ParentConfidante Blog

Does My Child Have A.D.D.?

A recent article highlights the importance of environmental factors when diagnosing and treating children with Attention Deficit Disorder (A.D.D.).  Dr. L. Alan Sroufe (NY Times, 1/29/12) wrote a comprehensive article on the overuse of drugs in the treatment of A.D.D. He takes issue with the assumption that there is a "brain deficit" in children who have attention difficulties and points out that the improvement in attention fades over time and that all people benefit from stimulant medication when focusing on more rote tasks.  His basic point, is that society is overlooking environmental influences in the rush to medicate.  For instance, emotional problems such as depression, turmoil at home, lack of social support, and ineffective parenting can produce behavior and attention problems  and these factors are not addressed in the rush to medication.

Many of Dr.Sroufe's observations were confirmed in my practice as a school psychologist.  I found ADHD becoming an increasingly frequent diagnosis with medication as the primary recommendation.  However, I  knew from working with the student that there were other, sometimes more pressing factors such as family distress or parenting disagreement.  It was much easier to go the path of medication than tangle with the difficult task of understanding the family dynamics and making changes.

That being said, there were many instances when medication was crucial and effective.  The child learned, felt better about himself because he wasn't constantly being redirected and gained socially as well.  Even if it's true that the effect of the medication fades after three years, three years is a long time, and the benefits could improve that child's life forever.

One reason I became an educational consultant and started ParentConfidante School Success Consulting is that many of the evaluations I read were incomplete and didn't consider all factors.  In my work, I refer parents to highly skilled professionals whose assessments are reliable and give a complete picture of the child and what would be helpful. An accurate diagnosis is crucial if the child is to make lasting progress. To help your child make the positive steps she deserves contact me at 646-300-1881.

 

 

 

 

 

Changing the Diagnostic Criteria for Autism and Asperger Syndrome

The American Psychiatric Association is reassessing the diagnostic criteria for autistic and the proposed changes, as described in the NY Times article of Jan. 20,2012, may exclude many people who are now diagnosed as having Autism, Asperger Syndrome or Pervasive Developmental Disorder-Not Otherwise Specified (P.D.D.-N.O.S).  These diagnoses would be consolidated under one category - Autism Spectrum  Disorder - eliminating the Asperger's and PDD-NOS categories.  While the new criteria will have little impact on the diagnosis of youngsters who are "classically autistic" - those who have severe limitations in their cognitive and social functioning- there may well be an impact on those youngsters who are cognitively able but have a social disability.

Parents are understandably concerned given that mandated services (IEP) are often dependent on a diagnosis.  It will be important to see how the changes  will ultimately affect the delivery of services, but the attempt to clarify diagnosis is an important and needed undertaking. In the past, there has been a good deal of confusion especially regarding the identification of Asperger Syndrome - does every child who prefers to play alone have Asperger's and are deficits in social intreraction the main determinant?  In fact, there are other determining factors for a classification of Asperger Syndrome and many children who fall within this group need continued support.

There was some concern when it was first divulged that there would be a consolidation in criteria with Asperger's eliminated, because Asperger Syndrome, properly diagnosed, is distinct from classical autism and descriptive.  It will be important, in the tightening up of this diagnostic category, that those who need services continue to receive them.  While these youngsters are cognitively able, their narrow interests, perseverative behavior, and social incapacity makes it very difficult from them to succeed without support.