tag:blogger.com,1999:blog-8184208181444239184.post4947949188813202081..comments2024-03-29T01:56:37.975-04:00Comments on Child in Mind: A Conversation with Paul Tough: How Children (Don't) SucceedClaudia M. Gold, MDhttp://www.blogger.com/profile/13081419560269676730noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-8184208181444239184.post-58366276305946727972012-09-16T22:29:45.991-04:002012-09-16T22:29:45.991-04:00There's much to like in your post, but there&#...There's much to like in your post, but there's enough in it to undermine it's analytical thrust.<br /><br />The locus of the undermining point pertains to your comments regarding a child's response to the initiation of stimulants in the wake of an ADHD diagnosis. You note that the child's parents may see a return of pre-medication behaviors after a period of remediation. To be blunt, such a turn of events a should be anticipated if not expected.<br /><br />As you point out, providing pharmacotherapy for a child patient does not resolve environmental or contextual issues (e.g.: undiagnosed parental issues, martial issues, school/schooling issues, ...). Nor does this course of treatment remediate any of the comorbid disorders that are extraordinarily common to ADHD. Various studies provide solid evidence that CD, ODD, chronic or major depression, AD and other disorders present in children diagnosed with ADHD (especially the combined sub-type) at at rates of 40-80% of the diagnosed population (by disorder). To be concrete, the cohort of children diagnosed with ADHD-C are likely to also have ODD (65%), ASPD (>55%), MDD or dysthymia (70%), AD (65%) or substance abuse disorder as they approach their teen years.<br /><br />Treating ADHD with age appropriate psychotherapy and pharmacotherapy delivers resilient improvements in the vast majority of instances. It also opens the door to therapists, parents and 3rd party care-givers/educators to begin to identify and, as needed, disaggregate the comorbid disorders that are more often than not lurking behind - and fueling - the more acute expressions of behaviors that can appear to be solely ADHD symptomatic.Anonymousnoreply@blogger.com