Are Children With ADHD Gifted?
Gifted ADHD Children Less Impaired?
There's a lot to like about the Honos-Webb approach, says behavioral-developmental pediatrician Lawrence Diller, MD, author of Remembering Ritalin.
Like Honos-Webb, Diller sees ADHD "more as personality- and temperament-based rather than a mental disorder or a chemical imbalance."
"Impulsivity can be seen as spontaneity, and hyperactivity could be vitality -- but. There is a big 'but,'" he says. "The 'but' is that her work applies only to children with mild qualities of hyperactivity and impulsivity. Once you go beyond the mild, ADHD is the flip side of something positive. The children's struggles with family, schools, and peers diminish the positiveness of it."
Honos-Webb doesn't make this distinction. Her view is that ADHD is not something a child has, but a set of behaviors a child does. By working to understand why their child behaves in those ways, she feels parents can find ways to motivate the child to change those behaviors.
"Many parents actually buy into the idea their child cannot succeed, and many more are fearful their children will fail," she says. "If they find a child's gifts, it is like a jet stream. They get to where they want to go with less pushing."
ADHD Gifts, ADHD Meds
Reading The Gift of ADHD, you may get the idea Honos-Webb is against giving ADHD children Ritalin or other medications. Vasconcellos, for example, got that impression from looking over Honos-Webb's web site.
It's true that Honos-Webb does not see medication as a first-line treatment.
"The first thing I recommend is a child and family get 12 sessions of psychotherapy first before they even get evaluation for diagnosis, and certainly before trying medication," Honos-Webb says.
Though other experts aren't likely to insist on so many sessions before trying medication, Honos-Webb agrees that ADHD drugs help many children respond to behavioral therapies.
"Of course you need to consider medications if a child is about to fail to meet a major developmental milestone, or faces getting kicked out of school or being totally socially ostracized because they can't manage themselves," she says.
Abramowitz says after she diagnoses a child with ADHD, she is sure to bring up the topic of medication in her first feedback session with parents.
"There are many times when I recommend medications," she says. "If the parent is comfortable with the idea, I say, 'Let's do a trial.' And then we talk about what makes a trial good instead of sloppy, and I tell them what I hope their physician will do."
When parents don't want their child to take ADHD medications, Abramowitz supports the decision -- up to a point.
"If they want to try interventions without medications, I say fine. But I want them to know that studies clearly show the thing most likely to impact ADHD is medication," she says.