What does Hatrack think of this article? Fearmongering? Overly optimistic? Broadly accurate? Broadly inaccurate? Does it miss some points that you think should have been brought up in more detail?
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quote:for instance, childhood problems qualify as oppositional defiant disorder if the child exhibits at least four of eight behavior patterns, including “often loses temper,” “often argues with adults,” “is often touchy or easily annoyed by others” and “is often spiteful or vindictive.”
See now... it's things like this that make me agree with Richard Feynman when he said that clinical psychology was a load of hooey. Looking at those symptoms I see only one thing: it's called adolescence, its an extremely common disorder that can last anywhere from 5 to 10 years. The only cure is good steady parenting and a lot of patience.
Edit:
quote:Attention deficit disorder is perhaps the most straightforward diagnosis. Elementary school teachers are often the ones who first mention it as a possibility, and soon parents are answering questions from a standard checklist: Does the child have difficulty sustaining attention, following instructions, listening, organizing tasks? Does he or she fidget, squirm, impulsively interrupt, leave the classroom?
Mayhap here would be a good spot to point out something: that's called being restless. It comes when kids are forced to sit in a chair and attempt what is to them rather difficult and boring learning all day with little or no chance to run around outside and play. When I was in 4th grade we used to have 3 recesses a day. Each one lasted anywhere from 30 minutes to an hour. These days I hear tell of 4th grades where kids barely get 10 minutes... and that's only on some days. What the hell? They're still kids they need recess! How do you expect them to hold on to math if they're sitting there full of energy, itching to run around?
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quote:Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.
[and] The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
--DSM-IV
Edited to add: That is to say, the criteria in themselves preclude "normal adolescence" by contrasting with "normal" on the bell curve. Additionally, impairment of functioning (as contrasted with peers) is as important a quality of the characteristics assessed as the nature of the characteristics listed themselves.
There are, indeed, problems with adolescent psychology. They are more nuanced than those raised here, I think.
Edited again to add: For example, as Alcon noted, the decrease in recess and other physical activity time may well be a problem with assessing "normal" functioning for kids suspected of having ADHD.
posted
That's a good point, CT. Those criteria do seem fairly subjective, which would probably lead to the difficulties in diagnosis and treatment discussed in the article.
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quote:Originally posted by Storm Saxon: That's a good point, CT. Those criteria do seem fairly subjective, which would probably lead to the difficulties in diagnosis and treatment discussed in the article.
I'd like to see it more clearly acknowledged that to fulfil the various criteria, one must not just be "restless" or "often loses temper," but must do so to an extent that falls outside normal behavior for his or her peer group. [This is explicitly made a part of the diagnostic criteria. If one is behaving typically for an adolescent, then the diagnosis is prohibited from being made.]
The diagnostic criteria by definition pick out outliers, not kids that fall into the middle of the group. Not "just adolescents." And there has to be documentaion of negative harms as well -- adverse sequelae from the behavior. It may still be subjective, but it isn't random. That would be a straw man version, as it were.
Edited to add: That's about all I have to say about it. Good to raise the issue, better still to do it in a more rigorous way.
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posted
There are definitely problems. However, IMO (and what experience I have with my kids and my sibs), the problem is not the diagnoses.
It's that they are being made after 20 minutes.
One of my kids got a diagnosis from a shrink after a 60-minute meeting with us (the parents) and a 50-minutes session with the child. We stopped seeing that shrink for some pretty significant conflict of interest issues, and took the kid to a place where he was more thoroughly evaluated. Hours and hours of different kinds of testing, more paperwork (various tests/surveys/indices of behavior) for me to fill out than could be believed, and ongoing therapy. Medication wasn't even suggested until therapy had been ongoing for 6 months.
IMO, that is how it should work. Instant diagnoses and prescriptions are about as effective as any other "miracle cure."
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Good (or at least, substantive) criteria can't make up for improper use of them. Don't blame the criteria, though, for that -- blame those that aren't applying them correctly.)
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My experiences with the child/adolescent psychiatry fields actually make me think that the trend is toward more thoughtful and careful and ACCURATE diagnoses. I have kids with Tourette's and one with bipolar disorder, and the professionals we have dealt with have been marvelous and sensitive and quite conservative when it comes to medication. Certainly there have been no "instant diagnoses." I agree that those would be quite dangerous.
