"The Diagnosis," Medication and Knowing the Limits

July 10, 2020

If you have followed this blog a while, you know there are emerging themes that reoccur.

One of the big ones that I find myself continually beating the drum over is pushing back on “the diagnosis” (typically “ADHD” or “ADD”) after a few choice “buzz word” have been said by a parent.

Recently, a mom, said a few of these about her 10 year old daughter, Regina, to a medical specialist, regarding concerns that she has had for some time.

Here are some of the items endorsed in  rating scale the mom completed:

“Has difficulty making and keeping friends.”

“Avoids difficult tasks like homework.”

“Can be argumentative.”

“Doesn’t read ‘cause and effect,’ both in social situations and in reading comprehension.”

“Gives up quickly.”

“Can be too hasty – doesn’t think before doing.”

“Has difficulty with problem-solving.”

After sharing these concerns, the mom was informed by the practitioner, “I think Regina has ADHD and we should put her on medication.”

There was no discussion about some of the top concerns such as, reading “cause and effect,” avoiding homework or the difficulty that Regina has keeping friends.

What was implied was that the medication would take care of all of these concerns.

Let’s get it straight.

If a medication such as stimulant is effective it will probably do one thing – increase the capacity to focus more effectively.

That’s it.

While the medication may help a child focus, the skills of concern will not be impacted.

When explaining these things to parents, frequently I draw on sports analogies.

Let’s say you’re a golfer who isn’t the most focused while going through a round.  You decide to try a stimulant to help you focus better.  After taking the stimulant,  there is no doubt that your concentration is improved.

The problem is your swing had significant flaws prior to taking the medication.  What happened to these flaws once the medication was started? Did the flaws go away?

Of course not.

The only thing that will improve the skills will be to work with a coach/teacher who can target the skill areas and have them practiced over time.

Schools will state that once the child has gotten “the diagnosis” that the child has a medical problem and they should return to the medical practitioner to have the child managed.

Medical practitioners are not functioning in the role of coach/teacher, so the child is in a loop that goes round and round.

For Regina, there are specific things that she can do for example that would help her make and keep friends.  Social skills can be taught and practiced.

Takeaway Point

It’s ok to get “the diagnosis.”  Stimulants may help your child focus better.

Specific skills are not impacted by medication.

Know the limits.

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All comments (4)
  • Cindy Schultz
    July 10, 2020 at 4:07 pm

    Yes, yes, yes, spot on Dr. Selznick! Thank you, there is no medication in the world that will solve all those issues. Teaching, showing them […] Read MoreYes, yes, yes, spot on Dr. Selznick! Thank you, there is no medication in the world that will solve all those issues. Teaching, showing them the skills needed, and practicing with them will help to accomplish this. Read Less

    Reply
  • Steven Sussman,
    July 11, 2020 at 4:42 am

    I am a psychologist specializing exclusively with kids and teens with "Disruptive Behavior Disorders." Meds as you say can only help with focus... but […] Read MoreI am a psychologist specializing exclusively with kids and teens with "Disruptive Behavior Disorders." Meds as you say can only help with focus... but before teaching them compensatory life skills/strategies...my experience is that I have to highly motivate the child first...to WANT to practice and master life/academic skills...otherwise they resist similarly to the way they resist their teachers, parents, coaches, etc. Such kids need highly stimulating, exciting, and entertaining/humorous techniques to overcome their attention and concentration difficulties; particularly if they have AD/HD. Traditional therapy often fails them because it uses "auditory learning" techniques (questioning, explaining, verbiage, etc) when as you point out AD/HD kids tend to be "visual learners." They need to learn through hands on, creative techniques that stimulate their senses and minds). Your work has influenced me greatly. Sincerely, Steven Sussman, PhD Psychologist Read Less

    Reply
    • Hi Steve: Thanks for the nice words, I greatly appreciate it. Man, I couldn't agree more with what you are saying. Over the years, I […] Read MoreHi Steve: Thanks for the nice words, I greatly appreciate it. Man, I couldn't agree more with what you are saying. Over the years, I have relied on my personality (such as it is) to try and draw the kid in. If it were shown on some type of training video it would probably be appalling to many therapists, as I try and rely on ways to get the kid to "buy in," by using humor, joking, teasing, etc. I think the kids we specialize in are so turned off and shut down that nothing short of that will reach them. Why don't you mail me some cards to the Cooper Learning Center. I am often in a position to make referrals. Maybe we can do a chat webinar or a Parent @ & A one of these days. If you are interested in that, please email me at rselznick@comcast.com. Best, Richard Read Less

      Reply

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