Unicorns and fairies (and pirates)

So the letter for show and tell on Friday was U, meaning, bring in something that starts with U. I love these impossible letters. What are you supposed to do with X, if you don't own a toy xylophone? (I realize everyone probably owns a toy xylophone. It's one of those things you would not necessarily have chosen for your child but that your child ends up acquiring anyway. Like temporary tattoos.) Really I think it should be acceptable to just write the letter on a piece of paper, in marker or something, and bring that in. Kiddo decided that his letter U should be a unicorn, because he knew that I could supply one.

I had a big love for unicorns when I was a kid. (This is how it shakes out. Regular-type girls love horses. Geek girls love unicorns.) Unicorn bedsheets. Unicorn necklaces. Unicorn T-shirts. Ceramic unicorns and unicorns full of bubble bath formula. Unicorn prints on my wall. "The Last Unicorn" on VHS. Unfortunately most of that has vanished with time. What's left, mainly, is my old My Little Ponies, some of which happen to be unicorns. How they all got in my closet is beyond me. They appear to have snuck in along with the Cabbage Patch Kid.

Anyway kiddo requested a rainbow unicorn. I have no idea what prompted that -- I'm going to blame "Dora the Explorer," because he's been watching it lately, and because I can -- but it just so happens that I have one. Her name is Windy. You can see her here. There's quite a bit of devotion to My Little Pony out there.

I'm not entirely sure how many 6-year-old boys ask to bring a rainbow unicorn to school for show and tell. I don't know that rainbow unicorns exist on the same planet as most 6-year-old boys. DH did gently try to explain that this was more of a girl toy, but kiddo didn't care. Well, shrug then. I gave him the unicorn.

He was quite taken with her, except that her mane kept getting in her eyes and that bothered him. But he took her to school, and that night she acquired a space on his bed, next to Cowboy Woody and whichever Matchbox car he'd chosen for night duty. The next day he asked to swap her out for a different pony, because her hair was still in her eyes. (The '80s ponies did all have that Veronica Lake thing going on.) I gave him a different pony, and he was happy.

And the next day, we attended the Fairy and Pirate Festival. No, really. This town event started off as the Fairy Festival, but clearly this was not gender-inclusive enough so it was amended. Kiddette wore her pink fairy wings. Kiddo wore his two-year-old pirate costume. They blended right in with a sea of little girls in sparkly dresses and wings and boys in bandannas and the occasional eye patch. Some of the business folk and craft vendors manning the tents, endearingly, also wore wings. There was a "bounce castle" -- okay, no, it was a bounce house, talk about inflation -- and a big slide and a treasure hunt and games and dance demonstrations. You have not seen cute until you've seen Irish step dancers performing with wings on.

I have to say, occasionally I am puzzled at how thoroughly geek culture has gone mainstream. Adults walking around in fairy wings. Summer blockbusters riddled with superheroes. "Star Trek" movies that actually make money. Teen romance novels full of vampires and werewolves. It's all very strange. Don't people know that only geeks are supposed to like this stuff?

Now how is the next generation of geeks supposed to rebel against the mainstream? Read "Babysitters Club" novels and play Scrabble?

My point is, it's weird. But kiddo and kiddette don't care about such things. They just liked the "bounce castle." And, well, I would too.

The week in ADHD news

So a study came out recently saying that the majority of pediatric specialists ignore the American Academy of Pediatrics' guidelines for treating ADHD in preschoolers. (I learned about it here; the full story is here.) Researchers at the Cohen Children's Medical Center of New York sent out a questionnaire to 3,000 specialists nationwide. The AAP guidelines, which were revised in 2011 to extend the minimum age for diagnosis from 6 down to 4 -- in other words, the age at which kiddo was diagnosed -- say behavioral therapy should come first, with medication as more of a last resort. In other words, what we did. But more than 1 in 5 specialists said they go with the drugs first.

Sigh. Any second now I expect the NY Times to weigh in on the terrible terrible overmedication of America's youth, while once again not managing to find a single child or parent actually dealing with ADHD to interview about it.


