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Add Drugs and Keep Away from Sharp Objects: Institutionalizing Child Rearing
Parkland is just a few miles away from where I live. I have friends whose children went to Marjory Stoneman Douglas High School. The shootings at this school, and for that matter every other school is tragic. Our instinct, of course, at such senseless violence against the most innocent of us brings up rage and a desire to make sense of it all. Some of us will point fingers at the tools of the massacre, and many of us will demonize those we already disagree with. This tragedy is big enough for us relive our worst nightmares. And the easy fix is to look to blame our favorite villains.
I recently spoke to a friend who is having trouble with her own son. Not Parkland-variety trouble, but trouble nevertheless. She is a single mother and a good person. She works hard to provide a loving environment to her only son, who is the center of her universe. For as long as I have known them, however, she has had challenges with her son. My own two kids, a few years older than hers, seem to never have the kinds of problems she has had. It would be easy to attribute this to one or two facts such as that mine grew-up in a two parent home and hers did not, but we all know that reality is not ever that simple.
Here are some of my observations of my friends “troubled” child.
From a very young age, he was diagnosed with ADHD and was put on a medication. Growing up in India, I never heard of ADHD. I would never consider medicating my children for a chronic, non-threatening condition at a young age without at least trying some alternatives. My kids were not without fault growing up, and it never occurred to me to “medicate” them to have peace of mind. If someone had suggested ADHD medication to me, I would certainly seek a second opinion. The number of children being raised with medication at young ages is alarming. The long-term effects of not teaching our children to cope with their emotions and just have them take pills for it is just bad and wrong. As I have seen my friends son grow older, his challenges have grown in size with him. Instead of working with her son, my friend has taken the easy, institutionalized way of just medicating him.
Also from a very young age, my friend’s son has been seeing a psychiatrist. Once again, I feel, perhaps wrongly, that this child is missing out on the one connection he needs — with the one parent he has. Once again I feel that my friend has found an institutional solution to an everyday problem. While I understand the need for psychiatry, this is not a child that has suffered any real trauma in life. He is an intelligent, middle-class kid having gone to private schools all his life, and having a pretty decent extended family and a stable household.
There are two modes of communication in my friend’s household. One is a totally loving, caring and vulnerable, and the other is speaking over each other, generally in higher decibels. There is not much adult conversation. There are threats and promises, no voluntary exchanges. On the few occasions when I’ve had the pleasure of taking care of this young man, I’ve noticed him “fake yelling” at me to get attention. When he discovered that all he needed to do was ask, the conversation became more normal, more civil.
Both his eating habits and his health are in the “needs improvement” column. He has always been overweight, and there is not a whole lot of nutrition in his daily intake.
This is a very sweet, intelligent, caring and capable young man, given to mood swings and some mildly violent behavior. He has trouble coping with things big and small. Coping, for right now, means taking a pill or paying someone to listen to your issues for him. I think much of his issues could very easily have been addressed by some real parenting, and instead what he has gotten is a lot of institutional help, and has been made to feel pretty “defective” by people with credentials and authority. This kid will never shoot up a school; however, it is going to take a long time for him to grow up and be stable emotionally.
The 19-year-old who shot up the school in Parkland also had coping issues. He did much worse, though. He killed 17 people in order to be heard. Sheriffs had been called to his home 39 times. While I don’t know enough about him to say that “all he needed was better parenting,” better parenting would have certainly prevented the killings. Institutional solutions are only so good. In each one of these cases, it seems to me, that there is a failure much sooner, much larger. While everyone “knew” he was trouble, all that was done was drugs, and the solution the morning after seems to be “keep him away from sharp object.”
I think there is something fundamentally wrong with this picture; with this attitude, this way of thinking. Children are gifts and must be treated as such. Institutional answers will not work. Our worlds should not be an asylum, where inmates are drugged and kept away from sharp objects.
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Thank you for this post. Well stated.
