We fingerpainted T and C. Of course, instead of coloring in his T like instructed, T Monster drew his own T's all over his paper. Yeah for nonconformity. Something tells me that his kindergarten teacher might not be as excited about him not following directions, but the point was learning about the letter. I think he got it.

Next, we went to the park-- which caused the Princess great concern that we were getting into the van instead of schooling. We collected leaves and woodsy treasures, and watched ants dismantle and carry away a piece of McD's hamburg-- which, of course, caused the T Monster to remember that he climbed over the table and under a few dozen times instead of eating lunch. So, we had a minor breakdown until I reminded him that we brought apples and pretzels with us for a picnic snack. Then, we went back to watching the ants.

We like going to the park because its one of the few places in town where Kirby, our don't-call-him-a-mutt-he's-a-hybrid Pomabea (Pomeranian/Beagle), can go with us. All three did three laps around the pond, climbing the rocks. I'm still amazed no one fell in.

I couldn't help but ponder on the idea of organized preschool. I used to be a preschool director and teacher before that. I have a degree in early ed. As I watched my two four-year-olds and their puppy carefully maneuver their way around the rock barrier of the pond, occasionally stopping to dunk a hand in the water to try to catch a minnow, I thought of their peers around town in preschool classrooms. Maybe they have all the fancy equipment that I'm missing right now and wish I had for my kids, but aren't they just maybe missing out on something greater? The pure joy of watching a hamburg get ripped apart by a bunch of bugs or finding the perfect leaf only to throw it over the bridge and scurry to the other side to see which one emerges first?

I don't think T Monster is ready for a classroom yet.

Or maybe Mom's not ready to give up her babies yet.

Then, T Monster announced that his "run was going out" and he wanted to go home. I thought I might have to carry him, but he made it. I know that there are those who would criticize us for deciding to put him on Chlonidine, but I'm okay with the decision. It makes me sad at times to hear my son say things like "my run was going out" when its a beautiful late summer day at the park. Come deal with his little brain that never goes to sleep all night long as he throws five or six major temper tantrums in the middle of the night over silly things like not liking the orange blinking light on the smoke detector. Then tell me that I'm wrong for giving him a med that helps him sleep for four hours in a row at night and helps him deal with his mood swings and irritability to a more normal four-year-old level. His half pill after lunch usually means a 45 minute nap and the likelihood that I can get through dinner prep time without him hurting himself or someone else. The best part is not hearing him say things negative about himself once he calms down from one of his rages. The fact that it helps him be comfortable with himself makes it worth it to me.

The Princess's favorite part of the day: glueing her pretty red leaves on green paper

T Monster's favorite part of the day: climbing on the rocks at the pond and watching circles form when he threw pebbles in (hey, that's science, right?)

What Is ADHD?

ADHD is a common psychiatric behavioral disorder that affects children and adolescents as well as adults. Approximately 7.8 percent of all school-aged children, or about 4.4 million U.S. children aged 4 to 17 years, have been diagnosed with ADHD at some point in their lives, according to the Centers for Disease Control and Prevention (CDC). The disorder is also estimated to affect 4.4 percent of U.S. adults aged 18-44 based on results from the National Comorbidity Survey Replication, a nationally representative household survey, which used a lay-administered diagnostic interview to access a wide range of DSM-IV disorders. When this percentage is extrapolated to the full U.S. population, approximately 9.8 million adults are believed to have ADHD.

Although ADHD can affect people of all ages, the core symptoms of the disorder (inattention, hyperactivity and impulsivity) may manifest differently in adults than in children. Children with ADHD often have difficulty focusing, are easily distracted, have trouble staying still and frequently are unable to control their impulsive behavior. In adults, hyperactivity may manifest as inner restlessness. Inattention may present as a lack of focus and organization, and an inability to finish tasks. These symptoms have an effect on multiple aspects of life, for example, at work, school or in social relationships.

If you believe you or your child exhibits symptoms of ADHD, a trained professional, such as a psychiatrist, can perform a comprehensive evaluation to determine whether these behaviors are symptoms of the disorder.

The Web Site

Shire, the ADHD Support Company, has relaunched its educational Web site, ADHDSupport. com, designed to provide families, caregivers, educators and patients with tools and resources about ADHD. The newly enhanced Web site provides visitors with an easy-to-navigate road map to help learn about ADHD. The site offers information about the recognition, diagnosis and management of the disorder, assistance with how to identify a health care professional and what to expect when meeting with a physician about ADHD. Additionally, the Web site will feature a symptom tracker to be used in follow-up discussions with health care professionals, practical tips on how to get organized and stay organized, and the best ways to set and evaluate goals. A teacher discussion guide and homework planner, as well as an e-mail reminder program--which allows users to set up various reminders for themselves or for their children, including for medical appointments, prescriptions and social activities--will be available by late summer 2008.

