Why I Don’t Diagnose Oppositional Defiant Disorder (Part 1 of 4)

by James Wiley, MD, FAAP  - @adddoc Okay, I have diagnosed it. On occasion, I still might diagnose a young person with it. However, every time I think ODD, I ask myself “What is making this kid so angry and defiant?”  And if I do diagnose ODD I consider it my failure to answer that question. Almost all of the DSM 5 diagnoses, including ODD, have the same final criterion; the symptoms are not better explained by something else. I think ODD behaviors almost always arise from other diagnoses or social situations. Failure to consider this criterion leads to significant over diagnosis of ODD, which is too often cited as the most common co-occurring condition along side ADHD. This week I’d like to further discuss some common conditions and situations that replace the diagnosis of ODD in my practice. In this… Read More »

ADHD Medication: Dangers of a Medication Vacation

Stopping your child’s medication for the summer may not be in their best interest. For years, pediatricians told parents to give ADHD medication when they had to — on school days during school hours. But times change. We now know that school problems are only the tip of the iceberg for kids with ADHD. They have problems with paying attention, time management, forgetting/never hearing instructions and organization at home and with peers. These issues relate to executive function—the brain running the ‘home office’ of the kid’s life. Poor executive function is why it takes kids with ADHD an hour to shower. Does this scenario sound familiar to you? “Get in the shower…..get in the shower….Why haven’t you gotten in the shower?" "I’m not going to tell you again to get in the shower." "GET IN THE SHOWER!!" Water turns on.… Read More »

Meet Dr. Abston!

Dr. Abston serves patients in the Huntsville, Alabama office. Pippa Abston, MD, PhD (Dr. Pippa to her patients) has practiced general pediatrics for over 24 years. She was raised in Tuscaloosa, Alabama (Roll Tide!) and attended the University of Alabama, followed by the University of South Alabama College of Medicine’s combined MD, PhD program. After residency at Greenville Children’s Hospital in South Carolina, she was in private practice for several years before accepting an invitation to join the UAB Huntsville medical school faculty, where she taught and cared for patients for 13 years. In 2018, she left UAB to explore options for filling serious gaps in mental health care in Alabama, while working part time for a school-based nonprofit clinic. She established and directed an autism diagnostic clinic at UAB Huntsville, taught parenting skills to residents and medical students, helped… Read More »

5 Simple Things to Help Behavior & Attention Issues

ADHD is common and it is also over diagnosed. In our frantic modern world we can forget some of the basics that contribute to healthy attention and behavior. At Focus-MD we don’t believe that there are a lot of parents rushing to medicate their kids. Most patients come to us having tried other interventions first. Here are some suggestions that are likely to help with behavior and attention problems regardless of their cause. Better Sleep None of God’s children no matter how small or how tall pay attention and behave well if they haven’t had adequate sleep. Intrusion of screen time in the bedroom has gone from TV watching to constant contact with texting, social media, video streaming and gaming. Eliminate media from the bedroom at least 30 minutes before bedtime; a good book is still ok. Animals and other… Read More »

It’s Not Too Late to Start a New Year’s Resolution

Within a blink of an eye, the first few weeks of the New Year have come and gone. Have you been sticking to your resolutions? If not, don’t fret! Change doesn’t have to start on January 1st, it can start now!  It’s no secret that children and adults with ADHD or other learning disorders have a hard time sticking to a plan and completing tasks. We’re here to help you keep your New Year’s resolution. Here are five tips that can keep you on track: 1. Change = Gradual Process Look at change as a gradual process and it will become clear that ‘anytime' is an opportune time to start making your goal a reality. Make sure the goals you choose are manageable, that way it doesn't become overwhelming and you’ll enjoy what you’re doing. 2. Put it in writing!… Read More »