Attention deficit or sleep deficit?

Some cases of Attention Deficit Hyperactivity Disorder may be a sleep disorder in disguise, writes Vatsal G. Thakkar, a psychiatry professor, in the New York Times.

Eleven percent of schoolchildren have been diagnosed with ADHD, he writes. Adult diagnoses are up too.

For some people — especially children — sleep deprivation does not necessarily cause lethargy; instead they become hyperactive and unfocused.

Adults and children are sleeping less, Thakkar writes.

The number of adults who reported sleeping fewer than seven hours each night went from some 2 percent in 1960 to more than 35 percent in 2011. Sleep is even more crucial for children, who need delta sleep — the deep, rejuvenating, slow-wave kind — for proper growth and development. Yet today’s youngsters sleep more than an hour less than they did a hundred years ago. And for all ages, contemporary daytime activities — marked by nonstop 14-hour schedules and inescapable melatonin-inhibiting iDevices — often impair sleep. It might just be a coincidence, but this sleep-restricting lifestyle began getting more extreme in the 1990s, the decade with the explosion in A.D.H.D. diagnoses.

Children with an A.D.H.D. diagnosis are likely to also have “sleep-disordered breathing like apnea or snoring, restless leg syndrome or non-restorative sleep, in which delta sleep is frequently interrupted,” he writes.

In a 2004 study, 34 children with A.D.H.D.  all showed a deficit of delta sleep, compared with only a few of the 32 control subjects.

Sleep disorders can be treated, writes Thakkar, who has a rare form of narcolepsy.

Early high school start times don’t fit adolescents’ sleep patterns, research shows. “Tor a teenager, a 7 a.m. alarm call is the equivalent of a 5 a.m. start for people in their 50s,” writes Russell Foster in New Scientist. It’s the hormones.

Huck Finn, 2013


– Signe Wilkinson

19% of teen boys diagnosed with ADHD

Nineteen percent of high-school-age boys and 11 percent of school-age children overall have been diagnosed with attention deficit hyperactivity disorder (ADHD), according to the federal Centers for Disease Control and Prevention. Diagnosis rates have soared by 53 percent in the last decade, reports the New York Times.

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.”

Fifteen percent of school-age boys and 7 percent of girls now carry the ADHD label.

ADHD medications such as Adderall, Ritalin, Concerta and Vyvanse “can vastly improve focus and drive” for students with mild or nonexistent symptoms, reports the Times. An ADHD “diagnosis has become a popular shortcut to better grades, some experts said, with many students unaware of or disregarding the medication’s health risks.”

Ann Althouse wonders about possible side effects of “viewing youthful spirit as abnormal” and “skewing academic competition with performance-enhancing drugs.”

‘I want to be a mass murderer’ when I grow up

“When I grow up, I want to be a mass murderer,” wrote Brian McGuigan in his second-grade journal. Abandoned by his father, he was an angry child who was “hated” by classmates.

The entry was a story about me as a grown-up, an emerging mass murderer with a Frankenstein combination shotgun and machine gun mounted to my arm. I was probably playing too much “Contra” then. I used the gun to shoot anyone who messed with me, not an indiscriminate killing spree but a revenge fantasy against nameless, faceless bodies, all of whom may or may not have been my father. . . . the police never caught me because a hockey mask concealed my face, like Jason’s.

His teacher called his mother, not the police. After a conference, he began weekly appointments with a therapist.

Ms. Ashley talked animated and slowly like a Teddy Ruxpin doll. We chatted about school, my mom, Nintendo, and since I had trouble sitting still, she let me play with the toys. My favorite were the cars. I could pretend I was driving anywhere. Miss Ashley asked me lots of questions — “What’s your favorite subject in school?”; “Are you a Mets fan or Yankees”?; “Do you like pizza?” but never “What do you want to be when you grow up?” Sometimes my answers were one word, and other times I’d speak at length, spinning stories around her like a tether ball, some of which probably weren’t true at all because I lied often, not out of malice but boredom.

He also started taking Ritalin, which made it possible for him to sit still and focus in class.

 As my energy decreased, my motivation did, too. I spent most weekends zoned out playing Zelda for hours, basking in the fuzzed glow of the television. My mother told me to go out and play, but I just wanted to stay inside and play video games, relaxed and focused on the task, and not bounce around the neighborhood causing trouble.

By high school, “a class clown occasionally but no longer by trade,” he was an honor roll student.  When he was caught smoking pot, his mother showed him the second-grade journal entry.

I wondered where I would be if not for my mother, Mrs. McKierney and Miss Ashley, if I would have ended up like Jason, minus the succession of campy sequels.

It sounds like the Ritalin helped too.

McGuigan lives in Seattle where he is the program director at Richard Hugo House, a community writing center.

In Los Angeles, mental health workers work with schools and law enforcement to help troubled students who might turn to violence, reports the New York Times. 

Each day, several dozen calls come in to the program’s dispatch center from principals, counselors, school security officers or parents worried about students who have talked about suicide, exhibited bizarre behavior or made outright threats.

Mental  health workers try to convince principals not to expel students who’ve made threats. “Doing so only pushes the problem onto another school or leaves a child at home with free time to surf the Internet and nurse a grudge against the school.”

How a Kansas farm town saved its school

With only 70 students in kindergarten through 12th grade, Walton School faced closure.  People in the small Kansas town saw the school as “the only thing standing between their community and a future as a ghost town, writes Susan Headden.  The district turned it into a K-4 charter school, the Walton Rural Life Center, with a hands-on curriculum linked to farming.

  One of only two such elementary schools in the country, Walton, which now has 170 students (it pulls from outside the district), is considered an unqualified success. It scores in the top 5 percent on the state’s standardized achievement tests; it has been celebrated by the U.S. Department of Education; and educators come from across the country to learn its secrets. The school is so popular that its waiting list, now at 40, extends as far out as 2015. Some parents try to register their children while they are still in the womb.

