable, and often inattentive. However, you can
see how badly she wants to focus and learn like everyone else. Often
she can’t figure out why she is acting out and shows such a desire to
control her impulses. I wonder if in this case, if she is truly a
student with ADHD whether medication would be helpful for her. I
think the real issue lies in both standardizing and differentiating
assessments for identifying ADHD. If we can come up with a
consistent, respected assessment that accounts for subgroups like
ethnicity and gender, then we can have a better picture of who truly
needs medication and who would be better off without it.
potential benefits of ADHD. Some of my students with ADHD are the
most engaged and enthusiastic learners of the class.
Sciutto and Eisenberg make a great point by emphasizing the idea that
“for ADHD to be over-diagnosed, the number of false positives must
substantially exceed the number of false negatives” (p. 108). We
rarely hear about false negatives in the media or from our special
education coordinators and principals. We are often asked to try
every possible option before referring a student for testing. To be
honest, I had never even thought about unidentified ADHD students
because I had always assumed that I would be able to clearly see their
symptoms. With all of the media attention to overdiagnosis, I also
assumed that my own beliefs about student behavior might be
overgeneralizing or overdiagnosing. However, Sciutto and Eisenberg’s
argument about gender differences was particularly informative for my
own teaching. Because girls manifest symptoms of ADHD differently
than boys, they are often missed when identifying students with ADHD.
Their argument makes me wonder whether some girls in my own classroom
could be going unnoticed with ADHD.
In terms of Holly’s question about overmedicating students, I wonder
if we would be better off debating about the identification process
for ADHD. I find it hard to take a stand on overmedication because
I’m unsure whether we are over or under diagnosing our students. If
we are indeed overdiagnosing our students and giving them medicine
that will only have negative side effects, then of course we should be
more careful about assigning labels. However, I fully believe that if
medication will improve a child’s quality of life we should give him
or her the opportunity to take it. If students are not diagnosed and
experience “social impairment” and “inattentiveness,” then perhaps we
should be more open about using medication. I have one student in my
class who is in special education for an auditory processing disorder,
but consistently shows symptoms of ADHD. She has so little impulse
control, is wildly excitable, and often inattentive. However, you can
see how badly she wants to focus and learn like everyone else. Often
she can’t figure out why she is acting out and shows such a desire to
control her impulses. I wonder if in this case, if she is truly a
student with ADHD whether medication would be helpful for her. I
think the real issue lies in both standardizing and differentiating
assessments for identifying ADHD. If we can come up with a
consistent, respected assessment that accounts for subgroups like
ethnicity and gender, then we can have a better picture of who truly
needs medication and who would be better off without it.
Amanda Washington
Mar 14, 2011, 3:48:34 PM3/14/11
to Foundations of Special Education 541
As I read the thread, I kept thinking about Kay Redfield Jamison, the
author of An Unquiet Mind. She describes herself as a young student
being unable to retain information, wildly exciteable (at times), and
unattentive-often glaring out of the window and seemingly not paying
attention to things that were happening around her. She had many
symptoms of a child with ADHA but she was not diagnosed as being ADHD.
Such is the same, I feel, with many of the children that we work with
in DCPS. As I look in my special education department and the
children who are labeled as having ADHD, it seems improbable that ALL
of the children could have an identical disability. I do think that
we are too quick to use medicine to help students focus, primarily in
urban school environments. Furthermore, I think that it is common to
discredit the possibility of "the child going through...stress because
of negative household experiences." (108). CLARIFICATION: This is NOT
to say that every child that exhibits inattentive behavior in class
has undergone a traumatic experience or depression, however, I do
think that children within the urban school environment are too
quickly written off as specifically having ADHD without proper
investigation of personal reasons for inattentive behavior.
I think that this is moreso coming from a personal experience. I dear
friend of mine began finding it extremely difficult to focus in
college. He started having to read textual information four and five
times over to get the context, became unattentive in college lectures,
and tried extremely hard to remain focused and level headed in class
but found himself CONSTANTLY off task, having to reread, having to ask
questions because he was having trouble absorbing information. For a
while he began saying, I think that I am ADHD and was even told that
he had adult ADHD from our college clinic. As it turned out, he was
actually later found to be manic-depressive. If he had taken the
advice of "medical experts" who did little testing, as discussed in
the article, he would have gone throughout life misdiagnosed and more
than likely on a prescription drug for ADHD-something that in the end
would not have been beneficial to his well being.
