Final Thoughts

After posting my major blog post I am very happy with how it turned out. I think that my argument was very clearly laid out and it was very convincing, supported by solid sources. The writing process was very long and complicated. My thesis and argument changed many times since I began the writing process. At first I was planning on arguing that ADHD medication is over prescribed but upon further research I came to the conclusion that it was not. The next argument that I was planning on using in my blog is that teacher’s should change their teaching styles to help out those students with ADHD. After further research with this I decided that I wanted my audience to be parent’s with children who have ADHD rather than teacher’s. I feel like my final argument is far superior to my other previous arguments, and I am glad that I changed my argument so much even though doing so made the writing process longer.

One thing that I wish I was able to fit into my blog post is the difference between ADHD medications. Due to the 2000 word requirement, I did not have enough space to talk about the differences between the medications that are given out to children with ADHD. I had to clump all the medications together, even though many of them work differently, and have different side effects. There is a big difference between stimulant medication and non-medication stimulant.

Stimulants: Stimulants increase dopamine and norepinephrine in the brain to improve concentration while also decreasing fatigue. Stimulants are often the first course of medications used for ADHD treatment.

Non-stimulants: Non-stimulants affect the brain differently than stimulants. Though these drugs affect neurotransmitters, they don’t increase dopamine levels. It also generally takes longer to see results.  Click here to read more about the differences between Stimulant and Non-Stimulant medication

Going further I want to remind you of the importance of behavior therapy. Medication should never be a replacement to therapy, and only be given to your children alongside therapy if therapy alone is not working.

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Importance of Behavior Therapy for Children who have ADHD

 

OVERVIEW OF LEARNING DISABILITIES

Hardman who is cited in Kauchak states that almost 1 out of 10 students has some type of exceptionality that requires extra help in the classroom. An exceptionality as defined in Introduction to Teaching by Don Kauchak and Paul Eggen is a “learning or emotional need that results in their requiring special help to succeed and reach their full potential.” English2Another way to describe exceptionality is by calling this term a learning disability. There are over 10 different learning disabilities that each affect the bearer of the disability in different ways. In this post I will only be focusing on the most common learning disability, attention deficit hyperactivity disorder, or ADHD for short. 

WHAT IS ADHD?

 ADHD is defined as a chronic condition marked by persistent inattention, hyperactivity, and sometimes impulsivity. A few behavioral solutions are available to the parents of children who have ADHD. The first and safest option parents have is putting their child through behavior therapy. Many parents do not put their child through behavior therapy because according to the Center for Disease Control and Prevention’s (CDC) statement in the Washington Post, behavior therapy “can take more time, effort and resources than medicine.” However, the CDC encourages behavior therapy as the first step when treating children with ADHD because the results will be longer lasting than the use of medication. Click here to read my post specifically about this article

The second behavioral solution for parents of children with ADHD is to give their children medication that will calm them down and help them focus. Medication can be very beneficial to children who have ADHD. According to the CDC, medication helps treat ADHD symptoms in about 75% of the children who have ADHD. Medication cuts down on hyperactivity, interrupting, and fidgeting, but there is a downside to medication. The downside to the medication option is that many patients taking medication may experience side effects. 

Another downside to medication is that once a child stops taking medication or forgets to take the pill one morning, that child is back to square one.  The child will still retain the same behavior from before he took the medication, whereas with correct behavioral therapy, the child reaps the benefits from therapy even when not on medication. I believe that medication for children with ADHD should be the last option and only given out to children who have already attended behavior therapy.

DOWNSIDES TO TAKING MEDICATION

Most of the time the use of medication for children who have ADHD can be very beneficial, especially in children who have sizable symptoms, but it is crucial to not overlook the side effects and downsides to medicating your child. It is very important when deciding whether or not to put your child on medication to fully understand the possible side effects that medication can have on your child. Roy Boorady, MD, a child and adolescent psychiatrist lays out many of the side effects of children taking medication for ADHD in his article Side Effects of ADHD Medication. The side effects that Boorady focuses on in his article are sleep problems, eating issues, mood changes, and depression.

