Are we over medicating our children ?-
by Dr. Arthur S. Seiderman
Published at www.lancasteronline.com
ADD/ADHD and the use of drugs
The teacher tells the parent that Johnny is doing poorly in school because he can't concentrate and he should be on medication. The parent takes the child to the doctor and repeats what the teacher said. The doctor says, " No problem, I'll write a prescription for Johnny and that will help him concentrate better ". This may be one of the very few times in all of healthcare where an invasive intervention is prescribed WITHOUT any objective testing being performed for verification of the tentative diagnosis. These medications have significant side effects; and, 25 deaths have been attributed to these drugs. It is believed that these stimulant drugs might increase the risk strokes and serious arrhythmias in children and adults. As a result the FDA ( Federal Drug Administration, a U.S. federal agency ) voted to suggest that these drugs carry the most serious of the agency's drug risk--a " black box ". There are other alternatives which are NOT invasive. These should be explored first.
Let's look at the case of Robbie. Mother stated, " His teacher told us he can't concentrate, his mind wanders, he's learning disabled, socially and emotionally disturbed". " I want him out of my classroom unless he takes medication ." He was two years behind in reading and had turned into the class clown. Robbie told us that the teacher told him that he was NOT a very intelligent little boy. --I was in tears. It was found that although Robbie had 20/20 in each eye, the two eyes did not work together as a team ( convergence insufficiency ), As a result, he could not concentrate on tasks that were visual, i.e., reading, homework, and schoolwork in general. Trying to read a paragraph or two " wore him out, and my mind began to wander ." He described reading every word ( correctly ) in an assignment; but, at the end of the assignment he could not remember what he read. He said, " Oh no, I have to go back and reread everything ." He lost his place, skipped lines, reread lines when reading. Of course, he had difficulty when reading or studying. How could he not. Most general eye examinations do not test for binocular coordination. And, glasses are not helpful. Thus his previous eye examinations did not diagnosis this condition. The symptoms for convergence insufficiency are almost identical to those of ADD; and binocular deficiencies occur in 21 % of a general population. The incidence rises to 73 % in a learning disabled population. How many times have these children heard, " if you only try harder, if you only put your mind to it, if you only concentrated more," Many of the young people, simply, give up trying. Make no mistake about it, this is NOT willful misbehavior. The truth of the matter is that they simply can not do what we are asking them to do. These children need help. When the convergence insufficiency was correctly diagnosed, Robbie entered a vision therapy program to eliminate this condition. Using various instruments, computers, prisms, etc. Robbie began to use his brain differently and to coordinate his eyes together. After only a month, his family noticed results. " He wasn't fighting us about doing homework anymore. He actually became interested in reading." The therapy program lasted six months. By the end his reading level increased by 3 1/2 years, graduated high school and later college. Now the student, who used to do anything to avoid opening a book reads for pleasure almost every day. The boy who used to hide in the back of the room to avoid being called on is now a young man who is confident enough about himself and his abilities to joke about his previous troubles.
An extreme example of the trouble a child's undiagnosed vision problem can cause? No, happens all the time. Remember one in every five children experience binocular dysfunctions; and it occurs in 7 out of every 10 children with some form of learning problem ( reading, concentrating, ADHD/ADD, autistic spectrum, etc. ). Many who remain undiagnosed enter the world of alcohol, drug addiction and/or juvenile delinquency, and, may develop emotional problems. And, to think that in many, if not most, children this can be avoided without the use of potent drugs. Indeed, a very sad commentary.
ADD/ADHD is incorrectly diagnosed four times for every one correctly diagnosed child. Really. How could that be? The Centers for Disease Control and Prevention have published research that has shown that 3 to 7 % of school-aged children suffer from ADD/ADHD. If we can use 5% as the average, then in a class of 25 children only one child has ADD/ADHD. Yet 6 or 7 of those children are taking medications for ADD.
The research is abundant. Dr. Seiderman of Leola published the results ( Journal of the American Optometric Association ) of a five year, federally funded, study. Dr. Harold Solan's research ( Journal of Learning Disabilities ), " shows that visual attention and concentration skills necessary to succeed in school can be developed through programs of vision therapy and can lead to improvements in reading and learning." Solan went on to describe the accompanying symptoms that may occur: frequent loss of place when reading, confuses similar looking words, poor reading comprehension, sloppy handwriting, reversals, failure to recognize the same word in the next sentence, and/or complains of eyes hurting or headaches after reading. While there are too many studies to cite here, one more is worth noting. A recent study under the direction of NIH ( National Institutes of Health, a U.S. federal institution ) showed that these very symptoms that occur in both ADD/ADHD and convergence insufficiency could be eliminated through the use of the non-invasive intervention known as vision therapy.
It should be noted other interventions which might be helpful in lieu of medication include: psychological, occupational therapy, reading specialist, speech and language specialist, nutritional counseling, etc.
A complete differential diagnosis with appropriate testing must be performed first, before prescribing. And, you as a parent must speak up and insist on such testing before accepting medication for your child. Please note that medications can be very helpful when prescribed correctly, rather than indiscriminately. Perhaps, the best line of defense in making these important decisions is to become more informed on ADD/ADHD. convergence insufficiency, binocular dysfunctions, autism, etc.
A FREE two hour presentation will be held at The Shady Maple Banquet and Conference Center Monday, February 7 at 7 p.m. Dr. Arthur S. Seiderman, an optometrist and psychologist, who is a graduate of The Gesell Institute's program at Yale University has written several books, lectured throughout the USA, Canada, and Europe. His work has been translated into six languages. He taught graduate level courses at Penn State University for many years, is a past president of The Disabled Reader Group of The International Reading Association ( IRA ) and maintains his private practice in Leola, PA. Seiderman and Dr. Robert Fisher, a well known and highly respected clinical child psychologist and educator, will be presenting. If you would like to attend, please call 717-656-0534 to reserve your free seating. Come talk to these doctors and talk to other parents who have experienced the same issues with their children. For more information or questions call 717-656-0534 and ask for Missy. A very helpful web site is: www.helpaddvisiontherapy.com .