Presented Without Comment. Well, Okay, With Minimal Comment.

[dr_pretentious]

For y'all's consideration, this opinion piece against medicating preschoolers for ADHD.

It's the nature of young children to have a deficit in their attention and an excess of energy, relative to the levels of attentiveness and activity their teachers and caregivers wish they had. I'm at wit's end sometimes, myself, teaching a class size of one, so I sympathize, but wit's end for the adult does not necessarily mean pathology in the kid. A challenging temperament or developmental stage is not a disorder.

I know there really is such a thing as ADHD, and I have seen what a difference medication can make in the lives of some people who have it. But diagnosing and prescribing for children as young as age three? Come on, people. Sit down, take a deep breath, and reread Piaget.

A preschool teacher who can't return to Piaget as a touchstone should consider maybe changing jobs, or organizing to improve working conditions for preschool teachers. Failing that, s/he might try Xanax to treat Overextended Teacher Disorder.

Comments

[jasminewind.livejournal.com]

Couldn't agree more. ADHD is a problem, IMNSHO, when children do not develop their attentiveness, working memory and executive function in line w typical development. To me the hyperactivity and lack of physical stillness was the easiest part to address. Helping my kids think, plan and execute, that is where medication has made a difference.

[dr-pretentious.livejournal.com]

Here or elsewhere, would you be up for telling me more about how you dealt with the lack of physical stillness? I don't know whether I'm dealing with ADHD or just young-boy-energy-level, but there are some things Gareth wants to be able to do that he'd master a lot faster if he could sit for about ten minutes more per day.

[jasminewind.livejournal.com]

So many strategies!!!

It depends on what you need him to sit still for. Are we talking meals? Reading books? Writing? Listening to instructions? Do they need to be 10 minutes in a row or would 3 3 minute sessions be good? or 2 5 minute sessions?

In general meditation has been an important part of helping us get more stillnes. This works to get more stillness in the next 30minutes to 2 hours, only if you practice regularly. We often use these ideas before bedtime and as behavior & emotional (for the 12 year old girl mostly!) resets when they need to get back down from a less good space.
- We use a strategy called string breaths, where you pretend to hold a string between your fingers in your lap and then as you breathe in, you raise one hand up to your face and lower it back to the other as you exhale. I can now use this as a "hyperactive reset" for D - he does 3-5 of these and then tries to do whatever he was doing to spastically, this time a little calmer.
- We also lay down and put small stuffed animals on our diaphragms and lift them as we breathe.
- Fun, short (90 sec to 3 min) kid-centered visualizations are also fun - you lead them to a place and they have an adventure, then they tell you about their experience. It usually starts with them not imagining anything during the session but only listening to you and maybe making up "what might have been imagined". Eventually they can imagine while you are talking and they have fun.
- We have a meditation app that has different sounds that the kids pick and we do 1-3 minute meditations.

Tell me how else you are wanting to get stillness and I'll see if I can think of any strategies that have worked for us. Also remind me how old your kids are!

[tracyandrook.livejournal.com]

Well said, both of you.

Though I think Xanax for the teacher is a little strong to start with. I'd go with getting a decent nights sleep and some exercise. Just throwing pills at the problem is a shortcut that's no substitute for personal attention. ;-)

I also like Erickson for describing kids' activity levels. Their _job_ at this time is to develop physical and other skills. It is correct for kids to be active, curious, noisy even, and to want to try/challenge everything. Damping that down is a prescription for poor health and lower initiative later on.

[tracyandrook.livejournal.com]

....I mean, you wouldn't deny puppies, kittens, piglets, chicks, colts, fillies, fingerling fish, children of all species, the right to get rambunctious sometimes as they figure things out. No, you may not chew the furniture, but I understand your need to chew.
Can you tell I am ready for spring!!?

[dr-pretentious.livejournal.com]

I agree that Xanax for the teacher would be crazy to start with. I started my thinking toward that post by wondering how a rush-to-prescribe professional educator would feel if the standard response to classroom conflict were to medicate the teachers and administrators.

With Gareth, when he starts doing something problematic but not actively harmful, I sometimes manage to redirect him by asking something like, "How might early humans have put that impulse to good use?" Sometimes I just ask myself, but if I think I have some ideas that could be applied right away, I'll ask Gareth. Sending him to the backyard to pretend to forage has prevented quite a few conflicts from erupting.

Oh, man, everybody is ready for spring. I've got "Here Comes the Sun" running through my head every day.

[sligoe.livejournal.com]

My son was pre-diagnosed as ADHD earlier than age three. There were many symptoms that just didn't fit "normal kid" parameters, and his pediatrician had to deal with a very concerned mom who was noticing that things weren't going the same way as with his older brother and sister. Fortunately, my son's pediatrician had an enormous amount of experience with ADHD kids, and was able to plan out a treatment program for him that did not include medications until he was much older and in school. He felt that we should try to work on the behaviors, and then if medication was needed, we'd take another look at it then. I have to say that when he did need medication, it helped him dramatically, and as jasminewind says, more to help him plan, think, and execute than to slow him down---because that boy NEVER slowed down!

I think that kids today are not taught discipline at home, and that translates into teachers thinking that they are affected by ADHD. Teachers are expected to be surrogate parents to children, and when there are 30 or more kids in a classroom, teachers just cannot effectively teach, parent, observe, or help the kids. They have a job to do and if they can get it done by advising medication for the most rambunctious kids, then they'll do it. Not the best solution, but they've not been given the tools, the time, or the assistance to do what they're supposed to do to teach the kids. It's very sad.