Such is the same with many of the children that we diagnose with
ADHD. Yes many of them may in fact be suffering from ADHD, but many
times medical experts do a poor job of getting to the root of the
problem and children are presumed to be ADHD because of a few familiar
symptoms with little to no testing to back it up. Sciutto and
Eisenberg note that there may be many factors contributing to the
inability for children to pay attention in class-stress, depression,
anxiety, and even just "normal characteristics of childhood
adolescence" (106). I agree with the authors that many times the
overlap of symptoms make it extremely difficult to properly diagnose
ADHD.
Also, I think that many times if teachers cannot discipline children,
they consider them to be ADHD or to have behavioral problems. At my
school, I have noticed that many of the children who have been
diagnosed as ADHD or the students that some teachers warn me about are
just taking advantage of their situations. I don't think that a child
intrinsically values education and learning and so for a nine year old
child who would rather be outside playing or playing with videogames,
what is the point of listening? Is there isn't an adult figure that
is going to hold the student accountable, the student might take
advantage of the situation by becoming a child that exhibits ADHD
behavior. My response to SOME of these children- no, they don't have
ADHD...they just have not been effectively consequenced.
Finally, I DO think that the structure of schools has made it harder
for children to be efficient in classes. For example, my charter
school begins the day at 7:45 and ends at 5:00 pm. In this time,
students are given a 20 minute recess and a 30 minute lunch. Does
this seem ludacris to anyone else?! I absolutely value learning time
and allowing students optimum time to learn but imagine if you put the
Foundations of Education 541 Class in a classroom for over 7 hours and
our professor gave us just a one hour break in this time---I'd find it
hard to be attentive for the entire duration of my class! I think
that my charter school is the exception, however, my point is that
many children do not have adequate time (in my opinion) to just rest
their brains. The education system is so set on maximizing learning
time that we often forget that we are exhausting the minds of seven to
twelve year old children and holding them to the standards of focus
that most adults can't even successfully master.
I do think that ADHD is overly diagnosed and I think that it is for a
few reasons. 1) Inability to properly diagnose students because of
the overlapping symptoms of ADHD and other disorders. 2) Inability to
effectively consequence students who, as a result, take advantage of
the situation. 3) A far too exhaustive school day for children with
little time to break and relax their minds.
> > place, some of the worries of over-diagnosis will not be necessary.- Hide quoted text -
author of An Unquiet Mind. She describes herself as a young student
being unable to retain information, wildly exciteable (at times), and
unattentive-often glaring out of the window and seemingly not paying
attention to things that were happening around her. She had many
symptoms of a child with ADHA but she was not diagnosed as being ADHD.
Such is the same, I feel, with many of the children that we work with
in DCPS. As I look in my special education department and the
children who are labeled as having ADHD, it seems improbable that ALL
of the children could have an identical disability. I do think that
we are too quick to use medicine to help students focus, primarily in
urban school environments. Furthermore, I think that it is common to
discredit the possibility of "the child going through...stress because
of negative household experiences." (108). CLARIFICATION: This is NOT
to say that every child that exhibits inattentive behavior in class
has undergone a traumatic experience or depression, however, I do
think that children within the urban school environment are too
quickly written off as specifically having ADHD without proper
investigation of personal reasons for inattentive behavior.
I think that this is moreso coming from a personal experience. I dear
friend of mine began finding it extremely difficult to focus in
college. He started having to read textual information four and five
times over to get the context, became unattentive in college lectures,
and tried extremely hard to remain focused and level headed in class
but found himself CONSTANTLY off task, having to reread, having to ask
questions because he was having trouble absorbing information. For a
while he began saying, I think that I am ADHD and was even told that
he had adult ADHD from our college clinic. As it turned out, he was
actually later found to be manic-depressive. If he had taken the
advice of "medical experts" who did little testing, as discussed in
the article, he would have gone throughout life misdiagnosed and more
than likely on a prescription drug for ADHD-something that in the end
would not have been beneficial to his well being.
Such is the same with many of the children that we diagnose with
ADHD. Yes many of them may in fact be suffering from ADHD, but many
times medical experts do a poor job of getting to the root of the
problem and children are presumed to be ADHD because of a few familiar
symptoms with little to no testing to back it up. Sciutto and
Eisenberg note that there may be many factors contributing to the
inability for children to pay attention in class-stress, depression,
anxiety, and even just "normal characteristics of childhood
adolescence" (106). I agree with the authors that many times the
overlap of symptoms make it extremely difficult to properly diagnose
ADHD.
