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Child Diagnosis 101

The number of kids treated for bipolar disease grew 40-fold between 1994 and 2003. But whether that many kids actually have the mental illness also called manic depression is another story. While the concern over the rise in diagnoses isn't new (The Post's Sandra G. Boodman wrote about it in 2005), a report on the number of cases published in this month's Archives of General Psychiatry brought it back to the forefront.

"There is no evidence that there has been an increase in bipolar disorder of this size," Dr. Mark Olfson, a clinical psychiatry professor at New York State Psychiatric Institute and one of the authors of the bipolar report, told the Associated Press. "Either this increase we see represents a tendency for over-diagnosing recently or a tendency to under-diagnose in the past." Or both, according to New York University Child Study Center medical director Dr. Glenn Hirsch.

And if your child has managed to avoid a bipolar diagnosis, it's even more likely that he has Attention Deficit Hyperactivity Disorder. About 2.4 million kids ages 8 to 15 have been diagnosed with the condition that affects kids' ability to control their behavior and/or pay attention.

Between the two, that's an awful lot of kids being labeled with disease, often taking medicine to curb the symptoms. So, it was great to read about some research on treating ADHD kids without drugs. Apparently, adding structure to a preschooler's day can help some preschoolers overcome the affliction.

Are we a label-happy generation of parents and doctors? What do you think of how we treat children's mental and behavioral health? Do we over- or under-medicate them?

Mattel Recalls More Toys

Mattel, which recalled more than 20 million toys in August, is adding another 773,900 toys to its recall list this morning because they contain excessive amounts of lead. The new recalls are for various Barbie accessories, Fisher-Price Bongo Band toys and Geo Trax locomotive toys. The products were sold from September 2006 to last month.

By Stacey Garfinkle |  September 5, 2007; 7:00 AM ET  | Category:  Elementary Schoolers , Preschoolers , Tweens
Previous: Greening the Kids | Next: School Is Tiring!

Comments


ADHD is one of the most overdiagnosed condition in pediatrics. Doctors are quick to say "oh, he has ADHD" and prescribe treatment, usually some medication that is pushed on them by a pharmaceutical company, when there was nothing wrong with the child in the first place. It's good to see that some doctors are realizing throwing chemicals at a problem isn't always the best remedy; what would be better is to stop the quick, easy diagnosis for a more in depth look into what may be the underlying cause of a child's hyperactivity.

Posted by: John L | September 5, 2007 8:31 AM | Report abuse

Are we a label-happy generation of parents and doctors?
YES! I worked for a pharmacy for almost 14 years, you'd be amazed (or maybe not) at all the kids on legal drugs. And their parents.

What do you think of how we treat children's mental and behavioral health?
I'm sure there are some kids that are afflicted, but parents and teachers shouldn't be so quick to ask for drugs if they can't control the kids. How about more parenting workshops? How about behavioral therapy or more "activity"? Playing video games, watching TV, too much computer stuff cannot be good for the mind. I see the difference in myself with the last two and I'm 33.

Do we over- or under-medicate them?
OVER. See my first answer.

Posted by: WDC | September 5, 2007 8:33 AM | Report abuse

So, it was great to read about some research on treating ADHD kids without drugs. AND to John L. and WDC...

You are all ignorant. The most widespread national study of ADHD concluded that medication was by far the most effective treatment. Though the addition of behavioral therapy and/or psychotherapy was sometimes effective in treating ADHD, the study showed that their results were minor in comparison to medication alone. How dare you judge when you are not the parent of a child(ren) with this condition. You have no right. You have no idea how hard it is to live with a difficult child, whose life is made so much better when they are taking these "evil" medications.

Posted by: novamom | September 5, 2007 9:33 AM | Report abuse

Labels are for jars, not for people.
Poor kids. They are going to be treated differently the rest of their lives.

Posted by: Me | September 5, 2007 9:36 AM | Report abuse

"You are all ignorant. [...] How dare you judge when you are not the parent of a child(ren) with this condition. You have no right. You have no idea how hard it is to live with a difficult child, whose life is made so much better when they are taking these "evil" medications."

Posted by: novamom | September 5, 2007 09:33 AM

Heh heh. Wonder how your kids got wound up so tight.

Posted by: Bob | September 5, 2007 9:43 AM | Report abuse

With so many children being diagnosed as ADD and other conditions, I think back to my friend's situation about 15 years ago.

