Some thoughts about ADD/ADHD

I struggle with how best to approach attentional issues in my practice. I was taught by a developmental pediatrician in Madison that (diagnostic) labels were a convenience invented to make things simpler for clinicians and the billing office, but that they are of limited clinical value. and often actually harmful to patients. His concerns centered on the dangers of standardization and the dead-end effect. Treating the label distracts from seeing and treating the patient as a unique individual in a unique context with an individual manifestation of X. To make matters worse, there is an unfortunate tendency to stop thinking once one has assigned a label and then instituted a treatment driven by the label rather than the patient, making the labeling of patients a barrier to new information and evolving treatments.

(Feynmann writes about proudly telling his father that he’s identified a bird, to which his father replied that you don’t know what the bird is unless you know where it lives, what it uses in nests, what it eats, how it behaves, what its predators are, and what its song is like.)

This recent blog post by Steve Balt hit home. It is very well written. I recommend it. 

 


 

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