April 13, 2013

"America's Medicated Kids."

A 1-hour BBC documentary by Louis Theroux. I share Theroux's skepticism about medicating children, but I don't think he ends up explaining much about the problem in general. Instead of "America's Medicated Kids," a more accurate title would be "3 Medicated Kids in Pittsburgh." I do recommend this. Worth discussing.

ADDED: Next morning thoughts at the end of this post.


Quayle said...

...getting in trouble for digging in the garden, or whatever it was..."

Well, there's your first sign of a root cause.

But let's continue....

Quayle said...

"...I never did kill myself...it was basically just a threat...."

So, who's not listening to his [likely his, not her] son?

The dog is the barometer - the canary in the coalmine. When you're medicating the dog, you can probably bet that the problem isn't the dog.

Shana said...

The blonde woman is not very bright about children, specifically boys. "Would you prefer that I stay home or that I worked? Do you love me again?" What does she think he's going to say in front of a camera and witnesses. She's a head case.

I realize that some of these kids really are mentally ill and need medication, but most of them just needed some spankings when they were smaller, and parents with spines who didn't want to be best friends with their kids.

Shana said...

Jack just seems like he needs another rambunctious boy to wrestle with.

edutcher said...

It isn't so much spanking as discipline and guidance. I know of a kid that was never corrected, never given any kind of encouragement except to spoil him, and this is a bright kid.

Now, he doped up all the time and you'd think he's retarded.

Lem said...

You cant test the animals w/o getting into trouble... cant test certain ethnic groups of a certain socio economic background w/o getting into trouble... cant test the prisoners w/o getting into trouble...

Oh I know....

Bring the kids.

The world makes less and less sense to me every fucking day.

Shana said...

"Parents with spines who didn't need to be best friends with their kids" = discipline and guidance, Edutcher.

Shana said...

Then notice that the short mom rains on the young man's parade when he talks about preferring not to be on meds and working the same job successfully for four years. "Well, but you had a problem when they changed menus". I'm beginning to think it is the parents who have the mental issues here.

edutcher said...

Shana said...

"Parents with spines who didn't need to be best friends with their kids" = discipline and guidance, Edutcher.

No, it doesn't.

The father had no interest at all and the mother was only interested in expending as little effort as possible, which meant throwing anything at the kid necessary to keep him out of her hair.

Hitting the kid wasn't what he needed. Somebody who gave a damn about what happened to him was.

Lem said...

Does anybody realize these drugs may be undermining these kids potential?... and all because parents don't know what to do about aberrant behavior?

Let's make it a little harder for our kids to act out or whatever.

Its nuts!

Lem said...

"take the edge off" a six year old? wtf?

I cant continue to watch this.

And I don't even have kids.

Shana said...

Edutcher, I don't disagree with you about the father. The mother wants to be buddies. They both need a spine. The kid also thinks his parents don't like him, ans he's probably right. You can cash lots of disciplinary checks if you've put the money in the bank. They are already overdrawn. He sees right through them.

Shana said...

I completely agree, Lem.

John Lynch said...

My son has apraxia, which manifests as ADHD and a speech planning deficit.

After years of avoiding it we put him on medication. It works. It's not miraculous, and we keep the dose as low as possible. But it helps.

My reasoning was that without medication my son would not be able to learn to read and would not be able to do math. In short, even after being held back a year, he'd never be able to keep up with his class. Special ed, forever.

That wasn't acceptable. With medication he's at low grade level, but he's at least in the same room learning the same things.

I get that medication is overperscribed. I get that drugs can be a substitute for discipline. However, that's not every case.

In short, drugs are appropriate for treating medical problems. Medical, not social.

Chip Ahoy said...

It is like you're altering their bodies to better suit the situation, so not necessarily a bad thing. A similar situation arose with the second son of Amenhotep IV (Akhenaten), lesser known due to his not-regal flightiness and tendency for racket making, Toucanamun, his body too was altered a bit.

SJL said...

For what it's worth, I am from Pittsburgh, and this was shot close to 30 years ago, based upon the skyline in the video. No PPG.

edutcher said...

Shana said...

Edutcher, I don't disagree with you about the father. The mother wants to be buddies.

No, she doesn't. The kid was her path to a life of leisure, or so she thought. She wanted to be able to quit work and stay home reading Harlequin romances and watching the soaps, but Hubbo made her work anyway.

She's neglected the kid as much as he has.

Mitchell the Bat said...

There's nothing wrong with these kids that can't be fixed by scissors to the back of the neck.

Quayle said...

Ah-ah. Now we're getting to the center of the leper colony.