Also, I think that many times if teachers cannot discipline children,
they consider them to be ADHD or to have behavioral problems. At my
school, I have noticed that many of the children who have been
diagnosed as ADHD or the students that some teachers warn me about are
just taking advantage of their situations. I don't think that a child
intrinsically values education and learning and so for a nine year old
child who would rather be outside playing or playing with videogames,
what is the point of listening? Is there isn't an adult figure that
is going to hold the student accountable, the student might take
advantage of the situation by becoming a child that exhibits ADHD
behavior. My response to SOME of these children- no, they don't have
ADHD...they just have not been effectively consequenced.
Finally, I DO think that the structure of schools has made it harder
for children to be efficient in classes. For example, my charter
school begins the day at 7:45 and ends at 5:00 pm. In this time,
students are given a 20 minute recess and a 30 minute lunch. Does
this seem ludacris to anyone else?! I absolutely value learning time
and allowing students optimum time to learn but imagine if you put the
Foundations of Education 541 Class in a classroom for over 7 hours and
our professor gave us just a one hour break in this time---I'd find it
hard to be attentive for the entire duration of my class! I think
that my charter school is the exception, however, my point is that
many children do not have adequate time (in my opinion) to just rest
their brains. The education system is so set on maximizing learning
time that we often forget that we are exhausting the minds of seven to
twelve year old children and holding them to the standards of focus
that most adults can't even successfully master.
I do think that ADHD is overly diagnosed and I think that it is for a
few reasons. 1) Inability to properly diagnose students because of
the overlapping symptoms of ADHD and other disorders. 2) Inability to
effectively consequence students who, as a result, take advantage of
the situation. 3) A far too exhaustive school day for children with
little time to break and relax their minds.
Amanda Washington
Mar 14, 2011, 3:49:57 PM3/14/11
to Foundations of Special Education 541
OMM
Mar 14, 2011, 4:33:39 PM3/14/11
to Foundations of Special Education 541
American Psychiatric Association last report in 2000 stated that
approximately 3 to 7% of school aged children meet the criteria of
ADHD (American Psychiatric Association [APA], 2000). Can we really
say that ADHD is being diagnosised in too many children? Well,
according to this article there is a common conception that ADHD is
vastly overdiagnosised, with some suggesting that it is diagnosisi du
jour (Borgas, 1997) and that it may be a desirable diagnosis for some
parents (Smelter & Rasch, 1996). Now we have to ask the question on
what spectrum are we defining overdiagnosising. I honestly can seay
in my kindergarten class, my boys are more active thatn my girls and
sometimes it's unbearable. I think to myself, "Why don't their
parents put them on medicine?" Which goes back to say, are we
overdiagnosising our children?
After reading such an article as this, I don't believe that medicine
is too widely available. I believe that parents need to seek out the
medicine. A lot of parents refuse to put their child in that category
and suffer 18 years of mental exhaustion because they child is too
active. I think that if we are using the right resources to diagnosis
the children then we have to believe that we are helping them despite
of this article that state a lot of children have been
misdiagnosised.
On Mar 14, 3:49 pm, Amanda Washington <amandaewashing...@gmail.com>
wrote:
approximately 3 to 7% of school aged children meet the criteria of
ADHD (American Psychiatric Association [APA], 2000). Can we really
say that ADHD is being diagnosised in too many children? Well,
according to this article there is a common conception that ADHD is
vastly overdiagnosised, with some suggesting that it is diagnosisi du
jour (Borgas, 1997) and that it may be a desirable diagnosis for some
parents (Smelter & Rasch, 1996). Now we have to ask the question on
what spectrum are we defining overdiagnosising. I honestly can seay
in my kindergarten class, my boys are more active thatn my girls and
sometimes it's unbearable. I think to myself, "Why don't their
parents put them on medicine?" Which goes back to say, are we
overdiagnosising our children?
After reading such an article as this, I don't believe that medicine
is too widely available. I believe that parents need to seek out the
medicine. A lot of parents refuse to put their child in that category
and suffer 18 years of mental exhaustion because they child is too
active. I think that if we are using the right resources to diagnosis
the children then we have to believe that we are helping them despite
of this article that state a lot of children have been
misdiagnosised.
On Mar 14, 3:49 pm, Amanda Washington <amandaewashing...@gmail.com>
wrote:
OMM
Mar 14, 2011, 4:35:33 PM3/14/11
to Foundations of Special Education 541
I do think that ADHD is overly diagnosed and I think that it is for a
few reasons. 1) Inability to properly diagnose students because of
the overlapping symptoms of ADHD and other disorders. 2) Inability to
effectively consequence students who, as a result, take advantage of
the situation. 3) A far too exhaustive school day for children with
little time to break and relax their minds.
