Dr. Elizabeth Reeve and Child Psychiatry

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I'm wondering what everyone thought of Wednesday Evening's topic at Toxic Child by Dr. Elizabeth Reeve. I was amazed at the many different side effects that can be presented when taking some of these drugs. Also the fact that side effects can also be interpreted as symptoms and how in the world could anyone keep any of that straight. When working with children this type of knowledge can be important in helping us figure out some of the behaviors. A child taking meds for particular symptoms may exhibit some atit-social behaviors and those behaviors may not be in control of the child because of the medications that child is on. That puts a different slant on how we may react to that anti-social behavior. If we can atrtibute this type of behavior to a side effect we may be able to have more patience in dealing with the child and that might make forbuilding a better relationship. My son, now 24, was on Ritalin and then Cylert to help him focus and concentrate as we tried desperately to have his behavior and developmental disabilities diagnosed. As a parent, I often felt guilt about medicating my child. Dr. Reeve gave me some new understanding on that and I think I may be able to work on some of the guilty feelings and maybe put them away. This knowledge can help me as I work with young children and their families.

-- Anonymous, February 11, 1999


My experience with children in or out of the classroom that deal with disabilities such as ADHD has been quite limited. The students I work with are college level and those students tend to keep those types of things to themselves unless they feel strongly that I need to adapt my courses to them to better suit their needs. But, I am very interested to hear from those of you who DO work with these students on a daily basis and what some of your experiences are (such as highs and lows with behavior or ability to concentrate, parental communication, your individual adjustments that you may make to accommodate a particular student's disability, preschool age kids vs. primary grade level v. upper elementary etc.)

On a personal note, I came away from the lecture far more informed than I ever was before.

-- Anonymous, February 12, 1999

I found the first part of Dr. Reeves'presentation a little slow and difficult to follow (or it could have been that I was tired) but I was able to track a little better after the break. When I got home from class that night, I was talking to my husband about our topic to get his reaction and to find out what he does with his patients. He said that he does prescribe some of the drugs we learned about and feels that they do produce positive results. He has patients that have gone from failing in school to getting A's. I agreee with his reasoning that if it work with results like that and the side effects are not that overbearing, it should be prescribe and taken without question or guilt. I know some parents that a very adamant about not letting their kid take prescribed drugs. It seems like they don't want to admit that their child needs help because that would be admitting that the child has problems. However, the alternative is not great for anyone who has to deal with distracted and unfocused students. I think their are many of us who don't like to take any kind of drug but if it cures an illness or heals the pain, I've learned to take my drugs when I need them. Dana

-- Anonymous, February 13, 1999

I CAN'T IMAGINE a parent not wanting to help their child because they don't like medications! In my family and in-law family at least seven of us have major medical problems that would be disabling or life-threatening if medications were not available. My younger daughter may have had severe hearing problems had my physician not recommended putting tubes in her ears at age 10 months. Most people can build up a trust relationship with a doctor and therefore be willing to try what the physician prescribes.

In my classroom last year I witnessed what Ritalin (sp?) can do for a student. He was focused for my Keyboarding class for ninth graders on the days he took the medicine. His problem, however, was that his mom sometimes forgot to give him his medicine, or she forgot to go buy it for him! On those days he was literally out of his seat more than he was in it. And that is usual for a class where students have a piece of equipment to hold their attention.

I think the "doc" was a very good speaker and answered questions very well.

-- Anonymous, February 13, 1999

As I sat there and listened to Dr. Reeve I was amazed at all the information about ADHD that was new to me. The number of medications and the side effects made me wonder how anyone keeps it all straight. I know how I feel sometimes if I have had too many cups of coffee. That feeling like my skin can hardly contain my body. I can't imagine how difficult that would be if that was something I had to deal with daily. The idea of having to take medication daily just to function would be something that would take some getting use to on my part. I can certainly understand the need for it but I know that as a parent there is something about giving my child medication daily to change their behavior that would cause me much more concern than say giving my child insulin on a regular basis. I think for me it's the changing of behavior that feels weird. My intellect tells me it would be best for them if that is what they needed but my emotions would need some working with so that I would not feel guilty.

Because I work with very young children I am often the first person outside of the family that has an obligation to bring behavior concerns to parents. It is a very difficult situation to be in because often I know something is not quite right but at two,three and four years old you don't very often get the final diagnosis. It is very frustrating at times. Dr. Reeve helped with my understanding of that whole diagnosis process. The list of symptoms was also very helpful

-- Anonymous, February 13, 1999

There was a lot of good information presented by Dr Reeve. I learned more about the diagnostic process, and how schools can contribute to the diagnosis. Dr Reeve pointed out how schools and parents can work together to determine what is best for the child.

I think it is difficult for parents to medicate their children for behavior modification because it is like saying they do not like their children the way they are. I agree that parents need to not feel guilty about medicating for ADHD when it is appropriate for their child. However, I do feel that ADHD has been over diagnosed, and medication is often the first route that is looked to for behavior modification. Parents I have worked with have had day care providers, teachers and teacher aides tell them that that their child has ADHD and needs to be put on medication. Yet, when the child is in our classroom, there doesn't appear to be the same behavior problems. The situation of too many children in a setting that is not developmentally appropriate along with inappropriate expectations can contribute to this. I was grateful to hear that Dr Reeve carefully considers both the home and school settings in her diagnosis. I wondered what alternatives she offers or what referrals she makes when a child she sees does not receive a diagnosis of ADHD.

