Popular Posts

Total Downloads Worldwide

Wednesday 18 April 2018


More than medication' needed to treat ADHD

Image copyrightGETTY IMAGES
Image captionThe Scottish ADHD Coalition's report raises concerns that medication is overly relied on

Families of children with ADHD are warning that too often medication is the only option they are offered to manage the condition.
A survey of parents across Scotland found evidence of delays in diagnosing ADHD and inadequate support afterwards.
The Scottish ADHD Coalition also uncovered concerns about inadequate training of school staff.
The Scottish government said medication was offered in accordance with good clinical practice.
It was often accompanied by non-drug treatments such as counselling, it added.
About 5% of schoolchildren have ADHD, a neuro-developmental condition which causes hyperactivity, impulsiveness and inattention.
However, only 1% (9,000) children are known to have the condition north of the border. The Scottish ADHD Coalition believes it is under-diagnosed in many areas.

Media captionReece's top tips for living with ADHD

And in its latest report on ADHD services in Scotland, it raises concerns of an over-reliance on medication in treating the condition.
In a survey of more than 200 parents, 93% said their child had been prescribed medication for their condition and it was helpful.
But in many cases it was the only treatment offered. The survey also found:
  • Almost two third (63%) of parents were offered no training to help them manage their child's condition.
  • Almost half (41%) were given no written information about ADHD.
  • Around 15% said they had received psychological input.
Geraldine Mynors, the coalition's chairwoman, said many children could benefit from more support to address a complex range of difficulties.
"The voices of parents coming through this survey are very clear: there is an over-reliance on medication as the only treatment available to manage ADHD," she said.
"Excellent parent training programmes such as Parents Inc, developed by NHS Fife, are all too rarely available to give parents the long term skills that they need".

Presentational grey line
Avril Sinclair

'Life is very fast'

Avril Sinclair set up the Brighter Days support group for families living with ADHD in Livingston, after two of her four children were diagnosed with the condition.
"Life is very fast," she said. "We're always on the go. We try to keep to a routine but it's difficult, it's got a lot of challenges."
Her eldest son, Reece, was seven when he was diagnosed with ADHD after experiencing problems at school.
She said he benefited from medication as well as a range of specialist help, including play therapy.
When his younger brother Ryan was diagnosed with the same condition, Ms Sinclair said the family decided not to give the youngster medication.
She said her experience of dealing with Reece means she knows how to cope with Ryan's condition.
"Until we find that he's fallen behind at school or we are not able to cope will I look at medication," she said.
But that decision means she has not been offered any additional support to deal with Ryan's ADHD.
She said she believed parents whose children come off medication find it more difficult to access extra support.

Presentational grey line

The report, Attending to Parents: Children's ADHD Services in Scotland 2018,outlined the positive work carried out by the Child and Adolescent Mental Health Services (CAMHS).
But it found that many families had long waits for both diagnoses and CAMHS appointments, where some felt staff were over-stretched.
And some parents told the coalition that, when they refused medication for their child, CAMHS quickly discharged them, making it harder for them to obtain further support.
Problems in school were also highlighted in the report, which revealed that only a quarter of parents (26%) believed their child's teachers had a good understanding of ADHD.
About 5% of respondents said their child had been permanently excluded from school, while a third (33%) said their child had been temporarily suspended at least once.
The report found a perception among parents that access to support for learning staff to help classroom teachers was jeopardised by staff and funding cuts.
Lorna Redford, a trustee of the coalition, said: "The survey findings reflect what we hear from parents all the time.
"It is imperative that school staff are recruited in sufficient numbers and trained about ADHD to ensure our children and young people receive the same educational opportunities as their non-ADHD peers.
"This modest and realistic target would reap huge rewards in the mental health, quality of life and societal outcomes for sufferers."
The Scottish government said it took the mental health of young people "very seriously".
Mental Health Minister Maureen Watt said: "That is why we have doubled the number of child and adolescent mental health service psychology posts in recent years, and we're investing an extra £150m in mental health over five years.
"Drugs for ADHD are routinely prescribed in line with good clinical practice, including on-going supervision by health professionals to ensure patients only remain on them as long as appropriate.
"They are often used alongside treatments such as counselling or psychological therapies provided locally.
"Early intervention and prevention are the cornerstone of our approach to mental health and wellbeing."

