Comments on: Ritalin to boost exam scores http://www.kevinmd.com/blog/2007/05/ritalin-to-boost-exam-scores.html Tue, 14 Feb 2012 17:18:00 +0000 hourly 1 By: Mikehttp://www.kevinmd.com/blog/2007/05/ritalin-to-boost-exam-scores.html#comment-75631 Mike Thu, 31 May 2007 02:50:00 +0000 http://clients.emmense.com/kevinmd/2007/05/ritalin-to-boost-exam-scores.html#comment-75631 Anon 9:18<br/><br/>What does that have to do with the diagnosis of ADHD???<br/><br/>Its not just attention defecit. In kids, its the hyperactivity. And often, as the kids grow (like my brother) they have ego dystonic reactions. They can't keep out the competeing thoughts and it makes them angry at themselves and sad.<br/><br/>Why are you confusing that with giving extra time on tests??? You might as well say antidepressents are just masking a defective human being, so why give them? It's because those patients (ostensibly) want to feel better.<br/><br/>ADHD is overdiagnosed, and once an adult, its even less believable. But the emotional state and baseline brain functioning with the regular timing of society is certainly a goal one can take medicine for.<br/><br/>However, once you are at that level, trying to enhance performance is a whole different thing. So the tow are different issues, though related to the same class of drugs. It is difficult for doctors to make the distinction right now, I'll give you that.<br/><br/>But there is a difference. Anon 9:18

What does that have to do with the diagnosis of ADHD???

Its not just attention defecit. In kids, its the hyperactivity. And often, as the kids grow (like my brother) they have ego dystonic reactions. They can’t keep out the competeing thoughts and it makes them angry at themselves and sad.

Why are you confusing that with giving extra time on tests??? You might as well say antidepressents are just masking a defective human being, so why give them? It’s because those patients (ostensibly) want to feel better.

ADHD is overdiagnosed, and once an adult, its even less believable. But the emotional state and baseline brain functioning with the regular timing of society is certainly a goal one can take medicine for.

However, once you are at that level, trying to enhance performance is a whole different thing. So the tow are different issues, though related to the same class of drugs. It is difficult for doctors to make the distinction right now, I’ll give you that.

But there is a difference.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/05/ritalin-to-boost-exam-scores.html#comment-75626 Anonymous Thu, 31 May 2007 02:18:00 +0000 http://clients.emmense.com/kevinmd/2007/05/ritalin-to-boost-exam-scores.html#comment-75626 Kids using stimulants to elevate their test scores exposing themselves to small risks of direct harm and with the risks to them and to society that accrue from artificially elevated test scores that are not a accurage reflection of their relative ability to perform: A problem? Perhaps. Serious? Maybe.<br/><br/>Is it really a bigger problem however than all the kids properly "diagnosed" with ADHD who get Ritalin properly prescribed and monitored, with the same result of artificial elevation of performance beyond what they will be expected to exhibit in real world situations of the working world, further distorted by a label that confers special priveleges such as extra testing time to erode the validity of the comparative value of testing even further? Isn't this as great or greater a problem? Furthermore, one has the errosive effects of the label itself on the emotional developement of the child, reinforcing feelings of inferiority as well as entitlement to special treatement and externalization of responsibility for ones own performance.<br/><br/>I always wonder how schools and individuals ethically justify giving extra time for examination to, for example, "special" law students, who have absolutely no intentions of giving a discount to clients on their hourly rate for any extra time they take to do their legal work. How do you compensate the patient for the extra time the "special" surgeon needs to do the case? What happens when the ADHD med student who got special testing conditions (extra time, isolation from distrations) is on call at 2 am, off the daily Ritalin cycle, and dealing with clinical drama that unfolds in it's own time and without regard for his need for a distraction free environment?<br/><br/>I am not opposed to the diagnosis of ADHD, the development of special instructional methods, or the judicious use of stimulants to optimize functioning. I am adamantly opposed however assessing perfomance and aptitude under different conditions such as test setting or timing. Special instructional methods are a way of helping the child to adapt to the condition and optimize performance. Special testing conditions are an attempt to get society to adapt to the childs failure to adapt by accepting lower standards while pretending otherwise. The victims are their future customers, clients, and employers. They are also victims as they are cheated of that glorious feeling that comes from knowing that one has overcome a short hand.<br/><br/>--uncompromising, unapologetic, accomodation rejecting and untreated ADHD MD Kids using stimulants to elevate their test scores exposing themselves to small risks of direct harm and with the risks to them and to society that accrue from artificially elevated test scores that are not a accurage reflection of their relative ability to perform: A problem? Perhaps. Serious? Maybe.