We're shown a 15 year old who has "oppositional defiance" - apparently a great rarity.

But fortunately her fed-up looking mother is there to compel submission with all the mother-opposition necessary.

We're told that drugs help "oppositional defiance", and I don't doubt it.

They certainly help the parent(s). There's no need to do the hard work of making yourself an attractive, trustworthy, and persuasive leader to your children.

You can stay the repulsive, controlling, condemning person into which you've allowed yourself to develop, and just haul your kids to the doctor, dump the blame on the kid, and get them all fixed up.

And this for the small hassle of driving to the nearest CVS and the low, low price of a monthly HMO co-pay.

Deirdre Mundy said...

I think we provide drugs to quickly, especially for ADHD. In the under 18 crowd, EVERYTHING manifests as innattention, impulsivity and hyperactivity, so when you throw drugs at everyone, you can make many problems worse.

For instance, in kids, OCD and ADHD are actually opposites, but look the same to teachers and primary care docs. However, if you give an OCD kids ADHD meds, you'll break him.

I'm ADHD, and so are my kids, and we don't go the 'medicine' route.Instead we do the 'lots of physical activity and healthy food and practice at learning to focus and be polite' thing.... BUT it's not an instant fix, and mine our homeschooled, so if they want to bounce up and down and sing while they do their math, no one cares. And if they blurt out an answer or ask an off-topic but interesting question, it means a trip to the internet for answers, not a trip to the principal for bad behavior.....

Shana said...

I also don't doubt that Mr. Brit Twit shopped around to find some particularly foolish, ineffectice parents to showcase. Super Manny to the rescue.

So on the one hand you've got the parents who don't understand that for kids to like you, they have to respect you first. Then you've got critical, condemning mom. Then Jack's mom doesn't seem to understand normal childhood behavior, especially boyish behavior.

galdosiana said...

Even their dog is on anti-anxiety meds. Wow.

Quayle said...

This video needs to be reviewed as part of this important discussion.

"Our children are living in the most intensely stimulating period in the history of the earth."

"They're being besieged with information and calls for their attention from every conceivable platform [PCs, phones, TV, iPads, etc.]..and we're penalizing them for getting distracted."

"From what?"

"Boring stuff..."

Deirdre Mundy said...

Quayle, supposedly the non-ADHD don't get distracted from boring stuff.

One lab did a test where they took ADHD kids and normal kids to the zoo and told them to walk straight through on a certain route without dawdling, leaving the path, or getting distracted by the animals.

non-ADHD kids, no problem. ADHD kids? Stopped to watch the animals.
Which makes sense. Animals are cool. There's no reward for going straight through the zoo, and you get to stay until you finish the task, so why, as an eight year old, WOULDN'T you choose to wander the zoo instead??

ADHD has been redefined to 'possessing the modicum of intelligence necessary to have normal curiosity about how the world works.'

Quayle said...

Yeah, my view is that they aren't suffering from attention deficit.

They're suffering from hyper attention to a lot of implications, ramifications, and connections.

We stick them in boxes in a manufacturing line (our public schools), and we expect them to stay in the box.

And if they don't, we send them to the doctor to get made pliant to our manufacturing machine.

Gahrie said...

We stick them in boxes in a manufacturing line (our public schools), and we expect them to stay in the box.

So what is your answer? As teachers we would love to teach small groups of kids in interesting settings (say a clearing in the forest, or a day visit to a museum etc) But how are you going to pay for that?

Right now I am given up to 40 kids in a room, with abilities ranging from far below basic/special ed all the way to advanced/honors and told I have to individualize my instruction to each kid.

My high school doesn't even offer general education anymore. The lowest course level is college prep, and we pretend that there is a chance in hell that 100% of our kids are going to college, when we graduate only 72% of them.

Deirdre Mundy said...

But the medication often brings the brilliant kids down to 'acceptably average and dull...'

I wonder if some of our economic doldrums is because we medicated a generation of innovators.

One of the most ADHD kids I ever knew was a millionaire by 27......

Quayle said...

I hear you, Gahrie.

We always find a way to pay for what we really value.

We presently value money and entertainment.

When we value education and relationships, we'll spend on that.

Freeman Hunt said...

A friend was telling me the other day that she's worried about her son. He's a first grader, and his teachers say he doesn't want to stay in his seat and do his work. He has, however, already mastered all of the first grade material. I told her that I didn't see the problem; it's perfectly reasonable for a seven year old boy to want to move around and perfectly reasonable for anyone to refuse to sit at a desk all day "learning" what one already knows.

Shana said...

