Mudcat Café message #1613955 The Mudcat Café TM
Thread #86484   Message #1613955
Posted By: Mark Cohen
26-Nov-05 - 12:27 AM
Thread Name: ADHD- Ritalin
Subject: RE: ADHD- Ritalin
I guess we'll have to agree to disagree on this one. I would like to correct what I think are a couple of misstatements in your last post, though.

Letter and number reversals are not dyslexia. Dyslexia, or reading disorder, is a condition in which there is significant difficulty with reading in a person of otherwise normal intelligence. There are deficits in specific brain processes, especially those that have to do with phonemic awareness. The brains of people with dyslexia are literally wired differently than the brains of people who are good readers, and there is very good scientific evidence showing that. I admit that I used to be extremely skeptical of people who kept talking about dyslexia, until I read more about it and saw children and adults who had it. It does exist, and it responds well to a good educational program that is based on phonics, among other things. People with dyslexia can learn to be adequate readers, but they generally don't become fluent readers. They learn to use alternate brain pathways, which are slower and less efficient.

Your statement, "If a child does have a learning disability beneath the ADHD, no drug will help that child learn" is accurate, but misleading. It's kind of like saying, "If a child has nearsightedness and a learning disability, no prescription for glasses will help that child learn." Of course the glasses don't treat his learning disability...but he can't see what's on the blackboard without them! (I often tell children with ADHD that the medication is "like putting glasses on your brain--it helps your brain to focus.") Certainly, the treatment for a learning disability involves educational intervention, not drugs. But if he also has ADHD and it isn't treated, he may not derive much benefit from the educational intervention, because he may not be able to pay attention to what his teacher is trying to tell him.

I agree that counseling, behavior modification, and appropriate educational intervention when needed, are an important part of the treatment for ADHD--I always stress that to parents. In my mind, the purpose of Ritalin is not to "control behavior"; if it were, I wouldn't prescribe it for children who have ADHD without hyperactivity. It's to help the child improve his ability to focus, organize his activities, and succeed at school, at home, and with friends.

And I do always ask for information from the teacher, and often speak with the teacher directly. I have a great deal of respect for the difficulty of a teacher's job. I think they're grossly undervalued and undercompensated for what they do. (I think that many of the problems we're facing today could be improved if our society valued education and teachers as much as it values video games, reality TV, and professional sports.) Ideally, treating ADHD should be a partnership between the doctor, the parents, and the teacher. Unfortunately, that seldom is the way it happens.

Aloha,
Mark