Who made your child’s diagnosis, how was it arrived at, and does it matter?

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Recently I’ve had people send me several news stories about the over-medication, or inaccurate medication of young people.

(Examples: “Drowned in a Stream of Prescriptions” – this story is about an ‘adult’ child and therefore different from the younger children I’m speaking of in what follows in this post. http://www.nytimes.com/2013/02/03/us/concerns-about-adhd-practices-and-amphetamine-addiction.html?emc=eta1&_r=0

“Attention Disorder or not, pills to help in school” – a story of pills being used to make up for over-crowding and other school and social issues.

http://www.nytimes.com/2012/10/09/health/attention-disorder-or-not-children-prescribed-pills-to-help-in-school.html?pagewanted=all)

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These stories prompted me to think — does the average busy parent, (possibly with more than one disabled child to care for), even have an opportunity to stop and think about the qualifications a doctor needs to accurately diagnosis a disorder like AD/HD? Even if a doctor is qualified to make the diagnosis, did the doctor take the time and go through the necessary steps to accurately diagnose a child? Or did a doctor take shortcuts that led to a quick best guess? Is a doctor ‘just trying’ medication to see if it helps; in this case ‘help’ being shorthand for getting a child to focus more at school.

Unlike antibiotics, which arguably aren’t going to leave a person any worse off if prescribed when not needed, anti-depressants, and the stimulate medication usually prescribed for AD/HD, can both lead to dangerous outcomes if given to a child who doesn’t have a medical need that warrants these drugs.

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What I am suggesting today is that when parents are given a diagnosis of depression, or AD/HD – or any other disability that a doctor feels requires medication – that parents ask what diagnostic tests have been given that helped the doctor arrive at this diagnosis. Particularly with AD/HD it isn’t enough for even a qualified doctor to just talk to the family or give a quick questionnaire about a child’s symptoms. Along with a full medical history, a doctor should give a child a range of diagnostic tests before arriving at an AD/HD diagnosis. The actual tests may vary slightly between health care providers, but there should be some ‘proof’ that supports the clinical diagnosis.

Depression and other affective disorders are more complicated to diagnose, in that there is not a set of standardized tests that can necessarily be applied to reach an accurate diagnosis. This is why it is important to seek out professionals who are qualified to make the diagnosis: a psychiatrist or neuro-psychologist who works with young people is the sort of professional I would seek out to work with a child. The qualified doctor should take a complete medical history of a child including the child’s family medical history, ascertaining if there is any family history of affective disorders.

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The doctor should also have follow up meetings with a child, particularly if medication is prescribed, to accurately judge how a child is responding to the medication. Finally, depression and bi-polar disorder both respond best when medication is accompanied by talk therapy – if a doctor is prescribing medication and not requiring follow up talk therapy you need to find a different professional to treat your child.

A qualified doctor making a legitimate diagnosis of a mood disorder, AD/HD or similar disorder and finding a useful medication to prescribe to a child can be a life safer. Parents as always, however, have to be their child’s advocates. Do not allow someone to medicate your child without having first done ample medical tests to ascertain that the medication being prescribed is treating a disorder your child actually has. The right medication is only ‘right’ if it treats an illness or disorder that one lives with.

cdr

 

 

 

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