Presentational grey line
Rhys Sinclair
Image captionRhys Sinclair take medication for his ADHD and he has received additional specialist support

What is ADHD?

  • It is a neuro-developmental condition, with symptoms including inattention, impulsivity and hyperactivity.
  • ADHD is caused by a mix of factors, including environment and early childhood experiences but it strongly hereditary.
  • Symptoms are apparent in early childhood and for most people continue into adulthood.
  • It rarely exists on its own and is associated with autism, dyslexia, dyspraxia, sensory processing disorders and tic disorder.
  • It can lead to problems including poor academic achievement, unemployment, criminality, and drug and alcohol dependency.
Source: Scottish ADHD Coalition

Saturday 7 April 2018

'Concetr8' - Satirical Novel about an ADHD Epidemic - New Article - Courtesy of TES Website

Non-academic children are likely to grow up thinking of themselves as failures or, increasingly, as sufferers from mental disorders, says the author of a new satirical novel about the ADHD epidemic
The classroom is not a natural environment. Children did not evolve to sit obediently in rows listening to an adult tasked with dispensing knowledge.
Highly artificial though it is, the classroom has been adopted by more or less every culture, as the most appropriate setting to prepare children for adulthood. It works for the vast majority of children.
But, for as long as there have been classrooms, wherever they may be, there has always been the odd child who cannot stomach being there. How that child is treated serves as a barometer of a culture’s tolerance and attitude towards the idea of childhood.

Beaten into obedience

In the UK, up until some hard-to-pinpoint cultural shift in the 1960s or 1970s, obedience was seen as probably the single most important characteristic a child was expected to learn. Accordingly, parents were happy to accept that a stranger, if accredited as a teacher, would be allowed to beat their child with sticks, belts or slippers until an appropriate degree of obedience was instilled.
As our society changed, and corporal punishment began to be questioned and then, ultimately, outlawed, other forms of discipline had to be found. We tell ourselves that our modern, reward-based methods of cajoling children to behave how adults wish them to are infinitely more humane than the brutal physical punishments of the past. Yet, when we look at what happens to children who don’t respond compliantly to the usual inducements – those who continue to disrupt a classroom – the humanity of mainstream methodology is questionable.
Every parent knows that a child who is bored is likely to become inattentive or disruptive. But a contemporary child who will not sit still, cannot listen and keep quiet when required, and won’t obey the teacher stands a high chance of being given a diagnosis of attention deficity hyperactivity disorder (ADHD), and with it a prescription for Ritalin or some other stimulant medication. The same behavioursthat were once seen as "naughty" or "bad" are now often categorised as a mental illness, and "treated" with drugs. The pharmaceutical-medical complex has convinced us that this diagnosis and medication constitutes compassionate help for a sick child. The medical evidence, however, is sketchy.

Has Ritalin replaced the rod?

Sami Timimi, consultant child psychiatrist at Lincolnshire Partnership NHS Foundation Trust and professor of child psychiatry at the University of Lincoln, agrees that those children who get an ADHD diagnosis are exhibiting often challenging and destructive behaviours. But he points out: "There is no robust evidence to demonstrate that what we call ADHD correlates with any known biological or neurological abnormality."
There is still no diagnostic test – no marker in the body – that can identify a person with ADHD. The results of more than 40 brain scan studies are described by Timimi as "consistently inconsistent". No conclusive pattern in brain activity has been found to explain or identify ADHD, which raises the question of whether this is truly a brain disorder that should be treated with a psychoactive drug, or is simply the contemporary label that is attached to non-compliant behaviour.
Few people in the 1850s or even the 1950s questioned the efficacy of the cane. Nowadays, Ritalin goes mostly unchallenged as method for coercing conformity out of disobedient children. Voices of dissent, however, are gaining ground. Even the BMJ, in a 2012 article, has asked, "Has Ritalin replaced the rod?"
Matthew Smith, senior lecturer in history at the University of Strathclyde and author of Hyperactive: the controversial history of ADHD, takes this argument even further. He says that we have gone beyond pathologising naughtiness as a mental disorder, and have reached a point where: "All sorts of children, simply those that daydream and don’t pay attention, can now be diagnosed with ADHD and placed on medication."