To piggyback on what Quayle has been saying:
My parents went to rural Texas high schools, were not academic types (a jock and a cheerleader), yet both have grammar, spelling, writing, and math skills that put succeeding generations to shame. Yet to hear them tell it, they didn't have as much homework and testing as I did, and certainly not what the current generation is experiencing.

My working hypothesis is that our current education and child-raising culture underestimates the benefits to kids of being left alone occasionally to do what they want without being regimented and bossed around by adults. Daydreaming, tinkering, catching snakes, playing with neighbor kids, or street kickball, or whatever....let the kids have some time to call their own. Or give them a physical job to do where they can accomplish something without being infantilized.

Freeman Hunt said...

When a little boy doesn't want to sit at a desk filling out mindless worksheets all day and listening to an adult tell him things he already knows, it is now said that he has "attention problems." That is insane.

Or, another thing you see, parents keep their children constantly entertained in front of screens to keep them easy to manage, and then when the same children have difficulty maintaining concentration on something that requires effort, they say the child has"attention problems." That's insane.

I'm sure there are children with real attention problems, but I would bet they don't even make up a simple majority of children labeled as such.

Freeman Hunt said...

Phone typing = terribly written comments. Sorry.

...maybe it's really attention problems!

Shana said...

Phone typing gets me every time. I've quit worrying about it.

sydney said...

There are two things that bother me about this little glimpse into the lives of the young and medicated:
1) The adults, from the parents to the mental health professionals have no qualms about discussing these children's personality faults right in front of them. And I'm sorry, I know they are looking at these behaviors as clinical diseases, but it still comes down as a judgement on these kids for who they are. Can you imagine sitting there while authority figures discuss your short comings like that? No wonder the child Hugh thinks everyone hates him. (And you know, I bet that's why he identifies with the villains in Disney movies. Everyone hates them, too.)

2) The psychiatrists who are prescribing these drugs don't spend much time with these kids, do they? Maybe the encounters were cut short for the cameras, but the clinical interactions with the doctors were extremely superficial. I am inclined to think these were are true representations. My patients who see psychiatrists describe their encounters much the same way. Louis the documentarian enteracted more with those kids than their psychiatrist did. (And I bet he helped some of them more, too.)

Carol said...

Yep. I've always thought that psychobabble was just the "modern" version of religion. Instead of telling someone they're a sinner, you tell them they're mental. Between adults and children, it's something is wrong with YOU, YOU'RE deficient somehow. Shape up or you're going to Hell (asylum).

Leit Bart said...

This brought to mind an interview over at Reason about the anti-bullying movement. The author says there's been a real shift in the last ten years among parents, teachers, and educators to write a script of what childhood should be.


She's got a point.

Re ADD, my experience suggests teachers are the reason for the big uptick in its diagnosis. Teachers are subtly, but constantly, pushing Ritalin with "she has a little trouble paying attention" comments.

But the placebo effect works marvelously on teachers. If they think your child is on Ritalin, voila! Attention and "activity" problems virtually disappear. They can't help but look for behavior that validates their bias.

Synova said...

"So what is your answer? As teachers we would love to teach small groups of kids in interesting settings (say a clearing in the forest, or a day visit to a museum etc) But how are you going to pay for that?"

Just a random comment... "interesting settings" are horrible for ADD kids. It's like putting SQUIRREL! Um... where was I.

C Stanley said...

Lots of uninformed and judgemental comments, but. i realize that no one can understand without being in the shoes of a parent of a child with these illnesses.

Part of the trouble with the documentary (haven't watched the whole thing yet but I gather it continues in a similar vein) is that it's showing the kids after they are on medications. It would be a bit more helpful (though still incomplete) if there was a way to really show symptomatic kids before they recieve any treatment. If some of you saw that, you wouldn't be foolish enough to think that it was a lack of discipline, or insufficient exercise, or poor relationship with parents (that one reminded me of the old "refrigerator mom label that used to be applied to mothers of autistic kids...God how horrible that must of been for those mothers to deal with that judgement!)

I guess it took a while for it to sink in me but at some point after questioning whether my parenting was responsible at all in my son's symptoms, i realized it was not causative. That is to say, I realized that there were certainly ways I could "up my game" to be the best parent I could be for him, but that is much different than cause and effect.

When I think about what I know now that I didn't before this experience, I can see one key point of understanding that explains why mentally ill kids look to the outside workd like spoiled and/ or neglected kids. The fact is, the kids who act out from mental illness are doing so because of inability to self regulate, which is exactly what happens with neurotypical kids who aren't given a good balance of nurturing and discipline. The difference though is that normal parenting techniques simply do not work to fix this when you aren't dealing with a neurotypical kid. That's kind of the point- the brain isn't responding to stimuli, experiences, or other information in a normal manner. Development doesn't proceed normally, no matter what a parent does.