OK, why do I think doctors (and/or parents) opt for medication first? Because it's covered by insurance. Basically the reason we haven't been back to kiddo's behavioral therapist is because she dropped our insurer, and while she offered to keep seeing him at the co-pay rate, we felt like that was more of a short-term favor. Most occupational therapy facilities (and, I have a feeling) ABA facilities don't take insurance, and after our ongoing aggravation with the OT Facility That Wouldn't Quit Billing, I can understand why. They're not equipped for that level of paperwork. So what are parents supposed to do if they can't afford to pay for therapy out of pocket? They go with what's covered.

Also, behavioral therapy is a long-term time commitment. I had to come in to work late on appointment days; kiddo occasionally missed part of kindergarten. It helped, sure, and we got some good advice on dealing with him (this is most of the point). But not everyone can make that kind of commitment.

And also, I think there is such a general lack of education out there about ADHD and other mental issues/disorders that people think the meds are what you're supposed to do. Got ADHD? Oh, well, get drugs. The other (and preferable, if you can swing them) options never come up because people don't know what they are.

I do find it troubling that doctors are just throwing medication at little kids to solve the problem. But I also think doctors will just throw medication at anything to solve any problem. Case in point: Many years ago I went to my doctor looking for help and advice about my insomnia. He rolled his eyes and gave me a prescription for Ambien. I'd actually kinda been hoping for an informed discussion about what might be causing the insomnia and what I could do about it, but sure, OK, Doc, I'll just take these meds and quit bothering you. The upshot: I took it maybe three times, didn't like it and stopped. And then I had children and insomnia basically ceased to be a problem, because when you have kids you're always tired and will never turn down an hour or 15 of sleep if you can get it.

So you want doctors to stop overmedicating kids? Great. I'm with you. But how about getting doctors to stop overmedicating the entire rest of the country while you're at it?

Bringing me (tangentially) to point number 2: This is Speak Up for Kids month, according to the Child Mind Institute in New York. (And you thought it was just Mother's Day.) The institute, which helps kids with all manner of behavioral and learning disorders (and has a pretty informative website, do check it out), runs a campaign every May to inform people about these disorders and about how kids' mental health is disregarded and underserved. I can't say they're wrong. If more people (and more doctors, apparently) really understood ADHD or autism or OCD or Tourette's or any number of other issues, they'd be better prepared to help kids who have them, wouldn't they? And maybe overmedicating would be less of an issue.

Anyway, that's my four or five cents. Now I have to get back in bed so the kids can serve me breakfast. Happy Mother's Day, all.

Status quo, maintained

I asked the school about ABA therapy, noting that our pediatrician strongly recommended it and wrote us out a prescription and everything, and also noting that I'm worried about how kiddo is going to do next year when he switches to a full day of school. The school folks are checking into it, but noted that they would have to get clearance to arrange such services for a non-IEP student.

Well, I knew that whole "he doesn't need an IEP, he's doing great academically" decision would come back to exasperate me at some point.


In all honesty, his school has done a lot for him -- classroom accommodations, OT, social skills group, regular meetings to discuss progress -- so I can't really complain. The boards on additudemag.com are full of parents upset that their school won't give accommodations or won't follow the 504 plan or won't discuss issues with the parents or won't even acknowledge that ADHD is a real thing, and write the kid off as lazy/stupid/badly parented. We're in a pretty good place, comparatively.


But I do think he could use the therapy. I'd rather go the extra mile now, than wait until he's really floundering and try frantically to make up for lost time.


I will say kiddo has one thing very much going for him: He's a dancing fool. We were at a first communion party yesterday, with a dance floor and a kid-friendly DJ and everything, and he basically danced the whole time, except when he was eating. It's hilarious and adorable (and in about eight years, will serve him well at school dances). Some of the other boys at the party were out in the hallway instead, tumbling around and tackling each other and throwing a ball around (and probably threatening the nice loungy furniture), and I know if kiddo had joined them he would've taken the roughhousing that half-step too far and hurt someone, or gotten in trouble -- inevitably being the only one to get in trouble, and not understanding why. So dance away, my son. Rock it Gangnam Style.