Her son was very hyperactive and unfocused during school. Every afternoon brought a new problem. I watched as she and the teacher tried different discipline techniques, different rewards systems, etc. Each time they tried something new, I kept telling her, quit giving him those colored juice drinks at lunch. Finally, when all else failed she angrily decided to prove the point that I was wrong. So she stopped the juice drinks and gave him milk or water at lunch. By the end of the week, the teacher contacted her and asked her what she was doing because his behavior had been under control all week. She sheepishly told her she had taken away his colored fruit drinks.

The point of this story is that so many children could be "treated" for thier ADD by just changing thier diet. While juice is good for you, it's loaded with sugar and what a way to start the afternoon. And it's not just the juice drinks, its the sweets for breakfast, the soda when they get home, the artificially colored junk foods that they eat. Any child will react adversely to any combination of this stuff.

I do believe that ADHD exists and living next door to such a child, I know that these parents have a lot of handle and that medication can help. But I also believe that the diet that many children have causes them to be hyperactive and mislabled which is a detriment to the child in many ways.

Posted by: AnotherMom | September 5, 2007 10:23 AM | Report abuse

ADHD is a real diagnosis and those kids that truly have it will often require medication to get through the day. Blaming parents (looking at you, Bob) for their child's condition makes as much sense as blaming a parent for their child's epilepsy. Having said that, the diagnostic methods favor overdiagnosis by relying on subjective measures of attentiveness from parents and, notoriously, teachers. You should see some of the teacher evaluations that come back on these poor kids.

Posted by: Dad and Dr. | September 5, 2007 10:38 AM | Report abuse

Since I know at least six kids who were diagnosed with ADD and ADHD and I myself was diagnosed as an adult with ADD, I want to add a few things.

In no cases that I'm aware of did the doctor prescribe drugs first or consider drugs like ritalin were an easy way out. In all cases, including my own, diet, limiting computer use, exercise and behavioral therapy like list-making were tried first. I never took drugs for it.

The elementary school teachers I heard about seemed stressed, but genuinely wanted to help the situation without drugs because they read the same stories about ritalin and adderall in the newspapers that you do.

There were a few parents and other teachers who had knee-jerk reactions like "get them on drugs already" and a few family members who acted like no problem existed and "boys will be boys." But when a bright kid is failing in school, something must be done.

The fact is that the society we live in is different than the one we grew up in. Our kids will be much more connected to computers 24/7 than we were and in ways our parents (who thought cars would connect us to the world) ever thought. Wishing and hoping won't give Johnny a job that doesn't have him in front of a computer most of the time. I've seen cotton harvesters with a computer screen in the cab and a computer that details data back to a central server via cell phone technology- that's modern farming people, we ain't ever going back from whence we came.

So... don't pretend the syndrome doesn't exist. Don't look toward drugs for the quick fix either. It's a tighrope walk.

Posted by: DCer | September 5, 2007 10:47 AM | Report abuse

One of my greatest fears. Since these mental disorders are subjectively diagnosed, I'm afraid that the public school system will begin screening kids, assessing labels, and I, as a parent, will be forced to medicate my child with these permanently brain altering substances. Then, If I refuse to medicate my child, I will then be charged with neglect, and my children will be taken away from me.

All because a teacher couldn't get my 1st grader to behave.

Is this fear real... or imagined?

Posted by: FatDaddy | September 5, 2007 10:52 AM | Report abuse

Is this fear real... or imagined?
----

Honestly? Have you talked to someone about these paranoid thoughts?

Posted by: Anonymous | September 5, 2007 11:08 AM | Report abuse

"ADHD is a real diagnosis and those kids that truly have it will often require medication to get through the day. Blaming parents (looking at you, Bob) for their child's condition makes as much sense as blaming a parent for their child's epilepsy."

Posted by: Dad and Dr. | September 5, 2007 10:38 AM

Oh, I agree fully that ADHD is real, and I agree that some kids require medication. On the other hand, you've got to admit that novamom completely flew off the handle without provocation.

Some behaviors are learned behaviors, you know.

Posted by: Bob | September 5, 2007 11:14 AM | Report abuse

My concern is the long term effect of these drugs (like all medications, but these in particular since they mess with the psyche and brain) and some are narcotics for Pete's sake.

50 years from now are we going to have walking zombies? Or people on disability because they "can't work" or "can't function"? No one really knows.

Will they be labeled for life? Will they use that label as an excuse on jobs or higher education? Or when they just don't feel like doing homework?