"ADHD is a common psychiatric disorder that can impact the lives of many people, including patients, caregivers, friends and co-workers. It has certainly impacted my own life both personally and professionally," said Michele Novotni, Ph.D., internationally recognized ADHD expert, former president and CEO of the national Attention Deficit Disorder Association (ADDA), psychologist and consultant in the development of ADHDSupport.com. "Because I have seen the pain of unrealized dreams and untapped potential firsthand among those with ADHD, I am passionate about providing information about ADHD in easily accessible formats. In fact, there are many people who do not realize that they or their children may have ADHD and many are unaware of the resources available to help individuals with ADHD find out more about the disorder. After reviewing ADHDSupport.com from a clinical and personal perspective, I can confirm that the Web site is a helpful tool for support and information about ADHD."

For More Information About ADHD

To learn more about ADHD, visit the newly enhanced www.ADHDSupport.com.

Information taken from www.napsnet.com

My daughter started high school last week, and mom just can't believe she's THAT old now. Where did all the years go?

My son's home schooling did not start until this week and it was very laid back. The real work begins next week, after Labor Day. This week he is focusing on Math as a review, and cursive handwriting. He hates handwriting, but I tell him it is something you will do every day of your life.

Next week, we will focus on science and Math. I have a few things I need to purchase online (I forgot to do that last week - ugh!) before we can really dive in. I hope this school year is better than last year. *Crossing my fingers* Why does it have to be so hard for him to do school work? I will probably never know the answer to that question. ;)

When school started here August 19th, I began working in our local school district, part time, as a Special Education Aide. I work with a little boy in first grade who is autistic. I have never been around an autistic child, so I am learning something new every day. He's a very sweet boy but will talk nonstop about bizarre things lol.

To learn more about Autism, I hit the Internet. I wanted to prepare myself on how to handle him when his meltdowns occur. Luckily, he does not have very many. I find it strange that the school has not set up a behavior modification system. When my ADHD son was in school, he followed one every year. I am going to talk to someone about doing one with this boy.

One thing I've learned is that this boy, Chris, hates PE when it's in the gym. For some strange reason, the moron PE teacher has been doing it inside even when the weather is perfect outside. So what happens? Chris refuses to even be in the gym. Well, I just take him out because his PE class is a regular PE one. I have read that autistic children do not do so well in PE due to the fact that they despise group participation. Some members of the school staff tell me, "You need to make him stay in PE." Easier said than done, people! What do they know? They do not work with him. IMO, he should not be in that class, but in an adaptive PE class. But this is a very small rural school, so the chances of that are slim to none.

It appears that this school is clueless when it comes to Autism. Nobody seems to know anything. That really helps me a lot. NOT!  It's going to be  a LONG school year.

Now, off that subject and back to my son...

His behavior has not been good at all lately. Before summer, he was awesome, and then he went to his father's mother's house for the whole summer. Since he's been back, he's very defiant and immature (well, she does treat him like a baby), which is driving me completely crazy. I may have to set up a stricter behavior system soon.

TGIF! That's all I need to say! I have a 3-day weekend and hopefully we can get through it without meltdowns. *Again, crossing my fingers.*

]]> http://thesidewalkpsychiatrist.wordpress.com/?p=156 Fri, 29 Aug 2008 11:46:29 +0000 doctordan http://thesidewalkpsychiatrist.wordpress.com/?p=156 James writes in to say . . .

I started having panic attacks and was very unsociable and kept to myself,all this started about 10 years ago. The doctors diagnosed me as bipolor,i’ve been on every med available for bipolar with no positive results. Last december my doc decided to try me on 20 mg 1 a day generic adderral. It turned my life around i was talking to people i had avoided for years and started back doing normal activities instead of cutting myself off from the rest of the world i also was not as angry as before. To start with one a day is all i could handle, it gave me more than enough energy. Now in august i am taking 4 a day and i feel almost like i did before i started taking them. I have severe headaches and mood swings,i also become very angry easily. My doc switched me to vyvanse, i am scared i will fall back in the rut i was in for all those years. Will vyvanse be as good as adderral, and how long should i take it before i notice a change? I wonder if i quit adderral for a couple of months and then start it again , will it give me the affect it originally did? My behavior is affecting my whole life. Is there any advice or anything encouraging?

James, I'm going to start with the assumption that your diagnosis of Bipolar disorder is accurate.  With that assumption in place, the medication used for Bipolar are quite varied so that it is a leap to say that you have tried "every med available" but I will even accept that as fact.  A question that is not answered is if you tried COMBINATIONS of medications.  For example, combinations of antidepressants, or antidepressants with Lamictal can be quite powerful.  It is also not unusual for patients to benefit from combinations when use of single agents is not helpful.  But let's assume that combinations were tried but were not successful.  Use of a stimulant medication is a bit unorthodox . . . and brilliant!  Hats off to your shrink!

