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<blockquote data-quote="Dr. Douglas Riley" data-source="post: 253498" data-attributes="member: 6888"><p>SLR: I can appreciate the importance of your question. We unfortunately seem to be living in a time in which viewpoints on childhood behavior are narrowing, rather than expanding, and the the emphasis is placed on treating the observable symptoms instead of the underlying causes. One example that I gripe about all the time is the whole ADHD conundrum. If a child is off task in the classroom, has trouble finishing his work, and is disruptive (all readily observable symptoms), he is automatically assumed to have ADHD. The fact of it is that he might be under the sway of any number of forces. Maybe his sleep is disturbed due to enlarged tonsils, maybe he is having trouble learning the material, maybe he is bored, maybe things aren't good at home, maybe he's getting bullied or shunned by his peers, and so on. </p><p> </p><p>Years ago, I was free to orient my testing of these children to looking at them very broadly in an attempt to find the underlying cause. Today, insurance benefits only cover testing for something that can ultimatley be treated with medication (it is <em>medical</em> insurance, after all, so I do see their point as much as I disagree with it). While the school psychologists and school social workers do a fine job of testing/evaluating for underlying learning issues and home issues, they are overwhelmed and cannot possibly evaluate all of the children who need their help, thus many, many kids never get an evaluation. </p><p> </p><p>The pediatrician's that I know in my area find this very disheartening, as they are a group of people who are remarkably devoted to caring for children. The truth of it is that the medical system is dominated by insurance company guidelines and regulations, which are themselves tied to the DSM-IV diagnostic manual, which itself is simply a list of symptoms. Sorry to go on so long - to summarize, the system is symptom driven, not cause driven, and I believe that children suffer due to this.</p><p> </p><p>Doug Riley</p></blockquote><p></p>
[QUOTE="Dr. Douglas Riley, post: 253498, member: 6888"] SLR: I can appreciate the importance of your question. We unfortunately seem to be living in a time in which viewpoints on childhood behavior are narrowing, rather than expanding, and the the emphasis is placed on treating the observable symptoms instead of the underlying causes. One example that I gripe about all the time is the whole ADHD conundrum. If a child is off task in the classroom, has trouble finishing his work, and is disruptive (all readily observable symptoms), he is automatically assumed to have ADHD. The fact of it is that he might be under the sway of any number of forces. Maybe his sleep is disturbed due to enlarged tonsils, maybe he is having trouble learning the material, maybe he is bored, maybe things aren't good at home, maybe he's getting bullied or shunned by his peers, and so on. Years ago, I was free to orient my testing of these children to looking at them very broadly in an attempt to find the underlying cause. Today, insurance benefits only cover testing for something that can ultimatley be treated with medication (it is [I]medical[/I] insurance, after all, so I do see their point as much as I disagree with it). While the school psychologists and school social workers do a fine job of testing/evaluating for underlying learning issues and home issues, they are overwhelmed and cannot possibly evaluate all of the children who need their help, thus many, many kids never get an evaluation. The pediatrician's that I know in my area find this very disheartening, as they are a group of people who are remarkably devoted to caring for children. The truth of it is that the medical system is dominated by insurance company guidelines and regulations, which are themselves tied to the DSM-IV diagnostic manual, which itself is simply a list of symptoms. Sorry to go on so long - to summarize, the system is symptom driven, not cause driven, and I believe that children suffer due to this. Doug Riley [/QUOTE]
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