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Medication Holidays, ADHD, and the outdoors


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Yah, Dan asked that we discuss some of the issues with ADD/ADHD kids on campouts. ;) One of the things that's come out in the story of Michael Auberry bein' lost in NC is that he frequently took a "medication holiday" when out on camping trips. That seems to be somethin' that causes issues around here, especially at our summer camp from time to time.

 

What are the personal experiences of the group, in workin' with such kids and their parents? What kind of "internal practices" have yeh set up that you've found helpful? What sort of problems or challenges have you run into that others might learn from?

 

Please share your "real life" experiences and insights, with enough detail to "get a real feel for" the situation.

 

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jeesh Dan, we have had all these discussions before. Each time they are different. New people replying or older forum members contribute something new. These all shape and construction the discussion to where we learn something new from these "old" discussions. And its a fairly defined topic not just scouts with ADHD.

 

 

 

 

 

 

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I'll come at this from two angles:

First:

A. If a doctor prescribes a medication, it is supposed to be taken as prescribed. Let's say someone has insulin dependent diabetes (Type 1). This person should check blood glucose and take required amount of insulin as prescribed.

 

B. A parent is chronically depressed and is prescribed medication, the parent takes the required medication.

 

There should be no "holiday" because becasue the individual is camping.

 

Second:

A. I'm a chiropractor when not scouting. I can tell you all with certainty that ADD/ADHD are OVER DIAGNOSED AND OVER PRESCRIBED.

 

B. If a child is truly, and I mean sincerely ADD, not the kid who doesn't pay attention in class or who gets bored with school work because he is actually a genius, but truly ADD, the kid NEEDS to take medication as prescribed. Anyone who has a prescription should follow it, otherwise don't waste your time and your doctor's time.

 

C. Research shows that kids with ADD/ADHD and who receive regular chiropractic care get better. Just so everyone is clear, I don't push chiropractic to anybody (at socuting events), I don't adjust kids on campouts, etc. I never adjust children without parental consent. It's not the time or place.

 

D. For more info, PM or email me at jgonzalezdc@doctor.com and put scouter in the subject line. I get too much spam.

 

 

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Yah, dan, yeh don't have to participate in the discussion if you don't want to. It was just an invitation, eh? ;)

 

For me, I share some of the feelings others expressed in sympathy with the scout leaders of young Michael's troop. You bring a lad on a trip, and you're responsible for him. He's homesick, you do your best to comfort him and cut him some slack (even tho you get panned for a YP violation :( ). Then when you least expect it, he gets a notion to hitchhike home on an impulse, and bein' off his meds, he acts on the impulse and launches off on a hike in the direction of the highway, tellin' no one.

 

You as adult leader get featured for days in the national media. Thank goodness in this case Michael's dad stood up for the leaders, eh? But that could have been different, too.

 

The issue of "goin' off meds," with the results, seems a fairly common one in the field. I'm just curious to know what other folks do, and how they handle it, what procedures they set up, how they manage the conversations with the parents.

 

You know, things that might help the troops and camps I work with. ;)

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Of course this was a major topic of discussion among adults at the troop meeting tonight. I don't understand something though. Generally, as Gonzo says, when you have a prescription you take it regularly. Skipping days is a bad idea. However, several parents told me that their children take medication for ADD/ADHD and that their doctors tell them not to dose the children on weekends and school holidays.

 

I have no idea how common that is or if it makes better sense to those of you with more experience than I have in dealing with children who have been diagnosed with this condition. I also don't claim to know if that was the case with the scout who was lost (and found) in NC. I do know we've had a few boys in the troop who seem to be on this pattern though, and it doesn't shock me to discover that these guys are often sort of hard to handle at camp outs!

 

I don't know if my reaction to this should be "What were those doctors and parents thinking?!" or, "Wow, those must be some pretty horrible meds if a kid needs a break from them on a weekly basis!" This assumes that the kids were correctly diagnosed to start with...

 

At any rate, we do ask parents to be as forthcoming as possible with us about their children's medical conditions, and to make sure to send along medication. We have a couple of people with an appropriate background to dispense meds on camp outs too. But if parents don't disclose and/or don't send the meds, I'm not sure there is a whole lot that can be done most of the time.

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We had kids on meds & the parents didn't send them on weekend campouts because they wanted to give their son a break. They said they do it a lot on weekends when they are home. HELLO! They are going to be in the outdoors with animals & sharp tools & living in a tent with another boy! That's a heck of a lot different from sitting in front of the TV playing video games from Friday night until Sunday night! HELLO!

 

Placing this type of responsibility on unit leaders is just flat out wrong. If little Timmy is on meds all week, he needs to be on them for the camping trip.

 

Ed Mori

1 Peter 4:10

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Having a son with ADD, I understand the notion of a "Medication Holiday". It is even suggested from time to time from the pediatrician. But, parents have to think about what they are doing. Generally, ADD is an inability to properly focus. Of course it makes logical sense to take the meds during the week at school because it's helps them learn what they are being taught. When you are at a Scouting campout - or any event where your child will be working, the same need to remian focused exists, and the meds should be taken. At school, it you loose focus, you get a bad grade. At a campout, if you lose focus, someone could get hurt.

