Stark realities of foster "care" revealed by federal judge in Nevada
The Oakland-based National Center for Youth Law was the loser in federal court in Las Vegas on Thursday when US District Judge Robert C. Jones dismissed a class-action lawsuit against the Nevada Dept. of Health and Human Services's director, Michael Willden; Clark County manager, Virginia Valentine; and county Dept. of Family Services director, Tom Morton, at left. The lawsuit sought class action status for three subgroups among the county's 3,600 foster children and monetary damages for the 13 foster children named as plaintiffs.
Read More:
http://californiaschildren.typepad.com/californias-children/2010/10/stark-realities-of-foster-care-revealed-by-federal-judge-in-nevada.html
Isabella Brooke Knightly and Austin Gamez-Knightly
In Memory of my Loving Husband, William F. Knightly Jr. Murdered by ILLEGAL Palliative Care at a Nashua, NH Hospital
Saturday, October 30, 2010
Friday, October 29, 2010
Instead of using foster homes, county prefers to keep it in the family
Instead of using foster homes, county prefers to keep it in the family
Published: Friday, October 29, 2010
By Jason Lea
JLea@News-Herald.com
Lake County has 23 fewer active foster families than it did two years ago.
That may sound bad but, actually, it's a good thing.
There are fewer foster families because fewer families are needed. In 2006, 158 children were in the custody of Lake County. That number has dropped every subsequent year, according to information from Lake County Job and Family Services. Currently, there are only 66 kids in the county's custody.
State statistics mirror these trends. There were 21,038 in Ohio's custody in July 2003. In July 2010, that total dwindled to 12,197, according to the Children's Bureau of U.S. Department of Health and Human Services.
Teresa Palm is the children services administrator for the county JFS. She said there were at least two reasons that fewer children were being taken from their biological households and put in foster care. The biggest reason is more at-risk kids are moving in with family members or friends of the family, instead of foster homes. These are called kinship placements.
Read More:
http://www.news-herald.com/articles/2010/10/29/news/nh3180662.txt
Published: Friday, October 29, 2010
By Jason Lea
JLea@News-Herald.com
Lake County has 23 fewer active foster families than it did two years ago.
That may sound bad but, actually, it's a good thing.
There are fewer foster families because fewer families are needed. In 2006, 158 children were in the custody of Lake County. That number has dropped every subsequent year, according to information from Lake County Job and Family Services. Currently, there are only 66 kids in the county's custody.
State statistics mirror these trends. There were 21,038 in Ohio's custody in July 2003. In July 2010, that total dwindled to 12,197, according to the Children's Bureau of U.S. Department of Health and Human Services.
Teresa Palm is the children services administrator for the county JFS. She said there were at least two reasons that fewer children were being taken from their biological households and put in foster care. The biggest reason is more at-risk kids are moving in with family members or friends of the family, instead of foster homes. These are called kinship placements.
Read More:
http://www.news-herald.com/articles/2010/10/29/news/nh3180662.txt
Food Additives And ADHD Drugs Are Destroying The Health of Our Children
Food Additives And ADHD Drugs Are Destroying The Health of Our Children
Dangerous food additives are creating a toxic environment for our children's health spurring allergies and ADHD. To add fuel to the fire, conventional medicine is addressing the symptoms with ineffective drugs which are essentially useless in the long-term.
One mother is leading the movement to raise awareness of allergens in food.
When Robyn O'Brien served her children scrambled eggs one day for breakfast early in 2006, the mother of four had no clue it would change her life drastically and forever.
"I had made scrambled eggs and put them in front of all four kids and decided to put them in front of the baby," the 36-year-old said. "I put them on her highchair and she didn't want them, fussed and pushed them away. And I didn't think anything of it."
But 9-month-old Tory's aversion to the breakfast staple had little to do with taste, as O'Brien soon found out.
"I put her down for a nap. A few minutes later and there was some mother instinct in me because I went in to check on her for some reason, which I rarely do, and her face was swollen shut," O'Brien said.
A life-threatening reaction to eggs caused grotesque swelling of the infant's face and instantly shook O'Brien to her core. She said her daughter's severe response prompted her to take a closer look at what she was feeding all of her children and to educate herself on food allergies.
