Are Toddlers Taking Too Many Drugs? Fear-Mongering by the WSJ and NYT.

I'm way up on my soap box here, but I can't leave this without comment.I just read this load posted on a friend's facebook. My friend is awesome, and very smart. I suspect it was a knee-jerk that made her post this with a "what the what?" comment.

First of all, CCHR (the org that performed the analysis cited by WSJ in paragraph two of the above link) is a Scientology front group. This organization would naturally attempt to frighten the public into further distrust of the psychiatric field, due to its anti-psychology, pro-Scientology auditing/tech faith.

Second, if you skip the CCHR "analysis" and read the NY Times article cited in the WSJ blog post, it becomes clear what the real issue is, and it is an issue of privilege and lack of public funding for programs supporting low-income, high-risk families: children on Medicaid, our poorest, least privileged children, and those most likely to be victims of abuse and/or living in unstable homes, are being prescribed these medications at much higher numbers than children with private insurance, who are most often more privileged and in more stable homes than children on Medicaid, and are more likely to receive treatment and support that does not include medication.

Third, the article claims an extrapolated number of 10,000 toddlers on Medicaid nationwide being prescribed stimulant medications. Considering that there are approximately 25 million toddlers in the United States, that means ~.04% of toddlers total. Not as scary as the article and the "analysis" would have us think, though it does point out problems in our health and human services system that should be addressed, namely the need for behavioral training and support (and not just medical care support and early intervention programs, but also requirements for affordable quality daycare, paid time-off, adequate paid sick leave, etc.) for parents, as well as for caregivers and doctors who provide that support to the low-income, high-risk children. From the article: "Dr. Visser said that effective nonpharmacological treatments, such as teaching parents and day care workers to provide more structured environments for such children, were often ignored."

A personal anecdote might illustrate the problems parents face today that might encourage them to allow their children to be prescribed ADHD medications without trying other things first. We were fortunate when our premature triplets were born to have an excellent state-funded early childhood intervention program that provided a developmental specialist weekly, an occupational therapist and physical therapist bi-weekly, respite care at a hugely discounted rate weekly, and, at age three, state-funded preschool programs with excellent and highly qualified teachers. Developmental problems were discovered and addressed immediately with the latest ideas and techniques; we were trained, encouraged, and supported in doing what needed to be done to help get our children up to speed from a very early age; we were allowed respite from caring for our very high-maintenance children for a few hours each week, which saved our own mental health.

Over the years since then, funding for all of these programs has dried up and the early intervention program we received so much from has shrunk from that lack. There is a huge waiting list for services. The program depends more on dwindling private donations now than it can count on from state or federal grants or funds. The children on the waiting list are often living in low-income, high-risk households and neither they nor their parents or caregivers are receiving any of the help, training, teaching, or support that my family received 12 years ago. Nor do most of them have access to high-quality medical care and neuropsychology and PT/OT specialists that we were able to use for evaluation and diagnosis once our children grew out of the state-funded programs, thanks to our excellent private insurance.

Even without the additional challenges of parenting in a chaotic or violent household, when a low-income parent has to choose between staying home with his or her impulsive or aggressive child who can't get into a quality daycare because of behavior issues and medicating the child so the parent can earn a paycheck to keep the heat on and food on the table, the choice is pretty clear.

This WSJ blog post seems irresponsible to me, and is simply fear-mongering without either pinpointing the actual problem or suggesting possible solutions. Nor does it provide citation for some of its claims, such as the sharp rise in anti-psychotic drugs for infants and very young children. Some sort of citation might help us figure out if that is actually the case and if there is some reason for that rise. The NY Times article cited by the WSJ isn't much better, although you *can* at least see the actual problem isn't the medication of the toddlers, but the underlying reasons why parents might fall back on medication in the first place. The "analysis" by CCHR is not trustworthy at all and should not even be considered.

