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Old 01-24-18, 02:50 AM
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If a child responds well to meds they have ADHD...if not...they don't?

Okay so I have a new therapist who I don't think knows what they're talking about and would like some clarification here.

She says she's worked a bit with children in the distant past with ADHD and she goes on and on about how amazing stimulants are for those children.
She also believes that stimulants work differently for those with ADHD then for those who don't...which I agree with.

The thing she believes though, that throws me off...is she thinks that if a child takes a stimulant like ritalin and it calms them down and they're able to concentrate and what not...it's clear they have ADHD. If the stimulant doesn't calm them down, or makes them more hyper...then it's clear they DON'T have ADHD.
It's a black and white thing to her. I guess she's been telling parents this for years.

And it leaves me a bit frustrated cause I think she's flat out wrong and has likely been giving people misinformation for all these years.

Your thoughts?
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Old 01-24-18, 03:05 AM
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Re: If a child responds well to meds they have ADHD...if not...they don't?

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Originally Posted by psychopathetic View Post
Okay so I have a new therapist who I don't think knows what they're talking about and would like some clarification here.
The thing she believes though, that throws me off...is she thinks that

[...]

And it leaves me a bit frustrated cause I think she's flat out wrong and has likely been giving people misinformation for all these years.

Your thoughts?
It sounds like she's wrong and has been giving people misinformation for years.

Yes, it's more likely that a kid with ADHD will respond well to a stimulant than a kid without. And yes, majority of kids with ADHD do respond well to stimulants.

However...

Some kids (I think I've heard something like ~30%?) with ADHD don't respond well to Ritalin. Some don't respond well to stimulants generally. Some kids have comorbid problems like anxiety disorders or OCD or bipolar disorder or metabolic issues that can lead to poor toleration of stimulants.

A poor response to stimulants does not, in and of itself, rule out ADHD.

Some kids without ADHD may respond to stimulants. At low doses, they can increase focus even in some people without ADHD. Stimulants also appear to help some people with depression or other problems.

A "positive" response to stimulants does not, in and of itself, confirm ADHD.

What confirms ADHD in a child, at present, is a thorough evaluation by a qualified professional who has taken into account personal and family medical history, current and past symptoms and impairments in multiple settings, and input from people who know the child well.
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Old 01-24-18, 05:13 AM
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Re: If a child responds well to meds they have ADHD...if not...they don't?

How one responds to stimulants is not indicative of whether or not they have adhd.
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Old 01-24-18, 09:24 AM
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Re: If a child responds well to meds they have ADHD...if not...they don't?

Well this is interesting....Sarah and Namazu have FAAAAAR more experience than I do on this subject, and yet, I have seen exactly what your doctor has described.

My daughter is hyperactive, my son is attention deficit, they are both on different stimulants. When my daughter is on the stimulant she has a greater ability to sit and learn. Off of them she MUST get up and get a drink, a bandaid, sharpen her pencil, tell the teacher something urgently which turns out to be her dog died 3 years ago...etc. The stimulant calms her.

My son has what they refer to as brain fog. Have you ever tried to talk to a stoned or drunk person and their brain doesn't seem to be in the same room with their body? That's my son! He didn't know when tests were, SWORE half the test was on stuff that the teacher never even mentioned. He was not mentally present for about 50% of his classes. On the meds he's able to focus, the brain fog practically goes away. He is not only mentally present but contributing to the conversation.

A friend of mine has an ADHD boy. One day, about 2 years ago, she decided to see what her child felt like on the meds. She told me "I didn't understand that because I wasn't ADHD it wouldn't have the same effect on me. It was like I had super powers! I couldn't sit still, I had to keep moving, I think I dusted my whole house in about 30 minutes, and then went shopping and the world was moving SOO slow, and I was going through it at super speed, but things kept distracting me, like a flashy logo, or even the shiny floor, I kept forgetting what I was there in that aisle for." She said she told the Dr. what she had done and the doctor said "And now you know what it is like to have ADHD."