I'll be 83 in 50 years, I'm concerned for my own well-being!

And I agree with Bob and the juice person.

Posted by: WDC | September 5, 2007 11:35 AM | Report abuse

While I do believe that ADD/HD do exist as true organic dysfucntion I also believe that a great deal of the children are misdiagnosed and could be well served through proper nutrition, proper exercise and proper rest. I'm amazed at the number of parents who are putting 1st graders to bed at 9:30 or 10 pm and getting them up early to start the day! I truly believe a lot of the kids who misbehave at school are just plain tired.

Posted by: Moxiemom | September 5, 2007 11:41 AM | Report abuse

That was the point I was making prior to novamom's blow up; that ADHD is overdiagnosed, not that it does not exist. All too often it is the 'easy way out' for teachers, doctors and even parents, even if all that's needed is a change of diet or additional exercise.

And I don't see Fatdaddy's concern as being paranoid; teachers already have authority to initiate some actions by parents. Requiring medication to control children in a classroom isn't that big a step further...

Posted by: John L | September 5, 2007 11:42 AM | Report abuse

My concern is the long term effect of these drugs (like all medications, but these in particular since they mess with the psyche and brain) and some are narcotics for Pete's sake.

50 years from now are we going to have walking zombies? Or people on disability because they "can't work" or "can't function"? No one really knows.

Will they be labeled for life? Will they use that label as an excuse on jobs or higher education? Or when they just don't feel like doing homework?

I'll be 83 in 50 years, I'm concerned for my own well-being!

And I agree with Bob and the juice person.

Posted by: WDC | September 5, 2007 11:35 AM

Your comment radiates your "concern", particularly your reference to someone using a diagnosis of mental illness or defect as an excuse. Is it an excuse when a paraplegic requests reasonable accommodations? Why would it be an excuse for someone with a ADHD to ask to take an exam in a quiet room rather than in a library with 600 people milling around?

Sure you agree with Bob and juice person because you neither suffer from ADHD nor love anyone else suffering from it either. If you did, you would take it as seriously as you do any other mental challenge about which you know squat, like strokes, for example.

Posted by: gcoward | September 5, 2007 11:51 AM | Report abuse

So you're all raising squirrelly kids. Just take a look at the parents -- the apple doesn't fall far from the tree.

Posted by: Anonymous | September 5, 2007 12:07 PM | Report abuse

I have seen both sides of this issue. I have a brother with true ADHD. Unfortunately, his mom didn't believe in medication. She'd take him off, his grades would plummet; my dad would put him back on, and he'd be an A-B student again. He has really struggled for a lot of his life because of a lack of consistent treatment.

On the other hand, I have a daughter whose teachers keep "suggesting" I have looked at for ADHD (the first at 3!!). Her doctor completely laughed off the notion -- whereas my brother literally can't concentrate, she can concentrate extremely well. But only when she's interested. And a lot of times, school moves too slowly for her. So she fidgets, talks, gets in trouble, etc.

Her behavior in school isn't acceptable, and we support the teachers in their behavior modification efforts (which we're also doing at home, of course). And she has made tremendous progress. But I'm sorry, ADHD isn't shorthand for "any kid who won't sit quietly all day." And I will NOT medicate a perfectly healthy kid just to make her teacher's life easier (or my own, for that matter). Plenty of sleep, plenty of exercise, a reasonable diet, and calm, consistent discipline go a long way.

Posted by: Laura | September 5, 2007 12:14 PM | Report abuse

Re "flying off the handle"...this is obviously a hot button issue for me, but please do not think for a moment that we did not deal with this in a patient, reasoned manner. Medication was certainly not the first remedy considered. And we never in a million years would have diagnosed our kid based on a teacher's recommendation. We had a gut feeling from age 2 that this would be the diagnosis, but we waited until our kid entered school to go for a formal diagnosis--it would not have done anything for us to do so earlier--except it would have made our lives easier at home, which we were not willing to do. School was a different story. And, again, we went to an experienced clinic for an evaluation--we felt that a pediatrician was not a specialist in ADHD. Then we saw a psychiatrist who specializes again. So, yes, I reacted harshly, but people (including the author) who go around perpetuating the myth that ADHD kids are not helped with meds, or that it is not a real disorder, or that it is widely overdiagnosed, do nothing to help those of us who did it the right way...