If you want to help families with children experiencing challenges that can often be managed in ways other than medicating, consider contributing to a local organization that provides services and support to low-income families with toddlers or to families with developmentally delayed children. Any pediatrician can give you a name. Also bug your state representatives, your US representatives, and your senators to encourage them to increase funding to these types of organization and to work to make it easier for families to do what is best for their children while working to keep them fed, housed, clothed, and healthy.

Back In The USSA - Pet Adventures Edition

The clan has returned from Israel to the USA.

The trip itself was, let's say, interesting. Delta lost our pets twice. It was due to a combination of uninformed employee error and Nigel's inability to believe anything I say unless I am backed up by at least 50 experts.

At Ben Gurion airport, we were told to pick the pets up from baggage claim and run them through customs when we arrived in Atlanta. However, Nigel, hoping they were wrong, asked a flight attendant about it and she informed him that, no, we didn't have to do that, and that the pets would just be put on our next flight.

Of course, I protested. But without 50 experts to back me up, Nigel insisted that the flight attendant was the person he would believe.

So, we got onto our next flight, and he asked if the pets made it on board. They said no, but that they would find them and get them on. This delayed take-off by 45 minutes. In the end, Delta informed Nigel that he was supposed to pick them up and run them through customs and returning them to baggage. Which I knew. At any rate, by the time we arrived in Portland, Nigel was angry with me because I was right and angry with Delta because they had effectively washed their hands of the issue.

We worked with a Delta supervisor for three hours upon arrival and discovered that Delta in Atlanta did not know where our pets were. While waiting for Nigel to come to pick us up at baggage claim with the rental vehicle, I called my mom. She informed me that Dennis from a kennel in Atlanta had called her and told her that he had our pets there and asking that she tell us to call him. I called Dennis and explained the situation. He said that we were not the only people to have had this happen, which was reassuring.

It took three days of negotiations and faxes and phone calls to get the pets to Portland, and when we got to Delta's cargo office, they couldn't find them. Turned out that Atlanta had left the baggage tags on their carriers and they were sent up with the baggage. Once that was discovered, they were brought to cargo, where we had to get paperwork and take it to Customs and Immigration, down the road, for an officer to sign. We brought the signed papers, paid 85.00, and took the pets to our hotel. They were quite happy to see us. Our poor dog had peed all over her carrier and the pad, which I ended up having to throw away after trying to wash the smell out twice.

I have to say that Officer Weddington of the Atlanta Customs/Homeland Security office was extremely helpful and sympathetic. I wrote an e-mail commending her. The Delta supervisor at Portland was also kind and helpful. The people at cargo were efficient and forced the baggage people to drop everything to find our pets.

Nigel plans to write nasty-grams to everyone at Delta even though this was the fault of only two people, one of whom doesn't work for Delta. That would be HIM. Sigh.

Lesson: In order to avoid Nigel's distrust of information provided by me, get everything in writing. Verify information with people other than flight attendants. Don't fuck around with customs.

Christmas Rant

I don’t give a crap about Christmas. There. Call me Scrooge, I don’t care.

I also don’t give a crap about my birthday, my wedding anniversary, Valentine’s Day, St. Patrick’s Day, Thanksgiving, or, really, any day that has been set aside as something special, but seems to actually be set aside in order to encourage profligate and unnecessary spending.

Every day I am alive is as special as the day on which I was born. Every day I am married to my wonderful Nigel is as special as the day on which we married. Every day on which I have enough to eat is as special as Thanksgiving. Every day on which I act as a good citizen and enjoy the fruits of democracy is as special as Independence Day.

But I digress. Back to Christmas. Both my family and Nigel’s family are populated by several poor planners and spendthrifts. Without going into boring detail and a 40 page rant, let’s just say that my brother and his family, Nigel’s brother and his girlfriend, and Nigel’s mom and her boyfriend have planned their finances very poorly and can’t control their impulses to spend money they do not have to buy luxury items. We have given Nigel’s mom large amounts of money twice within the past year, simply to allow her to eat and pay her bills. My brother and Nigel’s brother generally leech off of my mom and Nigel’s dad respectively.

