ADHD in Preschoolers: Overmedicated and Undertreated

Psychology Benefits Society

Young boy with sad expression

Doug Tynan, PhD (Director, Integrated Healthcare, APA Center for Psychology and Health)

An estimated 194,000 toddlers and preschoolers (age 2-5 years) in the United States have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and about 1 in 2 of them is not receiving the recommended treatment according to the Centers for Disease Control and Prevention. Yes, that is correct – about half of the young children diagnosed with ADHD are not receiving the appropriate treatment.

Since 2011, the treatment guidelines from the American Academy of Pediatrics have recommended that preschoolers diagnosed with ADHD receive behavioral therapy first before medication. But, almost 50% of diagnosed preschoolers received no behavioral therapy. Too many are being treated with stimulants and other psychoactive medications as the sole form of treatment.

This is a serious problem for four reasons:

  1. There are no valid diagnostic criteria for ADHD for children in this age…

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“My Choice!” Are Women in India Free or Obligated to Choose?

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It took 68 years and the courage of a hundred women for an independent India to allow women to exercise their freedom of speech. Speech that has been savagely suppressed by a patriarchal society. A voice that has been cunningly muffled by “the virtues” society imposed on women. Women in India rarely exercise their freedom. When they do, they are oppressed by the society, again, in the name of morality, female virtue, and the double standards of equality. It would be an understatement to say that women in India have been oppressed for thousands of years.

What is freedom, or freedom of choice? In a literal sense, it is the autonomy a person has to choose her own actions. One might argue that we all have equal freedom. If we can mentally set aside, for a moment, the slave-like lives of women in some parts of the country, it is true that both men and women in India can do as they choose.

However, viewing freedom only in terms of available choices gives us an inflated image. Freedom is choice – with consequences. For instance, in any democratic society, we are not free to kill, because those who do face the consequence of death or a life sentence. Therefore, freedom is not the number of options. Rather, it is the severity of consequences that accompany the available options, which determine one’s freedom of choice.

Legality is not the only limit on our freedom. Morality is a society’s set of commonly agreed upon codes of conduct, which determine acceptable social behaviors. Though social norms are specific to a society and have no direct legal consequences, there is a great overlap between the two systems. In fact, social norms can change legal norms through social reform and revolutions.

According to a moral system, misconduct can range from frivolous misbehaviors to consequential acts of promiscuity. Whereas the violations of minor etiquette are overlooked, moral misconduct, particularly of a sexual nature, is strictly punished. The penalty, typically, is social embarrassment, but it could take the form of such dire consequences as social ostracizing, stoning, or lynching.

One important question for the purposes of the current discussion on gender equality is: Are women in India given equal freedom of choice as men?

I like to think that gender inequality does not exist in present-day India because what you see in the news and what you hear from women are the tales of gender bias. Yet the growing number of gang-rapes in the country, the increasing statistics on domestic violence against women, the continued practice of female infanticide in some parts of the country, and the alarming rise in sex trafficking involving women and children are only a few of the mounting indicators of women’s oppression in India.

Some may challenge my view that we make gender discrimination. After all, many believe that today’s women have equal opportunities and freedom as men. There is some truth to it. More women are educated, working independently, and supporting their families now than they did fifty years ago. The presence of women in both public and private institutions is increasing, and women are impacting national policies by being an increasingly powerful force in politics, public service, and higher education. Indeed my own argument that we practice gender inequality seems to ignore recent developments in policies in support of women empowerment.

While it is true that India, in recent years, has seen political emancipation of women, it does not necessarily follow that India, as a society, has fundamentally changed. Let me ask you this: Do you think Indian society supports working women as it does working men? Do we encourage – not discourage – women who question the society’s male-centered conventions? Do we value and not belittle, respect and not scorn the efforts of women who break gender roles?

As much as I hate to admit it, gender inequality in India is real, and it is arguably the most important factor determining who we are, individually and as a nation. A recent incident clearly shows the truth in this statement: how people reacted to a short film, “My choice,” which Vogue Magazine, India released as a part of the Woman Empowerment campaign. In this video, a hundred women, most of whom are ordinary women from different walks of life, question the conventions our male-dominated society has imposed on them. These women proclaimed their individuality, freedom of choice and the right to live on their own terms.

One would think the valor that was displayed by these women would be supported, but people in India – the educated elite, both men and women alike – raised their eyebrows, rather than raised their voices in support. These erudite people condemned the video as bashing men and super-empowering women, as insulting men and degrading women, as promoting promiscuity in women and blaspheming India’s traditions. Several videos were released in response, mocking the original and suggesting it was men who need to be empowered. As depressing as it sounds, undeniably, social emancipation of women in India is still a utopia.

What do you think? I don’t want you to base your opinions on my interpretation. Rather, I suggest you form your own opinion, and I invite you to share it here. Here are some resources to get you started: The lyrics (I gathered from the web) of the video are provided below; the original women-empowering video can be accessed here while the supposedly men-empowering video can be accessed here.

Another men-empowering video, which I may address in my next post (though I’m not sure if it deserves our attention), can be found here. (Warning: viewer discretion is recommended, as it, in my opinion, is a video filled with profanities).

My argument is simple. In an equal society, men and women face the same consequences when they violate societal norms (such as cheating). If this is not the case in India, then Indian women do not have equal freedom of choice. Whereas men’s social misconducts are met with minor to no consequence, women are ostracized or brutally attacked, in some cases. In other words, men can get away with cheating, but women cannot.