The drugs that are used are scary, and very imperfect, and can cause all manner of side effects ( not to mention the expense, and dealing with doctor appts, and the effect that this may have on his self image) I absolutely hate that my son is on medication. I deal with that, though, with the knowledge that we have no better option right now. I'm constantly researching to see what is on the horizon, hopeful that psychiatry will begin addressing these problems in a more rational manner, finding root causes and correcting rather than treating symptoms. There is a lot going on with gene research and the CAM field is showing promise with nutraceuticals.

I get that people are concerned with overmedication of kids. I am too, and I am no fan of the psyciatric or pharmacological industries. I also realize it's disturbing to think of young kids being given strong medications for psychiatric conditions. Kids are also now given strong chemotherapy drugs when they have cancer though. That's unquestionably the right thing to do, because we don't question the diagnosis. That is a big problem with mental illness, but I would hope that everyone would agree that mental illness does exist and that some people do have symptoms that begin in childhood.

Quayle said...
This comment has been removed by the author.
Freeman Hunt said...

C. Stanley, your kid needing medication does not mean that all or even most kids who are on medication need to be. I don't think people mean to deny that any children exist who need medication; they're questioning the general trend.

Quayle said...

As the veiled referenced "judgmental person", I'll bite.

The entire problem you're going to have in making traction with your point, C Stanley, is that you're going to have to tell us all why your line drawing for normal/abnormal is based in anything but an arbitrary, modern cultural choice.

You may as a parent feel the judgment, but I'm actually advocating no judgment of the kids.

And parents can always try to be better, even if none of us will ever achieve perfect parenting totally. (It wasn't designed to be so.)

There are so many attributes and characteristics of a human soul, and each, if measured, would fall along some continuum or range.

I advocate reflecting back to a child - teaching a child - that while some of their characteristics may be on one edge of a bell curve, others are solid center, and others are on the adjudged "good" edge. Thus, their attributes that seem negative in one category are actually features or byproducts of other great and amazing gifts and talents in others.

A holistic view of a soul; not one that sees in a child a personality nail sticking up and longs to pound it down.

And I don't apologize for what may seem to you to be judgment. I hope I always side with the weaker and the more vulnerable, which in this case are the children.

sydney said...

I've always thought that psychobabble was just the "modern" version of religion. Instead of telling someone they're a sinner, you tell them they're mental.

At least religion offers the hope of change. You can stop sinning and be forgiven. You can find the inspiration and strength to change from religion. But if you are told that your faults are caused by your innate chemistry, a diseased mind, etc, then there is no hope for change. Only a fix from drugs. Now mind you, there is real mental illness that requires medication - schizophrenia, severe depression, severe anxiety, severe OCD- but these kids do not appear to be in that category. While we only see them after medication, we do hear their histories from their parents.

C Stanley said...

@ Freeman- I get it and I assumed many of the commenters felt that way. The point remains though that it really isn't as easy to tell from the outside looking in, whether you are seeing a family dealing with a real mental illness or one that has followed the trend of treating rambunctiousness or spiritedness with meds.

@Quayle- i really wasn't referring to anyone in particular but if the shoe fits ;-) . And we'll have to agree to disagree. There's no way for me to explain my criteria in this format, and especially with the need to protect privacy. I can only say that I feel completely confident that our observations had nothing to do with judging my son's behavior against a need for him to be culturally normal.

Really my main reason for commenting as I did was that I would have reacted similarly to the way some of you did, and made similar comments, a dozen years ago but now my perspective has completely changed. I hope and pray that none of you has to go through the transformation for the same reason.

Inga said...

What is that old Indian saying, "Walk a mile in my moccasins"?

Quayle said...

C Stanley.

I also don't want to reveal too much, but I really do know of what I speak.

I'm aware that there are truly acute situations and that we've been able to assist with pharmacological substances.

I also sometimes wonder if, parents notwithstanding, we have a culture that brings out certain traits and characteristics.

Or even from substances that are part of our diet.

What if we found that the use of birth control were affecting the development of our children, for example. Or something else that is being chronically used, but never really studied.

So, I get it I really do.

My point is that most of what passes for diagnosis and treatment is pure quackery and malparenting.

Gahrie said...

Just a random comment... "interesting settings" are horrible for ADD kids. It's like putting SQUIRREL! Um... where was I.

But in my scenario, that wouldn't be a problem. If you are only working with a group of six or so kids, in a non-regimented setting, you can go explore those squirrels, and still achieve real learning.

