Saturday, 23 June 2012

ADD/ADHD and Ritalin: Time to Admit Mistakes

This is a serious post, about a serious issue. It’s a big one too, I didn’t want to leave anything out. Sorry if you came to me for short and snappy humour today, try this older post of mine on a remotely similar subject instead!

But seriously ...

I read a very good article in ChildMag last month entitled 'Rethinking Ritalin'. I rate the quality of any piece of writing largely on the way it makes me feel and this article made me feel like writing this post, so it must have been good. You can read the whole piece here, and I recommend it, especially to parents but it opens;

A mother describes what is becoming an increasingly common scenario in homes across South Africa and the western world. "My son was in Grade 1 when the teacher called me in." Says Lynne, a Mum from Johannesburg (could be me, could be me ...). "She said he had concentration issues and couldn't focus to finish work, he was getting bored and walked about disrupting class." Lynne immediately braced herself for the three letter diagnosis currently handed down to an estimated one in ten children: ADD, or attention deficit disorder. Then when an Educational Psychologist confirmed it, she braced herself again for the most commonly prescribed solution: Ritalin. "Today every other child seems to be on it" Lynne sighs. "But everything I'd heard made me totally against it. I was afraid and confused."

I think I'm with Lynne. And incidentally, Lynne now runs the national office of Adhasa in Randburg.

We Don’t Know What It Is Yet!

One in ten children is a very high ratio for a ... what is it exactly? A condition? A disease? Either way, it's a high ratio when you consider that ADD and ADHD (attention deficit combined with hyperactvity) are, as yet ... UNPROVEN!! Yes, that's right. Did you realise that? There is no data proving any of the theories that it's a disease, a brain dysfunction. No valid test to prove a child has it, whatever 'it' is. Because we don't actually know yet remember. Dr Mary Ann Block, head of the Citizens Commission and author of 'No More Ritalin' is quoted in the ChildMag article as asking "If there is no valid test; no data proving ADHD is a brain dysfunction, why in the world are millions of children being labelled with ADHD and prescribed these drugs?."

She has a point hey? Especially when you consider three other facts that really stick with me from reading the article.

1. Ritalin, as a drug, is stronger than cocaine. Yes, I did say that. Would you give your kids cocaine?? Okay if in measured doses? I don't even allow my kids Cola yet!

2. Ritalin has been used on children for approx 60 years. That's a very short time span as far as knowing the long-term effects of the drug. The original injection version was ceased, as it caused worrying side effects. We are effectively testing the long term effects of this strong drug on our children.

3. It's been estimated that a million children in the US alone may have been falsely diagnosed.

No wonder Lynne was afraid. Her son's school told her they wouldn't take him back unless she put him on Ritalin. So pleased to report she changed schools and started trying other treatments instead, although she did eventually resort to Ritalin at high school age, there were problems with side effects and her son's currently 16 and off medication. And Lynne is definitely now very much more informed on the subject than the school who originally tried to insist she drug her child.

Just Attention Seeking Behaviour?

It would seem that ADD and ADHD have very quickly, and worryingly very effectively, become labels to give any child who has problems concentrating at school or home, no matter what the reason. And that, I think, is the point we are getting to now, just some 60 years since the label 'ADD' was first bandied about. That is, we are realising that children find it hard to focus on the things we want them to focus on, let's be honest, at school and at home and they can behave disruptively for many, many different reasons.
 And as parents, don't we all know that really? What does your child do if they are upset about anything in any way? They attention seek, right? Do naughty to get your attention and help? Do we drug them to control their behaviour or do we deal with the problem? What the hell happened that we live in a world where we drug our kids behaviour away, before we try finding out what's wrong?

Ignore The Pressure, Get Better Informed

Mum's, Dad's, I IMPLORE you. If a Teacher or any other official gives you their opinion (which is all it is) that your child has a dysfunction, or a disease that they need to be heavily medicated for - don't just take their word for it. Nobody knows your child better than you do. And with a bit of research, you'll know more about ADD, ADHD and Ritalin than that 'Expert' who just gave you their opinion. Truly, get informed. We owe our kids at least that.

Thank the 'Expert' (on an undiagnosed condition) for their opinion and then take your child home and give them a big hug. Because it's likely somewhere in their young life, they may have a problem or a worry or a need that they don't know or understand how to express.