"I did not know what was happening. I was so unfamiliar with food allergy and what a reaction looked like," said O'Brien, who lives in Colorado. "That's really when my education began."
Learning About Additives
What O'Brien soon learned was that artificial dyes are used in sugary cereals, candies, sodas and other goodies marketed toward children. Sometimes artificial dyes are even used to simulate the colors of fruits and vegetables.
What further disturbed O'Brien was the fact that U.S. consumers regularly ingest the additives in their food, but they have been removed from the same foods in some other countries.
In fact, Mars Inc. responded to pressure from the British government last year by removing artificial colors from its well-known Starburst and Skittles candies sold in the United Kingdom, after a British study bolstered a hypothesis that such additives increase hyperactivity in children.
Food industry giant Kraft Foods Inc. also did the same thing in early 2007 with its British version of Lunchables.
Whereas British consumers have revolted against artificial food dyes in the U.K., Americans haven't been as vocal as their counterparts. That is something O'Brien hopes to change.
"My goal is simply to have the same value placed on the lives of the American children," O'Brien said.
Mom on a Mission
O'Brien even created a Web site, which she launched on Mother's Day 2006, to serve as a parental resource and forum on children's food allergies.
The site is specific with its concerns.
"At AllergyKids, our concern is that industry funding ties between the agri-chemical companies and pediatric allergists who have served on the FDA 'generally recognized as safe' panels and testified to the safety of MSG, aspartame, glutamate and genetically engineered proteins, may prevent full disclosure of leading global research highlighting a ban of these ingredients in Europe, Australia, the UK and other developed countries in an effort to protect children," the site says.
O'Brien even created a symbol a green stop sign with an exclamation point in the center to identify a child with food allergies. It can be put on lunch bags, wristbands and even shoes.
"My goal now is to say, 'OK, this is what's happening. Let's inspire other mothers to take control so that our children can benefit like the children around the world,'" O'Brien said.
In her own life, O'Brien has gotten strict about what she feeds her children and encourages others to do what she has done: Throw out as much non-organic processed food as they can afford to. Also, avoid anything that's genetically modified, artificially created or raised with hormones and don't eat food with ingredients you are unable to pronounce.
"I thought, 'Well, I want to cook like the moms in Europe and avoid these chemical additives and see if that makes a difference in my children's health and behavior.' And so we did," O'Brien said. "We moved from the tubes of blue yogurt to regular yogurt and we started mixing honey into it. "
Not everyone in her family was happy about the changes.
"I encountered major resistance from my boys," O'Brien said. "They loved that blue yogurt and it was easy and it was convenient, but to see the dramatic improvement in my boys especially as we cleaned out their diets it was amazing. It was incredibly inspiring. They slept better; they were able to concentrate in school. Their behavior improved."
The Allergies-Additives Connection
Two recent British studies found that certain food dyes, as well as the common preservative sodium benzoate, may have an adverse effect on some children's behavior. Researchers said the increase in ADHD diagnoses could be partly to blame on the preservative.
"It can affect their focus, their concentration. They become more easily distractible, become more impulsive. I think we're looking at a whole population of kids with skewed immune systems," said Dr. Kenneth Bock, who wrote a book that supports the theory that food additives could lead to hyperactivity in children.
A Southampton Study in the UK showed that additives cause hyperactivity in children within an hour after consumption. Food additives, especially the artificial colors are made from coal tar derivatives and synthetic chemicals. Within an hour of ingestion, hyperactive behavior is evident.
ADHD Drugs Don't Work
It was a team of American scientists researching what is called the "Multi-Modal Treatment Study of Children with ADHD -- MTA for short, who found that ADHD drugs are useless over long-term use. The drugs used to treat ADHD such as Ritalin and Concerta are ineffective treatment methodolgies which are constantly promoted by conventional medicine. They have no benefits whatsoever after three years and even though they may show some short-term benefits depending on who is watching, and depending on their judgment of the child's behavior, the truth is there is no long-term benefit whatsoever.
They found that these drugs stunt the growth of children. "They were not growing as much as other children in terms of both their height and their weight," said the report's co-author, Prof. William Pelham from the University of Buffalo. "I think we exaggerated the beneficial impact of medication in the first study," he added in reference to a study they did a few years ago where they declared that these drugs were helping children.
