Wow! I just found out that I’ve just reached my ninth anniversary of writing these blogs. The first one was published on 6/24/2009 (2009 Blog Post). Time does fly.
Having written nearly 320 of these posts, I do my best to try to keep things fresh, but I know there are some themes that reemerge. While no one has complained to me (at least not to my face) about that, I apologize if there is a certain repetitive beating of drum.
With that apology out of the way, I can go back to one of my favorite ongoing drumbeats (or to use my wife’s description – “You’re like a dog with a bone.”)
This week’s, theme, one that I’ve hit upon in many different permutations, has to do with the tendency to offer unitary explanations of complex kid issues (e.g., the “diagnosis” of ADHD explaining everything.)
I was prompted to respond to an article that appeared www.understood.org with the title: ““Is ADHD Real?” How I Respond When People Doubt ADHD.”
Now I don’t doubt the veracity of ADHD’s existence, but this is what I said as a comment to the article:
DrSelz New Jersey 2 days ago
As a practitioner in the field, for me the issue is not whether ADHD is real or not, but the casual way that ADHD is “diagnosed,” with very little consideration for alternative hypotheses that explain off-task behavior, distractibility, etc. It is a very rare parent who would be able to challenge an MD’s diagnosis that was based on very little else beyond history and a brief neurological screening. I would be much more comfortable with the “diagnosis” if there were a range of other tests that were part of the assessment. That’s not likely to happen, since insurance companies don’t typically pay on these tests. Richard Selznick, Ph.D.
Take Bethany, an 8th grader who is anxious and off-task a lot. The school suggested to the mom that she was ADHD, so she took her to a physician who diagnosed her with ADHD after about 20 minutes and a brief review of the history.
The mom wasn’t satisfied with the explanation and the approach of “let’s get her on medication” as the top strategy, so she brought her in to be assessed more thoroughly.
Wouldn’t you know it, upon testing her there was a whole lot more in her “pie-chart” than the one factor explanation of “ADHD.”
While there was probably ADHD in the mix, there were also clear indicators that Bethany was having great trouble understanding what she was reading starting around the fourth grade level (the point where the text usually gets pretty tough). She had virtually no capacity to answer questions involving inferential thinking and she also was overwhelmed when presented with too much language to “process.”
For Bethany she was confused. Imagine going to a lecture that was 40% in English, but the rest was in nonsensical gibberish. Perhaps you might get some of the concepts, but most of it would be passing you by. How would you feel? How would you behave?
Right! Confused, Anxious and distracted.
After 9 years of writing these things, relative to moving us away from one-factor explanations of children the drum beat goes on and I’m still a “dog with a bone,”(Yes, I know I am mixing metaphors, but I am looking for you to laugh and it’s the only way I can think to make that happen at the moment!).——————————————————————-
Copyright, 2018 www.shutdownlearner.com
Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – firstname.lastname@example.org.
To receive free newsletter and updates, go to: www.shutdownlearner.com.
ADHD and ADD are real and LDs and ADHD/ADD can exacerbate the other. My own daughter now 18 and headed off to college in the fall was diagnosed with ADHD in the 1st grade by a pediatric neuropsychologist. I questioned/doubted that diagnosis suggesting that I thought she was dyslexic. All the signs were there!
I wasted too many years with just the ADHD diagnosis instead of swiftly providing appropriate interventions for a reading disability. By the 4th Grade a second private evaluation of course confirmed that I was right. At that point I pushed the school to provide her Orton 3x week 1 on 1, took her out of Spanish and started to explain to her how dyslexia made certain aspects of learning hard but had nothing to do with her intellect. It all made sense to her and resolved a mystery that had left left her feeling dumb for too long.
She just graduated a high performing high school cum laude with a 3.75 and a 32 ACT (with extra time of course). She is headed to A very good college which is happy to provide accommodations and a waiver of foreign language. Most colleges don’t make receiving accommodations a torturous process like so many public schools do.
So is my daughter ADD? I would still say yes but for sure the Dyslexia was and remains the bigger issue. Kids who struggle with reading, spelling and math facts everyday in school from 8:30-3 will of course become distracted and by the end of 3rd Grade feel quite dumb. But the solution for my daughter and so many isn’t Just medication- it’s Orton, a foreign language waiver, a calculator, extra time, an understanding of ones learning style and understanding that the difficulties are often in the area of basic skills and not higher level thinking skills. My daughter’s ADD is still there but the symptoms seem to now only require medication when academic and reading demands are high. She is In control, knows her learning style and knows when vyvanse is needed. Medication for her is not a crutch- it is just necessary just as extra time, a foreign language waiver and a calculator are necessary for her.
I think too many schools hang their hat on the ADHD label – they love to the blame the problem on a “medical” diagnosis instead of a LD but in so doing they do not address the real learning issue- which is often Dyslexia.
Thanks for your thoughtful comment and sharing your experience – I am with you 100% on this.