 

While I get aggrivated with the reports that the Scout was allowed to "Sleep In" and then left behind with just one leader, the truth is that most of the blame with he NC youth lies on the youth himself. ADD is NOT an excuse to misbehave or act irradically. It sounds like this kids wandered off at lunch time when the entire Troop was present, so it could happen at any time. The first Scout law is "Trustworthy" and this young man was not trustworthy because he did what he knew was wrong. A 12-13 year old boy should be old enough to self-medicate when needed. The issue of trustworthiness needs to be brought up with this Scout and he needs to understand that there could be repercussions if he is not. He is putting himself, his Troop and the BSA at risk when he takes matters into his own hands.

 

I also heard on an interview last night that the mother said she will never take her eyes off of him again. I just cringe when I hear stuff like that because she is not letting him grow and learn from what was obviously judgemental error by this young man.

 

I'll get off my soapbox, but it just kills me that people labels kids "ADD kids" and blame all of their problems on that. These children are no different than anyone else. They have the responsibility to take meds, they should do it for their own safety, just like a diabetic kid must take meds for his own safety. It's a meater of teaching all boys responsibility and make sure they are doing what is neccessary.

 

-AD

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I'm with Gonzo on the overdiagnosed and overmedicated situation. I'm 36, and don't remember the term ADD growing up. Some things don't hold everyones interest. I learned 22 years ago at JLT that the average person has an attention span of 20 minutes, so your troop program should change after 20 minutes. It's the same with school or anything else.

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I'm not any sort of a Doctor.

My heart goes out to the parents of kids who have to deal with children who really do suffer from ADD and or ADHD.

While I know I might be wrong and maybe I am just plain wrong! I can't help thinking at times we fall into having trends.

A local Doctor found he had high cholesterol. For about 18 months it seemed he was sending about half of his patients to be put on low cholesterol diets.

From watching TV and hearing what is said at work the new disorder of the month seems to be bi-polar!!

Back in 2001 Blane's Mom came to me and said that Blane didn't take his meds during the summer vacation. Blane was going to the Jambo.

I'll admit my first thought was "Hey Lady don't do me any favors!"

Blane was and is a super nice Lad. Sure he had some problems. He seemed unable to stand still for more than a couple of seconds, he never ever stopped talking. If you asked him how he was doing? You got a blow by blow recount of everything he'd done so far that day in more detail than you might ever need!! I really like him and was so very pleased when he became an Eagle Scout. I know how very hard it must have been for him.

One day at the Jambo he was cook for his Patrol. Something wasn't going well and him and his PL were exchanging very loud words. Blane was upset and yelled "I'm ADD!" his PL yelled back "So am I!" No one had informed me that the PL was and I never knew.

Sadly we have had to remove a Scout from the Ship. Andy suffers from ADD, but unlike Blane who is a nice Lad Andy isn't. I very rarely find a Lad that I just don't like, but Andy was one. I tried really hard to work with him and for him but I knew I wasn't getting through. He was rude, surly and sneaky.

I tried to put myself in his shoes. I think I can understand how very frustrated he gets. I really felt sad that he seemed unable to make friends or keep friends.

Sadly one night another male Scout who was sleeping woke up because Andy was fondling him.

Andy's parents tried to make the argument that he hadn't taken his meds and how hard it is to get a Lad of 17 to take them. In fact they took him to the Doctor who adjusted his meds. Needless to say his Dad was very embarrassed. His Dad and I go back almost 25 years.

The Ship's Committee on my recommendation decided that in the best interests of the other Scouts ADD or not this just wasn't acceptable behaviour and he needed to be removed.

I have thought about this a lot.

It seems in Andy's case that he just doesn't understand that his actions have consequences.

Before this incident he stole some of the pants from members of the HS Track team. He left the pants, money and cell phones in the boys bathroom. He would have got away with it but the next day he wore the belt from one of the pair of pants to school.

Sadly Andy has put his parents through a lot.His actions have put the marriage of his parents on the rocks, the pressure at home is unbearable all of which doesn't help the Lad.

I now think that ADD and ADHD really are no different than most other challenges or handicaps. Just as I have known some deaf Scouts who were really super kids, I know some who are little toads.

I think the same applies to ADD and ADHD.

I'm happy to go along with whatever their parents decide is in the best interest of their kid. I not happy to accept bad manners, or un-scout like behaviour.

Ea.

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My son has been on Ritalin since the middle of kdgn., and he's now in 5th grade. He is labelled ADHD, and although the teachers and I don't see attention problems, he definitely is hyperactive and impulsive when he's not on his meds.