"We had thought that children medicated longer would have better outcomes. That did not happen to be the case. The children had a substantial decrease in their growth rate," he continued. The second point was that there were no benefits to children taking these drugs whatsoever.
What they did not say in the results of this study is that the same drugs also stunt the growth of the children's brains. MRI brain scans later proved that children on ADHD medications had brains that were three years behind schedule in development. 80% of the children who were looked at with MRI scans were on ADHD medications.
Children taking stimulants as a treatment for ADHD are also 20 percent more likely to visit a doctor with heart-related symptoms, according to a new study conducted by researchers at the University of Florida and published in the journal Pediatrics.
Researchers examined the records on 55,000 children between the ages of 3 and 20 who had undergone treatment for ADHD using central nervous system stimulants between 1994 and 2004. Their health profiles were compared with those of nearly two million other children in the Florida Medicaid database, making the current study the largest ever on the safety of ADHD drugs.
The Pharmaceutical Credo: Sell, Sell, Sell
This is what the ADHD industry is like. It is as if they have to carry on this outrageous lie, and they cannot really tell the truth because then the whole house of cards would collapse and everybody would realize this is all one giant fraud.
They cannot tell the truth so they have to keep coming up with new lies to try to market this to more people. First, it was just a children's disorder. Then the drug companies realized they could sell this same speed drug to adults. Children are only a small part of the total market.
They have to keep pushing these drugs onto more children. They have to keep those parents in a state of fear. That's how they sell more drugs. They have to keep people believing in this fictitious disease. That's the only way they are going to make money. This is an industry that makes money by exploiting the bodies of children, and the evidence is very clear.
Even the NIH is now saying that these drugs stunt the growth of children. That is a scientific fact announced by a mainstream medical research organization. This is not fringe science. This is not alternative medicine. This is not conjecture on the part of some person who has an axe to grind with psychiatry. This is mainstream medicine announcing that these drugs stunts the growth of children.
Flawed Children or Flawed System?
The Multi-Modal Treatment Study's co-author is Professor William Pelham at the University of Buffalo. He is the one who found out that these drugs do not help children at all in the long run. He says, "In the short run, medication will help the child behave better. In the long run, it will not and that information should be made very clear to parents."
Dr. Tim Kendall, of the Royal College of Psychiatrists (the person who is working on some new guidelines about ADHD for the NHS) says, "A generous understanding would be to say that doctors have reached the point where they do not know what else to offer."
He says, "I hope we will be able to make recommendations that will give people a comprehensive approach to treatment…" there is that word "treatment" again. He continues, "and that will advise about what teachers might be able to do within the classroom when they are trying to deal with children who have difficult problems of this kind. I think the important thing is we have a comprehensive approach that does not focus on just one type of treatment."
One mother is leading the movement to raise awareness of allergens in food.
http://preventdisease.com/home/tips89.shtml
Dangerous food additives are creating a toxic environment for our children's health spurring allergies and ADHD. To add fuel to the fire, conventional medicine is addressing the symptoms with ineffective drugs which are essentially useless in the long-term.
One mother is leading the movement to raise awareness of allergens in food.
When Robyn O'Brien served her children scrambled eggs one day for breakfast early in 2006, the mother of four had no clue it would change her life drastically and forever.
"I had made scrambled eggs and put them in front of all four kids and decided to put them in front of the baby," the 36-year-old said. "I put them on her highchair and she didn't want them, fussed and pushed them away. And I didn't think anything of it."
But 9-month-old Tory's aversion to the breakfast staple had little to do with taste, as O'Brien soon found out.
"I put her down for a nap. A few minutes later and there was some mother instinct in me because I went in to check on her for some reason, which I rarely do, and her face was swollen shut," O'Brien said.
A life-threatening reaction to eggs caused grotesque swelling of the infant's face and instantly shook O'Brien to her core. She said her daughter's severe response prompted her to take a closer look at what she was feeding all of her children and to educate herself on food allergies.
"I did not know what was happening. I was so unfamiliar with food allergy and what a reaction looked like," said O'Brien, who lives in Colorado. "That's really when my education began."