To be honest, I have a lot more trouble with the folks who say (very well-meaning, I'm sure) things like "she's just a 15-year-old girl. All 15-year-old girls are moody. You should not be medicating her for THAT." It does not help.
And there is a seed of truth in all of that. As a parent, there are days when I ask myself: "What is causing behavior X? Is it the bipolar? Is it Tourette's? Is it PMS, for heaven's sake? Or is it because she's 15?" And the answer, after much gnashing of teeth, always comes back to this: "If it is unacceptable behavior, it is unacceptable behavior. The consequence for behavior X is effect Y." And we continue to treat the disorders and to treat her like a human and to have days when we want to wring her neck. Like any teenager.
I'm not sure I'm really adding anything of substance here. I'm half asleep. .
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posted
Sharpie, it seems to matter a LOT where you go. (Not surprisingly.) Certainly there are plenty of places like where we took my kids -- but there are also plenty that specialize in instant-fixes.
Guess which kind was recommended by the kid's school? Posts: 32919 | Registered: Mar 2003
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posted
Oh, and the oppositional defiance! My family has this all through the generations, and it is NOT "adolescence." It is very very difficult to deal with. The ODD people I know are explosive and, well, DIFFICULT. Family outings, holidays, even dinners can be wrecked in an instant. And are. Over and over. It's not adolescence. ODD is real and can be horrible.
posted
Yeah, I know, Rivka. We are lucky to be in the DC area and in the Fairfax County schools. Seriously lucky.
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There are also apparently conflict of interest issues, ie 'Big Pharma'.
I'm sure. Which is why I recommend places like where I took my kids, at least initially, rather than individuals in private practice. Not that there aren't some great ones -- my brothers saw a marvelous one! But I think the odds are better, and there are fewer conflict of interest and other issues.
They usually have a sliding scale as well.
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I had the impression (from my parents, who do allot of work with child behavior problems) that Oppositional defiant disorder exists primarily to get funding to help children with no other clear diagnosis that explains their symptoms.
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posted
See, in eighth grade, after I started taking Zoloft for depression(which I see as a correct diagnosis), my psychologist told me I had ADD. I don't even know how she came to the conclusion. My mom mentioned something once about me "not paying attention in school." The doctor decided that this meant I was UNABLE to pay attention in school, which was not the case. I just didn't NEED to pay attention to understand the stuff, especially in math and reading. I learned much quicker, so once I understood, I stopped paying attention. My grades were fine and everything, but apparently, this was cause for my regular doctor to prescribe Concerta, a narcotic used to trteat ADD. After a few months on the stuff, I hated how it was making me feel. my grades started dropping AFTER I started taking it, because it made me tired and I fell asleep in school all the time. But after I stopped taking it, I was fine.
I definately think ADD is far too overdiagnosed. We stopped having recess in sixth grade, except for a few minutes if we finished out lunch early. Honestly, I think high schools should still have recess- to give the kids a nice, relaxing break from the hell of everyday school. College students normally have this- their classes aren't back to back, and if they are, they normally don't last seven hours without a break. If we need breaks when we're older, and we need them when we're young, why can't we have them when we're in between the two?
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quote:Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.
[and] The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
--DSM-IV
CT, thank you for posting this. I've read a lot of articles - all in popular media for lay persons - and never seen that mentioned. Sometimes when seeing checklists for things like ADD I've seen the article mention that the criteria should be interpreted as if the attribute is unusual and displayed in way that interferes with life, but not usually. I've always had the same kind of skepticism about such diagnoses as described that Alcon expressed - basically, "That can't be all there is to it." I'm glad I was right about that.
Is the quoted portion a general provision of the DSM-IV - that is, is it supposed to be applied to all diagnoses that use criteria lists? If so, I think responsible journalism requires mentioning this in any article that lists criteria for diagnosis.
quote:Originally posted by Tinros: See, in eighth grade, after I started taking Zoloft for depression(which I see as a correct diagnosis), my psychologist told me I had ADD. I don't even know how she came to the conclusion. My mom mentioned something once about me "not paying attention in school." The doctor decided that this meant I was UNABLE to pay attention in school, which was not the case. I just didn't NEED to pay attention to understand the stuff, especially in math and reading. I learned much quicker, so once I understood, I stopped paying attention. My grades were fine and everything, but apparently, this was cause for my regular doctor to prescribe Concerta, a narcotic used to trteat ADD. After a few months on the stuff, I hated how it was making me feel. my grades started dropping AFTER I started taking it, because it made me tired and I fell asleep in school all the time. But after I stopped taking it, I was fine.