Many children who take medication for their ADHD have a hard time going to sleep at night. This is because many times the medication that children are taking is too strong and it keeps the brain stimulated for too long. If your child has a hard time getting a good night of sleep, they will have trouble the next day in class staying focused because they are too tired, effectively counteracting the use of medication. Another side effect that many children on ADHD medication experience is the loss of appetite. When taking extended release medication, a very common type of medication for ADHD, the drug peaks after about four hours after it has been taken. Doctors normally suggest taking medication in the morning before going to school, so many times children are not hungry when it’s time for lunch. This is a very real issue because if your child is not eating and getting enough nutrients, your child can experience delayed growth or even develop other medical problems.

MENTAL HEATH PROBLEMS

Many times taking medication for ADHD can also affect your child’s mental health. One very serious side effect that affects the mental health of many children after taking ADHD medication is the rebound or come-down.

Some parents describe something we call the “rebound effect.” After the medication wears off, their child becomes very irritable and aggressive. Sometimes parents tell me, “Every day at 4:30, I know it’s going to happen.”

After the medication wears off, many children become aggressive towards their parents making it so that the child does not act like his normal self. This rebound effect is due the medication leaving the receptors in the brain too quickly. Another side effect that affects the mental health of children on ADHD medication is the risk of developing mood swings. When the dose is too high for a child, often he or she may begin to look sedated or zombie-like but this can be fixed with a lower dosage, but many times even when the dosage is correct some kids will still get moody and irritable on medication. Not only can medication cause moody and irritable behavior, but children taking ADHD medication also have a high risk for developing depression. Boorady states, “Of course we have to keep in mind that kids who have ADHD can also develop depression. In fact they are  higher risk for developing major depressive disorder than other kids.” Depression is a very serious issue that should not be taken lightly when considering whether or not to give your child medication for their ADHD.

ALTERNATIVES TO MEDICATION

It is not fair to subject your child to side effects such as mood swings, eating issues, and sleeping problems as well as very serious medical problems such as depression without first exploring the other options. One alternative to giving your child mediation right away is the implementation of behavioral therapy. Behavioral therapy is defined as a series of Englishtechniques to improve parenting skills and a child’s behavior. Click here to see Dr. Kimberly Williams speak about how to use behavior therapy to help your child.

A few examples of behavior therapy are presented in A Review of Non-Medication Interventions to Improve the Academic Performance of Children and Youth With ADHD.  The first type of behavioral therapy that appears in this journal is consequence-based therapy,  meaning taking something away from the child such as desert or video games if the child acts up.

Both token reinforcement and response cost were highly effective in increasing the rate of responding, work completion, and overall accuracy of academic responding. In most cases, the effect sizes for these consequence-based interventions were large

The second type of behavioral therapy presented in this journal is self-regulation therapy. This means that the child with ADHD is in charge of monitoring themselves. This type of behavior therapy was also found to be very successful in changing the behavior of children with ADHD for the better.

Another example of behavior therapy was presented to me by Rick Lavoie when he came to speak at Elon about teaching students with learning disabilities. Lavoie touched on the fact that teachers play a very important role in the development of students with learning disabilities. Lavoie stated whenever a student with special needs or a learning disability makes a social mistake that the teacher should comfort the student and conduct a social skill autopsy. Click here to read more about Rick Lavoie’s presentation and to learn more about social skill autopsies

According to Patrica Quinn, M.D., a doctor who has treated patients with ADHD for the past 25 years, behavior therapy can help with certain symptoms of ADHD that medication can not.

 A pill decreases common ADHD symptoms like impulsivity and distractibility, but it doesn’t change behavior. A child on medication might be disinclined to punch someone, because he’s less impulsive, but he doesn’t know what to do instead. Behavior therapy fills in the blanks, by giving a child positive alternative behaviors to use.