So, my point is, I'm looking at it like an if/then clause. If stimulants calm them, then they have ADHD. If stimulants make them run around like they are on speed, then they don't. If there is no reaction to a stimulant, try another kind, and go back to clause one and two.
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Old 01-24-18, 11:58 AM
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Re: If a child responds well to meds they have ADHD...if not...they don't?

Thanks a lot for that post Caco! I really appreciate hearing from someone who has experienced this first hand with their own children/friends.
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Old 01-24-18, 12:06 PM
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Re: If a child responds well to meds they have ADHD...if not...they don't?

It's clear that meds really, really help a lot of kids (and adults!) who have ADHD, and cause problems for some without ADHD. I don't think any of us here would argue otherwise.

But what I am saying is that anecdotes do not equal data, and it's a mistake to confuse the two. The data suggest that there are kids who do not respond well to stimulants despite meeting the criteria for ADHD diagnosis, and kids who show some positive response who don't meet the criteria for an ADHD diagnosis. Ignoring those cases and assuming that response to meds is a failproof diagnostic tool is a serious mistake.
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Old 01-24-18, 12:28 PM
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Re: If a child responds well to meds they have ADHD...if not...they don't?

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Originally Posted by namazu View Post
But what I am saying is that anecdotes do not equal data, and it's a mistake to confuse the two. The data suggest that there are kids who do not respond well to stimulants despite meeting the criteria for ADHD diagnosis, and kids who show some positive response who don't meet the criteria for an ADHD diagnosis. Ignoring those cases and assuming that response to meds is a failproof diagnostic tool is a serious mistake.
Agreed and well worded.
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Old 01-24-18, 03:37 PM
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Re: If a child responds well to meds they have ADHD...if not...they don't?

Stimulants tend to improve cognitive performance in the *short term* for most people, including those with and without ADHD. There's solid clinical evidence that people with ADHD can benefit *long term*, whereas there aren't any long term studies for those without ADHD. My guess is that, for those without ADHD, the effects of stimulants wear off pretty quickly, but without clinical experiments, we're just speculating.

Also, there are definitely people who probably are misdiagnosed, and there are people who are correctly diagnosed, but simply have bad luck and do not find symptom relief with stimulants.

In short, I think stimulant response can provide hints, but shouldn't be used by itself to make definitive conclusions.
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Old 01-26-18, 01:42 PM
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Re: If a child responds well to meds they have ADHD...if not...they don't?

Three kids now aged 21,17 and 14. All with adhd. My son did amazing on medication up until he decided to not take stimulants anymore after resuming them from a summer break. He was 16 so I let him decide. Middle daughter began the on and off cycle around 5-8th grade. All different kinds- her mood was horribly affected (due to undiagnosed BP I feel) and there were a few months between the starts and the stops where it seemed to help but she always crashed hard. Her 8th grade year was good-until the end and it started affecting her badly. She said she didnt want stimulants anymore (and we tried them all) and I felt she knew her body well enough to know it wasnt helping. My youngest daughter we tried for only about 6 months. They didnt help and they increased her anxiety terribly. So she didnt even get benefits while putting up with the side effects. I am 100% behind medication and have gotten my oldest Jake, to agree to wellbutrin which has helped for depression and his adhd. I have to let him decide if he wants to go further. Maybe my girls will get older and come to try them again and be able to tolerate them but for now this is where we are at. Its important to note that my 14 year old Ella, is all PI with major anxiety disorder. Becca the 17 year old is Bipolar, minimal anxiety and adhd C purely for the impulsivity. My son is adhd C and has always leaned towards the H- sort of always bouncing off the walls, runs up the stairs and down the stairs-never walks and he is a man now (I hate to believe that) but he is. So three different presentations of ADHD and multiple meds have at least proven to me that meds may or may not work but the disorder is still there.
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