In cases of Unipolar Depression that is unresponsive to medication, there are a variety of augmenting strategies that can be used.  One of them is to use stimulant medication such as Ritalin or Dexedrine.  Adderall, of course, is a dexedrine-based medication.  Using stimulant medication in Bipolar patients can be tricky.  The risk of precipitating mood instability, irritability, or frank mania is uncomfortably high.  I can suppose that, at first, it was able to bump you out of your depression for a while . . . and then you became tolerant to it . . . and it was increased . . . and you became tolerant . . . etc until now you are on 80 mg daily (a whopping dose) and not getting benefit.  Is switching to Vyvanse any better?  Hhhhhhmmmmm . . . hard to say.  It is not a big difference.  Adderall is a combination of two amphetamine salts and two dexedrine salts.  Vyvanse is also a dextroamphetameine product. Not a lot of difference.  Might make a difference . . . but . . . maybe not.  Won't know till you try.  

My preference would be to put a mood stabilizer on board (whichever one you tolerated best) and then challenge you with a stimulant.  This could be either with a dexedrine product like Vyvanse, or with a ritalin product (such as Ritalin LA or Concerta).  The hope is that the stimulant medication would provide the same mood boost with the mood stabilizer providing for stability and act as a buffer for the irritability.  One of the tricks we use with ADHD kids who develop tolerance is to switch between a Ritalin product and a Dexedrine product.  For some reason, this can work with some kids.  Will it help with you??? Maybe.  Certainly seems worth a shot.

Good luck and keep plugging away.  If your doc gets stumped, arrange for a second opinion.  There are always new options and combinations to consider as well as life-style changes and therapies that can be helpful.

--Dan Hartman, MD

Conrad and Jaeger are progressing in their transformation from stupid, worthless puppies to intelligent, irreplaceable dogs.  They will never be like Noah, but they're enjoyable more often than not these days.

This morning, Buttercup* and I were sitting on the couch.  She had pulled up the game table and was working in a workbook, and I was reading The White Dove to her. All three dogs were snoozing on various pieces of furniture throughout the room.  For some reason, I got up and walked away from my spot for not more than a minute.  Apparently, Jaeg thinks that when I move, it's for his benefit, because, once again, he had stretched himself across the space between her and the back of the couch.  He loves to be close to her, and every time I move, I lose my place to him.  If someone isn't sitting next to her, he and Heidi both try to sneak up onto the couch by her.  This was the first time he has stretched out all confident like that.  His head was on the armrest, just in case she wanted to pet him, I am sure!  He's such a goof!

Conrad is like the dumb jock, and Jaeger is like the geek. We can tell that Conrad is going to be a really good hunter, but he lacks sense.  He's in his element when he's outdoors being all athletic and stuff, but he's kind of a clod in the house.   Honestly, if I hadn't seen how sharp he is outside, I'd think he was dumber than a box of rocks!  Jaeg, otoh, seems more philosophical and, well, brainy.  He likes to run around the backyard with Conrad, but he learns commands better than Conrad.

Conrad is sort of homely.  I've never had a dog that I had to get used to looking at.  Jaeg has Puss in Boots eyes.  Conrad's white is bright white when he's clean, though, while Jaeger's fur leaves a lot to be desired for someone who's used to dogs that are actually attractive in a domestic setting, like, say, German Shepherds.

Jaeg is no longer the housebroken one.  As Conrad has improved, Jaeg has regressed.  *sigh*  And so has Heidi.   We have become much more regimented in how we handle them.  We now have a feeding schedule, and we try to take them out every two hours whether they act like they need to go or not.  We had a schedule before, but it wasn't written down.  It helps to have written reminders.

The boys have been keeping the pups in their room at night.  I'm not in love with that.  I'm sure Homer has allergies, and that's not helping, but all three boys are very good about attending to the dogs.  They're twice as responsible as I was at any given age in my childhood.  Homer lets Conrad and Jaeg sleep on his bed.  They're as flexible as wet noodles and don't mind sleeping in a pile, so it basically works out at the moment.

The puppies make me appreciate Heidi.  It's nice to have one dog who won't destroy the house while we're not paying attention for more than 15 seconds.

On Diet:

Homer and I have continued to eat gluten free.  I believe it has been about three weeks for him, and almost two months for me.  He has noticed a difference, and I have seen a big difference in him.  He doesn't act depressed and lethargic all the time.    He still craves bread, but we both got glutened by Qdoba over the weekend, and he has stopped asking me how much longer he has to go without gluten.