Ritalin should be the very, very last resort. No, f@*k it, it should be no resort at all as far as I'm concerned. A Durban based Clinical Psychologist, Robin Vanderplank, is quoted in the article as saying "Unless a child is in danger of abuse from frustrated parents (!!), Ritalin should be a last resort". Gee whiz guys, parents? There's help out there, please. For our children, see if you can get to the bottom of the problem first.

Try Everything Else

Adhasa supports the following steps in getting to the bottom of and improving your child's concentration or behaviour issues. Without the use of drugs;

1. Exercise: Helps naturally channel energy and focus, releases feel good endorphins.
2. Water: Dehydration leads to poor concentration. Try and ensure your child drinks 6-8 cups (size relevant) per day.
3. Diet: Feed your child healthily. Avoid high fat, refined carbs, colourants, preservatives and other additives. Sugar, caffeine, even white flour. Think natural, healthy, even home grown. In addition, use supplements because we can't always eat perfectly healthily, even when we're trying our darndest. A good Multivitamin and an Omega Oil will help.
4. STRESS!!: Is a major contributor to, as I'm now going to refer to them, ADD and ADHD 'symptoms'. Strive to keep a happy home, talk to your kids, know what irks them. Deal with things calmly, try and keep shouting etc to a minimum. Common problems that can deeply upset our children include Parental conflict, divorce or separation, abuse or bullying, unrecognised allergies, hearing or vision problems and general stress or depression.
5. Make space for your child: Sounds odd? I mean allow them the right to have their feelings, feel and express them without feeling belittled or that you don't have time for them. "Try to see things from your childs point of view" Vanderplank urges. Emotional growth and development is as important to our kids as physical growth and development.
6. Know how your child learns: We're all different. Some children show symptoms, especially in concentrating in school and on tasks, because they just need to learn differently. Check this article on the different ways we learn, and then watch your child. Work with him/her on something and see if you can see it. Kids are down, unresponsive and distracted when they're struggling to learn something. Up, excited and involved when they are 'getting' it. See if you can figure out how your child learns best, talk to the school. Change schools if you must, to a more flexible system that will allow your child to learn in the way that suits them.

But couldn't all of the above just come under the heading 'Be A Good Parent'? Sorry, am I being a bit harsh? I'm including myself remember, I'm a parent too and I'd struggle keeping the above in my head all day every day, as much as any other parent. But we must try at least.

Get Open Minded Help

If you're worried your child is showing symptoms or someone else has told you they have, go Google. Get informed, find your local Adhasa or similar and make sure YOU'RE the one who understands YOUR child the best. I couldn't believe the attitude of another Educational Psychologist, Terry Wilke who says in the article "ADHD children not on Ritalin are more likely to use recreational drugs to 'self-medicate'." Can you believe it? Prescribe your kids cocaine-strength drugs from a young age, and prevent them from experimenting with recreational drugs when they're older? WTF Mr Wilke?! Make certain you're not talking to anybody that closed minded or decided about Ritalin. Remember, ADD and ADHA is still an unproven phenomenon with no real proven test and Ritalin simply hasn't been around long enough for anybody to be certain of the long-term effects on our kids. Make sure you get advice from someone who's open to trying other methods.

And if your child HAS been diagnosed with ADD or ADHD and is already on medication or about to be started on it, I so feel for you. Truly I do. I'd guess, maybe I'm wrong, that you probably feel scared, like Lynne did. Have you tried all of the above? Have you tried everything you possibly can to keep your children unmedicated? Please do. Go back to your doctor, talk about trying other things, lower doses, complimentary therapy. And if they won't listen, get a second opinion. A third, a fourth.

What's the rush to deal with this issue so hastily and easily? There's time for more testing, both of the drug and of alternative methods for treatment. And of the symptoms and causes themselves. In this Mum's humble opinion, it's time to admit mistakes with rushed diagnoses and prescriptions to our children of this worrying drug and try something new.

I appreciate that for some parents, for some children Ritalin is (?) or would seem to be the only answer in desperate situations. But our children are too important for us to just accept that, and look no further surely?

Frankly, I believe they deserve us to do far better for them than just issue them with a dose of hard drugs.