I believe I need to disagree with your premise here. I will not comment on your friend’s child – I know nothing of the situation or the parenting.
However, while I do not automatically believe that for children with neurological issues medication is always good thing, I will not automatically believe it is always a bad thing either. I have seen children whose lives have changed almost overnight when properly medicated for their ADHD. I have also seen children whose parents are adamant against medication struggle daily with being able to focus on school work, or even sit in a chair without literally falling out of it. This does not even address the students I see who can get through their day, sometimes even with a smile, because they have been medicated and see a therapist for their depression or anxiety.
I know this comparison may be overused, but if a child had diabetes or cancer, would you make the suggestion that it could be overcome with good parenting? Or would you use the tools (medication and education) that are available in order to make the child’s life more livable?
To condemn medication and counseling for children as unnecessary if you are a good parent is offensive and thoughtless.
I know of kids where medication worked also. But I can’t count on all 10 fingers for whom medication was suggested, rejected and other alternatives sought.
I think way too many people grasp onto the medication route, and we have no idea the long term damage that causes
@juliana: Here’s an article on ADHD:
https://www.webmd.com/add-adhd/guide/adhd-how-common#1
While I am sure there are cases where medication is needed, there is an epidemic of over diagnosis. My friends son, in particular, is not an “extreme case that needs medication”. As for your comment on cancer and diabetes, I will ignore it since I don’t think it was made in good faith.
BTW, I think medication is too quickly handed out for adults also.
When my cousin’s son was tragically killed in a car accident, he and his daughter were prescribed anti depressants (or something) and remained on them for quite a while (I have no idea how long). I do know this – it’s been 8 years and my cousin has not yet handled the death.
I think the drugs prevented him from going through the first stage of hell, which is necessary to get to the next stage
I’ve been blissfully sheltered from the realities of serious mental illness within my immediate circle of family and friends and haven’t, until recently, begun to understand just how devastating real depression and other mood disorders can be for those who experience them more directly. 15 years ago I watched the episode of The Sopranos in which a school counselor suggested that Anthony Jr. suffered from ADHD and agreed with Tony that the symptoms sounded like the typical behavior of a teenage boy. Doubtlessly, there is a tendency to over-medicate non-severe cases as well as relatively normal misbehavior. However, it’s hard to watch something like this documentary and not feel for the parent who, even with medication at her disposal, has a child utterly out of control: https://documentaryvine.com/video/louis-theroux-americas-medicated-kids/
The medication, of course, is not a cure-all, as many of these cases of violence are the result of a previously medicated person with serious mental illness being unable to cope with the difference between their mollified state and the reality of their disease once they stop taking their drugs.
Sadly, there are no good answers, unless someone can come up with a cure for mental illness.
We were told that our youngest likely had some level of ADHD and that there was some testing to complete to confirm the diagnosis before starting medications. We did not do the testing and found non medication ways to cope. She is now doing great.
And unless that testing has improved greatly, it’s completely subjective. My sister got the recommendation from a potential school that her son get tested. She mentioned it to her doc – he turned to her and said “I don’t ever want to hear ADHD come out of your mouth again.” When she shared with the school her doc disagreed, they wanted her to go to a doc they recommended.
Obviously, he didn’t go to that school. And he’s fine; he was nothing but a very high energy youngster.
I know several parents who went from doc to doc until they got the diagnosis they wanted; once they got a diagnosis their kid was protected from a lot of discipline expectations at school.
This is a common story I have heard. Also, diet is a good way to help out as well. My oldest would have nightmares if she consumed any caffeine past 6:00 p.m., and sugar close to bedtime. She still has this. She has other food sensitivities that I would never know of had I not paid attention.
My friend’s son has stayed with me for extended periods and has no trouble with focus. How ever when he is allowed sodas for breakfast, things change a bit.
My son has no such food sensitivities and can eat junk all day long.