Learning About Additives
What O'Brien soon learned was that artificial dyes are used in sugary cereals, candies, sodas and other goodies marketed toward children. Sometimes artificial dyes are even used to simulate the colors of fruits and vegetables.
What further disturbed O'Brien was the fact that U.S. consumers regularly ingest the additives in their food, but they have been removed from the same foods in some other countries.
In fact, Mars Inc. responded to pressure from the British government last year by removing artificial colors from its well-known Starburst and Skittles candies sold in the United Kingdom, after a British study bolstered a hypothesis that such additives increase hyperactivity in children.
Food industry giant Kraft Foods Inc. also did the same thing in early 2007 with its British version of Lunchables.
Whereas British consumers have revolted against artificial food dyes in the U.K., Americans haven't been as vocal as their counterparts. That is something O'Brien hopes to change.
"My goal is simply to have the same value placed on the lives of the American children," O'Brien said.
Mom on a Mission
O'Brien even created a Web site, which she launched on Mother's Day 2006, to serve as a parental resource and forum on children's food allergies.
The site is specific with its concerns.
"At AllergyKids, our concern is that industry funding ties between the agri-chemical companies and pediatric allergists who have served on the FDA 'generally recognized as safe' panels and testified to the safety of MSG, aspartame, glutamate and genetically engineered proteins, may prevent full disclosure of leading global research highlighting a ban of these ingredients in Europe, Australia, the UK and other developed countries in an effort to protect children," the site says.
O'Brien even created a symbol a green stop sign with an exclamation point in the center to identify a child with food allergies. It can be put on lunch bags, wristbands and even shoes.
"My goal now is to say, 'OK, this is what's happening. Let's inspire other mothers to take control so that our children can benefit like the children around the world,'" O'Brien said.
In her own life, O'Brien has gotten strict about what she feeds her children and encourages others to do what she has done: Throw out as much non-organic processed food as they can afford to. Also, avoid anything that's genetically modified, artificially created or raised with hormones and don't eat food with ingredients you are unable to pronounce.
"I thought, 'Well, I want to cook like the moms in Europe and avoid these chemical additives and see if that makes a difference in my children's health and behavior.' And so we did," O'Brien said. "We moved from the tubes of blue yogurt to regular yogurt and we started mixing honey into it. "
Not everyone in her family was happy about the changes.
"I encountered major resistance from my boys," O'Brien said. "They loved that blue yogurt and it was easy and it was convenient, but to see the dramatic improvement in my boys especially as we cleaned out their diets it was amazing. It was incredibly inspiring. They slept better; they were able to concentrate in school. Their behavior improved."
The Allergies-Additives Connection
Two recent British studies found that certain food dyes, as well as the common preservative sodium benzoate, may have an adverse effect on some children's behavior. Researchers said the increase in ADHD diagnoses could be partly to blame on the preservative.
"It can affect their focus, their concentration. They become more easily distractible, become more impulsive. I think we're looking at a whole population of kids with skewed immune systems," said Dr. Kenneth Bock, who wrote a book that supports the theory that food additives could lead to hyperactivity in children.
A Southampton Study in the UK showed that additives cause hyperactivity in children within an hour after consumption. Food additives, especially the artificial colors are made from coal tar derivatives and synthetic chemicals. Within an hour of ingestion, hyperactive behavior is evident.
ADHD Drugs Don't Work
It was a team of American scientists researching what is called the "Multi-Modal Treatment Study of Children with ADHD -- MTA for short, who found that ADHD drugs are useless over long-term use. The drugs used to treat ADHD such as Ritalin and Concerta are ineffective treatment methodolgies which are constantly promoted by conventional medicine. They have no benefits whatsoever after three years and even though they may show some short-term benefits depending on who is watching, and depending on their judgment of the child's behavior, the truth is there is no long-term benefit whatsoever.
They found that these drugs stunt the growth of children. "They were not growing as much as other children in terms of both their height and their weight," said the report's co-author, Prof. William Pelham from the University of Buffalo. "I think we exaggerated the beneficial impact of medication in the first study," he added in reference to a study they did a few years ago where they declared that these drugs were helping children.
"We had thought that children medicated longer would have better outcomes. That did not happen to be the case. The children had a substantial decrease in their growth rate," he continued. The second point was that there were no benefits to children taking these drugs whatsoever.