[dr-pretentious.livejournal.com]

It's so good to hear success stories about unusual kids. Cautionary tales lose their charm after a while. It sounds like you had an awesome pediatrician.

I think that kids today are not taught discipline at home, and that translates into teachers thinking that they are affected by ADHD. Teachers are expected to be surrogate parents to children, and when there are 30 or more kids in a classroom, teachers just cannot effectively teach, parent, observe, or help the kids. They have a job to do and if they can get it done by advising medication for the most rambunctious kids, then they'll do it. Not the best solution, but they've not been given the tools, the time, or the assistance to do what they're supposed to do to teach the kids. It's very sad.

This is part of what drove me out of classroom teaching. Not the biggest part, but a part. The unfinished work of childrearing has crept all the way into college classrooms, with people who are legally adults needing basic social skills my generation mostly learned at home from our mostly underemployed mothers before we started kindergarten. Nobody wants to pick up the drudgework that used to be dumped on moms as a matter of course, and honestly, there's no reason moms should be the only ones stuck with it either, so I don't see that changing on a societal scale anytime soon.

[(Anonymous)]

If the class size is 30 or 40 (or even 20 in kindergarden) the teacher cannot work and other students cannot work properly unless every one is relatively quiet, cooperative, and focused. Class sizes are too large. Play time is fazed out too soon. Oh,and Boy children are written off as 'just boys they can't help it' so they are given anger and frustration not discipline.

Dorothy Weaver

[dr-pretentious.livejournal.com]

There are a lot of things worth improving about working conditions for teachers, especially teachers of the very young. I don't blame teachers for feeling desperate or thinking about desperate measures. (Taking the desperate measures is another matter.) Our culture currently requires the impossible of both teachers and students, and then brandishes the idea of accountability at them to force them to comply with insane demands.

The system could use a lot of reform. Just not the wave of reform it's currently getting.

The "boys will be boys" problem is a serious one in so many ways. On the one hand, now that I'm raising boys, I have to concede that there really are differences in how normal development plays out. On the other hand, if the rule of law doesn't apply equally in schools to boys and girls, you soon end up in Steubenville.

I was sexually harassed and terrorized for years on a near-daily basis by a classmate, from 5th grade through 11th. A zero-tolerance approach of expelling him in 5th grade would probably not have been appropriate, but I do wish anyone had bothered intervening in any way whatsoever by the time 11th grade rolled around. My teachers and principals -- in elementary, middle, and high school -- all agreed that this kid was a boys-will-be-boys case. One of the principals told me that a bookish girl like me should be grateful to receive so much male attention. Had the internet been available to my harasser and his friends, I have no doubt the harassment would have escalated to the level of felony.

Honestly, I don't know what the most useful moral of that story is. At this moment, it seems to me that if too much high-energy boy-typical behavior gets labeled as pathology, it'll be a lot harder to identify and deal with the tiny minority of boys who actually pose an ongoing danger to their classmates. When we draw the line at the boy who can't sit still in his chair, and say that's the point at which medication is required, it gets harder to make a distinction between restlessness and sociopathy.

[tracyandrook.livejournal.com]

I wouldn't mind discussing what I learned about this but I think it would be a different thread. (and of course she continues) I went to a training seminar given by the Hunterdon County dept of ed that featured educators on this topic from Colorado's Front Range, which has witnessed a disproportionate amount of mass shootings. Basically it amounts to persons in authority setting clear limits, giving clear warning about consequences, and making absolutely sure that those consequences take place if the limits are crossed. That very same day I used the strategy with a rambunctious young man (11yo) of my acquaintance, and it worked. I still have to do it sometimes, but it still works, because the kid is basically good. Medical/chemical restraint was not mentioned in the training.

[rachel e. young (from livejournal.com)]

Some practical ideas: a mini trampoline (they make ones that fold for storage but I think you may have one already but it is probably in storage). Allow a few bounces for correct answers. I can't recall the reference but I read a study of someone using this strategy for ADHD kids. It helps with my high energy kid when we do it (although we are not using it in that structured a way).

Check out the Tools of the Mind curriculum for preschool and early grades. It teaches a lot of planning, self control and executive function skills through play. I have a book someplace that I haven't gotten all the way through (I think it was about a $25 book).

[tracyandrook.livejournal.com]

I think they have a mini trampoline, and it's great, and the kids like it.

[jasminewind.livejournal.com]

This is one of our strategies as well. We bought a mini tramp on craigslist and used it as a centering tool during A's homeschool year. I don't use it as much anymore but should probably start again, now that she has stopped her sports activity. Hrm...

[rachel e. young (from livejournal.com)]

Yeah, I have to get ours out to a more usable spot again. It helps a lot in the winter but I hate tripping over it all the time.

[spindlewand.livejournal.com]

I've been very concerned about a child of mine who has ADHD (I am quite certain child has it and agree with the diagnosis - if it's not this it's something else they have not figured out yet ) I am very interested in how parents who have obviously looked at the whole situation and tried all sorts of things feel about medication, so I am grateful for the sharing, even though it was not aimed in my direction - thank you all. I have so far taken the stance that I want to hold off medicating him as long as possible, on that basis that, among other things, we really don't know how the meds affect brain development. I definitely do not want to zombie the child out. We have tried a number of things and I am not sure if anything is working fast enough to avert problems that will dog child forever. Clearly there are very focused ways of using medication perhaps to the child's good and I need to look more into these approaches. Thank you all for your perspectives .