On Mar 14, 3:48 pm, Amanda Washington <amandaewashing...@gmail.com>
wrote:
>
> read more »- Hide quoted text -
Betsy
Mar 14, 2011, 5:50:21 PM3/14/11
to Foundations of Special Education 541
Amanda, I have had an opposite experience with ADHD! I had a lot of
students in the suburbs taking meds for ADHD and in my four years in
the DC schools I have not had any taking meds for this! In DC, I have
only had a handful who had been diagnosed with this but their parents
chose not to medicate them. I do have a student who is currently
taking anxiety meds to help her since her father was killed and on the
days she does not take her medicine she is angry, suspicious and gets
in fights. She once pushed me over a chair. Not a lot of learning on
those days--she is mostly busy with relational problems, lots of
drama, inattentiveness, fidgeting and storming around the classroom...
I certainly have seen more reluctance to medicate in the city than
burbville-- I have always thought parents in the burbs were too quick
to medicate compared to the families I have gotten to know in the
city. Funny how our experiences are so different sometimes!
> ...
>
> read more »
students in the suburbs taking meds for ADHD and in my four years in
the DC schools I have not had any taking meds for this! In DC, I have
only had a handful who had been diagnosed with this but their parents
chose not to medicate them. I do have a student who is currently
taking anxiety meds to help her since her father was killed and on the
days she does not take her medicine she is angry, suspicious and gets
in fights. She once pushed me over a chair. Not a lot of learning on
those days--she is mostly busy with relational problems, lots of
drama, inattentiveness, fidgeting and storming around the classroom...
I certainly have seen more reluctance to medicate in the city than
burbville-- I have always thought parents in the burbs were too quick
to medicate compared to the families I have gotten to know in the
city. Funny how our experiences are so different sometimes!
>
> read more »
Alida Maravi
Mar 14, 2011, 8:18:27 PM3/14/11
to Foundations of Special Education 541
I was surprised about how little the article focused on the complete
treatment process for ADHD or other related conditions that have ADHD
as a side effect (including trauma). It seems as if Sciutto and
Eisenberg consider four scenarios possible: either 1) you are ADHD,
but have not been diagnosed, 2) you are ADHD and are taking medication
for it, 3) you are not ADHD, but are taking medication for it, or 4)
you are not ADHD and are not taking medication for it. This leaves
little room for the possibility of children receiving a combination of
medication and psychotherapy (the recommended approach for anyone with
ADHD) or simply receiving psychotherapy treatment as a way to address
behavioral issues that may be caused by ADHD or other related issues.
I have a student who is extremely hyperactive - he can't stay still
ever and he can rarely stay seated for more than 5 minutes. He has an
extremely hard time getting any work done because he is constantly
distracted. Do I know if he is "officially" ADHD? No. Are there
other factors that could be affecting his behavioral issues? Yes. (His
parents are recently divorced and are not on good terms. He spends
his time going back and forth between houses and hearing them bad
mouth each other). Does the fact that I am not sure he has ADHD and
that there are outside sources for stress mean that I am not going
find help for him? Absolutely not. He sees the school counselor once
a week for a small group session with children that have ADHD and have
a host of other issues. His participation in this group has been
crucial to his growth as a student and as an individual. I would hate
to deprive him of this experience because I don't want to "over-
diagnose" or even consider the possibility of ADHD or a related
condition. I agree with many people who have posted saying that we
need to pay attention to the needs of the individual child, but
making over-generalizations that we can't prove (like "yes, ADHD is
over-diagnosed" and "kids with behavioral issues that may or may not
be ADHD are overmedicated") may cause us to overlook the real issues
our students face, simply because we are biased. Now, I know the
issue gets trickier when medication is involved. I don't necessarily
agree with the statement that many physicians aren't using the
appropriate measures when testing ADHD because as the article
mentions, it is not an illness that can be measured by taking a blood
sample and it is also an illness that can be intertwined with many
other issues or may appear as the result of an overarching mental
health issue. The assessment process in itself is not a "good" one
that will provide 100% accurate results with just one test. However,
if psychiatrists are going through the appropriate process in terms of
prescribing medication, providing psychotherapy for patients suspected
