Indianapolis Recorder, Indianapolis, Marion County, 9 March 2001 — Page 4

fOPRIDAY, MARCH 9,2001

THE INDIANAPOLIS RECORDER

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ADD Continued from A1 rics of Riley Hospital, says 90 percent of the children referred to him as having ADD/ADHD do not have the disorder. Instead these children may have behavioral problems that need to be addressed. Diagnosing a child with ADD is a group effort. The clinical diagnosis is based on three primary sources: parents, school, and doctor’s observations said Green. Usually a complaint by the school of parents to the doctor will begin the clinical diagnosis. "The first visit usually lasts three hours if psychological testing is '^Vlone; if the testing is not done ^ Gibout one hour," Green said. This ^■tyisit helps formulate an opinion if the child has ADD or ADHD. A standardized questionnaire, which helps doctors understand the child's behavior, must be filled out by the child's teacher(s) and parents said Dr. Jesse Dias, a pediatrician for Clarion Health at Methodist Hospital. i ‘- - She said the assessment that she - |,; does generally involves taking the •-'-parents’ report as well as reports - 1 ■ itnd questionnaires from classroom teachers involved with the child. ••"‘'"Then I sit down with the kid and ^parentsand evaluate and score those -^questionnaires,” Dr. Dias said. :irjr. D ur i n g this time. Dias figures L f^but if the chi Id fits the criteria of the -^ Diagnostic and Statistical Manual Mental Health Disorders, Fourth '’‘'‘tdition (DSM-IV) for determin- - f 'Ung if a child has ADD/ADHD. vuiThe questionnaire is not the only factor in determining whether the -oic’hild has the disorder, lof i "You can’t just take the quesu) Ifionnaire, you’ve got to look at the . / Environment under which this questionnaire is being filled out. Then kfotoe make an assessment and de--f jvelop a care plan," Dias said. -!»,a Both doctors agree the child’s c-mhome environment may play a big .j'Tactor in the disorder. High risk neighborhoods may cause a child to exhibit signs of the disorder, but the child may not have ADD/ ADHD. Factors inside the home such as alcoholism and abuse may cause a child to exhibit signs of the

disorder.

*' ’ "It is possible that if a parent is gone from home, the kid is going to -'•tact out in school to get the attenn ‘lion, he might not have attentiondeficit disorder, but he might be

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ficer escorted me into a room and assured me that everything would be okay." Her rapist had been accused of previous violent misconduct, and a ■hi warrant was issued for his arrest. ■ i His popularity on campus drew •‘i wide support from fellow students. Within acouple of weeks, Erika "withdrew from all of her classes, vi i A prosecutor was assigned to vJIer case, and a restraining order %nmediately enforced to prevent her rapist from contacting her. Erika’s life instantly switched from taking pre-law courses to fre''.quently visiting the office of the eounty prosecutor. • Three years after being raped, Erika accepted a plea bargain by the defense attorney, and her rapist pleaded guilty to a Class C felony ✓ .criminal charge for raping her. "I couldn't go through a trial and have a jury tell me that it didn't happen. Wherever he goes, the felony charge will follow him, always," said Erika. Stephen Thompson had his sights set on a professional foot✓ball career. $ c Now, he lectures at colleges and universities across the country and (discusses sexual aggression on campus. j b > v “Rape is a premeditated act,” j*|id Thompson, an associate proijHjessor at Central Michigan Uni verfity. “We've done a great job of making it difficult for women to come forwards" After being raped, he says, women are harshly judged by society. Factors such as sending mixed . messages, wearing inappropriate M> ‘ dothing, and engaging in alcohol in {ife.typically used against rape vic- *- 'flms. 1 '' J - - In addition. Thompson acknowl11 ■ Edges that women are more likely 1J ’ Vo report a burglary to their house before reporting a rape. tooiL “i s j t ever ok to force a woman njiy.'

