Friday, September 5, 2008

That '65 Mustang in the garage. Parenting. Things I will get around to one day.

Computer working again. Plenty of topics to blog abt right now, but I jacked up my computer and it took me a while to get it running again - I need to have a backup computer.

For a great, recent story: Gurgle this headline to find the AP news story:
"Help-wanted ad for nanny: `My kids are a pain'"

As soon as I see the headline, I know what is coming. The kid is gonna have one of these diagnoses that get given to kids who are not adequately parented.

If you haven't read the story yet, basically, the mom in a busy family posts an ad for a nanny, NY style. Let's cut the crap, yes I am hard to work for deal with it, etc.

And, in the ad, there it is: if you don't believe in Ritalin for kids, don't apply.

I do not know these people. I just have this image in my head. I can see it now. Mom is busy with her social group, and Dad is keeping the rent paid with his business. No one has time to parent. So, hire a nanny.

Sure enough, the kid is gonna fail to please. Neglect your children and they will get your attention one way or another. So, the kid is restless at school, or whatever. So, you take the kid to the head-shrinker, and within 30 minutes, you have your ADHD diagnosis. Now, you can blame any unsatisfactory behavior, performance, mood etc. on the ADHD, not your lack of involvement in your kid's life.

It just bugs me. I see it a lot.

A kid is not like that project car you have in the garage, under the tarp, that you are gonna restore one day. The kid is not and old Mustang. I understand the desire to have good intentions but never get around to some project. I have an old, classic Austrian road bike (Austro-Daimler) waiting to be restored. I will get to it one day.

But kids are different. They require parenting. They are not a hobby, or some project. when you don't parent them the right way, you will end up with trouble. The worst is that there are docs are ready to help you pin the blame on the kid.

Diagnostically, you need to rule out social confounders before diagnosing ADHD. In the research on ADHD (not to mention any names, Dr. Biederman), I never see this assessment as part of the diagnostic process for defining a study group of kids with ADHD. They report that they merely conducted the eval per DSM, then randomized the kids or whatever step was next. In the real world, we all hear of docs providing the ADHD (or bipolar or whatever) dx after only assessing for 30 minutes.

That is not right. Kids are suffering from this disservice in research and in clinical practice.


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