For this reason alone, the women in the “My Choice!” video are most certainly right in declaring their independence. As an affirmative response, I say, “yes, it is your choice and yours alone!”

In my next post, “My Choice! Series II,” I will continue my argument in support of women’s freedom of choice.

[Note: This is the first of a series titled “My Choice!,” in which I discuss whether women in India are treated equally and have freedom of choice, as men do.]

Lyrics of “My Choice!”

||Directed by Homi Adajania; Written by Kersi Khambatta, Voiced by Deepika padukone, & portrayed by 100 Indian women, including, Deepika, 16 celebrities and 69 ordinary women from all walks of life ||

 My Choice! My body my mind, My Choice! To wear the clothes I like even if my spirit roams naked, My Choice! To be a size zero or size 15, they don’t have size for my spirit, they never will! My Choice! To use cotton and silk to trap my soul is to believe you can halt the expansion of the universe OR capture sunlight in the palm of your hand! Your mind is a cage, let it free, My mind is not let it be                                                                                              

 My Choice! To Marry or Not to Marry, To have sex before marriage, To have outside the marriage, To not have sex; My choice! To love temporarily or To Lust forever, My Choice! To love a man, or a woman or both; Remember you are my choice; I am not your privilege                                                                              

The bindi on my forehead, The ring on my finger, adding your surname to mine; They are ornaments, they can be replaced; My love for you can’t, so treasure that! My Choice! To come home when I want: Don’t be upset if I come home at 4 AM, don’t be fooled if I come at 6 pm.; My Choice! To have your baby or not, to pick you from seven billion choices or not; so don’t get cocky; My pleasure may be your pain, my songs your noise; my order your anarchy, YOUR SINS MY VIRTUES     

My CHOICES are like my FINGERPRINTS! They make me UNIQUE; I am the tree not the forest; I am the SNOWFLAKE not the snow fall; YOU ARE THE SNOWFLAKE;                                                                                                    

Wake Up! Get out of the shit zone! I choose to empathize or to be indifferent;                                                                                                  

I choose to be DIFFERENT. I am the universe, infinite in every direction! This is My CHOICE!

Why We Do What We Do

20141205_214800910_iOSThis is not a lecture I typically give in my introductory psychology course. Nor is it a metaphysical explanation for human behavior. Here, I reflect on the factors that I believe motivate us to continue our journey – especially our professional journey – despite the odds.

Most of my college friends are settled either as IT professionals or doctors, lucrative professions with comfortable lifestyles. People, of course, not my friends, often ask why I haven’t settled yet. They are thinking of my financial insecurity, my temporary status as a Visiting Assistant Professor, and my hectic work schedule, not to mention the little time I have to spend with family and friends. My answer is simple: I love teaching, and I am passionate about research. So far, so good.

What is not convincing – even to me – is my answer to the follow-up question: why do I like it? My typical response is about the importance of disseminating knowledge to the next generation and the role teachers play in shaping our society. Although I believe teaching and research are noble endeavors, I do not accept that people persevere, against all odds, only to help others. Not even me.

In a field that, at least in the beginning, does not give much in terms of financial or professional rewards, I am not satisfied that pure altruism is sufficient motivation. Perhaps I am a self-absorbed megalomaniac, who reinforces his opinions through teaching. Or maybe I like the power I have over my students. Maybe I can’t survive outside of academia or am too lazy to work in a nine-to-five job. Such thoughts engulfed my mind and gave me restless nights until I experienced an ‘Aha!’ moment. My revelation happened on a Saturday afternoon while playing with my daughter, Nirvana, who turned two a few weeks ago.

I love spending time with Nirvana. She amazes me every day, and every moment is filled with joy. That Saturday, I asked myself, “Why do I love to spend time with my daughter?” My first thought was that I simply love her unconditionally. She is not apart from me; she is an extension of me. My rationale was that the drive to love and be with our offspring is innate, fundamental. While it is true that I love Nirvana unconditionally, it still begs the question, how is it that I can truly enjoy every moment of our interactions? I knew there must be something that keeps me going. A careful evaluation of our interactions and a deeper look at the activities Nirvana and I enjoy gave me some clarity.

What motivates me is the pleasure of watching her grow and the opportunities she gives me to discover new ways to teach her. As an example, initially she would only explore the pictures in our reading sessions. My every attempt to draw her attention to the words was fruitless. Eventually, I learned to acknowledge what it was about our reading sessions that she appreciated. In a way, she taught me to learn with her. In doing so, I enjoyed exploring the world with her, in novel and interesting ways.

An obvious fact emerged. We can’t teach our kids, or anyone, for that matter. We can only give them opportunities to explore their own unique learning methods, so they can discover the mysteries of the world on their own. It did not take me long to realize that teaching is not so different from parenting, after all.

It is now my belief that teaching, like parenting, is a dynamic process of exploring, testing and learning novel ways to share and gain knowledge. A more important point is that it is not only the student who learns; it is also the teacher who becomes more proficient at providing better learning opportunities and appropriately challenging the students, so they can unlock their unique potential.

So, my revelation is that the “why” I do what I do is similar to why I love spending time with my daughter. It is the pleasure of watching them grow and the adventure of growing with them. It is the fulfillment I feel when I see how my students, and my daughter, use the knowledge I share in ways that I could have never imagined. It is my conviction that a committed teacher is like a caring parent, who learns to let the child learn. This is why I do what I do.

“Why” do YOU do what you do?