Is it really a bigger problem however than all the kids properly “diagnosed” with ADHD who get Ritalin properly prescribed and monitored, with the same result of artificial elevation of performance beyond what they will be expected to exhibit in real world situations of the working world, further distorted by a label that confers special priveleges such as extra testing time to erode the validity of the comparative value of testing even further? Isn’t this as great or greater a problem? Furthermore, one has the errosive effects of the label itself on the emotional developement of the child, reinforcing feelings of inferiority as well as entitlement to special treatement and externalization of responsibility for ones own performance.

I always wonder how schools and individuals ethically justify giving extra time for examination to, for example, “special” law students, who have absolutely no intentions of giving a discount to clients on their hourly rate for any extra time they take to do their legal work. How do you compensate the patient for the extra time the “special” surgeon needs to do the case? What happens when the ADHD med student who got special testing conditions (extra time, isolation from distrations) is on call at 2 am, off the daily Ritalin cycle, and dealing with clinical drama that unfolds in it’s own time and without regard for his need for a distraction free environment?

I am not opposed to the diagnosis of ADHD, the development of special instructional methods, or the judicious use of stimulants to optimize functioning. I am adamantly opposed however assessing perfomance and aptitude under different conditions such as test setting or timing. Special instructional methods are a way of helping the child to adapt to the condition and optimize performance. Special testing conditions are an attempt to get society to adapt to the childs failure to adapt by accepting lower standards while pretending otherwise. The victims are their future customers, clients, and employers. They are also victims as they are cheated of that glorious feeling that comes from knowing that one has overcome a short hand.

–uncompromising, unapologetic, accomodation rejecting and untreated ADHD MD

]]> By: Happymanhttp://www.kevinmd.com/blog/2007/05/ritalin-to-boost-exam-scores.html#comment-75622 Happyman Thu, 31 May 2007 01:10:00 +0000 http://clients.emmense.com/kevinmd/2007/05/ritalin-to-boost-exam-scores.html#comment-75622 anon mike says: "at least if you are seeing a physician then you are being counseled on the adverse effects and perhaps monitored durng routine visits. "<br/><br/>isn't the point that, if readily available WITHOUT a rx, parents giving it to their CHILDREN will not likely be seeing a pediatrician in the first place??? After all, they know better than any "professional" what they need to do to get their kid into harvard (sarcasm). anon mike says: “at least if you are seeing a physician then you are being counseled on the adverse effects and perhaps monitored durng routine visits. “

isn’t the point that, if readily available WITHOUT a rx, parents giving it to their CHILDREN will not likely be seeing a pediatrician in the first place??? After all, they know better than any “professional” what they need to do to get their kid into harvard (sarcasm).

]]> By: Mikehttp://www.kevinmd.com/blog/2007/05/ritalin-to-boost-exam-scores.html#comment-75613 Mike Wed, 30 May 2007 23:08:00 +0000 http://clients.emmense.com/kevinmd/2007/05/ritalin-to-boost-exam-scores.html#comment-75613 MIke... again you do not address the issue that kids have NO way to say no. Doctors should not be put in a position where they are hostages to those parents who edemand their kids be on ritalin without medical need. Pediatricians should not be forced to monitor kids for toxic side effects of drugs they didnt even prescribe.And kids should not be forced to take ritalin just to keep up with their schoolmates. <br/><br/>I agree its not news. But that doesn't mean it shouldn't be addressed over and over again. MIke… again you do not address the issue that kids have NO way to say no. Doctors should not be put in a position where they are hostages to those parents who edemand their kids be on ritalin without medical need. Pediatricians should not be forced to monitor kids for toxic side effects of drugs they didnt even prescribe.And kids should not be forced to take ritalin just to keep up with their schoolmates.

I agree its not news. But that doesn’t mean it shouldn’t be addressed over and over again.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/05/ritalin-to-boost-exam-scores.html#comment-75612 Anonymous Wed, 30 May 2007 22:55:00 +0000 http://clients.emmense.com/kevinmd/2007/05/ritalin-to-boost-exam-scores.html#comment-75612 Honest to God. Does anyone really think this is NEW news?? Honest to God. Does anyone really think this is NEW news??

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/05/ritalin-to-boost-exam-scores.html#comment-75607 Anonymous Wed, 30 May 2007 20:34:00 +0000 http://clients.emmense.com/kevinmd/2007/05/ritalin-to-boost-exam-scores.html#comment-75607 "Parents obtaining [ritalin] for their kids in violation of the controlled substances act run the risk of narcotics charges."<br/><br/>Since when is speed a "narcotic"? “Parents obtaining [ritalin] for their kids in violation of the controlled substances act run the risk of narcotics charges.”