to have ADHD, and following up with the effects of both of these kinds
of treatments, then the problem of providing too much treatment or a
certain kind of treatment (such as treatment with stimulants) should
not be an issue. If children are continually taking drugs like
Adderall or Ritalin and are not ADHD than a psychiatrist should
realize and stop this when analyzing the effects of the drugs. We
can't think of ADHD as a diagnosis that is absolute and remains with a
child forever and affects him or her in the same way always, it is
something that can change as the brain develops and as other issues
that occur in tandem with symptoms of ADHD are dealt with. Drugs like
Adderall and Ritalin have very strict FDA controls. For example,
these types of stimulants cannot LEGALLY be prescribed to a patient
for more than one month. That is, a patient technically has to see
his or her psychiatrist at least monthly and receive a monthly
assessment in order for doctors to write a new prescription. Are
these guidelines strictly followed? For the most part, it seems as if
they are not. Because of ties psychiatrists may have with
prescription drug companies or because they can automatically collect
the continual monthly fees for visits from patients that are content
with the effects of a stimulant (even if they aren't "really" ADHD),
without actually doing any of the assessment work that is legally
required, many psychiatrists do not comply with these regulations and
either provide patients with several month-long prescriptions in
advance or simply continue prescribing stimulants every month
regardless of their analyses of patients' progress or reaction to the
drugs. Is this an issue of systemic over-diagnosis? No. This is an
issue of "systemic" irresponsibility and medical malpractice on the
part of physicians that do not monitor ADHD past an initial
diagnosis.
I also think that studies on the prevalence of ADHD can't be accurate
because of the tremendous cost of even initial intake visits at
psychiatric clinics, which are often not covered by medical
insurance. It is unlikely that families that cannot afford these high
fees, even if they suspect ADHD or other mental illnesses, will
receive an initial diagnosis for these issues.
I guess the overarching question I have after reading this article and
reading the posts in our discussion are: why are people so quick to
say mental conditions like ADHD or Aspergers are over-diagnosed, but
you rarely hear anyone saying diseases like arthritis, Alzheimer's,
gastroenteritis or specific kinds of cancers are over-diagnosed?
Perhaps it is because some of these diseases are easier to pinpoint
and can be assessed using concrete methods like body scans and blood
tests. However, I also think there is a stigma against mental
conditions that causes people to question the validity of diagnoses
and treatment methods for these types of illnesses. Mental illness is
an illness just like any other disease that affects organs other than
the brain. If we had a student demonstrating a chronic physical
malady we wouldn't just say "well maybe it's not really indicative of
any actual disease, but just a phase or a condition common for most
children or a condition that is caused by some outside effect out of
our control." We would figure out what it was. If it was nothing,
fine - we would do whatever we could to accommodate that student
regardless of their diagnosis or lack thereof. If it was something
significant, we would seek the appropriate treatment for our
students. As teachers, if we really are going to cater to the
specific needs of each student, we need to consider all the
possibilities instead of simply saying "I am not going to seek
diagnosis or treatment for this student who may be ADHD because it is
a disease that is over-diagnosed and because I don't want to label my
challenging students just because I can't seem to handle them
effectively." If we are advocates for appropriate, adequate AND
AFFORDABLE psychiatric/ psychologic care where diagnosing patients is
not a one-visit "in and out" process, but an ongoing exploration of
the issues each individual faces, we may effectively address problems
that otherwise would be swept under the rug.
> ...
>
> read more »
treatment process for ADHD or other related conditions that have ADHD
as a side effect (including trauma). It seems as if Sciutto and
Eisenberg consider four scenarios possible: either 1) you are ADHD,
but have not been diagnosed, 2) you are ADHD and are taking medication
for it, 3) you are not ADHD, but are taking medication for it, or 4)
you are not ADHD and are not taking medication for it. This leaves
little room for the possibility of children receiving a combination of
medication and psychotherapy (the recommended approach for anyone with
ADHD) or simply receiving psychotherapy treatment as a way to address
behavioral issues that may be caused by ADHD or other related issues.