Behavior therapy teaches children with ADHD positive behavior instead of just pushing the bad behavior aside for a few hours like medication does. Another reason why children should go through behavior therapy before they go on medication is because many times after going through behavior therapy, the child will require a lower dose of medication then he normally would. William Pelham, Ph.D., states in Attitudemag

There’s clear evidence that a behavioral approach will work for the majority of children with ADHD, the benefit of using behavior therapy first is that, if a child also needs medication, he can often get by with a smaller dose.

In Side Effects of ADHD Medication, Boorady states that a smaller dose of medication means that your child will not experience as many side effects as he normally would with a higher dose. Pelham, director of the Center for Children and Families at the State University of New York is also an advocate for behavior therapy before putting children on medication for their ADHD. Pelham states that medication will almost always work at least in the short term for children with ADHD but Pelham suggests putting your child through behavior therapy first because that is the safer alternative.

If a child is put on medication before they are put through behavior therapy, it is uncommon for that child to be put through behavior therapy because the parents think it is not necessary because the medication is already working. Pelham conducted a four-year study at the University of Buffalo addressing the issue that is; parents not wanting to put their children through behavioral therapy after they have started medication.

Parents who see that medication is working are less motivated to follow through with behavior therapy. That would be fine if the data showed that medication alone helped the long-term trajectory of ADHD kids. It doesn’t.

This study shows that ADHD medication does not improve the cognitive ability of children who take medication after they stop taking the medication. According to Pelham, a child can take medication for 10 years, and the day the child stops taking medication, the benefits stop. Taking medication without going through behavior therapy at the same time is like putting a band-aid over a bullet hole.

It’s a lot harder to learn from scratch how to deal with a teenager who’s acting out than it is with a five-year-old who is acting out. The parent has lost five or ten years relying on medication and not dealing with problems that behavior therapy could have addressed. 

 

THE GOLDEN COMBINATION

If your child is on medication or is receiving behavior therapy but is still not progressing as much as they should be, consider putting your child on medication as well as putting your child through behavioral therapy. Using both methods to treat your child’s ADHD will be very beneficial because this will cancel out many of the downsides that each of these methods have on their own. Due to your child going through behavioral therapy, your child will not need as high of a dose that he normally would, minimizing the side effects created by the medication. Your child will be able to grow cognitively throughout the years while being on the same playing field as all of the other kids in the class. This would not be possible only taking medication or only going through behavioral therapy. The journal Nine Months of Multicomponent Behavioral Treatment for ADHD and Effectiveness of MTA Fading Procedures states

Later secondary analyses of the 14-month outcomes showed that by compositing several measures from both parents and teachers to increase reliability, it was possible to demonstrate a statistically significant though small (d = .26–.28) advantage of Comb over MedMgt

In this context “Comb” refers to the combination of medication and behavioral therapy and “MedMgt” refers to only medication. This peer reviewed scholarly article shows that the combination of medication as well as behavioral therapy is the best option when it comes to treating your child’s ADHD.

CONCLUSION

In conclusion, it is critical to know the side effects that putting your child on medication for their ADHD can have on them. Many times these side effects can change your child greatly, whether it be physically through loss of appetite or lack of sleep, or mentally through mood swings or the rebound after the medication wears off. It is important to note that medication can be a great thing and many children need to take to do well in school, but all children should attempt behavior therapy before they go on medication. There is no point in putting your child on medication before attempting behavior therapy because even if behavior therapy does not fully work for your child, the combination of both medication and behavior therapy works better than medication alone. If behavior therapy works for your child it will have long term affect on your child’s cognitive ability whereas medication will not. If behavior therapy does not work for your child there is no shame in medicating your child, it is just important for everyone to know that there are other alternative ways to treating ADHD besides medication.

WORKS CITED

Arnold, L. Eugene. “Nine Months of Multicomponent Behavioral Treatment for ADHD and Effectiveness of MTA Fading Procedures.” Proquest. Journal of Abnormal Child Psychology, Feb. 2004. Web. 2 May 2016.

