Wednesday, August 20, 2008

Michael Phelps: Mom gives "tips" for ADHD

A nice story in the popular press. Good Housekeeping has an interview with Michael Phelp’s mom, Deborah Phelps. The focus of the story is on her experience raising a son with ADHD, and her subsequent involvement with (yet another phony citizen’s advocacy group that is merely another front for Big Pharma’a multiprong marketing efforts) “ADHD Moms.”

The story (as long as the link stays active):
http://www.goodhousekeeping.com/names/real/deborah-phelps-interview

Mom’s group:
http://www.facebook.com/ADHDMoms

The man behind the curtain:
http://www.mcneilpediatrics.net/mcneilpediatrics/index.html

The man behind the man behind the curtain:
http://www.ortho-mcneil.com/ortho-mcneil/

Well, the story is truly nice. This single mom really took care of her son, despite his high activity level. And no dad in the picture.

The story gets her views on treatment of ADHD. Plus some tips.

But in the article is evidence of our culture’s misguided beliefs regarding treatment of mental disorders: When asked about “treatment,” Ms. Phelps acknowledges the role of Ritalin. Then, secondly, when asked for “tips” on how a parent can cope with ADHD, Ms. Phelps has a handful of hard-won wisdom: “Make a task list….I posted a task list on the refrigerator and gave him stickers when he completed his responsibilities.”

“The pool itself helped, too. ADHD children need parameters.”

“Treatment.” “Tips.” Get it?

Meds Vs. Therapy. Therapy lost this one: demoted to “tip” status.

Where did Ms. Phelps come up with the idea of a behavioral chart with stickers as rewards and recognition? In therapy, we call that “treatment.” Straight out of the handbook on treatment for kids. Sticker chart. Treatment.

But in the common view, the view that Big Pharma wants you to believe, the pill is the treatment, and the behavioral strategies are “tips.” Like: to avoid lint when cleaning windows, use newspapers instead of paper towels. To keep your guacamole from turning brown, squeeze lemon on it. Use ammonia to clean your diamond. Those are tips. Clever ideas, take ‘em or leave ‘em.

The truth is that children need to have rules and expectations. ADHD interferes with this. Pills help. But no pill will get your child to complete chores.

Kids, especially boys, need to burn off energy. And it is better if it is in some kind of activity with rules and parameters, rather than just running the streets or running mom ragged around the house. A pill will never make a kid take the trash out on trash day, or make a kid complete a homework assignment. Or stay in his chair through a whole class period. For someone with ADHD, it will help. It will get a kid in the range for performing the behavior, like a footstool can help Michael’s mom reach for something on the highest pantry shelf. But the footstool won’t get the can or whatever down for you.

Is this a big deal? What’s the big diff? Well, I think it is a big diff. If the doc says to take the meds: it will cure your kid’s ADHD problem, well, you are gonna be sorely disappointed. Cuz the kid is still gonna fail to have follow-through or stick-to-it-iveness or respect or to stay in his chair. The meds can get the kid in range, then you need some more “treatment” to achieve these goals.

But when this component of treatment is never mentioned, or is labeled as a “tip,” versus “treatment,” what degree of adherence do you think you are gonna get?

Well, rant off. What would be nice to hear in the future is: Ms. Phelps: how did you learn all of these behavioral strategies? How did you find the therapist or counselor who guided you to develop your first sticker chart? Did you believe in the chart idea at first? How long before you saw it work its magic? How many target behaviors did you have on it at each time? This is what the single moms raising kids with ADHD really need to hear.

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