Re: Some Doctors Shy Away From Diagnosing ADHD

Rich.@. wrote: 
On Thu, 29 Sep 2005 07:23:57 GMT, "LadyLollipop"
<LadyLollipop@xxxxxxxxxxxxx> wrote:


( I have been called a liar, by Mark Probert for saying many kids in my day care were NOT diagnosed.See below)


I officially retract what I said about Jan Drew being smarter than she
lets on. 

Mark criticized Jan for asserting that some of her children in day
care were *on* medications without a diagnosis.

To be clear. I did tell Jan that I did not believe her when she said that the kids were being prescribed medication *without a diagnosis.* That was the specific allegation that she made.

There is no reason to change my mind. Jan was told by me, Mark Lowery, MD (a board cerfified pediatrician) and others, that the patient's chart, and not the paperwork that Jan recieved in her day care service, must contain a diagnosis to justify the prescription of a medication. That would be ANY medication, not just those for treating ADHD.

I looked at Indiana laws and regulations extensively, and Jan posted a link or two (I do not precisely recall how many), and, none of them clearly required that she be provided with a diagnosis for her to dispense medications upon a written order of a doctor (which is mandatory).

This article in no way changes anything. In anything, it further reinforces my statements, and my long standing position, that children should be seen by their local pediatrician for a good physical, with blood work, etc. and then followed up with psychological and educational testing to get a good idea of what problems, if any, may impact the child in the classroom. That should be followed up with a parent and a teacher observational form of some sort (Connors, I believe, has a good one), and then a visit to a pediatric psychiatrist or neurologist for a formal diagnosis with treatment recommendations.

The fact that this is not done in many cases I attribute to the lack of adequate medical services, the expenses involved, and, difficulty dealing with the school districts who are resistant to a finding that the child needs special education services.

This article is about doctors reluctant to diagnose ADHD and not
doctors who put children on Ritalin and don't diagnose.

Exactly. In fact, it is the opposite of what Jan has alleged and inferred over the years.

The article also suggests that stimulants are UNDERprescribed due to
reluctance of doctors to make diagnosis or institute treatment unless
they are a specialist.

That is another point I have made. However, I prefer to point out that there is, like in any medical condition, mis-diagnosis. My regimen, as I described above, is designed to prevent that.

The article says that 50% of children with ADHD are not diagnosed and
as a result NEVER get treatment.

That makes it tragic. This is probably the result of the anti-science, anti-psychiatry, know-nothing, Scientoilogy inspired campaign that has lasted over a decade.

Glad to see Jan Drew wants these children to get the proper diagnosis
so that they can get effective treatment. Thanx to Jan Drew for
bringing this major problem with underdiagnosis and undertreatment.
Kudos to Jan!!

http://www.wtnh.com/global/story.asp?s=3900883&ClientType=Printable

                      Some doctors shy away from diagnosing ADHD

(WTNH, Sept. 26, 2005 5:20 PM) _ More and more pediatricians are reluctant in diagnosing children with attention deficit hyperactivity disorder.

ADHD is the most common psychiatric condition affecting children.

                      As many as 50 percent are never diagnosed.

                        a.. by Dr. Mike Rosen
                      Charlie Torsiello knew he was struggling in school.

Charlie Torsiello, 14 year old, says,"I was constantly distracted with other things. Looking around the room, not paying attention."

                      Charlie has ADD, Attention Deficit Disorder.

His mom Susan knew, from a previous child, exactly what was wrong but her pediatrician wouldn't treat either Charlie or his brother.

Susan Torsiello says,"When we suspected my older son had ADHD, he sent us to Schneider's directly to be evaluated because they have the lengthy interview process. He did not feel at that time that he felt comfortable."

Charlie's story is a common one. According to a new survey of pediatricians, many parents are told by their doctors they have to see a specialist to get help for their children's ADHD problems.

Andrew Adesman, M.D., ADHD expert, Schneider Children's Hospital, says,"It may be uncertainty about which is the right medicine, it may be concern about making the decision about whether medication is really indicated."

To change this, five years ago the American academy of pediatrics published guidelines to help primary care pediatricians properly diagnose and treat ADHD.

But still new research shows primary care pediatricians still don't want to deal with ADHD.

82 percent of the pediatricians surveyed say they generally refer their patients on to specialists but 14 percent said they absolutely refuse to initiate medications and they refuse to follow the medications after they've been started.

Andrew Adesman says,"The American Academy of Pediatrics believes primary care pediatricians can and should assume responsibility for diagnosis and treatment."

Fortunately for Charlie, his mom got him to a specialist and got him on the medication he needs.

Torsiello says,"I started concentrating better, started getting higher grades and everything."

Not all pediatricians have received the ADHD toolkit and only half of the doctors in the study say they don't use parent or teacher rating scales of the child's behavior.

This scales helps in diagnosis and treatment of ADHD.







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Best defense to logic is ignorance 
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