Since when is speed a “narcotic”?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/05/ritalin-to-boost-exam-scores.html#comment-75606 Anonymous Wed, 30 May 2007 20:26:00 +0000 http://clients.emmense.com/kevinmd/2007/05/ritalin-to-boost-exam-scores.html#comment-75606 yea...it is much much better for these kids to get these drugs without a physician's care...that is certainly the better scenario. <br/><br/>how is that for sarcasm? at least if you are seeing a physician then you are being counseled on the adverse effects and perhaps monitored durng routine visits. <br/><br/>mike yea…it is much much better for these kids to get these drugs without a physician’s care…that is certainly the better scenario.

how is that for sarcasm? at least if you are seeing a physician then you are being counseled on the adverse effects and perhaps monitored durng routine visits.

mike

]]> By: Richardhttp://www.kevinmd.com/blog/2007/05/ritalin-to-boost-exam-scores.html#comment-75605 Richard Wed, 30 May 2007 20:21:00 +0000 http://clients.emmense.com/kevinmd/2007/05/ritalin-to-boost-exam-scores.html#comment-75605 There's people in my medical school class using Ritalin as a "study aid". *shrug*. I'll pass without it, thank you very much. Although it does bother me a bit to think that pharmaceuticals may give them an unfair performance advantage. There’s people in my medical school class using Ritalin as a “study aid”. *shrug*. I’ll pass without it, thank you very much. Although it does bother me a bit to think that pharmaceuticals may give them an unfair performance advantage.

]]> By: Petrihttp://www.kevinmd.com/blog/2007/05/ritalin-to-boost-exam-scores.html#comment-75603 Petri Wed, 30 May 2007 17:49:00 +0000 http://clients.emmense.com/kevinmd/2007/05/ritalin-to-boost-exam-scores.html#comment-75603 I can respect such libertarian views such as legalizing drugs instead of waging some sort of a crusade against them. However, in this case I think it sets a poor precedent. It may always be the "choice" of each person to utilize such a drug, but should it be made readily available it could easily become the standard. Then every high achieving student would be faced with the choice of using the drug or constantly being at a disadvantage. Many would see this kind of pressure as persuading young adults to abuse. It's a similar case in sports, where legalizing steroids would make it all but impossible to compete unless you doped. I can respect such libertarian views such as legalizing drugs instead of waging some sort of a crusade against them. However, in this case I think it sets a poor precedent. It may always be the “choice” of each person to utilize such a drug, but should it be made readily available it could easily become the standard. Then every high achieving student would be faced with the choice of using the drug or constantly being at a disadvantage. Many would see this kind of pressure as persuading young adults to abuse. It’s a similar case in sports, where legalizing steroids would make it all but impossible to compete unless you doped.

]]> By: Mikehttp://www.kevinmd.com/blog/2007/05/ritalin-to-boost-exam-scores.html#comment-75600 Mike Wed, 30 May 2007 17:16:00 +0000 http://clients.emmense.com/kevinmd/2007/05/ritalin-to-boost-exam-scores.html#comment-75600 So "mike" above thinks we should just give it to whoever wants it. <br/><br/>These are KIDS!!! How do they supply infromed consent? We just let their parents give them drugs on the hope they do better in school? And then if toxic arrhythmias occur we just say "Aw shucks, bad parenting"???<br/><br/>Mike, what would you say to the pediatrician in a case like that? "Hey, its not my problem"<br/><br/>Very shortsighted. Legalizing marijuana is one thing. But just selling ritalin makes as much sense as giving amphetamines out to truck drivers (hey, they're doing it anyway, right?) or ephedra to those 16 year olds working out in the gym.<br/><br/>Hey, lets get rid of the steroid ban in sports also. Great idea. (sarcasm) So “mike” above thinks we should just give it to whoever wants it.

These are KIDS!!! How do they supply infromed consent? We just let their parents give them drugs on the hope they do better in school? And then if toxic arrhythmias occur we just say “Aw shucks, bad parenting”???

Mike, what would you say to the pediatrician in a case like that? “Hey, its not my problem”

Very shortsighted. Legalizing marijuana is one thing. But just selling ritalin makes as much sense as giving amphetamines out to truck drivers (hey, they’re doing it anyway, right?) or ephedra to those 16 year olds working out in the gym.

Hey, lets get rid of the steroid ban in sports also. Great idea. (sarcasm)

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