What they did not say in the results of this study is that the same drugs also stunt the growth of the children's brains. MRI brain scans later proved that children on ADHD medications had brains that were three years behind schedule in development. 80% of the children who were looked at with MRI scans were on ADHD medications.
Children taking stimulants as a treatment for ADHD are also 20 percent more likely to visit a doctor with heart-related symptoms, according to a new study conducted by researchers at the University of Florida and published in the journal Pediatrics.
Researchers examined the records on 55,000 children between the ages of 3 and 20 who had undergone treatment for ADHD using central nervous system stimulants between 1994 and 2004. Their health profiles were compared with those of nearly two million other children in the Florida Medicaid database, making the current study the largest ever on the safety of ADHD drugs.
The Pharmaceutical Credo: Sell, Sell, Sell
This is what the ADHD industry is like. It is as if they have to carry on this outrageous lie, and they cannot really tell the truth because then the whole house of cards would collapse and everybody would realize this is all one giant fraud.
They cannot tell the truth so they have to keep coming up with new lies to try to market this to more people. First, it was just a children's disorder. Then the drug companies realized they could sell this same speed drug to adults. Children are only a small part of the total market.
They have to keep pushing these drugs onto more children. They have to keep those parents in a state of fear. That's how they sell more drugs. They have to keep people believing in this fictitious disease. That's the only way they are going to make money. This is an industry that makes money by exploiting the bodies of children, and the evidence is very clear.
Even the NIH is now saying that these drugs stunt the growth of children. That is a scientific fact announced by a mainstream medical research organization. This is not fringe science. This is not alternative medicine. This is not conjecture on the part of some person who has an axe to grind with psychiatry. This is mainstream medicine announcing that these drugs stunts the growth of children.
Flawed Children or Flawed System?
The Multi-Modal Treatment Study's co-author is Professor William Pelham at the University of Buffalo. He is the one who found out that these drugs do not help children at all in the long run. He says, "In the short run, medication will help the child behave better. In the long run, it will not and that information should be made very clear to parents."
Dr. Tim Kendall, of the Royal College of Psychiatrists (the person who is working on some new guidelines about ADHD for the NHS) says, "A generous understanding would be to say that doctors have reached the point where they do not know what else to offer."
He says, "I hope we will be able to make recommendations that will give people a comprehensive approach to treatment…" there is that word "treatment" again. He continues, "and that will advise about what teachers might be able to do within the classroom when they are trying to deal with children who have difficult problems of this kind. I think the important thing is we have a comprehensive approach that does not focus on just one type of treatment."
One mother is leading the movement to raise awareness of allergens in food.
http://preventdisease.com/home/tips89.shtml
ADHD Misdiagnosed In Nearly 1 Million U.S. Kids Say Researchers
ADHD Misdiagnosed In Nearly 1 Million U.S. Kids Say Researchers
Two studies published recently suggest there could be something wrong with the way ADHD is diagnosed in young children in the US, one found that nearly 1 million kids are potentially misdiagnosed just because they are the youngest in their kindergarten year, with the youngest in class twice as likely to be on stimulant medication, while the other study confirmed that whether children were born just before or just after the kindergarten cutoff date significantly affected their chances of being diagnosed with ADHD.
Papers on both studies by US researchers are in press, to be published in the Journal of Health Economics, the first being a corrected proof that was first available online in June, and the other appeared online on 4 August.
In the first paper, Dr Todd Elder, assistant professor of economics at Michigan State University, looked at a sample of nearly 12,000 children from the Early Childhood Longitudinal Study Kindergarten Cohort, which is funded by the National Center for Education Statistics. He analysed the difference in ADHD diagnosis and medication rates between the youngest and the oldest children in a kindergarten grade.
He found that the youngest children were significantly more likely to be diagnosed with ADHD and to be prescribed behavior-modifying stimulants such as Ritalin than their older classmates. He told the press that the "smoking gun" was that the diagnoses depended on the children's age relative to classmates and the teacher's perceptions of whether they had symptoms.
Elder said:
"If a child is behaving poorly, if he's inattentive, if he can't sit still, it may simply be because he's 5 and the other kids are 6."