Only downside to the day, really, was the ice cream bar and the cake and the chocolate lollipops. Which were tasty, don't get me wrong. But I knew all the sugar would probably cause issues for kiddo, and I was right -- getting him out of the house this morning was a nightmare. He actually got out-and-out oppositional -- "No! I don't want to brush teeth! I want to play!" and running off -- which he hasn't done in a long time, certainly not since starting the medication. It's a conundrum, situations like that. Do I tell him he has to be the only kid in the room not eating dessert? Or do I suck it up and let him go all wonky later on? It's a lose-lose situation either way, seems like.

Professional help, round 3

Kiddo's pediatrician thinks we should be pursuing further behavioral training, so that he learns proper social skills. This is probably a valid point. Since he seems to be back to having semi-regular incidents at school. (For instance, hitting a classmate with a book today.) Said incidents may or may not be why so few classmates came to his birthday party.

The pediatrician recommended someone who deals in ABA therapy, or applied behavior analysis. Its goals, according to autismsupportnetwork.com (the therapy is frequently used with kids on the autism spectrum, though can also be used in other circumstances), are:

1. Managing the consequences of behavior by rewarding positive behavior, withholding positive consequences, or – in some cases - using punishment (e.g., scolding) to deter behavior
2. Re-arranging antecedents to promote positive behavior and minimize the likelihood of problem behavior (e.g., clarifying expectations, simplifying tasks, providing choices)
3. Teaching skills that allow individuals to be more successful and less reliant on problem behavior to meet their needs


We do some of this already, obviously, but could probably use the assist.

And speaking of professional help, our former OT facility could use an accountant. Currently DH is serving as one, to find out why they insist they're still owed $700 even though our insurer says they paid the claims. As far as he can tell,  none of the paperwork matches up. The owner has been taking a snippy attitude with us ever since I told off her billing person for expecting me to know more about insurance codes than she did. (I do not regret this, on account of the big hissy fit the owner threw about not getting paid in the first place, even though she didn't bother to tell us about it for months, until the amount owed was huge.)

And as all the adults get mired in arguments about money, kiddo still asks when he's going back to the gym doctor, because he liked it there so much. Even though he hasn't been there since September. Sigh.

Good news generally

We had another meeting with the school in which they said how much improved kiddo's behavior was and how well he's doing academically -- apparently he's jumped a few reading levels and is now slightly ahead of where he needs to be. The takeaway was, basically, "Keep doing what you're doing." His OT also sees some improvement but plans to continue working with him on motor skills and such.

I am a little concerned that his daily check mark quota on the behavior chart has gone down of late, from eight or nine to four or five. That might partially be the new-and-improved chart structure, which more closely tracks the specific times of day on his behaviors. It might be a more or less attentive substitute teacher, since his teacher gets a sub for conference days. What I'm afraid of, of course, is the medication suddenly not working anymore, because sometimes that happens.

Friday seemed to bear that out a bit; he got two checks. And was hitting kids and pushing them again. This literally a day after hearing the school officials rave about him.

Saturday, I took him to Trader Joe's. He likes these trips, because there are always free samples of food, and because if he finds the giant stuffed lobster hidden somewhere in the store, he gets to take a cereal bar from the prize box. And everything went great. I mean shockingly so. No running in the aisles. No hiding behind displays. No tantrums about wanting to ride in the cart even though he's grown way past the cart-riding stage. No throwing himself to the floor because he wasn't getting his way. I always knew where he was, and when I told him to go somewhere, he went. I almost wanted to pinch myself.

Saturday afternoon, the kids and I went for a walk, he on the tricycle he really shouldn't be riding anymore because his knees stick out at the sides (but he refuses to switch up to the bike). Things were fine until he and kiddette decided it would be fun to race ahead of me, and then kiddo thwacked the toy monkey right out of her hand and kept riding. And kept riding, even though I was yelling at him to stop. I caught up to him, confiscated the trike and made him walk right home.

Definitely he and kiddette egg each other on in a bad way, which might be what happened here. Occasionally if I want one of them to do something, I'll kick the other one out of the room, just to squash that tendency.