Posted by: novamom | September 5, 2007 12:16 PM | Report abuse

p.s. my kid gets plently of exercise, has never had a glass of juice in his life, has a healthy balanced diet, and sleeps very well...so please point those fingers elsewhere.

Posted by: novamom | September 5, 2007 12:18 PM | Report abuse

WDC, there are also long-term effects from leaving ADHD untreated. Presumably, you don't want to be taken care of fifty years from now by kids who consistently did poorly in school and then struggled through the rest of their lives because they didn't get treatment they needed.

Obviously, if changes to diet and sleep patterns help a struggling child, then go with those. But if those treatments don't work, and medication does, then it seems to me that medication deserves serious consideration.

Posted by: tomtildrum | September 5, 2007 12:30 PM | Report abuse

I've often wondered if I can do a study of my 3 year old, who has these occasional mood swings. He'll be happy one moment, then crying a while later. Must be bipolar disorder!

Oh, no, wait. That's what 3 year olds DO. It's called impulse control, and it has to do with cortical development. Start pumping meds into him now, and who knows what long-term effects that will have on, say---cortical development. We're WAAAY to quick to label, diagnose, and medicate in our society. And not just with kids.

The fact is, illnesses with true biological causes exist, and should always be carefully considered. But not everybody in our society is sick, or "suffering from Illness X" as the pharmaceutical lobby would have you believe. I'm beginning to think a disease exists only when there's either (1) a drug to treat it, or (2) a support group for it.

Posted by: Dadof2 | September 5, 2007 1:10 PM | Report abuse

Hmm. Do you think that novamom could be bipolar, then?

Posted by: Bob | September 5, 2007 1:14 PM | Report abuse

If you did, you would take it as seriously as you do any other mental challenge about which you know squat, like strokes, for example.

Posted by: gcoward | September 5, 2007 11:51 AM

There's no such thing as strokes. It's all in your head.

Posted by: Bob | September 5, 2007 1:22 PM | Report abuse

There's no such thing as strokes. It's all in your head.

LOL, Bob.

Posted by: Dad and Dr. | September 5, 2007 1:43 PM | Report abuse

Were these 'studies' done by pharmaceutical companies? Of course they are going to push meds on the public. They're in it for the big buck. DUH! Doctors are encouraged by the big pharms. to prescribe their meds, again getting more big bucks from the sale of drugs.
Look at the kids' diet -- full of sugar, caffeine, added food dyes? Take a room full of kids, fill them full of soda and birthday cake and you'll have raving maniacs on your hands. Are they in front of Xbox games, computers, TV all day? I've noticed I get short-tempered and distracted working on computers with cursors whizzing around at dizzying speeds -- I don't have 3 minutes to concentrate on a single thought.

Bottom line -- take a look at who is paying for those wonderful 'studies.'

Posted by: Just curious | September 5, 2007 1:44 PM | Report abuse

It looks like another afternoon of "straw man beatdown" here at the On Parenting blog. Presumably, everyone here agrees with the following:

(i) ADHD/ADD etc. are serious and legitimate disorders which under certain circumstances should be treated with drugs;

(ii) drugs such as ritalin and adderall (sp?) should not be prescribed casually, particularly to children, as they have the potential to be harmful; and

(iii) misdiagnoses of ADHD etc. in children who do not in fact have these disorders is a harm to be avoided.

So where's the controversy? Even parents of kids who have ADHD would have to agree that misdiagnosing a kid with a serious condition and jamming him full of ritalin is a bad idea. Conversely, the staunchest advocate of "diet and exercise" would have to agree that kids who actually have this condition and don't respond to diet and exercise should get all the help they need, including drugs. Anyone who can't see the wisdom of both those positions (and the fact that they are entirely consistent with one another) is an extremist and should be ignored.

Posted by: new dad | September 5, 2007 1:58 PM | Report abuse

One of my greatest fears. Since these mental disorders are subjectively diagnosed, I'm afraid that the public school system will begin screening kids, assessing labels, and I, as a parent, will be forced to medicate my child with these permanently brain altering substances. Then, If I refuse to medicate my child, I will then be charged with neglect, and my children will be taken away from me.

All because a teacher couldn't get my 1st grader to behave.

Is this fear real... or imagined?

Posted by: FatDaddy | September 5, 2007 10:52 AM

It's real, but it's manageable.