When I came to college and first sought school-sponsored counseling, they kept trying to push ADD testing on me. It drove me up a wall. Then they decided that clearly, I had some kind of reading-related learning disability and wanted to test me for that. And like you, I just don't see a need to pay attention all the time because I learn much more quickly than most of my peers. One of the things I'm loving about the masters program is that if the professor approves, I can take pretty much any class I want as an independent study.
One thing is...I always thought that my pediatrician relied too heavily on grades to determine mental health. I mean, all they ever used to do was ask my mother how I was doing in school.
quote:Originally posted by Dagonee: Is the quoted portion a general provision of the DSM-IV - that is, is it supposed to be applied to all diagnoses that use criteria lists? If so, I think responsible journalism requires mentioning this in any article that lists criteria for diagnosis.
It is a part of every diagnostic checklist (in one form or another), I believe -- that is, this is a standard check relisted each time a list of diagnostic criteria is given. Unfortunately, when the DSM-IV is quoted, the diagnostic checklist is often quoted in part, not full. The "fiddly bits" that are actually as important as the dramatic bits get left out for one reason or another.
I'll try to post some checklists in full later on (have to catch up on work email first) so that you can see.
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Storm Saxon, I'm going to remain noncommital on most of this discussion, for reasons which are varied and complicated but have nothing (! honest) to do with how I feel about the participants. I'm sure the conversation will not suffer from my absence there. Posts: 14017 | Registered: May 2000
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posted
It seems to me that the problem with that DSM-IV quote for diagnosis is that I believe the average itself is based off of what seems to me to be subjective criteria and analysis, which is also a problem with what is 'significant' or 'impaired'. This goes back to Stephen Drake's point about disabilities and their perception by doctors edit: in other threads, I think.
This isn't to say that subjective criteria aren't relevant. It's more to point out that it would seem to me to be difficult to establish an accurate baseline as to what constitutes abnormal.
The DSM-IV quote is, to me, axiomatic in psychiatric medicine, and I'm not sure of its relevance to trying to understand the accuracy of the article or the issues it raises as to the accuracy of diagnoses and treatment of childhood mental illness. That is, are there diagnoses that don't depend on the criteria in the quote? I find it hard to believe.
edit: O.K., CT. Thanks for your input in this thread.
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quote:Is the quoted portion a general provision of the DSM-IV - that is, is it supposed to be applied to all diagnoses that use criteria lists? If so, I think responsible journalism requires mentioning this in any article that lists criteria for diagnosis.
As far as I understand, this is an extremely common, though not universal, provision applied to most criteria lists.
If you want to check out the definitions, check out Oppositional Defiant Disorder and ADD/ADHD. You'll notice that they both have explicit reference to this concept.
You may also notice that ODD is limted by:
quote:A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months.
and ADHD by:
quote:Symptoms must have persisted for at least 6 months. Some of these symptoms need to have been present as a child, at 7 years old or younger. The symptoms also must exist in at least two separate settings (for example, at school and at home). The symptoms should be creating significant impairment in social, academic or occupational functioning or relationships.
I agree that there is a great deal of problems with psychological diagnosis and treatment of children and I'd suggest that a large portion of this is people not actually following the rules and going for the quick, 30 minute diagnosis followed by drug regimines.
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posted
Storm, This characteristic of DSM diagnosis was brouht up to deal with a specific complaint, which was that "There has to be more to it than this." It wasn't, as I saw it, intended to directly respond to the article you posted.
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quote:Originally posted by Pelegius: I had the impression (from my parents, who do allot of work with child behavior problems) that Oppositional defiant disorder exists primarily to get funding to help children with no other clear diagnosis that explains their symptoms.
I do not have this impression.
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quote:I'd like to see it more clearly acknowledged that to fulfil the various criteria, one must not just be "restless" or "often loses temper," but must do so to an extent that falls outside normal behavior for his or her peer group.
Cheers. Only I might change it a bit more:
quote:...but must do so to an extent that falls well (IE many standard deviations -- my statistics are too shaky for me to be naming numbers)outside normal behavior for his or her peer group.