Natise Vogt, the principal, says her school “is not out to produce the next generation of American farmers.”

 Walton picked agriculture for three simple reasons: kids love it, Kansas is a farm state, and as it turns out, there is almost nothing in elementary education that can’t be explained by relating it to cows and plows.

Take eggs. If second-grade teacher Staci Schill were running a standard classroom, she would be drilling her students on double-digit addition with the help of a prescribed textbook. There is still some of this kind of instruction, but building lessons around the agricultural theme lets kids see how they use their math facts in daily life. In this case, the students sell eggs produced by a small coop of hens. Every morning they rush out to collect and wash the eggs, inspect them for cracks, and box them for sale for $2 a dozen.  (They recently bought a sheep with the proceeds.) The students learn not just how to tell the difference between a Delaware Blue and a Rhode Island Red, but also about profit and loss and, when the chickens don’t lay enough to meet projections, supply and demand.

Walton kids take their rulers and protractors to everything from tractor tires to goat horns. They learn their ounces, cups, and pints by measuring grain for animal feed and oats for granola. Math and science come alive with trips to the grain elevator and a cruise inside a modern tractor, complete with GPS. The fourth-graders recently made a mockup of a wind turbine, learning about things like torque and the behavior of different blades.

Walton is attracting students with disabilities such as Asperger’s syndrome and attention deficit disorder: 25 percent of students have special needs, nearly double the rate for the district.

 

More adults diagnosed with ADHD

A growing number of adults are being diagnosed with Attention Deficit Hyperactivity Disorder, reports the San Jose Mercury News.

About 4 percent to 6 percent of adults in the United States suffer from ADHD, said Shashank Joshi, a child and family psychiatrist at Stanford University. In nearly all cases, adult ADHD represents the continuation of a childhood condition. “It’s rare for an adult that walks in to say, ‘For the first time when I went to college, I started having these problems,’ ” Joshi said.

According to the U.S. Centers for Disease Control and Prevention, about 8 percent of school-age children — an estimated 5 million children — have been diagnosed with ADHD. About half to two-thirds of those children experience symptoms as adults, according to Joshi.

When a child is diagnosed with ADHD, a parent may recognize the symptoms and seek a diagnosis.

Why so many hyperactive kids?

Nine percent of school-age children in America have attention deficit disorder, according to a health professional.   Why so many? Pediatrician Lawrence Diller blames a growing willingness to medicalize childhood misbehavior.  Uncertain about discipline and worried too much about self-esteem, parents turn to professionals, who are quick to prescribe drugs for what may be “minor differences in children’s behavior or performance.”

Children are under more stress at school, Diller adds.

. . . more than 20 years ago kindergartners only had to sing the ABCs and play “ring around the rosie.” Now, they are expected to read and do simple math before the start of first grade.

When both parents are working, children spend a long day trying to meet the “behavioral demands” of structured preschool and  after-school programs, he writes. “Parents are tired, too, when they finally get their kids at the end of the day.”

Via I Speak of Dreams.

Kids on welfare: The disability dilemma

Disability checks for children have become The Other Welfare, reports the Boston Globe. Low-income parents can boost their income by getting children on Supplemental Security Income (SSI), often for learning and behavioral problems such as hyperactivity. That encourages parents to get their children on drugs such as Ritalin.

Qualifying is not always easy — many applicants believe it is essential that a child needs to be on psychotropic drugs to qualify. But once enrolled, there is little incentive to get off. And officials rarely check to see if the children are getting better.

Preschoolers with delayed speech make up the fastest growing category of new SSI claims, reports the Globe. Once on SSI, they’re unlikely to leave, even if they outgrow their speech problems. Their disability status may lower expectations for their school performance.

Teens on SSI avoid taking jobs for fear of losing the payments. (Under federal law, someone who earns above a minimum amount is considered no longer disabled — even if the worker really is disabled.)

SSI for children was designed for parents raising kids with serious physical disabilities that create extra costs. But it was expanded in the ’80s. Now the majority of children on SSI are not physically disabled, reports the Globe.

The series won the 2011 Casey Medal for Meritorious Journalism.

With two Mercury News colleagues, I won the Casey Medal back in the day for our welfare series. Our teen mother supplemented welfare with an SSI check for her older son, who’d been born very early and was expected to be disabled. When he was four, the pediatrician praised the mother for her excellent care, told her the boy was developing normally and reported his healthy status to SSI. Without the extra money, the mother decided to get a full-time job instead of trying to complete a community college degree. The economy was booming and she’d done well in a work-study job, so she probably succeeded. I hope. All her phone numbers went bad and I wasn’t able to reach her again. She was 19.

It’s not the sugar

Don’t worry too much about the post-Halloween sugar rush. Sugar doesn’t make kids hyperactive, writes Dan Willingham on The Answer Sheet, citing dozens of studies.  If children act crazy after eating candy, it may be the excitement of trick or treating or the birthday party or just the thrill of a sweet treat.

Or it may be parental expectations:  In a study, supposedly sugar-sensitive boys were given a drink sweetened with aspartame.

Half of the moms were told that the drink had a lot of sugar in it, and half were told it had none.

Mothers and sons then interacted on several tasks (e.g., building a Lego house together). Moms who were told their children had had sugar later rated their sons’ behavior during this interaction as more hyperactive.

Sugar also has no effect on children diagnosed with ADHD, Willingham writes.

Factory schools in the 21st century

In this animated video, Sir Ken Robinson talks about changing education paradigms, the fictitious ADHD epidemic and children’s loss of divergent thinking ability as they go through school.