All kids are different, and there is no panacea. An attentive parent, however can make a lot of difference.
My daughter and my son-in-law live in our back house, so I know my son-in-law very, very well. And in my unqualified opinion, his ADHD must be off the chart. I’ve seen him switch between phone calls while carrying a kid while cooking dinner. And when he hangs up he starts a conversation with me that’s completely unrelated – he’s obviously been thinking about it when he was doing four other things.
He’s well into his 30s and went to school before the ADHD diagnosis epidemic.
He dropped out of school at 16. took his GED and has worked ever since. And he’s usually got 3 or 4 big projects going on at the same time.
I have no doubt that medication might have helped him with school, but who knows what it would have done to the talents he has that make him so successful and unique?
This is simply an apples and oranges comparison. There are objective standards to determine whether someone had diabetes or cancer. You can test blood sugar. Is normal or it is not. You can do lab work, imaging and surgery to find out yes or no to a cancer diagnosis.
ADHD is based on behavior and the subjective impressions of the person doing the evaluation.
https://www.psychologytoday.com/blog/side-effects/201710/adhd-is-now-widely-overdiagnosed-and-multiple-reasons
So to strain your example. Your child has stomach pain with no objective testing that determines the cause of the pain. Do you start chemotherapy?
Part of the problem with ADHD is there is a benefit to the diagnosis.
Schools push it because it’s easier to medicate then do other intervention, and the schools get extra money for every kid with the condition.
Parents sometimes push for the diagnosis because their kid gets special classes in school, special treatment when it comes to discipline, gets special treatment in tests ( like unlimited times on standardized tests) and can benefit financially, SS disability.
There is a great deal of perverse incentives at play here.
It’s also worth noting in this conversation that ADHD is different from the kind of mood disorders that result in suicidal depression or violent psychotic breaks. It’s easy to confuse normal-to-edge teenage hyperactivity as ADHD, but is over-diagnosing or over-medicating as common with clinically depressed or bi-polar kids?
My point was not to argue whether every child who has or does not have an ADHD diagnosis has been evaluated properly, or whether the motivations behind getting a diagnosis are pure. My point was that good parenting may not be enough – that there are times when medication and counseling are very beneficial to anyone with a neurological disorder. And to imply that someone who may have a disorder is simply suffering from bad parenting is insulting.
@ Kozak – Schools push it because it’s easier to medicate then do other intervention, and the schools get extra money for every kid with the condition. – This is simply untrue. Schools do not get extra money for every child who has ADHD. They only get extra funding for students who meet criteria for special education – many students with ADHD do not meet that criteria. The extra funding rarely covers the actual costs of servicing children in special education. Even if asked directly, we cannot recommend that a student be seen by a physician – we are educators not diagnosticians. We tell parents it is their decision if they want to take their child to a doctor. We absolutely cannot demand that a child be medicated. Now, that may be our school district policy and not a widespread practice, and there have been teachers who have had to have that policy clarified for them, but that is the policy.
@Jager – ADHD is based on behavior and the subjective impressions of the person doing the evaluation. – So are other mental illness and other neurological disorders – Autism, anxiety, depression all come to mind. Just because you cannot do a blood test to determine a disorder does not mean it does not exist and does not impact the functioning of the person who has it.
One size does not fit all, I think we’ve got that.
I just can’t forget, however, the 16 year old girl who was helping us with gardening and when left alone would get very emotional, excited and weepy. My wife or I would kind of ignore the emotion and just talk to her, and in a few minutes she would be calm and all would be well. We had to keep an eye on her to always.
She isn’t working here any more, it was her choice not ours, she told us – and her mother as well – that she prefers the drugs. And now she is on higher doses of some sort of psychotropic and regular counselling. But all is well.
The mother isn’t happy with this, but the experts are telling her this is for the best.
I’m just not sure.
ADHD is the second most common learning disability diagnosis.