At any rate, the tale continues as we plan for our trip back to the US for Christmas. Nigel got an e-mail from his brother recently saying that he and his girlfriend have no money but that their mom has helped him get presents for us and for the kids. This pisses me off on several levels:
1) His mom doesn’t have any money. How does Nigel’s brother have the nerve to leech off her? Why give gifts at all?
2) Again, his mom doesn’t have any money. Why give gifts at all?
3) When we give his mom money to allow her to pay bills and eat food, why would she think it is okay to use that money to buy crap for our kids!? We can buy crap for our own kids without her as the middle man. Why would she think it is okay to buy crap for our kids for Nigel’s BROTHER to give them?
4) Why can’t we just have a nice dinner and stay up all night talking and laughing and listening to music? Why do there have to be gifts at all when nobody has the money to pay for them?

We have asked them NOT to give presents they can’t afford. Why do they insist on it? Especially when they can’t even buy themselves the requirements for life without subsidization? I understand the desire to give things to your grandchildren, nieces, and nephews. I do not begrudge them wanting credit for getting things for the kids. They want the kids to love them the most and apparently think that unless they buy crap for them, the kids won’t love them. Whatever – we’re trying to raise the kids not to think that way. We’re trying to raise them to be responsible and productive members of society, neither dependent on others nor with others dependent on them. We’re trying to raise them knowing that PEOPLE are more important than THINGS, and that love is better displayed through everyday kindnesses than through the occasional giving of things.

There is an additional angle here, too, in that MY mom spent her whole life planning for retirement. She invested the maximum allowable into her retirement fund, made sure she did not spend money she didn’t have, and hired a financial planner to help her maximize her money and prepare for the earliest possible retirement date. Because of her good planning, she actually has disposable income, not as much as in the recent past, due to the current economic crisis, but she does well for herself – through her own hard work and thoughtful planning. This is a bone of contention between her and MIL. MIL feels competitive. While she can’t buy the kids one expensive toy or other gift, as my mom has done in the past, she tries to outdo my mom in quantity, with bags and bags of crappy crap from the Dollar Store.
In addition, Nigel’s dad recently remarried a woman with seemingly bottomless reserves of cash. So there’s competition there as well.

Nigel and I have also been actively planning for the time when we either don’t want to work anymore or cannot work anymore. We have invested and planned for ourselves and for our kids’ futures. We have pinched pennies and minimized spending on non-necessities for the past 15 years and have built up a nice nest egg.

Am I wrong to be offended? Am I a bitch for thinking that the $100.00 my MIL spent on bags of Dollar Store crap that will be broken within 24 hours of Christmas would have been better spent on my MIL’s household heating bill, or that Nigel’s brother would be better off using any money MIL gives him to pay off one of his credit card bills instead of buying crap for my kids? Am I stingy for thinking that if she has the nerve to ask for financial help from Nigel and I this Christmas, I will put my foot down and tell her to piss off until she can swear on a stack of WalMart circulars that she will not buy a single thing for us or our kids during the year? I fear that Nigel and I will not benefit from our hard work and penny pinching because of the profligacy of our families. Will we have to continue working until we die so that our families can buy Christmas presents for people? Fuck that.

I need to think of some sort of solution for the dilemma. My first thoughts are that I need to get Nigel’s support and tell everyone, my family AND his, that next year, for the kids’ birthday and for Christmas, if they MUST give presents, they will contribute to a central pool of money and that money will be used by the kids to buy something they want or need. Nobody will know how much any other person put into the pool, thus removing the competition angle. Also, any additional gifts given will be returned and the money will be given back to the giver or applied to the giver’s utility bill or mortgage/rent. This should also apply to any gifts given to me or to Nigel. We do not need socks or sweaters or potpourri, and if we do, we can get it ourselves.

Can’t we make Christmas, which I hate anyway, into a simple day, one to spend with our family eating and talking and laughing and having fun? Now, THAT, I wouldn’t hate.