Boorady, Roy, MD. “Side Effects of ADHD Medication.” Childmind.org. Child Mind Institute, n.d. Web. 27 Apr. 2016.

Cha, Ariana Eunjung. “CDC Warns That Americans May Be Overmedicating Youngest Children with ADHD.” Washington Post. The Washington Post, 3 May 2016. Web. 5 May 2016.

Kauchak, Donald P., and Paul D. Eggen. Introduction to Teaching: Becoming a Professional. New York: Pearson Learning Solutions, 2011. Print.

McCarthy, Laura Flynn. “Behavior Therapy for Children with ADHD: More Carrot, Less Stick.” Additudemag. Attitude Magazine, n.d. Web. 02 May 2016.

Trout, Alexandra L., et al. “A Review of Non-Medication Interventions to Improve the Academic Performance of Children and Youth with ADHD.” Remedial and Special Education 28.4 (2007): 207-26. ProQuest. Web. 02 May 2016.

OTHER BLOG POSTS

Addition Context

Preliminary Idea

Current News Story

Campus Event

Additional Context 2

Final Thoughts

Additional Context Post 2

For my second additional context post I am going to talk about the differences between learning disabilities and the medication used to treat them

Definitions

Dyslexia: A reading disorder characterized by difficulty recognizing letters, learning letter sounds, and identifying rhyming words. Young children with the disorder may also experience delayed language development and have trouble learning to spell and write as they reach school age.

Dysgraphia: Characterized by distorted and incorrect handwriting as well as issues with fine-motor skills. This is often misdiagnosed as dyslexia or dyscalculia due to little being known about this.

Dyscalculia: Characterized by problems with learning fundamentals such as basic numerical skills. Children who have this disability have trouble processing formulas or basic addition and subtraction.

Dyspraxia: Characterized by a significant difficulty in carrying out routine tasks involving balance, fine-motor control, and kinesthetic coordination.

ADHD: A chornic condition marked by persistent inattention, hyperactivity, and sometimes impulsivity.

ADD: ADD is very similar to ADHD but without the H. In ADD the symptom of hyperactivity is absent . ADD is often not diagnosed because of the absence of hyperactivity. Due to this absence, many people assume the child is imply shy, quiet, or slow, when in fact they have trouble paying attention and focusing.

Medication

The most common type of medication used for treating ADHD is called a stimulant. Stimulants have a calming effect on children with ADHD. ADHD medications reduce hyperactivity and impulsivity and imporve their ability to focus and learn.

The various different medications used to treat ADHD are Adderall, Concerta, Focalin, Ritalin, and Vyvanse.

 

Treatment of ADHD

http://www.drhallowell.com/add-adhd/top10questions/

http://www.brainbalancecenters.com/who-we-can-help/learning-disorders/

 

Additional Context

For my first additional context post I am going to talk about the history of learning disabilities specifically ADHD.

1800s to mid 1900s: Learning and attention issues aren’t on the public radar. But they are a topic of conversation among scientists and doctors. 

In 1904 the British medical journal Lancet published the poem “The Story of Fidgety Phillip”. This poem is thought to be the first ever thing published about ADHD. “Phillip won’t sit still, He wriggles, and giggles, and then, I declare, swings backwards, and tilts up his chair.”

In 1955 the FDA approves the drug Ritalin to treat depression and fatigue but not for ADHD.

1960s and 1970s: The education and medical professions in the U.S. recognize learning disabilities. Public schools and federal government start paying attention to learning disabilities.

In 1968 the term ADHD first appears and Ritalin is now used as a treatment for this.

In 1973 Congress passed Section 504 of the Rehabilitation Act of 1973. This prohibited the discrimination against people with learning disabilities in programs that receive public funding.

1980s and 1990s: The education and medical communities strive to understand learning and attention issues and how to help kid who have them. ADHD becomes more widely known. 

