Re: Some Doctors Shy Away From Diagnosing ADHD

LadyLollipop wrote:
"Mark Probert" <markprobert@xxxxxxxxxxxxxxxx> wrote in message news:_G0%e.26598$Xa.17816@xxxxxxxxxxx

LadyLollipop wrote:

"Mark Probert" <markprobert@xxxxxxxxxxxxxxxx> wrote in message news:3ZY_e.26523$Xa.3843@xxxxxxxxxxx


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). 

The FACT is:

Mark called me a liar, years ago, on another ng, LONG before, Mark Lowery ever posted anything.

I was correct then, as I am now.


You were not correct then, you are not correct now. You called me a liar, when if fact I was not lying.


 You were never required to have a

diagnosis as the physician maintianed records are, thus, your claim that kids were being prescribed medications without a diagnosis was, is, and will always be a lie. Mark Lowery just fortified my argument with his hands on (the records) experience.


Mark Lowery knows nothing. You know nothing, of what I was required to have, period. 

The rules were posted by you. There was no requirement.



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.


It is no such thing.

YOU and Richard H Jacobson are BOTH PROVEN L I A R S MANY TIMES OVER.

Only in you sicko, net stalking, bring the family into mind. If you are so upset over what Rich said about how you acted toward your poor parents, then you should be able to see how I am pissed at your and your handlers actions. But, you do not. Thus, you are a hypocrite.


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



Poor, Richard  H Jacobson. Poor, Mark Probert.

http://www.newsinferno.com/storypages/9-28-2005~001.html

Consumers Union is not a very good source of meical information. 


Unless, they agreed with you, can it, Mark.

Study by Consumers Union Concludes ADHD Medications are Over-Prescribed to Children
Date Published: September 28, 2005
Source: Newsinferno.com News Staff

A report by Consumers Union (CU), the publisher of Consumer Reports , concludes that while useful, stimulants used to treat millions of children in the U.S. with attention deficit hyperactivity disorder (ADHD) are probably over-prescribed.

Although the study selected several of the stimulant drugs as "Best Buys," it also advised its readers that available evidence indicates most of the drugs are equally effective.

CU chose several forms of methylphenidate (the substance in the brand-name drug Ritalin) as a best buy, including Metadate, Methylin, and generic forms of the drug. It also favored generic forms of dextroamphetamine, which cost $10 to $48 per month, depending on dosage.

Consumer Reports based its selection on a review of scientific studies to determine the effectiveness of drugs prescribed for ADHD and then applied average pricing data. The publishers have previously done similar reviews for antihistamines and nonsteroidal anti-inflammatory painkillers.

The report, however, cautions that many children taking the medication have only mild symptoms of the disorder or do not have it all. According to Centers for Disease Control and Prevention (CDC) statistics, 4 million American children between the ages of 3 and 17 have been diagnosed with ADD (Attention Deficit Disorder).

This amounts to roughly 6.5% of the population with boys being much more susceptible than girls. In approximately 65% of the diagnosed cases, the children are treated with stimulants. Government statistics also indicate that stimulants are being prescribed to children who have not been diagnosed with the problem.

The report advises that many factors are involved in diagnosing ADHD including a series of interviews, an assessment of school performance, and emotional and learning difficulties.

The article warns parents to be wary if a doctor makes a diagnosis and prescribes a drug after a single relatively short visit. CU recommends getting a second opinion if parents question the initial diagnosis.

This advice is echoed by experts who believe more than one doctor or therapist should be involved in the evaluation.

The stimulants do have negative side-effects including sleeplessness, loss of appetite, stomach pain, and headaches.

The FDA is currently conducting a review of the reports of more serious side-effects including psychotic episodes and suicidal thoughts in children taking Concerta, a brand-name form of methylphenidate.

The agency decided several months ago, however, not to require a warning about these other potential risks on the drug's label but. It has put off making a final decision until after the results of the review.



However, you posted the article we were initially discussing which clearly substantiates UNDERdiagnosis and UNDERprescribing.

The problem is that there is no really good information on this subject regardless of where you look. Thus, I skip the OVER- and UNDER- claims, and go for CORRECT diagnosis, as I pointed out. If you get it right, over and under are meaningless non-issues.


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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