Entries for December 2008

Edward Hallowell is a psychiatrist with ADHD himself whose latest book, Superparenting for ADD (Random House, $25), is aimed at convincing parents, teachers, and kids that attention deficit hyperactivity disorder (or attention deficit disorder) is a trait, not a disability. I asked Ned what's new; here's an edited version of our conversation.

You say the medical model of ADHD as a disease distorts the truth of what it's like to live with attention deficit hyperactivity disorder. Why is that?
The diagnosis of ADHD can be devastating. I have this disability: I need treatment and medication. I think the only real disability is shame and loss of hope, and we in mental health have been creating that. What my coauthor, Peter Jensen, and I want to do is blow up that model and replace it with one that's full of hope and excitement.

Sports-related concussions pose a big risk to children and teenagers, particularly since kids rarely tell parents or coaches that they've been bonked in the head so hard that they feel confused, nauseous, or have a headache that won't go away. Doctors increasingly realize that serious head injuries can cause permanent brain damage, particularly if they're not treated properly. Thus, parents need to make sure that young athletes know the symptoms and aren't afraid to report them.

That's the news from a review of problems with sports-related concussion, reported in the January Pediatrics. The numbers are eye-opening; 69 percent of high school football players in Minnesota who were hit so hard they lost consciousness kept playing that day, as did 81 percent of players who had a concussion without passing out. Someone who has just had a concussion is far more likely to have another within 10 days, the researchers say, and repeated concussions greatly increase the risk of permanent brain damage.

Lots of kids aren't going to find what they asked for under the tree this Christmas, and lots of parents are stressed out about not being able to deliver a perfect holiday. Four fifths of people expect a stressful holiday because of the economy this December, according to a new poll from the American Psychological Association, and the number's even higher among parents.

I'm a minimalist when it comes to Christmas loot, but I've still had a hard time telling myself that it's OK to give the kids less this year. So, I called Mary Alvord, a psychologist in Rockville, Md., who serves as a public education coordinator for the APA. Her advice? Disappointment can be a valuable gift. "Disappointment is one of those life lessons we all need to learn," Alvord says. Teach kids now that they don't always get what they want, and they'll be equipped to cope with disappointment throughout life.

Having a child with autism can be a huge financial strain, with 52 percent of parents saying the family's finances are drained. Three quarters of parents of children with autism worry that their child won't ever get a job or won't have enough money to get by after the parents die.

These sad numbers come from a new survey of 1,652 parents of children with autism up to age 30, as well as 917 parents with typically developing children. The survey was conducted by Easter Seals.

"Normal" families weren't nearly as stressed financially—just 13 percent of typical parents said child-rearing was draining their family's resources, and 18 percent said they worry about who will provide for their children after they die.

Don't count on your child's doctor to ask whether you're worried about mental health issues such as ADHD or bad behavior. Fifty-six percent of parents say their pediatrician or family-practice doctor never asks about mental health concerns, according to a new survey out of C.S. Mott Children's Hospital at the University of Michigan. Another 22 percent say they get asked sometimes, with 22 percent more saying their doc is always on the ball.

This is no small issue, seeing as 1 in 10 children suffers a serious emotional or mental disorder, according to the surgeon general. Twenty percent of the 2,245 parents polled said that one or more of their children had been diagnosed with a mental health problem, the most common being attention deficit hyperactivity disorder, a behavior problem, or depression.

I talked with WTOP Radio this week about what parents can do to make sure that a psychiatric drug—or any medication, for that matter—recommended for your child is the right choice. The bottom line when facing a scary decision about medication: Do some research, and don't be afraid to tell the doctor that you need some time to think.

If you do decide that the medication is worth a try, consider it a trial run, and figure you'll re-evaluate in a few weeks or months whether it's the right choice for your child. You're the parent, and it's up to you.

If you could give your children a legal drug that would make them better students, would you jump at the chance—or jump the other way? That's the question raised by brain researchers this week in Nature, a leading scientific journal. The drugs in question are Ritalin and Adderall, the widely used yet controversial medications used to treat attention deficit-hyperactive disorder. "Enhancement is not a dirty word," says Henry Greely, a Stanford University law professor and coauthor of the commentary.

Kids are already hip to this, of course. High school and college students have no problem buying Adderall from their peers despite the fact that it's a felony to buy or sell the stimulant without a prescription. My colleague Alison Go investigated the situation on campus for our 2007 report on the health consequences of legal stimulants and found that students are well aware of Adderall's pluses (stay up all night to cram for exams or party) and minuses (jitters, unpleasant crashes with overuse, possible addiction).

The news that television, the Internet, video games, movies, and other media are bad for kids' health shouldn't come as a huge surprise to any parent who has ever heard the phrase "couch potato." But with no less of an authority than the National Institutes of Health weighing in and saying that 80 percent of the studies it reviewed have linked media use to negative health effects, is it time to take drastic action? Torch the remote? Trash Guitar Hero: World Tour? Not so fast.

First, the evidence doesn't find that media use is all bad. I've reported on more than a few of the 173 studies reviewed by this report, and quite a few find just correlations: One, for instance, found that children with ADHD had watched more TV as toddlers. But that doesn't mean that TV-watching caused the ADHD. It could be that children with ADHD are more attracted to the fast editing and visual imagery of video, so watch more than would a child who is happy to spend hours alone with blocks.