House of Eratosthenes

It’s the “tock” after the “tick”; the “haw” after the “yee”. For the last ten years prescriptions of psychiatric drugs to children have skyrocketed, usually for some variant of the learning disability ADD (Attention Deficit Disorder) — if you utter a peep of protest to this, toward the phenomenon as a whole or in relation to a specific case, in the wrong audience you WILL be subjected to some haughty lecturing and second-hand anecdotal evidence that it “definitely exists.”

Even though you probably didn’t say anything contrary to that.

I remember the five-hour meeting in which I was beaten up about this, as a parent. It ended not when we ran out of things to talk about, but when the daycare center was about to charge me by the minute for not picking up my son. The part that I’m not going to forget any time soon, was when we reviewed the test scores that said he was in the “third percentile” of showing symptoms associated with Asperger’s.

Now, I wanted to make sure I understood the data the school psychologist was presenting to me, so I validated the way I validate everything of considerable complexity that might be easily misinterpreted — I restated it in a synonymous way, to show my brain was working it over and to display the results it had cooked up.

This kind of connects back to the post previous — a relatively innocuous but unpredictable event, thoroughly messed things up. Third percentile, I had supposed, was three percent. HOw many symptoms the boy had showed, compared to what might have been used to diagnose Asperger’s, was left unstated — that could be anything. But among a hundred boys showing behavior identical to my son’s…or more accurately, providing the same score on the test my son took…three percent of them were subsequently diagnosed with Asperger’s, which effectively means there’s a three percent chance my son “has” it, assuming you regard a “diagnosis” as an event constituting absolute “proof.”

“I thought third percentile meant there was a ninety-seven percent chance,” one of the teachers said. All momentum was lost. The school psychologist checked his notes. He wasn’t sure which one it was.

Four years later, my son was diagnosed as not having Asperger’s. But the meeting is what I’m talking about. The lack of curiosity about how things work, what things mean. Now that this has infiltrated the ranks of people who actually have degrees, we’ve lost the part of our social contract that says you get special training to figure out how things work…and therefore, to make sure things run right. Nowadays you get that higher-level training to become a better-paid process-follower.

And also in the post previous, I said…

The ultimate consequence is that people who understand how things work, or want to figure it out, have to be treated like freaks. Which, with a personal bias I’m ready to confess freely, it seems to me that we are.

And yes, I’d like some cheese with that whine.

But it isn’t quite so much me about whom I’m whining. It’s the younger set. The elementary- and middle-school-aged kids, mostly boys. The process-followers don’t understand how the toaster-disassemblers think about things, and so, they have been drugging us up to make us go away.

Last year in the United States, about 1.6 million children and teenagers – 280,000 of them under age 10 – were given at least two psychiatric drugs in combination, according to an analysis performed by Medco Health Solutions at the request of The New York Times. More than 500,000 were prescribed at least three psychiatric drugs. More than 160,000 got at least four medications together, the analysis found.

Many psychiatrists and parents believe that such drug combinations, often referred to as drug cocktails, help. But there is virtually no scientific evidence to justify this multiplication of pills, researchers say. A few studies have shown that a combination of two drugs can be helpful in adult patients, but the evidence in children is scant. And there is no evidence at all – “zero,” “zip,” “nil,” experts said – that combining three or more drugs is appropriate or even effective in children or adults.

“There are not any good scientific data to support the widespread use of these medicines in children, particularly in young children where the scientific data are even more scarce,” said Dr. Thomas Insel, director of the National Institute of Mental Health.

It’s difficult to exaggerate just what kind of trend has been taking place here. If you have kids, you are almost certain to know someone whose child has a learning disability and is taking medication for it — and that is understating the issue considerably. The childhood learning disability has materialized over the last dozen years as something between an epidemic…and a fashion statement.

A lot of people will object to that, I’m sure, because they agonized over the decision to put their own child on such a cocktail and don’t consider it a fad by any means. But the fact of the matter is, the prescriptions have skyrocketed. We did get along for several generations without these drugs. Nobody over age forty is going to ‘fess up to having been perfectly well-behaved at this age…a source of zero problems…which in my mind is conclusive proof that society at one time faced the same problems, and came up with a different solution involving far less expense and long-term agitation.

Fact of the matter is, the medication is a substitute for that swift swat in the butt that people can’t dish out anymore.

It’s also implemented as a solution for behavior that is not destructive or even punishable — but not easily understood, either. Again, there is nothing new about the phenomenon of parents discovering their children have personalities different from their own. It wasn’t always something that demanded medication. “I’d give anything to peel back Morgan’s skull and see for myself just what is going on in there!” — my own mother said on more than one occasion, in a variety of moods ranging from the curious to the maternally-pleased to the exasperated. She wasn’t alone among mothers.

But she’d be alone in saying that today. Mothers, now, understand their sons perfectly. They must. If they don’t, the boy will go on medication to make him understandable.

But ADD does exist. It exists as a specimen of something that has become a pet peeve of mine: Disorders with handy names and acronyms, that the lay-person believes to apply to a specific, medically-understood and possibly physiologic problem — but that, in actuality, applies to a bundle of symptoms and nothing more.

I would cite as an example, autism versus Asperger’s. Autism falls outside of this because, for however much we still have to learn about it, it is generally understood to be a brain development disorder. It is a neurological problem. Asperger’s, which has in the last few years come to be considered and then recognized as part of the autistic spectrum, is much cloudier. Like ADD, it remains little more than a list of observations, about what some subjects do.