I have a student who is extremely hyperactive - he can't stay still
ever and he can rarely stay seated for more than 5 minutes. He has an
extremely hard time getting any work done because he is constantly
distracted. Do I know if he is "officially" ADHD? No. Are there
other factors that could be affecting his behavioral issues? Yes. (His
parents are recently divorced and are not on good terms. He spends
his time going back and forth between houses and hearing them bad
mouth each other). Does the fact that I am not sure he has ADHD and
that there are outside sources for stress mean that I am not going
find help for him? Absolutely not. He sees the school counselor once
a week for a small group session with children that have ADHD and have
a host of other issues. His participation in this group has been
crucial to his growth as a student and as an individual. I would hate
to deprive him of this experience because I don't want to "over-
diagnose" or even consider the possibility of ADHD or a related
condition. I agree with many people who have posted saying that we
need to pay attention to the needs of the individual child, but
making over-generalizations that we can't prove (like "yes, ADHD is
over-diagnosed" and "kids with behavioral issues that may or may not
be ADHD are overmedicated") may cause us to overlook the real issues
our students face, simply because we are biased. Now, I know the
issue gets trickier when medication is involved. I don't necessarily
agree with the statement that many physicians aren't using the
appropriate measures when testing ADHD because as the article
mentions, it is not an illness that can be measured by taking a blood
sample and it is also an illness that can be intertwined with many
other issues or may appear as the result of an overarching mental
health issue. The assessment process in itself is not a "good" one
that will provide 100% accurate results with just one test. However,
if psychiatrists are going through the appropriate process in terms of
prescribing medication, providing psychotherapy for patients suspected
to have ADHD, and following up with the effects of both of these kinds
of treatments, then the problem of providing too much treatment or a
certain kind of treatment (such as treatment with stimulants) should
not be an issue. If children are continually taking drugs like
Adderall or Ritalin and are not ADHD than a psychiatrist should
realize and stop this when analyzing the effects of the drugs. We
can't think of ADHD as a diagnosis that is absolute and remains with a
child forever and affects him or her in the same way always, it is
something that can change as the brain develops and as other issues
that occur in tandem with symptoms of ADHD are dealt with. Drugs like
Adderall and Ritalin have very strict FDA controls. For example,
these types of stimulants cannot LEGALLY be prescribed to a patient
for more than one month. That is, a patient technically has to see
his or her psychiatrist at least monthly and receive a monthly
assessment in order for doctors to write a new prescription. Are
these guidelines strictly followed? For the most part, it seems as if
they are not. Because of ties psychiatrists may have with
prescription drug companies or because they can automatically collect
the continual monthly fees for visits from patients that are content
with the effects of a stimulant (even if they aren't "really" ADHD),
without actually doing any of the assessment work that is legally
required, many psychiatrists do not comply with these regulations and
either provide patients with several month-long prescriptions in
advance or simply continue prescribing stimulants every month
regardless of their analyses of patients' progress or reaction to the
drugs. Is this an issue of systemic over-diagnosis? No. This is an
issue of "systemic" irresponsibility and medical malpractice on the
part of physicians that do not monitor ADHD past an initial
diagnosis.
I also think that studies on the prevalence of ADHD can't be accurate
because of the tremendous cost of even initial intake visits at
psychiatric clinics, which are often not covered by medical
insurance. It is unlikely that families that cannot afford these high
fees, even if they suspect ADHD or other mental illnesses, will
receive an initial diagnosis for these issues.
I guess the overarching question I have after reading this article and
reading the posts in our discussion are: why are people so quick to
say mental conditions like ADHD or Aspergers are over-diagnosed, but
you rarely hear anyone saying diseases like arthritis, Alzheimer's,
gastroenteritis or specific kinds of cancers are over-diagnosed?
Perhaps it is because some of these diseases are easier to pinpoint
and can be assessed using concrete methods like body scans and blood
tests. However, I also think there is a stigma against mental
conditions that causes people to question the validity of diagnoses
and treatment methods for these types of illnesses. Mental illness is
an illness just like any other disease that affects organs other than
the brain. If we had a student demonstrating a chronic physical
malady we wouldn't just say "well maybe it's not really indicative of
any actual disease, but just a phase or a condition common for most
children or a condition that is caused by some outside effect out of
our control." We would figure out what it was. If it was nothing,
fine - we would do whatever we could to accommodate that student
regardless of their diagnosis or lack thereof. If it was something
significant, we would seek the appropriate treatment for our
students. As teachers, if we really are going to cater to the
specific needs of each student, we need to consider all the
possibilities instead of simply saying "I am not going to seek
diagnosis or treatment for this student who may be ADHD because it is
a disease that is over-diagnosed and because I don't want to label my
challenging students just because I can't seem to handle them
effectively." If we are advocates for appropriate, adequate AND
AFFORDABLE psychiatric/ psychologic care where diagnosing patients is
not a one-visit "in and out" process, but an ongoing exploration of
the issues each individual faces, we may effectively address problems
that otherwise would be swept under the rug.
>
> read more »
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