Symptoms off ADD • Excessively fidgets or squirms • Difficulty remaining seated • Easily distracted • Difficulty awaiting turn in games • Blurts out answers to questions • Difficulty following instructions • Difficulty sustaining attention • Shifts from one activity to another • Difficulty playing quietly • Often talks excessively • Often interrupts • Often doesn’t listen to what is said • Often loses things • Often engages in dangerous activities NOTE: Simply having symptoms does not necessarily mean a child has ADD. That diagnosis and treatment must be made by a physician.

seeking attention because of a par-ent-deficit disorder or a parent absence,” Dias stated. Dias also added that teachers are increasingly aware of what attention deficit disorder is and is not, and they should set up a conference with the parent(s) to find out if the child’s behavior at home mirrors the behavior at school. But oft times it’s the parents, not the teachers who are looking for an attention-deficit disorder diagnosis. Tom Doyle, director of special education for MSD of Pike Township, said, "In my experience, the majority of kids that have this diagnosis, the parents sought it out, not the school.” Dias believes that with so much information available on the disorder today, parents may believe, correctly or incorrectly, that their child suffers from attention-deficit disorder. Parents may read something online or watch a television program and think their child exhibits all of the signs without ever consulting a physician, who may pick up the subtle details. "People are playing physicians, and they come and tell the story, they tell the picture book story of what came on the Internet, ‘You know doctor, my kid’s got this, got this," and they may not tell you that RAPE Continued from A1 to have sex?” he asks, recognizing the importance of punishing rapists — not their victims. Since 1983, Thompson has talked to numerous rape survivors and rapists. He frequently wears a zebra logo with a red line through it. This signifies, he says, how lions single out one zebra from a herd. While the victim is being devoured, the remaining zebras look on. In society, there is a "it’s not going to happen to me” mentality, and Thompson admits that society usually looks over its shoulder and refuses to help rape survivors. Their are two types of rapists — stranger and an acquaintance — and Thompson suggests that both share similar traits. The stranger picks a location and selects his target using specific criteria such as age. Each woman that he comes into contact with is evaluated for her vulnerability and whether he can control her. An acquaintance rapist will also select his prey, says Thompson, and attempts to make her comfortable with him before he attacks. “You’re not going to stop rape until you get at why men rape and break the silence," added Thompson. “Victims are so traumatized with the incident and take most of the blame themselves,” said Lt. Jerry Minger, of the Indiana University Police Department in Bloomington. lU’s student body includes approximately 36,000 students, yet only five rape cases were reported last year. This growing trend towards low statistics is occurring at other Indiana campuses. Ball State University and Indiana University-Purdue University Indianapolis each had only one rape case reported last year. “I know that there were more (rape cases) than that. It’s really

they got this from the Internet, and of course the physician’s saying it’s very possible that you could have this, that and the other," said

Dias.

In the end though, it’s up to the doctor to determine whether or not a child has ADD/ADHD. If the child is found to have the disorder, establishing a care plan is essential. A concerted effort from the primary sources is needed for the child's benefit. This is where drugs such as Ritalin,, Adderall or Dexedrine may come into play. "The most successful (plan) is where the parent, school, and doctor are working together. If there's a break in the chain it's more difficult." said a social worker and guidance counselor for IPS. Methylphenidate hydrochloride or Ritalin is the most common drug used to treat children with ADD/ ADHD. Common side effects are nervousness and insomnia, but reducing the dosage or eliminating use in the afternoon or evening alleviates these problems. Ritalin works on a time-release basis and stimulates the central nervous system. The effects are similar to amphetamines and more potent than caffeine. It has a calming effect and helps children focus. As with any medication, there may be many adverse reactions. Those reactions may include hypersensitivity. anorexia, nausea, dizziness, palpitations, headache and more. Ritalin is not recommended for children under the age of 6 and adults may still use the drug. According to Green, "We don't like to use it for children under 5 or 6; it can be selectively used on children above 3. but we rarely do. There must be a lot of factors." Dias says most doctors don't want to medicate a young child because the range of activity is so broad. But she also mentioned a 4or 5-year-old may not have much stimulation at home and then go into a classroom where the environment is constantly changing. This stimulation may trigger behavior not present before. Ritalin has drawn repent.attention because of abuse by crtildren.'’ Since it is a drug, there^will be abuse, but Doyle says Pike Township places children into a drug diversion program, and if those students are caught a second time they may be expelled. Doyle states dealing the drug is a criminal of-

fense.