My changes in bold.
I feel better about those symptoms lists with that added caveat. I would also wish for better regulation of psychiatrists though, because I hear all sorts of horror stories about them diagnosing people (and not just in the media), where it really does fall with in the normal behavioural realm. It seems like all too many psychiatrists don't follow the criterion.
The other problem I have with psychiatry is that it's not in the practitioners interest to proclaim the patient healthy. It's in their interest to declare that they have a disorder and need further treatment. It means more money for them. I don't feel like this is a problem for medical doctors because its not nearly so easy to proclaim a chronic disease where there isn't one. I'm sure there are plenty of well meaning clinical psychologists for whom this isn't an issue, but I'm also sure there are plenty of them out there who, whether subconsciously or consciously, diagnose way more people than they should simply cause they need the money.
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Unless I have forgotten my statistics, this would equate to 3.2 out of 100,000 people (assuming a normal distribution).
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quote:It comes when kids are forced to sit in a chair and attempt what is to them rather difficult and boring learning all day with little or no chance to run around outside and play.
Although I strongly agree that ADD is hugely over-diagnosed, I do believe that it does exist. There's a big difference between a child being restless, disbehaving, unattentive in a class than a child being completely out-of-his/her-mind unable to concentrate for five seconds.
I say that in the most kindly way possible.
Some kids haven't learned to pay attention; they haven't been taught to spend time on one thing for an extended period. Others are bored with the particular thing (say, reading) but are super focused with something else (say, lego). Others are active kids and need to move or wiggle.
However, there are kids, very occaisionally, who simply cannot sit still, metaphorically. They cannot listen to instructions: an active kid might hop up and down but will be able to play a game. In my experience, a kid who cannot maintain interest in anything, reading, lego, games, toys, instructions, television, stories, his own problems, eating, might have ADD.
I'd be very wary of an ADD diagnosis that did not include viewing the child in a natural environment.
I don't have time to read the article (class!!!) but regarding this 'oppositional' disorder... yes there are children who are severely messed up. Many of them. In my experience, this almost always reflects back on the parenting (not parents, parenting).
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posted
Alcon, most people don't ever see a psychiatrist unless they actually do have some kind of problem. There's a stigma behind it; it's not like going for a yearly physical or something. It's unlikely that pychiatrists (in general...I don't know how I feel about a lot of child psychiatrists) are just diagnosing willy-nilly, intentionally or unintentionally. That doesn't mean there aren't misdiagnoses, though.
quote:Originally posted by MrSquicky: Storm, This characteristic of DSM diagnosis was brouht up to deal with a specific complaint, which was that "There has to be more to it than this." It wasn't, as I saw it, intended to directly respond to the article you posted.
posted
"I don't have time to read the article (class!!!) but regarding this 'oppositional' disorder... yes there are children who are severely messed up. Many of them. In my experience, this almost always reflects back on the parenting (not parents, parenting)."
Um. I disagree profoundly with this. In fact, there is growing evidence that it's the other way around; that parenting a mentally ill child affects one's parenting style hugely.
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quote:Originally posted by MrSquicky: Storm, This characteristic of DSM diagnosis was brouht up to deal with a specific complaint, which was that "There has to be more to it than this." It wasn't, as I saw it, intended to directly respond to the article you posted.
Exactly.
Except, that is, that this article did the same inappropriate foreshortening of the diagnostic criteria as mentioned above. As it reads, it is misleading, but this is common. [And that would be the impetus behind Alcon's initial frustration, I take it. I was responding to Alcon, though, not so much the general article itself, which I had already read.]
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To be honest, I have a lot more trouble with the folks who say (very well-meaning, I'm sure) things like "she's just a 15-year-old girl. All 15-year-old girls are moody. You should not be medicating her for THAT." It does not help.
I totally agree with this. I was (and still am) convinced that I was depressed during high school through my freshman year of college. Not severely, but enough to make my life miserable. Whenever I mentioned it to anyone, I was told that everyone went through what I was going through. I had talked to enough people my age to know that wasn't true, but being told that made things even worse. I was filled with self-doubt, if everyone else went through this and was able to handle it, why couldn't I? It made the whole situation so much worse.