I feel really, really, really bad that he does seem to have a problem with gluten.  It is so hard to watch people eat yummy things in front of you, especially if you're a kid.   The other day, Dub made biscuits.  I keep forgetting to buy bread, so he took matters into his own hands.  (I'm used to avoiding it like the plague, so it doesn't phase me, while I'm shopping, that other people might still want it.)  When the biscuits were done, Homer asked if those were the bisquits that he could eat.  Those things smelled so good!  I told him no, and he wilted.  I'm not sure how else to describe it.  I felt so bad for  him!  I whipped up some cornbread for him, and that helped, but there's nothing in the world that bakes quite like wheat flour.

Tonight, I finally remembered to do some recipe-reading and research before I was too tired to care.  (I haven't gotten my laptop fixed, so looking things up is a chore.  I'm anchored to the desktop.) Based on what I read tonight and what I have on hand,  I made what turned out to be like a generic quick bread.  It's a little too dense to be like sandwich bread - and no yeast, but it is good enough to slather on some Soy Garden and honey.  I am not crazy about gluten free garbanzo and fava flour, but I could hardly taste it in this concoction. Woo  hoo!!!

For my own future reference - GFCF/Egg Free bread experiment 1:

1/2 C GF garbanzo/fava flour (Bob's Red Mill)

1/2 C GF sweet sorghum flour (BRM)

1/2 C GF whole grain organic brown rice flour (Arrowhead Mills)

1/2 C refined white sugar (just plain old, health hazardous white sugar ;) )

1 tsp Xanthan gum

1 Tbsp Ener-G egg replacer

1 tsp (??? oh dear ... maybe it was a Tbsp) baking powder

1/2 C water

1/2 C vegetable oil

1 tsp molasses

1 tsp vanilla

1Tbsp vinegar

Notes:  Oven temp: 350 F

I mixed all of the dry ingredients before adding the wet ones, but I noticed my baking powder was chunky.  >:-|  Nothing like a mouth full of baking powder!  That didn't seem to effect the final product, but consider sifting the b.p. next time.

After adding wet ingredients, mixed until combined well but not mixed to death.

Baking: Used one loaf pan and sprayed with nonstick cooking spray.  It about doubled in size and did not stick to the pan.  Baked about 30 - 40 min, but don't keep poking a toothpick in it to check for doneness.  Since there is no yeast, every poke causes it to lose some height.  Patience, my young padawan.

Overall impression:  I went into this expecting to fail.  I was sure I'd end up with one more gloppy, gooby, half baked mess.  I haven't had a lot of success with egg free breads, unless they are yeast breads.  I just wanted to try some things that might make Homer's life more pleasant.  I'm definitely going to do this again in the near future. It was of the consistency of quick bread made with real eggs.    It was not more dense in the center as most of my breads are when eggs are called for but something else is used.  I am encouraged to have a gf/cf/egg free bread recipe that Homer likes.

Karen Joy, if you read this,  I have lost the emails we exchanged at the beginning of July, but I seem to remember you describing your flour mixture for everyday baking being a third of three different flours.  That was the main thing going through my head when I started out.  Thank God it worked!

On Driving:

I'm having a lot of fun riding around the countryside with Homer.  I've been having him drive me to Buttercup's house in the morning and then home from her house in the afternoon.  He says he doesn't like it, but I don't believe that for a second!  It is so nice to be able to not drive for a change!  :)  On the days that I work, he averages a little over a half hour of driving.  By the time he's 23, he should have all of the required hours in to be able to take the road test.  That'll work out well, because I think his insurance rate will be more affordable by that time!

Off I go to check on the German Shorthairs and to kick the German Shepherd Princess of the couch.  Auf wiedersehen!

Vår sagovärld befolkas av barn och vuxna som tänjer på gränserna och som inte alltid beter sig som omgivningen förväntar sig. När Pippi Långstrump gjorde entré väckte hon stark oro hos många som var rädda för att hennes anarkistiska självständighet skulle påverka barnens beteende negativt.

Astrid Lindgren berättade själv:

- Pippi blev en succé, även om det fanns de som var chockade över boken och trodde att nu skulle alla barn bära sig åt som Pippi.

"Inget normalt barn äter upp en tårta på ett kafferep", var det en som indignerat skrev. Och det var ju sant. Inget normalt barn lyfter en häst på rak arm heller. Men om man kan det, så kan man kanske sätta i sig en hel tårta också.

Pippi gick inte ens i skolan och visste inget om Karl XII eller hur man beter sig på kafferep. Men hon var snäll och Astrid Lindgren har skapat historier om fler originella och äventyrliga barn.

Emil i Lönneberga t.ex. Alla hans hyss ställde ju till det för omgivningen. Han var en "illbatting" i allas ögon utom i sin mors. Han hade svårt att se konsekvenserna av sina handlingar, han fördärvade kalaset för några till förmån för andra.

