Quirky? Eccentric?

iVillage Member
Registered: 03-19-2003
Quirky? Eccentric?
2
Tue, 04-27-2004 - 3:30am

Would your child or children fit into these definitions?


Here's an article http://www.msnbc.msn.com/id/4824772/


What's your take on it?

 


 



iVillage Member
Registered: 03-19-2003
Tue, 04-27-2004 - 7:24am
bumpin' it up

 


 



iVillage Member
Registered: 03-26-2003
Mon, 05-10-2004 - 2:43am
Hi,

On the same subject -here Dr Greene shares his views on diagnoses , in particular BP

Our biggest concern with the diagnosis of bipolar disorder in children is that, like other diagnoses, it does not help us understand the cognitive factors underlying the child’s difficulties. Indeed, the diagnosis leads to an almost instantaneous assumption of neurobiochemical underpinnings (and therefore instantaneous consideration of medical intervention). The reality is that mood stabilizers do not, and cannot be expected to, address the myriad cognitive issues we see in many of the children who walk through our doors with a pre-existing diagnosis of bipolar disorder (many of whom have been on a multitude of mood stabilizers, with little to show for it). For example, a child with significant language processing difficulties, and/or sensory hypersensitivities, and/or a tendency towards concrete, inflexible thinking (typical of a non-verbal learning disability) would certainly be capable of chronic, intense, severe aggressive outbursts.

Those familiar with the Collaborative Problem Solving model are aware that we have articulated “pathways” that can compromise a child’s ability to tolerate frustration and deal flexibly and adaptively with the world. These pathways are not meant to be categorical diagnoses, but rather areas in which easily frustrated children frequently evidence limitations or inefficiencies. They include executive functioning, social information processing, language processing, emotion regulation, sensory/motor skills, and concrete, inflexible thinking. We find that a thorough assessment of these pathways and of the situational factors fueling a child’s outbursts usually elucidates a quite predictable pattern of explosive and noncompliant behavior.

The good news is that atypical antipsychotics are effective at reducing “mania” and emotional reactivity, and decreasing the frequency and severity of aggressive outbursts. The bad news is that, anecdotally and in some studies, a very high percentage of children cannot tolerate these medications. An important question to consider: Should we think of mood stabilizing medication as a long-term treatment strategy? In other words, assuming that a mood stabilizer is indicated, are we anticipating that the child will remain on such medication for the rest of his or her life? Our answer: So long as lacking cognitive skills are neither assessed nor taught, mood stabilizing medication will remain a highly popular treatment option…because medicines do not teach children lacking cognitive and emotion regulation skills.

There’s a big down side to viewing childhood bipolar disorder as a purely neurobiochemical disorder: it prevents people in the child’s life from examining the role they may be playing in precipitating explosive outbursts. In fact, we believe that most meltdowns are not caused by a child alone but by incompatibility between a child and his/her environment. We find that what is most crucial about understanding explosive outbursts is assessing antecedent events (what happened before the child exploded). A situational analysis of outbursts can help determine the factors contributing to the outbursts. Do such outbursts occur primarily when the child is overwhelmed by linguistic demands? In response to sensory stimuli? When there is a demand for shifting of cognitive set? When an adult is in Basket A? These questions take us beyond biochemistry and help us understand what needs to change if meltdowns are to be reduced. And most of the adults we come across are happy to take an active role in changing things if it’s possible to reduce their children’s explosive outbursts without medical intervention.