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posted
For a comparison of how the criteria are reported versus what they actually look like in the text of the DSM-IV, compare the following. I quote in excess from the article to show that this segment isn't taken out of context (i.e., isn't elaborated on in the surrounding text).
quote:The most commonly diagnosed mental disorders in younger children include attention deficit hyperactivity disorder, or A.D.H.D., depression and anxiety, and oppositional defiant disorder.
All these labels are based primarily on symptom checklists. According to the American Psychiatric Association’s diagnostic manual, for instance, childhood problems qualify as oppositional defiant disorder if the child exhibits at least four of eight behavior patterns, including “often loses temper,” “often argues with adults,” “is often touchy or easily annoyed by others” and “is often spiteful or vindictive.” [bolding added]
At least six million American children have difficulties that are diagnosed as serious mental disorders, according to government surveys — a number that has tripled since the early 1990s. But there is little convincing evidence that the rates of illness have increased in the past few decades. Rather, many experts say it is the frequency of diagnosis ...
quote:Diagnostic criteria for 313.81 Oppositional Defiant Disorder
(cautionary statement)[*]
A. A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present:
(1) often loses temper (2) often argues with adults (3) often actively defies or refuses to comply with adults' requests or rules (4) often deliberately annoys people (5) often blames others for his or her mistakes or misbehavior (6) is often touchy or easily annoyed by others (7) is often angry and resentful (8) is often spiteful or vindictive
Note: Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.
B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.
C. The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder.
D. Criteria are not met for Conduct Disorder, and, if the individual is age 18 years or older, criteria are not met for Antisocial Personality Disorder.
[*link to general cautionary statement, noted in full here]
The DSM-IV quotation is from BehaveNet, which has been granted permission from the copyright holders of the DSM-IV to excerpt in full. As you can see, the full checklist is composed of items A (with subcomponents 1-8), B, C, and D. This is also clearly deliniated in the beginning of the DSM-IV text. Nonetheless, often only the one component is cited (A), and that without the attached disclaimers, anyway.
It is shoddy and misleading reporting. Unfortunately, it is done all the time.
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posted
I think there is too much emphasis on shoving a pill down people's throats - and I really, really don't like the idea of medicating young kids. If there are problems, then I think a first step should involve counseling, not prescriptions.
When my son had some behavior problems at school, a friend of mine immediately said "He's probably ADD. Your pediatrician will write you a script for it." That's the attitude that's out there right now - if they aren't behaving or doing exactly what you (or their teacher) wants them too, then medicate them. It makes me sad, and angry. My son was having trouble adjusting to the environment of a 1st grade classroom. After meeting with the teacher and making a plan to help him get more comfortable with a more regimented routine, he now does just fine and is a well-behaved and thriving student who is excited about going to school and his teacher is excited to have him there. No medication was needed, just some time and patience with a boy who was, after all, just six years old.
That's not to say that some children might genuinely need mediation, but for the love of all that's good in this world, it shouldn't be the first resort!
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posted
Agreed 100%. And I say that as someone who has seen the good that medication can do, when used in conjunction with therapy and other methods, not INSTEAD of them.
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posted
CT, I see the same kind of reporting done about the two subjects I have professional knowledge of. The difference is that, in the case of information technology, those articles are clearly not how-to articles and, in the case of law, the articles are generally reporting on an particular event - a trial or settlement, for example. As frustrating as I find both types of errors, in neither case is the error likely to spur someone to take a particular action, and the articles are usually not purporting to inform on the technical subject itself. Rather, the technical subject is an aspect of the story.
The difference with the psychiatric articles is that they are often couched in terms of "is your child suffering from X?" That is, the article itself is claiming to be providing accurate information and suggesting particular actions. This strikes me as potentially more harmful.
Granted, the action suggested is usually to have a child profesionally evaluated, which should provide significant safety net. But it still strikes me as very irresponsible reporting.
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Additionally distressing (for me) is that attacking the straw man version of the problem means getting carried far afield from the many other concerns that are tenable and do need to be raised. There is ample room and need for critique of this system, just not so much where the focus is often trained.
I suspect that there are two (not exclusive) pressures that drive us this way.
1) Sensationalism makes money, and this abbreviated checklist furor makes for easy soundbites that (rightfully) raise the ire of people who care about children. A more nuanced critique, even if more correct, would not sell as many papers.