Han hade gott hjärta och han var begåvad och påhittig, men hans beteende var inte alltid sådant att han skulle ha accepterats i dagens skola.

Kanske hade skolpsykologen konsulterats och kanske hade han fått stödundervisning eller personlig assistent i skolan.

Eller vad ska man säga om Karlsson på taket?

"Det finns bara en i hela huset som är ovanlig, och det är Karlsson på taket. Han bor uppe på taket, Karlsson, och redan det är ju ganska ovanligt. Det kan väl vara olika på andra håll i världen, men i Stockholm händer det nästan aldrig att någon bor i ett särskilt litet hus uppe på taket. Men det gör iallafall Karlsson. Han är en mycket liten och mycket trind och säker herre, och han kan flyga.

I flygplan och helikoptrar kan alla människor flyga, men det är ingen mer än Karlsson som kan flyga alldeles själv."

Det är svårt att avgöra Karlssons intelligens, men han hittade på, var självgod och egoistisk och han var inte snäll.

Men även tidigare har vi stött på annorlunda och avvikande barn. Max und Moritz härjade tidigt med grannarna i sin tyska hemby. Men till skillnad från Pippi och Emil var de riktigt elaka, eller var det bara pojkstreck och bristande inlevelseförmåga?

Boken om Max och Moritz skrevs av illustratören Wilhelm Busch redan 1865. När riksteatern uppförde en pjäs baserad på pojkarnas busstreck skrev de att "deras hyss       uppfyllde alla busungars hemligaste drömmar och mardrömmar."

Lennart Hellsing översatte Max och Moritz till svenska. Hans Krakel spektakel hängde och slängde i en gardin. Vad tänkte han på?

Och vad ska man säga om Alfons Åberg som är besvärlig när han ska gå och lägga sig, som gör en massa saker i stället för att göra sig iordning för dagis eller vågar säga att han inte törs slåss.

Vad ska det bli av den Vilda Bebin som gör allt han inte får, som somnar i taklampan och som hela tiden ställer till det för sin ensamma mamma?

Vi tycker om att läsa om barn som busar, ställer till det och som gör det som vi själva inte skulle våga göra. Men vi utgår från att det ska bli folk av dem också så småningom. Och när det gäller Emil så vet vi ju, enligt Astrid själv, att han blev kommunalpolitiker så småningom. Men alla de andra då? Vad händer med dom?

I can’t and won’t believe the conclusions of this survey.

I’m not saying that ADHD is or is not on the rise (in fact, soon I’ll talk about how common ADHD is!), but I am frustrated by headlines and so-called "national studies" that are inaccurate and weak.

This study found:

• 9% of children have ADHD

• Boys had ADHD more often than girls

• White and Black children have ADHD more than Hispanic children

• Children with Medicaid have ADHD more than uninsured or privately insured children

This study (and the headlines) forget to emphasize that they consider a child as suffering from ADHD if "a doctor or health professional ever told the parent that their child had ADHD....

I think that is crazy.

Just because a doctor SAID a youth has ADHD in no way means the youth ACTUALLY HAS the disorder. In fact, they aren’t even saying that a "mental health professional" said the youth had ADHD.

In this day and age of managed care, the burden on pediatricians and family physicians to assess and treat mental health disorders during brief time-limited visits, and health professionals lack of training in psychological testing-the rate of over, under and mis-diagnosis of mental health disorders among youth is becoming epidemic.

Anxiety looks like ADHD. Drug use can look like ADHD. The manic phase of Bipolar Disorder can look like ADHD. Hyperthyroidism can look like ADHD. Chronic lack of sleep can look like ADHD. A child who is being abused or neglected can look as if they have ADHD. Some children are more hyperactive or distractible than their siblings or peers-they don’t necessarily have ADHD.

Did each of these doctors rule out all these other potential causes? Did they interview the child, the parents, teachers, school counselors and other adults familiar with the youth’s behavior?

We don’t know.

This survey tells us what percentage of youth have been DIAGNOSED with ADHD. Many of them may not truly have the disorder. And there are likely plenty of youth walking around suffering from ADHD, but nobody has diagnosed them yet. So this survey tells us nothing about the how many youth TRULY HAVE ADHD.