” Based on 1999-2000 data from the national SEEP, the 50 states and the District of Columbia spent approximately $50 billion on special education services alone, and $78.3 billion on all educational services required to educate students with disabilities (including regular education services and other special needs programs such as Title I and English language learners) amounting to $8,080 per special education student.”
that’s a big incentive.
I’m going to quibble a bit on the word “functioning”. It seems as though we are talking about school. And I don’t believe the school experience should be the be all and end all to determine whether a child is “functioning”.
My prayer is that we do get school choice and a thousand lights will shine so that kids who do not “function” in institutional learning will have other options.
The relevant reality is often that simple. So, NO: we don’t all know that.
Of course these things do exist. They simply do not conform to your analogy to Cancer or Diabetes. When appropriate these above conditions do require medications.
The issue is that there is a difference between being depressed and meeting the clinical definition of a depression disorder. It is all a matter of degree of symptoms and how they effect your daily life. For my daughter the teacher did not like that she tended to fidget in her seat and squirm a lot. It did not affect her grades or the people around her, it was not affecting her daily life so medication should not have been recommended.
It is my position that a lot of kids may have some symptoms of ADHA and be perfectly able to be corrected without any medications. That does not mean that there is never a need for medication, just that we are medicating too many people, likely because it is easier than dealing with any issues. In a lot of mental conditions the medication is a mask not a treatment. If you break your arm and you take pain medication, the medication masks your pain but your arm is still broken. Some people just have depression and that is all there is to it. For these people medication is good. Other people get depression for a reason. Medication masks the symptoms but it does not solve the under lying issue. We medicate kids at a high rate because it is harder to work with them than to give them a pill.
Is there an identifiable physiological cause for ADHD?
At this time no. They don’t know exactly what causes it.
https://www.webmd.com/add-adhd/tc/attention-deficit-hyperactivity-disorder-adhd-cause
If I have time and can get my act together, I might put a post up on this.
But a couple of quick thoughts:
We all have a role to play here. My kids grew up with more than a few kids that were raised by single moms, two-parent working families and screwed up families. There were a lot of kids who glommed onto families like ours through school, sports, Boy Scouts or just being in the neighborhood. They had somewhere to go after school. I picked them up when they got sick at school. Took half a dozen home when we had an earthquake one morning and the school decided to close.
And I drove more kids to school than I can count. And a few boys spent suspensions in my house. They spent the day with us during uncountable “teacher in-service days” or short school days.
Those boys were treated like my own, as in when needed they pitched in, they were hollered at when they misbehaved and they were expected to sing along with Bohemium Rhapsody when it came on the radio.
I recently told a young man (who we didn’t know when he was young) to: For God’s sake, stand up straight and quit mumbling. When he hunched over later I put my hand on his back and pushed. When he mumbled I asked him to repeat himself until I understood him.
When he left he hugged me and thanked me. He told me no one had ever corrected him. (Two parent family; two perfect older sisters. He’s a little odd, I think his parents just kind of ignored him)
Most of those moms didn’t had to opportunity to share the favor to me, but there’s been others who have showed me unbelievable kindnesses over the years and this was my way of paying those kindnesses back. My experiences (and my daughter assures me it’s a lot worse now) is that there was a quid pro quo in parenting, in that you only offered a favor to someone who you “owed”. And vice versa. A closed loop system.
My point (and I’m sorry I don’t have more time; I realize this is scattered and not put together well) is if you have the opportunity to be involved in a young person’s life, take it.
So: We are giving powerful drugs to our children to change some particular behavior some people don’t care to deal with.
Greed.