"There's a big difference between a 5-year-old and a 6-year-old, and teachers and medical practitioners need to take that into account when evaluating whether children have ADHD," he urged.
Elder said medicating such children inappropriately was a cause for concern not just because of the effect of long term stimulant use on their health but also because it costs a lot of money: he estimated about 320 to 500 million US dollars is being wasted on unnecessary medication of young children for ADHD, of which 80 to 90 million is funded by Medicaid.
From his analysis, Elder found that the youngest kindergarten kids were 60 per cent more likely to be diagnosed with ADHD than the oldest in the same grade, and also, by the time those groups reached the fifth and eighth grades, the youngest were more than twice as likely to be on prescription stimulants.
Elder estimated that overall in the US, the misdiagnosis rate is about 1 in 5, that is around 900,000 of the 4.5 million children currently diagnosed with ADHD have been misdiagnosed.
Like the researchers in the second study, Elder used kindergarten eligibility cutoff dates to distinguish between the youngest and the oldest kids in a grade. While this date differs among states in the US, the most commonly used one is that used by 15 states to rule that kids must be 5 years old on or before 1st September to be eligible for kindergarten.
He found the same definitive pattern both in the case of individual states and when he compared across states.
Michigan for example has a cutoff date of 1st December for kindergarten attendance. Elder found higher rates of diagnosed ADHD among Michigan kids born on 1st December than born on 2nd December. Those born on the 1st December would have been the youngest in their grade, while those born on the 2nd, just one day later, because of the cutoff date, would have enrolled a year later and therefore been among the oldest in their grade.
Elder remarked that even though these kids were only born a day apart, they were assessed differently because they were being compared with classmates of a different age set.
Looking across states, Elder gave the example of Illinois and Michigan. In Illinois, where the cutoff date for kindergarten is 1st September, August-born kids were more likely to have been diagnosed with ADHD than Michigan kids born in August of the same year.
Elder's study defined a diagnosis of ADHD as including evidence of multiple symptoms, including inattention and hyperactivity sustained for six months or more observed in two settings, for instance the home and school, before the age of seven.
Although a mental health professional performs the diagnosis, the opinions of teachers often influence whether a child is sent for evaluation in the first place, said Elder.
"Many ADHD diagnoses may be driven by teachers' perceptions of poor behavior among the youngest children in a kindergarten classroom," said Elder, but the "symptoms" that teachers perceive may "merely reflect emotional or intellectual immaturity among the youngest students".
ADHD is the most commonly diagnosed behavioral disorder for kids in the United States, and currently there are no neurological markers for ADHD (such as a blood test for example). Experts disagree on how common it is, hotting up public debate about whether it is under- or over-diagnosed, said Elder.
In the second paper, researchers at North Carolina (NC) State University, Notre Dame and the University of Minnesota drew very similar conclusions to those of Elder's study.
Co-author Dr Melinda Morrill, a research assistant professor of economics at NC State, told the press that:
"The question we asked was whether children who are relatively young compared to their classroom peers were more likely to be diagnosed with ADHD."
Morrill and colleagues looked at kids born just before the kindergarten eligibility cutoff date and those born shortly after and found large discrepancies in rates of ADHD diagnosis and treatment based on small differences in birth dates.
For the study they analyzed data from two national health surveys and a national database of private health insurance claims. The data covered several periods between 1996 and 2006.
They found that kids who were "relatively old-for-grade", that is those born just after the kindergarten cutoff date, were 25 per cent less likely to have received a diagnosis for ADHD than their the "relatively young-for-grade" peers, that is kids born just before the cutoff date.
As their premise was that children born a few days apart should have the same underlying risk of developing ADHD, finding a significant discrepancy based on small differences in age suggests the problem is inappropriate diagnosis, concluded the researchers.
"This indicates that there are children who are diagnosed (or not) because of something other than underlying biological or medical reasons," said Morrill.
"We believe that younger children may be mistakenly diagnosed as having ADHD, when in fact they are simply less mature," she added, drawing the same conclusion as Elder in the first study.
However, she wished to stress that their study is "not downplaying the existence or significance of ADHD in children".
"What our research shows is that similar students have significantly different diagnosis rates depending on when their birthday falls in relation to the school year," she pointed out.