Plus......
1)    Doctors DIAGNOSE ADHD more often in boys (What about all the girls with ADHD walking around undiagnosed and untreated—the survey doesn’t mention them)

2)    Hispanic youth DIAGNOSED with ADHD less. Due to the stigma related to mental illness in the Hispanic community, is it possible parents are not seeking help from “doctors” for their child’s emotional or behavioral problems? (this study tells us nothing about the true rate of ADHD among Hispanic youth)

3)    Surprise, surprise…..children with Medicaid are DIAGNOSED more often with ADHD “Uninsured” youth aren’t getting diagnosed with ADHD because they aren’t seeing doctors. Privately insured youth are more likely to receive comprehensive mental health evaluations that accurately diagnose ADHD only when appropriate. With Medicaid, doctors are often limited regarding the amount of time they can spend assessing all the potential mental health disorders that mimic ADHD. Receiving a diagnosis of ADHD and a prescription for stimulant medication is much easier than addressing the complex issues that often make low-income youth distractible and impulsive.

If a government agency reports on the number of youth SUFFERING from the mental health disorder ADHD, the answer should not be based on “parent’s report of what a doctor or health professional said.” Even if this current survey accurately reflects the true prevalence of ADHD, using this method is misleading and fails to communicate to families, schools, and policy-makers the importance of a comprehensive mental heath evaluation for accurately identifying which youth truly have a mental health disorder, exactly which one(s) they suffer from, and which youth are displaying typical behavior for their age. Without quality control in this area, over, under, and mis-diagnosis will continue to plague families and schools across our nation.

En droppe droppad i livets älv,

har ingen kraft att flyta själv.

Det ställs ett krav på varenda droppe;

hjälp till att hålla de andra oppe!

                                         Tage Danielsson

I de fall ni råkar se henne irra runt på andra ställen, IRL eller på nätet, vänligen kontakta avdelningen för Bortsprungna Avsikter på DamptantsJouren.

I de fall ni inte råkar se henne på grund av Tvättbergets omfång, vänligen kontakta Haveri- eller Bärgningsavdelningen på Damptantsjouren.

I nästa nummer av Tvättberget  utlovas bl. a

-  Sockontroll - en trollkonst med gamla anor

-  LFA - luddfilterallergi- en ny folksjukdom

-  Fickguiden - undvik tvättade pengar

http://www.pharmaceutical-business-review.com/article_news.asp?guid=47DD5436-E104-43E3-88B9-C358294750B0

Or more accurately . . . I can feel free to prescribe it, they just ain't covering it.

So when a parent of a 6 year old recently asked for Vyvanse, it was not available for use.

This is the problem with virtually all new medicines that come out.  The tiered approach to prescription coverage requires that you use (generally) older and (generally) cheaper medications from the same class before using the (generally) newer and (generally) more expensive medications.  From one perspective I do understand this.  Pharmaceutical companies are out to make the big bucks . . . and insurance companies are trying to make their bottom line look good at the same time.  Sorry patients . . . you lose.  So in the Vyvanse game, I have to show failure or intolerance to two older agents before Vyvanse will be approved by many of the insurance companies in my area.  My experience with stimulants is that for most people, they all work the same.  So do I NEED to prescribe Vyvanse???  No, I don't.  I will prescribe Adderall instead and the kid in question will probably do just fine.  

But where is my opportunity for choice???

Where are my patient's right to choose treatment for themselves???

--DH MD

Why am I not surprised?

Drama Queen, our five-year-old, was also diagnosed ADHD today. Again, no big surprise. The surprise came when they started pointing out the facial features of fetal alcohol on her. I brought this one home from the hospital. She was my baby-- even if not legally before she was three. I never saw it. I've had that birth mother look me in the eye and swear that even though she has a drug and alcohol problem now, it NEVER came into play while she was carrying any of her kids. I was a bit floored. 

DQ has already been diagnosed with reactive attachment disorder, so they are going to start treating her for that too.

I'm not happy with labels. I don't like them. I don't like social labels like "prep" or "geek", "jock" and "nerd." So, I have some innate issues with labeling my kids. My husband told his mom "They are both ADHD" and I had to correct him with "They were both diagnosed with ADHD."

Hopefully, I can convince the rest of the world that its things they HAVE not things they ARE.

No homeschool today because of doc visits. Looking forward to normality tomorrow.

Really fascinating stuff.

It's interesting to see what happens to the energy dynamic in a room once people get the gist of what he's proposing -- that we're on the verge of remediating learning disabilities, not just improving or working around them through compensations. It becomes like a gospel revival meeting. The entire room leans forward, there are gasps of insight, and occasionally even spontaneous exclamations like Amen! and "You say it brother!" when someone has a flash of recognition.

The room was full of educators (my friend and I were the only just-parents there), so it was especially good to see that particular group of people excited about the possibilities.

For me, it remains to be seen how much good it will do for my kids, but we should know soon, as school starts next week.