2000 to Present Day: Awareness and research of ADHD issues takes off. Federal law more clearly defines special education services and gives parents more rights. Researchers start usuing brain imaging to study the causes of ADHD. 

In 2001 the No Child Left Behind Act was established. This act holds states and schools more accountable for student progress.

In 2004 IDEA is authorized. This gives parents more rights and better defined schools’ responsibilities for dealing with students with learning disabilities. IDEA programs were introuced to help struggling students before they are referred for special education services.

In 2007 the Office for Civil Rights as the U.S. Department of Education released a letter which states that denying kids with disabilities access to accelerated academic programs is a civil rights violation

 

https://www.understood.org/en/learning-attention-issues/getting-started/what-you-need-to-know/a-timeline-of-learning-and-attention-issues

Current News Story

 

In this post I will be talking about a news story that came out a few days titled CDC warns that Americans may be overmedicating youngest children with ADHD. This article talks about exactly what it sounds like. The CDC thinks that ADHD medication is given out too much. The CDC recommends behavior therapy first, before putting your child on medication. the CDC also claims that medication should cautiously given out because the long-term effects of medication have not been studied, “But the long-term effects of those drugs on a young brain and body have not been well studied, and the side effects can be numerous, including poor appetite, sleeplessness, irritability and slowed growth.”

I agree with the CDC in that behavior therapy should be the first option when you discover that your child has ADHD.

“Georgina Peacock, director of the CDC’s human development and disability division, said that experts recommend parent- or teacher-led behavior therapy for children with ADHD at this age as opposed to therapies like Applied Behavior Analysis, which focuses on the child and is considered by some to be the gold standard for treating children on the autism spectrum. Peacock explained that adult-led therapy can have a two-fold benefit: It helps strengthen the bond between a parent and a child and gives parents a toolkit to help them learn positive ways to set limits, impose appropriate consequences and improve communication.”

The CDC also states that no children under the age of 6 should be given medication because their brains are still developing at a very rapid pace. The CDC states that even tough the number of ADHD diagnoses are rising this does not mean that the issue is rising. The CDC states that the rise in the prevalence of ADHD can be caused from unrealistic demand in schools or from stressed out parents obsessed with having a perfect child.

 

Campus Event

For my campus event I went to a talk held by Rick Lavoie, M.A., M.Ed. Rick Lavoie holds a degree in Special Education and holds two Honorary Doctorates in Education from the University of Massachusetts and Mitchell College. Rick has lectured at many universities such as Harvard and Syracuse and he has also appeared on numerous national television shows such as the TODAY show and Good Morning America. This talk was about how to teach children with learning disabilities. This talk was directed for teaching fellows so this talk contained lots of very useful and specific information about learning disabilities and how to teach children who have learning disabilities. I took notes and wrote down various quotes that Rick said. One thing that Rick states was that “memorization days are over due to google and the access available to us”. This quote means that you shoud not completely focus on specific facts and questions because information is readily available to us at our fingertips, but teach your students how to learn and how to look up information. This is because information is constantly changing, information that was useful in the 90’s might not be useful today, but if the students are taught how to learn instead of memorization of facts they will do better in the future. Another thing that Rick touched on is that students with learning disabilities and special needs often do not understand social contracts. Because special needs children do not understand social contracts they need to be helped out using something called a social skill autopsy. When a kid with special needs makes a social mistake and gets made fun of or left out because of it the teacher should conduct a social skill autopsy. This social skill autopsy contains four steps:

step 1: have the student tell you what happened

step 2: ask the student what he or she thinks they did wrong

step 3: teach the student a social skill lesson

step 4:explain a social skill scenario based on what the student just learned in step 3.

The last thing that Rick Lavoie shared was that he thinks that all students should share the classroom and that students should not be separated by special needs. Rick feels like the special needs students do not hold back the regular students and the special needs students benefit from having regular students learning with them.