"The importance of relative standards in ADHD diagnoses: Evidence based on exact birth dates."
Todd E. Elder
Journal of Health Economics, In Press, Corrected Proof, Available online 17 June 2010
DOI:10.1016/j.jhealeco.2010.06.003
"Measuring Inappropriate Medical Diagnosis and Treatment in Survey Data: The Case of ADHD among School-Age Children."
William N. Evans, Melinda S. Morrill, Stephen T. Parente
Journal of Health Economics, In Press, Accepted Manuscript, Available online 4 August 2010.
DOI:10.1016/j.jhealeco.2010.07.005
-- Journal of Health Economics
Sources:
Michigan State University, North Carolina State University.
http://preventdisease.com/news/10/102910_adhd_misdiagnosed.shtml
Two studies published recently suggest there could be something wrong with the way ADHD is diagnosed in young children in the US, one found that nearly 1 million kids are potentially misdiagnosed just because they are the youngest in their kindergarten year, with the youngest in class twice as likely to be on stimulant medication, while the other study confirmed that whether children were born just before or just after the kindergarten cutoff date significantly affected their chances of being diagnosed with ADHD.
Papers on both studies by US researchers are in press, to be published in the Journal of Health Economics, the first being a corrected proof that was first available online in June, and the other appeared online on 4 August.
In the first paper, Dr Todd Elder, assistant professor of economics at Michigan State University, looked at a sample of nearly 12,000 children from the Early Childhood Longitudinal Study Kindergarten Cohort, which is funded by the National Center for Education Statistics. He analysed the difference in ADHD diagnosis and medication rates between the youngest and the oldest children in a kindergarten grade.
He found that the youngest children were significantly more likely to be diagnosed with ADHD and to be prescribed behavior-modifying stimulants such as Ritalin than their older classmates. He told the press that the "smoking gun" was that the diagnoses depended on the children's age relative to classmates and the teacher's perceptions of whether they had symptoms.
Elder said:
"If a child is behaving poorly, if he's inattentive, if he can't sit still, it may simply be because he's 5 and the other kids are 6."
"There's a big difference between a 5-year-old and a 6-year-old, and teachers and medical practitioners need to take that into account when evaluating whether children have ADHD," he urged.
Elder said medicating such children inappropriately was a cause for concern not just because of the effect of long term stimulant use on their health but also because it costs a lot of money: he estimated about 320 to 500 million US dollars is being wasted on unnecessary medication of young children for ADHD, of which 80 to 90 million is funded by Medicaid.
From his analysis, Elder found that the youngest kindergarten kids were 60 per cent more likely to be diagnosed with ADHD than the oldest in the same grade, and also, by the time those groups reached the fifth and eighth grades, the youngest were more than twice as likely to be on prescription stimulants.
Elder estimated that overall in the US, the misdiagnosis rate is about 1 in 5, that is around 900,000 of the 4.5 million children currently diagnosed with ADHD have been misdiagnosed.
Like the researchers in the second study, Elder used kindergarten eligibility cutoff dates to distinguish between the youngest and the oldest kids in a grade. While this date differs among states in the US, the most commonly used one is that used by 15 states to rule that kids must be 5 years old on or before 1st September to be eligible for kindergarten.
He found the same definitive pattern both in the case of individual states and when he compared across states.
Michigan for example has a cutoff date of 1st December for kindergarten attendance. Elder found higher rates of diagnosed ADHD among Michigan kids born on 1st December than born on 2nd December. Those born on the 1st December would have been the youngest in their grade, while those born on the 2nd, just one day later, because of the cutoff date, would have enrolled a year later and therefore been among the oldest in their grade.
Elder remarked that even though these kids were only born a day apart, they were assessed differently because they were being compared with classmates of a different age set.
Looking across states, Elder gave the example of Illinois and Michigan. In Illinois, where the cutoff date for kindergarten is 1st September, August-born kids were more likely to have been diagnosed with ADHD than Michigan kids born in August of the same year.
Elder's study defined a diagnosis of ADHD as including evidence of multiple symptoms, including inattention and hyperactivity sustained for six months or more observed in two settings, for instance the home and school, before the age of seven.
Although a mental health professional performs the diagnosis, the opinions of teachers often influence whether a child is sent for evaluation in the first place, said Elder.