The doctor also glossed over the side effects of drugs. For some children, not all or even many, side effects of weight loss or insomnia are a problem. This is where "drug holidays" may be appropriate. I also think we shouldn't underestimate the effectiveness of behavior modification therapy which can be used in conjunction with drug therapy or in place of it. Each child and family is different and all options need to be considered.

-- Anonymous, February 14, 1999

It was interesting to get a physicians view point of ADHD and the use of medications. I have frequently experienced parents opposing medications as a solution and only as a last resort. Dr. Reeve's presentation has given me new information and changed my thoughts about the use of medications for ADHD. I was also interested in hearing how physicians view schools and teachers in the referral and assessment process. It was of value to hear about the communication process that is used and how teachers can be more effective in communicating with them. It was a lot of information to take in, but it gave me information and vocabulary that I can use in working with students, parents and other professionals.

-- Anonymous, February 15, 1999

I just love how we all are comming from such different backgrounds and experiences. I walked out on Dr. Reeve, because I was not being presented with any new knowledge. So far, for me, I have learned nothing new through any of the Toxic Child classes. I consider it a HUGE waste of time. After years of working with special education I am very familiar with ADD and ADHD as well as issues of teen suicide and depression.Special educators sit in on all the SST(student support team)meetings and are part of the assessment teams that meet and discuss students with all of their service providers. That can be social workers, shrinks, psycholigists etc. We often get more info on a students then we care to. It was not so very long ago that ADD and ADHD were not considered to be handicapping conditions by ISD 709. Having a child with these diagnosis would not qualify that student for any kind of service. What I find interesting is how you all are responding to this. Especially those of you who are uncomfortable with medications. I have worked with EBD kids with ADHD in regular schools and in resedential treatment. I am here to tell you that having just one non-medicated student in your classroom,who is truely ADHD, will make you a sure fire believer in meds. Behavior modification will not work with an ADHD child.......put that same child on meds, provided he is not OVER MEDICATED, and you will see an entirely diferent child....complyent, attentive and being able to follow the classroom rules and interact in an appropriate way with his peers. After working with many attention deficit hyperactive disorder children and being a part of the evaluation and assessment process, I am truely a believer in how important medication is. I feel that any time you have a child in your room who is on any medication, you should know. You need the list of side effects,reasons that the child is on the meds....everything. The better infromed we are as the person who is with that child for 8 hours out of the day, the better. To those of you who feel guilty about medications....DON'T. An ADD or ADHD child without medication will usually be failing, constantly in trouble for behaviors and an outcast with his peers. With medication he has a chance at doing well in school. I also find it interesting that often parents will take their kids off meds., a med holiday durring the school week and not durring the weekend. I wonder how well they would do with 30 little kids in one room for 8 hrs. at a time with an ADD or ADHD student thrown into the mix. As teachers we have more and more to deal with in the classroom. I truely believe that it is the responsibility of parents to send their children to school ready to learn. If that means medications inorder to do that, then so be it.

-- Anonymous, February 16, 1999

sorry for all of my spelling mistakes...in a huge rush...

-- Anonymous, February 16, 1999

I have a student with Teretz? Syndrome. He is a very nice student when his medication is working. Sometimes he will be very attentive and participates in all of the discussions. Other days, he will be disruptive and disrespectful. Each time he gets out of line, I call his mom to let her know that something isn't right. They have the doctor check him out and most of the time, they have to change the type or the amount of the meds he is on. When the meds are not working, he is a totally different kid. I told his mom how frustrating it is to have a bad day when I know her son is a very good kid. She said she knows how I feel because she goes through it every day.

I don't know how much I learned from Dr. Reeve, but I do know I spent a lot of time thinking about how many of my students are on meds and how many should. I also know some students are abusing their ritalin and who are using other drugs with their meds.

I might be the youngest of the Cohort, but I don't remember so many kids on meds when I was in school. Was it because so many were not being diagnosed or is it something else?


-- Anonymous, February 16, 1999

I am enjoying the thoughtful responses and viewpoints of all who responded. I had to leave after our break (having spilled an entire cup of hot tea on myself!) and was disappointed in having to miss the information on the pharmaceuticals. We do not usually see children in the regular education classroom who are on medication for psychiatric disorders mentioned. If anyone has anything specific to add in addition to the notes, please let me know. I was interested in diagnoses of attachment disorders, sociopathic personality, etc. and the presenting symptoms. I am presuming most information was on ADHD, and how to best manage symptoms.

-- Anonymous, February 17, 1999

First off, I NEVER fell asleep in lecture about meds and kids. I was reading ahead because my experiences with these types of kids and meds usually show up when they have taken too much...either on purpose or accidentally. In my school setting I don't have much contact with these things because they have usually sorted themselves out by then. Out on the street we see lots of kids suffereing from all kinds of od's. The worst are the antidepressants...the tricyclics are the worst. The right amount is what makes someone get back into an active relationship with the world, but a little too much and everything shuts down. Usually there is no getting them back, the damage to the cardiac system is too devastating. As for the rest of the class, as well as the series, I just find myself learning more and more about some things I didn't know much about. Some of you have the good luck to work with these students in the formative times and the evidence of your good work comes to the surface when they get to us. We still have problems with lots of the same things that you did, but the students seem to be a bit better enabed to start solving their own problems and forming their own answers based on information not emotion. We have our ups and downs but its more a matter of guiding that forcing the students to do what they think needs to be done. I probably have more trouble with them coming to class hungover or strung out, but we talk a bit about the expectations of local governments as employers and they pretty generally get the hint. Stuff like this makes us better resources for our colleagues and our students.

-- Anonymous, February 22, 1999

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