My older son was diagnosed with autism when he was 6 1/2, in 1st grade. This was after four years of struggling with our HMO to get him to the pediatrician with "Neurological and Developmental Specialist" following his MD. And battling with the school district for more than CH (Communication Handicap) services.

Once we had the diagnosis, we used that to get better school services. That Dr became our regular pediatrician for both kids, and is something like a distant but valued and respected uncle. He cares about his patients and works with parents to advocate for school and other social services.

One of this Dr's suggestions for our son was a one month trial of ritalin. The drug rarely has any effect on autism, but when it works it's supposed to be an amazing improvement. Following the Dr's recommendation, we didn't tell the teacher we were trying the drug until the month was over. She had seen no changes, and we hadn't either - not a surprise, as the Dr had been careful to make clear.

However, his second purpose in suggesting the trial was completely successful. He'd pointed out during the initial consultation about the drug, that school staff are likely to suggest "drugging the kid into submission" (we hadn't encountered it yet at that time, but we were concerned because it was happening to other students in our son's class), and that if the trial didn't show any results, we'd be all ready for the eventuality. When it came, the answer was, "We tried that in '98 and it didn't help. Now let's focus on the things that will help our son."

Same thing applies to the diet/exercise/too-much-computer-time/sleep and all that sort of *stuff* getting thrown around on this blog today (as well as plenty of other places). Try changing these things and see if it helps. If it does, wonderful! But if it doesn't, you have the appropriate answer when someone else starts in on these "suggestions".

And just so no one misreads me as saying something (anything) will or won't work - My sister is epileptic, dyslexic, and adult-diagnosed with ADD. Her medications help her ADD, completely control her epilepsy, and do nothing for her dyslexia. Our mother is bi-polar, and her medications help as long as she keeps taking them. But every few years she decides she's "cured" and stops. Then it's back to the mental hospital, and struggling to get a new drug-regime to work (can't go back onto the old perscriptions - they don't work again).

My been-there-done-that recommendation is to find a pediatrician that you trust to work with you and your kid. Then make her/him an ally when dealing with the school system.

Posted by: Sue | September 5, 2007 2:04 PM | Report abuse

On the other hand, you've got to admit that novamom completely flew off the handle without provocation.
----

Nope, I did not read her post that way and think you misread it, looking for something that wasn't there.

Posted by: Anonymous | September 5, 2007 2:27 PM | Report abuse

Well, "September 5, 2007 02:27 PM", I consider novamom's quote to be flying off the handle.

If you still don't read it that way, I'd be curious to know what, for you, would constitute flying off the handle?

Here it is:

"You are all ignorant. [...] How dare you judge when you are not the parent of a child(ren) with this condition. You have no right. You have no idea how hard it is to live with a difficult child, whose life is made so much better when they are taking these "evil" medications." --novamom

Posted by: Bob | September 5, 2007 2:41 PM | Report abuse

How many names is Father of 4 going to post under - although I like FatDaddy a lot better than lil huskey.

Posted by: Anonymous | September 5, 2007 2:57 PM | Report abuse

I don't think most of you have ever met someone with ADD. In kids, it doesn't necessarily manifest as hyperactivity. Quite the opposite. They concentrate VERY well, but only on one thing at a time, and mostly it's not school work. Poor school work from bright kids is the #1 sign. They also sleep very deeply, and often wet the bed because of it. As adults, those suffering from ADD generally also suffer from depression, though it's more "situational" than chemical. They "fail" at tasks since they have trouble with completion, which is very upsetting and depressing. And they absolutely can't multitask. They tend to self medicate with lots of coffee during the day and a beer or 2 at night to sleep. A combination of drugs and behavior modification does wonders, but good diet, exercise, and sleep is vital, too.

Posted by: atb | September 5, 2007 3:06 PM | Report abuse

I wonder if what the real issue is that ADD is becoming the catch-all diagnosis for a wide variety of mental/behavioral/emotional problems for children. If mental health care for children is anything like it is for adults, many children are *not* being fully evaluated from the perspective of their overall health, but are being prescribed drugs based on a relatively cursory assessment from practitioners who are not really fully versed in everything that could be wrong. I know several young adults who have gone from ADD drugs while children to anti-depressants, anti-anxiety drugs, and/or sleeping pills as adults--all without really getting to the bottom of what the problem is. And none of the medical professionals they see seem to suggest any comprehensive mental health evaluation.

Posted by: MECM | September 5, 2007 3:09 PM | Report abuse

yes Bob, you owe Novamom an apology, what's your point?