If you want to find out more about Fast ForWord go to scholar google. Type in Fast ForWord.  You can also look for articles by Taller and Merzenich. I did it, and came away disheartened by the first few abstracts I read, which basically said the promise of Fast ForWord isn't borne out in reality. But. Then I looked at how long the testing went and we're talking about small groups of students, usually about 65 total who did the Fast ForWord program, or another program or nothing at all for about a month. I don't think a month is long enough. But there's over 1,000 articles so it will take some time to get through them.

If you're interested in testing out some Fast ForWord-esque games, try this site...

http://www.brainconnection.com/teasers/

Any parents out there whose kids have done the Fast ForWord program? Please let me know in the comments what was your experience? Did it help? Did it make no difference at all?

I can't resist a good story. If I could read morning, day and night, I would. Oddly enough, the mechanics of reading were difficult for me to master. My reading speed was, and still is, far below average. Most kids with these difficulties grow to hate reading, but for whatever reason, I was a persistent, voracious reader. In fact, aside from the pace, I was reading at a high school level in elementary school. My family saw me reading and discussing challenging books from an early age, and thought it was easy for me. I did everything I could to disguise my reading problems because I thought they were my fault. I thought I was lazy, crazy and stupid. This caused me trouble in school. In class I'd get sick to my stomach. I'd start dropping things on the floor, bumping at the legs of my desk, or tearing at the pages of my book until my teacher got mad.

Understanding the way my brain works, or my particular (and sometimes peculiar) cognitive style has cleared up a lot of confusion for me. I'm learning to be patient with myself, and I'm at peace with my cognitive style; I'm even grateful for it. If I could read faster I would understand less of what I read. When I take the time to weave my way across the page and between the lines of a book the stories stay with me. This makes me happy.

]]> http://geshu00000.wordpress.com/?p=41 Wed, 27 Aug 2008 15:50:33 +0000 geshu00000 http://geshu00000.wordpress.com/?p=41 Seeking Help for Mental Illness

For many reasons, people may avoid seeking an evaluation for their mental health concerns. Unfortunately, such people continue to suffer without benefiting from the wide range of safe and effective treatments available.

An important first step in recovery is seeking professional evaluation and treatment. The following website may be helpful in finding a qualified mental health solution:  http://torahforever.net/blessings.html

Having a Family Member With a Mental illness

Having a family member with a mental illness can be very stressful. Whether the ill person is a son, daughter, husband, wife, brother or sister, you will be affected by their illness too. A person with a psychiatric disorder often needs much love, help and support. At the same time, the problems, fears and behaviour of your ill relative may strain your patience and your ability to cope.

There are many different kinds of mental illness, and each has its own symptoms. During periods when your relative is ill, he/she may be demanding and disruptive, or extremely withdrawn and inactive. In fact, an ill person's behaviour may keep on changing because the symptoms may fluctuate.

Whether you suspect, or know for certain, that a member of your family has a psychiatric disorder, you will probably find that it helps to learn about the disorder.  Find more at:  http://torahforever.net/blessings.html

Det är bara jag som vet det. Det finns inte en enda människa på jorden som skulle kunna gissa sig till att jag demonstrerar. Jag har ingen banderoll, jag ger inte ett ljud ifrån mig. Det finns inga igenkänningstecken, ingenting avviker från en alldaglig söndagspromenad i slutet av augusti. Det finns inget som antyder att min promenad är något annat än en promenad. Inget sticker av mot det vanliga.

Jag går här i tysthet. Men inne i mitt huvud skanderar slagorden. Jag ropar högst fientliga slagord mot regeringen och dess politik. Jag ropar roliga, rytmiska och slående ramsor. Jag skriker ut några förolämpningar tillsammans med  en och annan kränkande mening. Jag trotsar auktoriteten, jag utmanar polisen, jag vänder mig till den allmänna opinionen och vrålar ut min beslutsamhet. Jag protesterar. Jag demonstrerar.

Men ingen ser min demonstration, varken damen som kommer emot mig, eller den lilla flickan som skuttande hinner passera mig. Inte ens konstapeln i en förbipasserande polisbil tittar på mig. Det är ingen demonstration. Jag är ju ensam och tyst.

Den fridfulla gatan, där människor möts, där var och en sköter sitt och följer sina planer, kanske inte är något annat än en stum teater för hemliga protester och osynliga revolter. Man kan aldrig veta.

Tänk en sekund på allt det som du inte kan se på en helt vanlig gata, när du tar en söndagspromenad i slutet av augusti.

På en gata blandas så många människoliv.  Några steg därifrån jag själv går kanske det står en cancersjuk kvinna , en förtvivlad arbetslös, en narkoman med abstinensbesvär , en gravid tonårsflicka , en invandrare utan giltiga handlingar , ett sviket framtidslöfte. Och jag vet ingenting. Jag kan inte veta. Uppenbarligen.

Det är för övrigt just så det är med dolda funktionshinder och handikapp. Det man inte synliggör finns inte.