"Many ADHD diagnoses may be driven by teachers' perceptions of poor behavior among the youngest children in a kindergarten classroom," said Elder, but the "symptoms" that teachers perceive may "merely reflect emotional or intellectual immaturity among the youngest students".
ADHD is the most commonly diagnosed behavioral disorder for kids in the United States, and currently there are no neurological markers for ADHD (such as a blood test for example). Experts disagree on how common it is, hotting up public debate about whether it is under- or over-diagnosed, said Elder.
In the second paper, researchers at North Carolina (NC) State University, Notre Dame and the University of Minnesota drew very similar conclusions to those of Elder's study.
Co-author Dr Melinda Morrill, a research assistant professor of economics at NC State, told the press that:
"The question we asked was whether children who are relatively young compared to their classroom peers were more likely to be diagnosed with ADHD."
Morrill and colleagues looked at kids born just before the kindergarten eligibility cutoff date and those born shortly after and found large discrepancies in rates of ADHD diagnosis and treatment based on small differences in birth dates.
For the study they analyzed data from two national health surveys and a national database of private health insurance claims. The data covered several periods between 1996 and 2006.
They found that kids who were "relatively old-for-grade", that is those born just after the kindergarten cutoff date, were 25 per cent less likely to have received a diagnosis for ADHD than their the "relatively young-for-grade" peers, that is kids born just before the cutoff date.
As their premise was that children born a few days apart should have the same underlying risk of developing ADHD, finding a significant discrepancy based on small differences in age suggests the problem is inappropriate diagnosis, concluded the researchers.
"This indicates that there are children who are diagnosed (or not) because of something other than underlying biological or medical reasons," said Morrill.
"We believe that younger children may be mistakenly diagnosed as having ADHD, when in fact they are simply less mature," she added, drawing the same conclusion as Elder in the first study.
However, she wished to stress that their study is "not downplaying the existence or significance of ADHD in children".
"What our research shows is that similar students have significantly different diagnosis rates depending on when their birthday falls in relation to the school year," she pointed out.
"The importance of relative standards in ADHD diagnoses: Evidence based on exact birth dates."
Todd E. Elder
Journal of Health Economics, In Press, Corrected Proof, Available online 17 June 2010
DOI:10.1016/j.jhealeco.2010.06.003
"Measuring Inappropriate Medical Diagnosis and Treatment in Survey Data: The Case of ADHD among School-Age Children."
William N. Evans, Melinda S. Morrill, Stephen T. Parente
Journal of Health Economics, In Press, Accepted Manuscript, Available online 4 August 2010.
DOI:10.1016/j.jhealeco.2010.07.005
-- Journal of Health Economics
Sources:
Michigan State University, North Carolina State University.
http://preventdisease.com/news/10/102910_adhd_misdiagnosed.shtml
Thursday, October 28, 2010
Mental health agency blasted-Keene, NH
Mental health agency blasted
Monadnock Family Services faces discipline
By Dave Eisenstadter
Sentinel Staff
Published: Thursday, October 28, 2010
On the heels of several state-level cuts to mental health services, Keene-based Monadnock Family Services faces a threat of a different kind.
Through a recent performance audit, the N.H. Bureau of Behavioral Health has slammed Monadnock Family Services with more than a dozen concerns requiring immediate action.
If the organization’s board of directors fails to come up with a plan to address the concerns by Nov. 14, Monadnock Family Services will lose its designation as community mental health center for the Monadnock Region.
Read More:
http://sentinelsource.com/articles/2010/10/28/news/local/free/id_417057.txt
Monadnock Family Services faces discipline
By Dave Eisenstadter
Sentinel Staff
Published: Thursday, October 28, 2010
On the heels of several state-level cuts to mental health services, Keene-based Monadnock Family Services faces a threat of a different kind.
Through a recent performance audit, the N.H. Bureau of Behavioral Health has slammed Monadnock Family Services with more than a dozen concerns requiring immediate action.
If the organization’s board of directors fails to come up with a plan to address the concerns by Nov. 14, Monadnock Family Services will lose its designation as community mental health center for the Monadnock Region.
Read More:
http://sentinelsource.com/articles/2010/10/28/news/local/free/id_417057.txt
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