2) It is probably in the best interest of those in power to have the discussion flurry around a misconception. Should this concern eventually become something that the profession actually has to deal with (say, policy and funding changes), then it can be easily refuted in a detailed forum.
quote:Granted, the action suggested is usually to have a child profesionally evaluated, which should provide significant safety net. But it still strikes me as very irresponsible reporting.
I suspect (not "know," but "suspect") that the advice to get your kid evaluated -- in the context of the weight of the rest of such texts -- is often taken in the Cover-Your-Bum attitude in which it is expressed. That is, I doubt such articles lead more people to have their children professionally assessed, but rather the opposite. Just a guess, though.
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posted
I'd add a third item to CT's list, which is that there is significant amounts of money out there, say in advertising contracts in this case, for people who propogate the idea that people should be taking drugs.
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quote: Additionally distressing (for me) is that attacking the straw man version of the problem
O.K., let's not get carried away here. The main conclusion of the article is that there is(to paraphrase) a significant grey area in effectiveness of diagnosis and treatment in treating 'mental illness' in children, a conclusion that no one in this thread has challenged, and which the addition of the information of the rest of the criteria from the DMSV-IV would not change.
While it's clear that the article engages in a half-truth in not presenting the rest of the information from the DSM-IV to make doctors look more flaky than they really are, I don't see that it significantly impacts the overall article, nor do I see that it raises a straw man.
In fact, I believe people in this thread have agreed that the criteria of the DSMV-IV are not being as strenuously adhered to as they need to be by the doctors themselves. So, the existence of hte criteria does not mean that doctors are actually following them rigorously as might be implied by their existence.
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posted
Storm, You just recapitulated what CT was saying. To wit, there are serious problems with the treatment of children, but that these problems are often overshadowed by people being upset at an inaccurate portrayal of the whole child psychology discipline.
There's a very important difference between being upset about people not following rigorous standards of effectiveness and safety and thinking that the people who set up the system don't know what they are doing and are just making it up.
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posted
I'm not saying that the rest of her post is wrong, but on the other hand, I don't get that the main thrust of the article was that doctors don't know what they are doing and are just making things up. I don't believe it rises to the level of straw man.
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posted
Storm Saxon, you quoted my response to Dagonee. I was discussing the thrust of many common articles about this subject with him, as we both have seen this general bent pretty commonly.
Other than to say that they got it wrong in this article as well (to the extent of offering an abbreviated and misleading summary of the criteria), I haven't been commenting on your article. In fact, I have tried to be expressly noncommittal on it, and have focused instead on the side issue which has come up in multiple posts in the discussion around that article.
I will try to be more clear about the exact referent of my pronouns in the future, and hopefully this will help.
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Edited to add in clarification [bolding is added]:
Dagonee:
quote:CT, I see the same kind of reporting done about the two subjects I have professional knowledge of. The difference is that, in the case of information technology, those articles are clearly not how-to articles and, in the case of law, the articles are generally reporting on an particular event - a trial or settlement, for example. As frustrating as I find both types of errors, in neither case is the error likely to spur someone to take a particular action, and the articles are usually not purporting to inform on the technical subject itself. Rather, the technical subject is an aspect of the story.
The difference with the psychiatric articles is that they are often couched in terms of "is your child suffering from X?" That is, the article itself is claiming to be providing accurate information and suggesting particular actions. This strikes me as potentially more harmful.
Granted, the action suggested is usually to have a child profesionally evaluated, which should provide significant safety net. But it still strikes me as very irresponsible reporting.
Me:
quote: I know, Dagonee. I feel the same.
Additionally distressing (for me) is that attacking the straw man version of the problem means getting carried far afield from the many other concerns that are tenable and do need to be raised. There is ample room and need for critique of this system, just not so much where the focus is often trained.
... I suspect (not "know," but "suspect") that the advice to get your kid evaluated -- in the context of the weight of the rest of such texts -- is often taken in the Cover-Your-Bum attitude in which it is expressed. That is, I doubt such articles lead more people to have their children professionally assessed, but rather the opposite. Just a guess, though.
quote:Originally posted by Storm Saxon: And he was responding to your point addressed particularly to the article in this thread.
Which, when he responded [to] it, became a discussion about articles in general. (See bolding [in quoted conversation] above.) We moved from the particular (an example) to the general (a class of items), which is why we were using referents of the plural.
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