Det enda smolket i bägaren är denna totala enkelspårighet kring "Inkludering" som ffa specialped. institutet fastnat i. De hävdar att skolan så i grunden ska förändra sitt arbetssätt så att alla elever ska kunna delta i allt. I realiteten betyder det att man anser att tex elever med grava utvecklingshämningar, dubbelhandikapp, stora koncentrationsstörningar, beteendeproblematik och svår dyslexi ska gå i samma (stora) klasser som sina "normalstörda" kamrater. Klasslärarna ska med stöd av de "nya" specialpedagogerna klara att hantera vilken sorts problematik som helst, samtidigt som övriga klassen ska få sin del av kakan.

För oss som arbetar med barn med de här problem så är snacket om inkludering ett skämt... En teori omöjlig att genomföra - i allafall med dagens skolekonomi... och det är den som är realitet. Att slänga ur sig en massa vackra sagoföreställningar gynnar ingen. Vi måste jobba mot det vi har - inte mot det som bara existerar i fantasin.

Vi ber inte barn med ryggmärgsbrock att springa 60 meter - men vi tänker numera helt glatt sparka in ett barn med tex svår ADHD i en rörigt, rörlig klass på kanske 25-32 elever. Det är "bara" att ändra på pedagogiken... utbilda lärarna lite mer... *suck*!

Det specialpedagogiska institutionen helt verkar vilja sudda ut, är de medicinska och biologiska fakta som finns kring barn med neuropsykiatriska funktionshinder. Precis som om avsaknaden av vissa signalsubstanser i hjärnan skulle försvinna för att eleven konkurrenssätts med fler barn... Det är så dumt så inte är sant!

Det finns t o m de som hävdar att de här barnen inte har problem - utan att problemet ligger i skolans organisation, eller samhällets struktur... Det blir liksom "fult" att säga att ett barn har ett neuropsykiatriskt funktionshinder. Hellre ska man ändra hela skolan/samhället, än att försöka hitta en skräddarsydd lösning till det individuella barnets problematik. Snacka om utopia!

Vi tar emot nya elever varje läsår till vår lilla undervisningsgrupp. Genomgående för de elever som kommer från de "stora" klasserna är att vi i början får lägga alla krut på att plocka upp skärvorna från ett krossat självförtroende och försiktigt limma ihop fogarna för att långsamt nå fram till ett helt barn igen. Först där efter kan vi börja med den egentliga ny-inlärningen.

Ibland undrar jag om de som utarbetar alla fina teorier ö h t vistats i barngrupper, eller bland barn med neuropsykiatriska funktionshinder?

Ibland landar det nämligen grejer i knät på oss som är så urbotat DUMT så man skäms...

Jag är mottaglig för nya influenser inom skolans värld - men jag är också realist - och humanist.

Det är grymt, nästan på gränsen till barnmisshandel, att stoppa in 1-2 ensamma barn med väldigt stora svårigheter bland en massa andra barn som samtidigt springer fram som på räls. Det säger sig själv att det barnet inte kommer utvecklas optimalt - pga att undervisningssituationen inte alls är anpassad till det barnets särskilda behov - hur gärna man än önskar att det var så.

Visst är det bra att ge barn bra förebilder bland kamraterna - men det är också oerhört viktigt att barn har andra barn att identifiera sig med, och känna samhörighet med...

Det k a n gå så länge barnen är små, men när barnet börjar nå puberteten och sökandet av en egen identitet blir större och större, då - när minsta lilla avvikelse kan få vilken unge som helst att hata sig själv - då är det riktigt, riktigt elakt att låta ett barn som knappt knäckt läskoden sitta i en klass bland kamrater som flytande läser Harry Potter på engelska....

Inkludering måste kunna innebära någonting annat än enbart "stor klass". För mig är det lika mycket inkludering att gå i en liten, anpassad grupp, och gå ut och delta i tex PE-ämnen i större grupper... Men det tycker inte dagens specialpedagogiska politik... och det är riktigt taskigt mot de här barnen.

Ska vi ha "världens bästa skola" och "en skola för alla" - som politikerna gärna slänger ur sig - så MÅSTE det finnas en hel massa olika lösningar - för alla barn är inte lika, inte ens om bokstavskombinationerna på pappret är samma som bänkgrannens...

(Att ha tex adhd - innebär absolut inte att man är på ett speciellt sätt. Symtomen på diagnosen är högst individuella - och "korsdiagnoser" är mer än vanliga. Och det beror det på vem som satt diagnosen... Diagnosen ADHD kan även innebära ADD - en bokstavskombination inte alla neurologer använder sig av... Det här är en djungel som är lätt att gå vilse i - något skolpolitiker och skrivbordspedagoger uppenbart ofta gör!)