Now, I don’t work in the field and I don’t have access to the stuff that goes into the medical literature, nor would I be notified if the situation were to be meaningfully changed. But it seems to me this is a critical difference to make, and I’m wary of our medical community for their lack of candor in pointing it out: If I’m a doctor and I diagnose your child with ADD, that is a completely different thing carrying completely different ramifications from diagnosing your child with Autism.

Think of a vending machine that counts quarters as nickels. A diagnosis of ADD is like an expression of opinion, based on the similarity in behavior between this vending machine, and other vending machines that do the same thing. A diagnosis of Autism is a far more clinical thing. That would be like isolating the gadget that sorts the coins, and maybe some set of levers, one of which or some of which might be bent — and announcing with some scientific confidence, “the problem lies somewhere here.” Of course in both cases you have the option to junk the machine and get a new one, or replace the faulty part. We can’t do that with kids. But the analogy still holds, and there is this widespread misunderstanding, I’ve noticed, among parents as well as among educational professionals…anytime the word “diagnosis” is used, it must be representative of that last scenario. This is not necessarily the case at all, I’ve found, especially with learning disorders. The word “diagnose” turns out far too often to be an expressed opinion, by someone with letters after their name, that a subject’s behavior sufficiently resembles the behavior of other subjects, that the cause is probably similar.

And there are gender politics at work here. When parents squabble over whether or not to put junior on the juice, I notice the Mom tends to be in favor of getting it done, and the Dad is the killjoy. The situation is carefully couched in languaged designed to confuse: Mom is not “for” the prescription, she just doesn’t see any other way. But at the high, summary level, the situation is consistent. The female mindset seeks to make everything secure, predictable and non-unique. Kids that go on the psychiatric drug most quickly, come from single-parent households, or households in which the father is confined to a submissive role in decisions like this, and is expected to acquiesce.

Thing I Know #179. Children seem to be “diagnosed” with lots of things lately. It has become customary for at least one of their parents to be somehow “enthusiastic” about said diagnosis, sometimes even confessing to having requested or demanded the diagnosis. Said parent is invariably female. Said child is invariably male. The lopsided gender trend is curious, and so is the spectacle of parents ordering diagnoses for their children, like pizzas or textbooks.

My tentative conclusion is that this is just a continuation of post-modern feminist hostility to masculine things. Manly-men, before they hit their pubescent years, are sloppy things and always have been. They are rowdy, disorganized, and more often than not a little bit smelly. Never easily understood. This has been the way things are for quite awhile…”snips, snails and puppy-dogs’ tails,” remember that? What’s happening, I think, is that since the early 1990’s we’ve had quite enough of the puppy dogs’ tails and the snails. We’re not terribly pleased with the snips either.

Well guess what. The newest research is placing some uncertainty on the supposition that kids displaying “symptoms,” who “need” the medication because their mothers “can’t see any other way,” …may not be so flawed after all.

Crucial parts of brains of children with attention deficit disorder develop more slowly than other youngsters’ brains, a phenomenon that earlier brain-imaging research missed, a new study says.

Developing more slowly in ADHD youngsters — the lag can be as much as three years — are brain regions that suppress inappropriate actions and thoughts, focus attention, remember things from moment to moment, work for reward and control movement. That was the finding of researchers, led by Dr. Philip Shaw of the National Institute of Mental Health, who reported the most detailed study yet on this problem in Monday’s online edition of Proceedings of the National Academy of Sciences.

“Finding a normal pattern of cortex maturation, albeit delayed, in children with ADHD should be reassuring to families and could help to explain why many youth eventually seem to grow out of the disorder,” Shaw said in a statement.
:
The research team used scans to measure the cortex thickness at 40,000 points in the brains of 223 children with ADHD and 223 others who were developing in a typical way. The scans were repeated two, three or four times at three-year intervals.

In both groups the sensory processing and motor control areas at the back and top of the brain peaked in thickness earlier in childhood, while the frontal cortex areas responsible for higher-order executive control functions peaked later, during the teen years, they said.

Delayed in the ADHD children was development of the higher-order functions and areas which coordinate those with the motor areas.

The only part of the brain that matured faster in the ADHD children was the motor cortex, a finding that the researchers said might account for the restlessness and fidgety symptoms common among those with the disorder.

Earlier brain imaging studies had not detected the developmental lag, the researchers said, because they focused on the size of the relatively large lobes of the brain.

What I find interesting is that in these couples-squabbles where the Mom wants to put the kid on the sauce and the Dad doesn’t, one thing that keeps coming out of the strongest and most stubborn fathers is the phrase “he’ll grow out of it.” This, like nothing else, has been precursorial to the poo-pooing and the wildly off-topic “it definitely exists” lecturing I referenced earlier.

But the research summarized above, validates exactly that. In a post-modern society tailored to the needs, whims, expectations and sensibilities of the female, the children who have been willed by God to to go through life as male things, are naturally out-of-place and adapting to their surroundings slowly. The task that has confronted them is a considerable one, made so by us. Most of these kids aren’t learning-disabled at all; they’re simply masculine. And just as confused by our draconically-feminized society, as our society is about them.

But they’ll get it. Their fathers have been saying so for quite awhile, and now the propeller-beanie egghead researchers are figuring it out too.

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Slower Brain Maturity Seen in ADHD KidsWednesday, November 14th, 2007

Slower Brain Maturity Seen in ADHD Kids
Wednesday, November 14th, 2007