Today was the Spring Shiai for kiddo's karate studio (and a couple other studios/dojos as well). I hadn't originally signed him up for it, because we were going to be out of town this weekend, but change of plans (boo strep throat). But since we suddenly had no plans, well. A shiai is a combination exhibition and sparring competition, plus the announcement of any students who are being promoted to a higher belt. Before today, I did not know this. 

Kiddo only just started, so he wasn't ready for sparring (plus we haven't actually dropped the $65 on the padded gear yet). He sat out that part, then rejoined the students for the demonstration, sitting on the floor with the other white belts until it was his turn, following along as best he could, then sitting back down. All this took several hours. And he was a total champ about it. He didn't freak that we weren't down there with him. He did the moves. He sat. No defiance, no refusal, no running. A little goofing around. At one point, when they were supposed to be standing still, he appeared to be doing his own version of the chicken dance. But really that was it. He didn't even get upset about no trophy or no new belt.  He followed directions and behaved. This is better than any trophy.

It did occur to me, sitting in the bleachers with an increasingly bored kiddette, that we were now doing the official parent thing -- sitting through your kid's athletic meet. On the plus side, better this than football. On the minus side, everything I know about karate I learned in "The Karate Kid," so I kept thinking "sand the floor" and "wax on, wax off" and "Do the crane, Daniel!"

So the good really outweighed the bad this weekend. Hoping to say the same about the coming week.

The Times is concerned

about the jump in ADHD cases and the corresponding rise in medications. Because obviously the real problem is crappy parents medicating their kids into submission, I assume. Anyway, from the article:

The figures showed that an estimated 6.4 million children ages 4 through 17 had received an A.D.H.D. diagnosis at some point in their lives, a 16 percent increase since 2007 and a 41 percent rise in the past decade. About two-thirds of those with a current diagnosis receive prescriptions for stimulants like Ritalin or Adderall, which can drastically improve the lives of those with A.D.H.D. but can also lead to addiction, anxiety and occasionally psychosis.

“Those are astronomical numbers. I’m floored,” said Dr. William Graf, a pediatric neurologist in New Haven and a professor at the Yale School of Medicine. He added, “Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy.” 

Or, possibly, there are a lot of kids out there who should've been diagnosed in the first place but weren't because people think ADHD isn't real? Sorry, just speculating wildly.

The article says:

While some doctors and patient advocates have welcomed rising diagnosis rates as evidence that the disorder is being better recognized and accepted, others said the new rates suggest that millions of children may be taking medication merely to calm behavior or to do better in school. Pills that are shared with or sold to classmates — diversion long tolerated in college settings and gaining traction in high-achieving high schools — are particularly dangerous, doctors say, because of their health risks when abused.

Yeah, and when I was in college it was Red Bull, and/or NoDoz. (Or in my case, coffee.) Sharing pills with classmates is essentially becoming a drug supplier to drug abusers and should be treated accordingly. But it's a misperception that the drugs are designed to give kids better grades. They're designed to help the kids focus long enough to get their own good grades. Because ADHD kids tend to be smart and creative thinkers whose easily distracted brains go wonky when they're loaded down with busywork and test-by-memorization.

Kiddo isn't on medication for his grades. He's in kindergarten. Do they even get grades in kindergarten? Is it smiley faces or something? He's on medication because occupational therapy, behavioral therapy, behavior charts and a social skills group weren't enough to help him keep his hands to himself or prevent meltdowns over things he didn't like or couldn't control. Emotionally, he isn't 6; he's more like 3 or 4. That's part of the disorder. (Believe me, at home it's like we have two 3-year-olds, not a 3-year-old and a 6-year-old.) I'm hopeful, long-term, that he'll catch up emotionally and the medication won't be a permanent thing. But it's working right now and right now is good enough.

The Times also said this:

A.D.H.D. has historically been estimated to affect 3 to 7 percent of children. The disorder has no definitive test and is determined only by speaking extensively with patients, parents and teachers, and ruling out other possible causes — a subjective process that is often skipped under time constraints and pressure from parents. It is considered a chronic condition that is often carried into adulthood.