 

Due to side effects such as lack of appetite, we do give our son "holidays" from Ritalin. He has no desire to eat lunch when he's on his meds., so we keep him off meds. on Saturdays, Sunday afternoons (after church), and in the summer (and other school breaks) when he's just going to be at home. I would never let him go on a camp-out without being on Ritalin, and I make sure he's on his meds if he goes to a birthday party, or any other situation where his impulsive/hyperactive behavior could cause problems.

 

One year at Day Camp, there was a boy from a different Pack who was on a Medication holiday. It was suspected that his mother took his Ritalin herself, in the summer time. The poor kid couldn't concentrate, and was constantly getting in trouble. Since I had plenty of experience with ADHD, I offered to be a Walker with his den. It took a lot of my energy to continually redirect him, but he was doing okay until I needed a bathroom break, and in the short time I was gone, he got kicked out of his den, and sent to the "office" for the rest of the day. I really felt sorry for him, because he was a good kid who just had an irresponsible parent.

 

Not all kids with ADD/ADHD would have wandered off like the North Carolina boy, but I imagine his impulsiveness was a factor in acting on his thoughts of being homesick and thinking he could hike, and then hitch-hike home.

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A couple of comments:

Lisa said: "Wow, those must be some pretty horrible meds if a kid needs a break from them on a weekly basis!" This assumes that the kids were correctly diagnosed to start with...

 

That's part of the overall problem, ADD/ADHD is over-diagnosed. Asperger's Syndrome is the "new" ADD by the way. So,don't be fooled if some parent says that their kid has Asperger's. It's basically the same thing with a different name.

 

Antelopedud,

I agree and disagree with some things. If the medication were correct, it should be taken all the time, not just during school days. While the 12-13 year old may be old enough to self medicate, the adults need to know who is taking prescription or over-the-counter meds for obvious reasons.

 

Anyone with a child on Ritalin needs to be aware of all of the fine print on the prescription. Some of the known or suspected side effects of Ritalin include withdrawal, depression, mood swings and SUICIDE. Be Careful and become informed. Talk with your child's pediatrician, Ritalin is dangerous, (chiropractic is safe).

 

Basically, try to require parents of these kids to attend EVERYTHING! Treat the lad the same, just have their parent present.

 

Before someone suggests it here, I don't claim that chiropractic can not 'cure' everything. But, chiropractors help many people with many conditions other than back pain and headaches.

 

Gonzo

 

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Antelope, no, not every kid that is 13-15 can be trusted to self-medicate, especially if they are truely ADD. They forget that they are to do things. That is why they are always getting in trouble over homework. If they can't remember homework assignments, what makes you think that they're going to remember to take their med's on time, if at all?

 

Let's get to the real reason for Med. Holidays:

 

1) 3 months in the summer giving the pocketbook a vacation. The med's

are expensive you know.

 

2) Weekends and days off school - Let's stretch the supply we have as

long as we can. Again, pocketbook relief.

 

3) A fast buck on the street, $10 -$20 a pill. Nice side income.

 

Sorry to take a negative view, but some parents really do do the above.

 

Let's remember true ADD/ADHD is best handled by a Behavior Health Specialist, yea the Shrink. The only reason that the Neuro's are involved is because of the TABOO that is placed on someone going to the shrink. When our Pediatrician asked us about a Neuro for our son and we said "NO, give us a shrink, they handle it better", she was thrilled and told us that most parents take offense when "SHRINK" is mentioned and run for the door.

 

Any child Dx'ed and medicated with a Behavior Related condition should never take a break from the medication. If the child is having problems/side-effects on a paricular regiment, the diagnosis needs to be reconsidered and make sure it is the right one.

 

Scout with questionable Behavior Issues should have a parent along for the trip to divie out the medications and handle their scout instead of leaving it for the SM and ASM's. My son is 16 and the other leaders know him well. There is only a few that I trust to remember to get the med's out on time. My oldest and I are usually on all the campouts (both ASM's) to handle the 16 y/o if needbe rather than hiding elsewhere for the weekend letting the other leaders worry about how to handle him, especially if he forgets his med's and fend for themsleves.

 

Gonzo, let's talk ADHD and Bipolar. A load of ADHD's are misDX'ed Bipolars. They are the ones who get worse on the Stimulants because the Stimulants through them to the Manic side of the spectrum. These are the kids that when placed on antidepressant and mood stabilizers all of a sudden improve and stop wanting to ponder suicide. The only true way to Dx the Bipolar is family Hx, especially one with Alcoholism in it anywhere in the last three generations. They're are both tied to the same gene. Kiddie Bipolar mimics ADHD because the kids have rapid cycling moodswings, several in an hour unlike adults where the cycles might take days and months to switch, therefore the kid appears hyper and the kid gets tagged with the wrong Dx.

Been there and been through it with the 16 year old.

As for Asperghers, different animal totally. Only comparision between them is that they all are Behavioral, different symptomologies, different problems. I've known a few, nothing like the other two, usually angry and ODD most of the time.

 

I feel for the kids, the parents and the Troops. It's not easy.

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