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  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.

Takeaway Point

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

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