Epidemic proportions

ADHD is reaching epidemic proportions. UK prescriptions for Ritalin and other similar ADHD medications have more than doubled in the past decade, from 359,100 in 2004 to 922,200 last year. In America, some estimates say 15 per cent of children now have the diagnosis. It generates pharmaceutical sales worth $10 billion (£7.4 billion) per year, a 50-fold increase in 20 years. Yet clinical proof of ADHD as a genuine illness has never been found.
Do these figures correlate with our belief that we are developing into an increasingly tolerant, child-friendly society? What does it say about us that more and more of our children are being told they have brains that are so defective they require a powerful long-term psychoactive drug intervention to render them tolerable members of society?
If it is a genetic disorder – a chemical imbalance in the brain requiring chemical correction – an epidemic can only be explained by the idea that there have always been a significant percentage of mentally ill children in our midst, and we have only recently become enlightened enough to identify them and give them the help they need.
If you question the notion of ADHD as a genuine genetic disorder, another explanation comes to the fore. As education becomes increasingly centralised and conformist, more rigidly tested, with schools facing sanction for failure to rack up measurable improvements on narrow governmentally fabricated criteria, intense pressure trickles down through the entire system from the education minister via headteachers to teachers, to the children themselves.

Underperformance must be explained

Children who do not perform and conform have always been a worry to teachers who want to educate and care for their charges. Now they are a threat to that teacher’s job security. Underperformance must be explained away. A diagnosis of special educational needs and disability (SEND) is a quick way to release some of that pressure.
Equally, it is hard for parents to resist the prevailing test-oriented ethos of what constitutes the success or failure of their child’s educational progress. In a world of competitive parenting, in which a "high-achieving" child is a badge of pride, a "low-achieving" child the cause of shame, few have the confidence to question the criteria by which success is being measured.
Not all of us are cut out for white-collar desk jobs. Yet British education purports to measure our worth as a human being solely by judging our aptitude for this kind of task. A non-academic child is likely to grow up thinking of him or herself as a failure, or, increasingly, as a sufferer from a mental disorder.

Deep scars to self-esteem

Teachers are linchpins in the process by which a child can be placed on long-term psychoactive medication and given a label of mental illness which, while it may seem to absolve parent, teacher and child of blame, can also leave deep scars in that child’s self-esteem. It is of vital importance that parents and teachers alike inform themselves of alternative voices in the ADHD debate, and are careful to ask themselves whether altering a child’s behaviour with a drug is truly the most compassionate approach in the long-term interests of that child.
Challenging behaviour is so-named not because it challenges the child but because it challenges the parent or teacher who requires compliance and cooperation. If Ritalin, which can calm down a misbehaving child with extraordinary rapidity, is soaring in popularity because it generates obedience in an ever-more prescriptive and competitive education system, rather than to cure a genuine genetic disorder, this gives rise to some painful questions about our society.
We may seem more child-centred and more compassionate, but are we? In 50 years’ time, will the drugging of millions uncooperative children with docility-inducing amphetamines seem as brutal as physical beating does now? There is a chance that it may.
William Sutcliffe’s novel, Concentr8, a satire on the ADHD epidemic, is out now in paperback. It is published by Bloomsbury, priced £7.99. He tweets as @Will_Sutcliffe8