Shana said...
This comment has been removed by the author.
Shana said...

C Stanley, undoubtedly, there are kids who, without medication, would end up dead, in jail, or just plain not living up to their potential. I am grateful that there is something to help your child. But...I have a diagnostician relative who sees pathology in every oddity and even very normal childhood behavior. I see a lot of completely hapless parents, mostly upper-middle class. In addition, if you go to the CDC website and look at the percentage of kids that are being labeled, and usually medicated, you can't help but be suspicious.

John Lynch said...

C Stanley said:

"The fact is, the kids who act out from mental illness are doing so because of inability to self regulate, which is exactly what happens with neurotypical kids who aren't given a good balance of nurturing and discipline. The difference though is that normal parenting techniques simply do not work to fix this when you aren't dealing with a neurotypical kid. That's kind of the point- the brain isn't responding to stimuli, experiences, or other information in a normal manner. Development doesn't proceed normally, no matter what a parent does."

Exactly! This is exactly right. I'm always amazed when I speak with a normal child of the same age as my son. They seem like little adults in comparison.

I'm not a hapless upper-middle class parent who quails at my son's tantrums. Quite the opposite. The problem wasn't behavior, it was the inability to concentrate for long enough to learn anything.

At some point I had to admit that my son wasn't going to learn how to read unless I was willing to do everything possible to help him. And what then? Failing to act has consequences, too.

C Stanley said...

Shana, part of the point though is that although the current meds help my child function better than he otherwise would, the medication isn't even close to being a good enough solution. The burden on parents in my situation is to keep digging for something that would help unlock the potential of the children that we've been entrusted with....and it would be enormously helpful if we didn't have the stigma of mental illness on our children AND the constant judgement of our parenting skills. All I'm suggesting is that people ought not to overgeneralize.

C Stanley said...

John Lynch, I'm glad, but not surprised, that that paragraph rang true in your experience. It's an important point that I hope outside observers who care about kids will seriously consider. Looking at the behavior of a mentally ill child and the behavior of a brat with hapless parents, most people would not be able to accurately determine which was which. The end result of a brain that doesn't process love and discipline normally and a brain that isn't exposed to enough love and discipline, isn't distinguishable in the child's behavior. If some people acknowledge that, they may then move on to observations about the behavior of the parents in those situations but all I can say is that discipline is very different for these kids. Expectations cannot be age appropriate and parents really do have to let some things go in looking at the bigger picture.

Deirdre Mundy said...

I think the concern is that with, for instance, ADHD, there's a spectrum, and the kneejerk reaction is now that if you're on the spectrum, you must have drugs.

The kid who can't focus long enough to learn ANYTHING needs drugs. But does the kid who would be OK if she just got more time to run around or a less distracting classroom environment?

(For the ADHD, a classroom environment is as or MORE distracting than being tutored alone on a log in the woods. There are those flourescent lights, always humming and blinking. The noises of the other kids. All those kids! And they're doing stuff... and you can talk to them and ...hey, I have this whole desk full of stuff I can pick at and look at the random posters and the windows and the noises from the hall and I wonder if there will be an assembly today. They happen sometimes and will I get recess or not, she said I'd only get recess if I was good but is this good? I can't tell. She's crazy. She just screams at me for NO REASON and Mom doesn't believe her when I tell her the teacher hates me and I'm really hungry but it's not lunch time yet and I used my water fountain pass for the week yesterday and it's only Tuesday why do they read so slow? I could read the whole chapter in the time it takes that kid to read a paragraph out loud, hey, at the end of the book there's an actually interesting story and...
What? Me? Um....I didn't here what she said but if I tell her that she'll get mad and I won't get recess again and I'll have to stay in cleaning out my desk instead so I'll just try to guess and call out NEBRASKA! They're all laughing again. I guess that wasn't the question. I want to go home.

Shana said...

My sociable, friendly nephew was brought home to homeschool after two years of being on "red" on the discipline chart every week in k and 1st. Ritalin was the next step. Parents said "nope" and homeschooled him. He's working his way through community college now, and still a great kid.

C Stanley said...

Shana- that's great for him. Moving farther along the spectrum of maladaptive behavior though, there are a lot of kids who can't function in the homeschooled environment either. And (backtracking to a point I think you raised upthread) I do think that the numbers of such kids has increased, probably due to epigenetics and the chemical effects of our food and environment. I don't believe that it's strictly overdiagnosis or medicating out of convenience although I think that accounts for some of the increase.

Shana said...

No, I agree he wasn't an extreme case. He was a late reader, etc., and would have been a disaster had he stayed in school. My point is just that there are thousands of kids just like him.