I am not a parent, so will not offer ‘answers’ or ‘solutions’. However, I did read somewhere that boys are diagnosed with ADHD at a higher percentage than girls. Therefore, they get medicated more often. The theory advanced for this was so teachers didn’t have to deal with hyper, excited boys who wouldn’t sit still and pay attention. Here’s my take, and this addresses several other issues—why was recess cut from the school day? Running around outside, tag, softball, Annie-Over, swings, etc. shouldn’t be thought ‘wasted time’. Playing together promotes friendship, cooperation, a sense of community. Studies have shown students do better in class after a break from sitting still and paying attention. Their parents have jobs where breaks are federally mandated if they work 8 hour days; why should their kids be slighted in this regard? This could also help with the trend towards obesity. Ok, I’ll quit, but does this make sense?
Obvious when you think about it. As recesses became shorter and less frequent, the principal at my kids’ school and I had several discussions about it. They all know it to be true; everyone agreed with me. But the pressure for academics was so high they just felt they didn’t have time. (Which is nonsense. My opinion? Every teacher hates recess and lunch duty and by getting rid of it, it reduces liability for accidents)
And we had PE everyday (my kids, twice a week). And it was our teacher who put a whistle on over her 60’s dress and barked us through jumping jacks and then refereed the kickball game.
When son #3 was having problems sitting still at school, I drove to one mile from the school; we all piled out and walked the rest of the way. Problem solved. He had plenty of opportunity to run off steam, instead of his teacher expecting him to sit still after being rousted out of bed, rushed through breakfast, rushed to get dressed ,then rushed to sit it in the car.
And none of my kids were expected to do their homework when they got home from school; the rule was they couldn’t play with anything that had to be plugged in or required batteries. Other than that, they were left to their own devices til dinner.
You don’t think there’s a chance that this could be the problem?
I have no problem with single moms – most of the ones I knew were single through no fault of their own.
But the wise ones get their kids in Scouts and sports and make sure they have good male role models.
ADHD is real, but more realistically it’s mis-named. People who have ADHD do not have a deficit of attention…they are able to pay attention to everything. They have the ability to focus deeply, sometimes too deeply, on things that truly interest them. It is the way their brain works…it’s in the “wiring.” Studies have suggested that persons with ADHD do not produce sufficient dopamine in their brain, so they tend to always be looking for the next thing…the dopamine seeking rush. The most effective adhd medications are stimulants, methylphenidate (ritalin) and various forms of amphetamine. Their action in the brain is similar, yet paradoxical in someone with the condition. The stimulant actually slows down the brain function. Imagine the person who isn’t “human” until they’ve had a cup of coffee in the morning. If you do fine with one cup of coffee or tea and others need a supersize Starbucks, someone with adhd would tolerate about two or three high-caffeine energy drinks and not feel jittery at all.
Some other medications can be prescribed along with the stimulant to help dial back the impulsivity that goes with the condition; however, these sorts of medications, for example the blood pressure medication Clonidine, can make a person feel too tired. Its a fine line between an effective dose and making someone feel miserable.
What is really miserable is when kids with adhd can’t make or keep friends because they act different, can’t pick up social cues so quickly, and feel that they just don’t fit in. Adhd is also a disorder in executive functioning…keeping organized, reading all the directions, finishing all the steps, remembering to hand in the assignment. It’s the executive function component that makes school so difficult.
Teachers don’t put kids on stimulant medications; pediatricians and psychiatrists prescribe them. Some kids are easy to diagnose when young and can benefit from very low doses of the medications. Some kids need high doses…like the coffee/energy drink comparison. The difference is immediate and can be transformative. The earlier someone can be diagnosed with adhd, the sooner they can begin to learn how to deal with it. It doesn’t go away, and the medication wears off, often long before bedtime. Some say you can grow out of adhd, but it may be that a person has developed the ability to compensate enough to function adequately in adulthood.
If you want a classic portrait of someone with Adhd, read Huckleberry Finn.
Or come live with my son in law. Without medication he had to develop coping skills. On one hand he can balance five things at the same time – on the other he can focus to unbelievable detail.
I just don’t think “school” and how one is doing there should be the decider on whether one can “function”. I also think the expectations are ridiculous – see above comment about no recess.