Funny, I don't remember the "subjective process" being skipped. I remember a two-month wait to see a pediatric neurologist at the county hospital. I also remember her conducting actual tests, of reflexes and motor skills (ADHDers tend to have issues with fine motor skills), in addition to going over the surveys.

Also, "historically"? This generation of kids growing up now is probably the first to even have access to medical and educational experts who knew anything about ADHD or what to look for. So what historically are we talking about? Because historically, what I remember from my own school days is that kids who couldn't do the work were written off as lazy or stupid, not as potentially having cognitive or behavioral issues that might be getting in the way. When you're talking about a disorder that right up until 1980 was still known as "minimal brain dysfunction," of all things, there is no historically. There's now and in the future.

So what's the result of all this hand-wringing by the Times? Comments like this.

As a school psychologist I have watched the rise in ADHD being diagnosed in children for the last thirty-four years. The diagnostic criteria for ADHD could be well termed: “Things that children do that annoy adults.”


And this.


Helicopter parenting and all that it entails, is one of the greatest factors in the ruination of their children. I have seen parents wanting their children to be labeled, to have a personal ed plan, so their children can have more time on tests, both classroom and standardized. Medicating the kids so that they can get better grades certainly makes these parents preen.


And this.

The problem is self created, we don't provide quality time to our kids, and that's what they are all craving for. 

Because it's always the parents' fault, right? And stories like this just confirm people's preconceived notions.

The Times, of course, was not done. They offered an editorial on the matter a day or two later, concluding thus:

The increase in reported cases, experts say, has been fueled by awareness of the disorder, drug company advertising, and parental pressure on doctors to prescribe drugs to help children focus. With the growing concern that many young people may be sharing or abusing these drugs, it is crucial that parents and doctors are vigilant about overmedication. 

 And by "experts" do we mean all two of the ones you interviewed for the last article?

Look, I agree that there likely is some overdiagnosing, and some unnecessary medicating, going on. I honestly don't think general-ed practitioners or pediatricians should be doing the diagnosing, unless they have significant experience in ADHD and other mental disorders. There's so clearly a general lack of knowledge and understanding in the general population that I'd only want to (and did) deal with a specialist. But I don't think any of that should take away from the many legitimate diagnoses out there, the many kids and adults who benefit from finding out exactly how their mind works and how to properly deal with it. 

Just once, I'd like the Times to interview someone who has ADHD, or the parent of an ADHDer. (Some non-celebrity, that is. They have, tangentially, interviewed Andres Torres and Michael Phelps about it.) Not to sound the alarm about drug abuse. Not to declare that all these kids can't possibly have this disorder. Just so they can tell their readers what it's really like to deal with ADHD. Because that alone would convey the idea that the Times says ADHD is real. That would be a powerful thing.

And then maybe I wouldn't feel like the most powerful paper in the country is taking potshots at my parenting decisions.

And kiddo is 6

He's not up yet, because I got home from work late last night and we had dinner late and baths and I made him do another "book report" -- he's supposed to write down the name of the book and author, draw a picture about the book and write a sentence about it -- because I misunderstood the directions on the whole reading-program thing and he's supposed to have done 19 of these things already, 25 for the school year. So he's doing one nearly every day to catch up. Fortunately he doesn't mind because it means I read a book to him first. Anyway, with all that he got to bed late. No hurry to wake him up, since his party starts at 11.

We're actually doing two parties this weekend, one for school friends and one for family and close friends of ours, most of whom also have kids anyway, all of whom live at least an hour away from us so we'd rather not make them drive out for a two-hour party at a restaurant. So basically, we'll be recovering from the first party and then cleaning the house for the second one. Because clearly we're gluttons for punishment.

I'm hoping he likes the present I made for him -- a Shutterfly book of his Lego creations. He's really pretty good with them, and just for fun I started taking pictures of his strange and fantastic vehicles. Like this one, for instance.

Things have been going well at school. His teacher reports he transitioned back from spring break very well. He has the occasional meltdown with us, because he's tired or hungry generally, but we know to stay calm and wait it out and then he calms down. He's even better about turning off the TV for dinner. So things are ... good? I think? Assuming all goes well at the parties.

And I believe he's up, since I hear him talking to Grandpa. Quiet moment over.