Would Tom Sawyer have been medicated?
Tom Sawyer was a very intelligent boy who also had a streak of orneriness, was inattentive at school and was prone to impulsive behaviors. We laugh while reading his antics, but in today's world, like approximately 25% of school-age white boys, he might have been diagnosed with ADD/ADHD and prescribed medication. Because most research suggests that ADD or ADHD is present in only 3-5% of the population, is it possible practitioners and parents are over-diagnosing and missing the true cause or issue (http://borntoexplore.org)? Although any child could be diagnosed, the incidences of diagnoses are higher in boys than girls.
There is no doubt that ADHD and other behavioral disorders exist. There is no doubt that medication can produce a very positive affect on both children and adults with disorders. The purpose of this article is to identify if are we assigning a label to anyone who meets behavioral criteria way too quickly? Unlike most illnesses, behavioral disorders cannot be detected with a blood test that comes back with a plus or minus sign. This makes behavioral diagnoses much harder than one for physical disorders like anemia or high cholesterol.
Criteria for behavioral disorders can include inattentiveness, inability to sit still, poor handwriting skills, trouble concentrating and impulsivity, among others. Unfortunately, these criteria could also be attributed to many other causes including high intelligence, different learning styles, boredom, or just plain boy behavior. It is important to note that poor grades do not necessarily represent a lower intelligence level.
Walk a child of each gender passed a mud puddle. Who is most likely to try to jump in it and get dirty? Sit a boy child and a girl child down with a coloring book. Who is most likely to sit still and color within the lines and who is most likely to make paper airplanes and try to hit someone with it? Unlike most stereotypes, I was the girl who would try to jump in the mud puddle (bonus points for hitting my brother with the splashing mud and a week of being grounded if I hit a parent so aiming was important) and make paper airplanes, but just because I was the exception doesn't mean the general consensus is incorrect. Boy behavior is generally different than girl behavior. Boys, especially as the testosterone level grows, are more prone to get physical, wrestle, play rough, get dirty and have physical accidents due to higher impulse levels.
It takes a very special practitioner to take the step past a quick behavioral checklist and really search for the root cause of the behaviors. The practitioner should be trying to find out answers to some of the following questions: Is the child bored in school? Is the child highly creative? Does the child learn differently or have a temperament that is not conducive to "proper" school behavior? Could there be family issues or failure of the parent to discipline properly? Is the child really showing age-appropriate behavior and the parent needs to change?
Unfortunately, most practitioners work under a strict time schedule. In order to make money to pay the high insurance and low payments from HMOs, most visits are minutes in length. With the practitioner's time limitations, parent's hectic lives and the practice of drug companies to hand out free samples and being major promoters of ADD/ADHD sites, a prescription is definitely the easy way out.
However, medicating our children is not always the best option, even if the medication supposedly works. Just because a child is being calmed down with the use of an amphetamine, is it really appropriate? Short-term results alone should not be the proof positive of a behavioral disorder. Before taking any medication, one should always weigh the side effects and risks of that medication in addition to checking out non-medical alternatives. Diabetics or those with high cholesterol are sometimes urged to change their eating habits and lifestyles sometimes in addition to medication and sometimes not. Should we treat our children's issues with any less care?
As parents, we must be our children's biggest supporter. We should ask lots of questions of teachers, doctors and ourselves when a problem becomes apparent. Because behavioral diagnoses are more difficult to determine, we have to be the responsible one to step up to the plate and take charge of the issues facing our children. Many times medication will not be warranted, but sometimes it will. No matter the decision, it should only be made when we truly know all the facts and can make an informed decision.
References for statistics:
http://borntoexplore.org