Adderall, introduced in 1996, is

the name of dextroamphetamine. Dexedrine is the brand name for dextroamphetamine sulfate. These drugs work in the same way as Ritalin. Amphetamines are a controlled substance and habit-form-ing. Children using these drugs should be monitored. Drug use is not the cure-all for ADD/ADHD. Modifications at home and school must be made to accommodate the child. Children need highly structured situations; need to be in front of the classroom: have one on one contact; a small amount of choices; small breaks; preparation for new experiences, and given instructions one step at a time, said Green. Without those coping mechanisms children may not remember todo things they've beentold. Dias uses the scenario of a mother telling her child to clean up his room, take a bath, and come down for dinner. The child will probably have a bath and neglect to clean his room. The parent may not realize this is a symptom of ADD and reprimand the child for being dis-

obedient.

Ed Burns, president and coordinator of CHADD (Children and Adults with Attention Deficit Disorder). has five daughters and seven grandchildren with ADD. Bums also has ADD. Problems with memory is something that happened to Burns and his children. As a chief executive officer Burns "would go into a meeting that I called and not remember what the meeting was about." Only after his grandson was diagnosed w ith ADD, did he go back and look at the behavior of himself and his daughters. His youngest daughter was 4 at that time and also showed signs of ADD. Bums said like most children with ADD his daughters had problems keeping up with schoolwork. "We have problems with mostly remembering things and being dis-

tracted. If there's a bird outside we' ll look at the bird and need help getting our mind back in the classroom." Burns said. When his daughter was diagnosed with ADD. Burns did have questions about using Ritalin, but hisdoctorexplained it was the usual treatment for ADD. A common myth is once a child reaches adolescence medication is no longer needed. According Burns most adults with ADD still take medication. His grandson who is now 22 is still on medication. Burns also takes Ritalin on occasion. “I still take medication on and off; when I have to digest a lot of information or when reading." Burns said. Those with hyperactivity tend to do "stupid things" and get into trouble said Burns. He drives this point home by telling about his granddaughter who threw pencils at a teacher when she was frustrated. Once she was diagnosed with ADHD and began taking Ritalin her behavior changed drastically. She is now a straight A student and the teacher's pet. Hyperactive children are more likely to get into bicycle accidents and as adults get into car accidents and experience road rage said Dias. These also are the children who seem to always have a broken bone. Burns and Dias both cite studies that prove children not treated for ADD are more 1 ikely to abuse drugs or alcohol, and Dias states 80 percent will have problems sleeping. They* ve received messages all their lives that something is wrong with them and turn to negative methods of coping. Many are juvenile delinquents because they can't control their impulsiveness. Burns says it is believed 50 to 60 percent of prison inmates have ADD. “If they get the opportunity to do what they are capable of doing, they do extremely well; if they don’t they end up in prison," Burns

said. He then named people such as Michael Jordan. Magic Johnson. Whoopi Goldberg, and Damn Glover, who are successful and have ADD. Reports from the National Institute of Health places the number of children w ith ADD as low as 3 to 5 percent, but Dias states there arc studies that go as high as 10 percent. She also believes some children in the inner-city might he inappropriately labeled with ADD because of other situations. Boys no matter what ethnicity tend to outnumber girls w ith ADD 3 to I. "1 haven't seen it broken down into ethnicity. But it is possible in my experience that African-Ameri-can kids may be more diagnosed And as we see Hispanies come in. it's possible that we're going to see that too." said Dias. Dias believes more studies on multiple intelligence should be done. Many times African-Ameri-can children and Hispanic children may learn differently than how schools teach. She would like to see more teachers being culturally sensitive and use more eclectic styles of teaching. "Does every kid have to be a math/science expert or should they know just a working know ledge of math/science? We do need some basic math, kids can not get by without math. But do they need to ace it? And we're wondering if they're making Cs then we've got a problem. It might not be a problem. It might be that they' ve got a different intelligence which is very valid." said Dias. If a child has ADD. the care is individualized. "You need to understand the particular child. There is no one size fits all. Children are individuals. Tailor a program to meet the child's individual measurements." Green said.

The Reward of Never Giving Up

hard for anyone in law enforcement because the amount of incidents reported are so low," Lt. Minger said. Erika hasn't spoken to her rapist since the incident. For now, she continues to make peace with the painful memories, a task which involves carefully putting the pieces of her life back together again. "I'm no longer a rape victim. I survived. I'm still here coping with it." she said.

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