Posted by: Anonymous | September 5, 2007 3:20 PM | Report abuse

I've got a lot of big shiny credentials and all, but honestly, Ritalin is the devil. They bribe doctors, and doctors overprescribe Ritalin. I had a friend growing up who was diagnosed with ADHD and put on Ritalin for nearly 15 years. When he was about 19, he changed therapists and they figured out he never had ADHD, he was psychotic. Ritalin doesn't even kids out, it just makes them quiet, which is what a lot of parents are looking for.

As a teacher, I've seen parents put their kids on drugs rather than examining their child's very real (and obvious) learning disability. Parents think its easier, and the child's welfare and healthy development be damned.

Posted by: Kat | September 5, 2007 3:33 PM | Report abuse

Yea Novamom most definately flew off the handle. If her childs situation stresses her out this much that she needs to react that way on a blog then maybe she needs to be in therapy along with her child.

Posted by: Anonymous | September 5, 2007 3:34 PM | Report abuse

Dudes, you're imagining a conversation with Novamom that doesn't exist in what she wrote. You're inventing anger and rage in a post that is devoid of it. I am both puzzled and scared by the way people are attributing real-world behavior in a blog post that doesn't contain it. That's not how you read things people, it's frightening to me. Read her post, she doesn't "fly off the handle" unless you invent it in your mind.

Posted by: Anonymous | September 5, 2007 4:25 PM | Report abuse

Anon at 4:25 - try reading novamom's original post at 9:33 and then her 12:16 post where she admits to reacting harshly -then you can comment. There's no imagination when she admitted to her harsh reaction.

Posted by: noname1 | September 5, 2007 4:28 PM | Report abuse

here I am!

Posted by: bababooey666 | September 5, 2007 7:21 PM | Report abuse

"I'm amazed at the number of parents who are putting 1st graders to bed at 9:30 or 10 pm and getting them up early to start the day!"

moxiemom - you'd be amazed at my 7 year old then. She goes to bed at 9:30 on school nights and is up at 7:15 in the morning, yet has no problems of any kind in school. My 4 year old (not in school yet) falls asleep around 10:00 and is up at 7:00 on his own. Kids have varying needs for sleep and you're being judgmental by "being amazed" at other families' sleeping habits.


Posted by: Pam | September 5, 2007 10:50 PM | Report abuse

is it a coincidence that the number of adhd cases has increased as technology has increased? there is evidence to support that industrialized nations have seen dramatic increases in adhd, while developing countries have not. perhaps children are exposed to too much stimulation during the birth to toddler age.

Posted by: lorac58 | September 6, 2007 12:02 PM | Report abuse

"moxiemom - you'd be amazed at my 7 year old then. She goes to bed at 9:30 on school nights and is up at 7:15 in the morning, yet has no problems of any kind in school. My 4 year old (not in school yet) falls asleep around 10:00 and is up at 7:00 on his own. Kids have varying needs for sleep and you're being judgmental by "being amazed" at other families' sleeping habits."

Sleep is a real, biological need, not a habit. 9 hours of sleep a day for a 4 year old is nowhere near adequate- he needs more like 11. Kids who are overtired may not act up, but it does take its toll on their health and it makes it more difficult for them to learn. If you put them to bed an hour or two earlier, I'm sure you'd notice a big difference. Kids need a lot of sleep, and even if they can get by with less, it's not optimal for their health.

Posted by: reston, va | September 6, 2007 2:50 PM | Report abuse

Posted by: WDC | September 7, 2007 10:06 AM | Report abuse

"Sleep is a real, biological need, not a habit. 9 hours of sleep a day for a 4 year old is nowhere near adequate- he needs more like 11. Kids who are overtired may not act up, but it does take its toll on their health and it makes it more difficult for them to learn. If you put them to bed an hour or two earlier, I'm sure you'd notice a big difference. Kids need a lot of sleep, and even if they can get by with less, it's not optimal for their health."

Oh, really - I guess you know everything there is to know about my family. But what you don't know is that my son (my fourth child, btw) is never sick. He's almost 5 and he hasn't been to the doctor for illness since he was about 15 months old. He is energetic, bright, and soaks up information like a sponge. And he sleeps when he NEEDS to sleep - he does not get "put to bed" - he goes to bed when he's sleepy, and he wakes up when his body tells him to.

Posted by: Pam | September 7, 2007 10:17 PM | Report abuse

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