Ask the Savvy Daddy Expert MD

by Tony Chen You may have seen that we here at Savvy Daddy have recently added a distinguished Panel of Experts. You can see their bios here, but basically these folks are profs, physicians, clinicians, and academics that are savvy gurus on topics relevant to us dads trying to raise great kids.  These experts have been gracious enough to answer real questions from real dads - email me your questions (tony at savvydaddy dot com) and I'll be passing along the most relevant & compelling questions to them.  Today, we are honored to present to you Dr. Russell Robertson, Chairman of Family & Community Medicine at the Feinberg School of Medicine at Northwestern University. Dad Question: What's your take on the explosion of ADHD in America? Are we diagnosing this disease correctly?  Why do you think most ADHD cases are boys? Robertson: We had dinner with good friends recently.  The husband had just retired from a high ranking position at a Fortune 500 company.  He described his behavior as a young boy as one that would have surely labeled him as ADHD and likely in today's world, would have found him on prescription medications.  Yet many of his "ADHD" behaviors made him highly productive and successful at multitasking.  He routinely answered over 300 emails per day. My concern is that the energy and vitality of young boys is wrongly and often assumed to be ADHD as opposed to behaviors that indicate a high degree of intelligence and curiosity.  Teachers (I was an elementary school and junior high school teacher) are often frustrated in dealing with these children and often because their classrooms are an increasingly challenging environment made more so by children who are presumed to be easily distracted. Instead, I would ask parents and teachers to re-direct rather than attempt to suppress these behaviors.  These boys, and they are mostly boys, are high energy kids and need to be exercised physically and mentally. They are like racehorses.  Sitting them in front of a computer screen to play games or in front of a TV, while temporarily distracting, is not good for them at all.  Make sure your kids are well exercised.  Playing with them at home is a great thing to do.  Ride bikes, play basketball, run with them.  This is great bonding time as well.  Challenge their intellects by learning more about their interests and then help them to engage in focusing on completing tasks.  Only children with the most disruptive behavior should be evaluated for medications and even then, I would look for mental health providers who have a reputation for being stingy with medications. I would also recommend a book my wife found for me to read. It is called, "The War Against Boys" by Susanna Hoff Summers - a fabulous read! Dad Question: What's your take on the growing trend of parents refusing to have their children vaccinated for fear of negative side-effects (e.g. autism)?  There seems to be "solid scientific evidence" on both sides of the argument, or is there? Robertson: By way of example, in the early 70's, the vaccine for pertussis was not as pure as it could have been and there were children who did have reactions, some that were severe.  In the United Kingdom, a number of parents chose not to vaccinate their children for pertussis as a response.  Subsequently, the number of children who died from pertussis easily outnumbered those who had been having reactions. What is happening at the present is a truly dangerous trend that is endangering the lives of millions of children.  Because the first vaccines for measles are not given until the age of 15 months, all children under this age are at risk of contracting measles from unvaccinated children.  World wide, over 200,000 children died from measles in 2007 and as new cases continue to appear in the US, there will inevitably be preventable deaths. While having a child with autism is a challenge beyond my imagining and understanding that the desire to locate a treatable cause is understood, after numerous studies, there is NO EVIDENCE that vaccines are a cause of autism.  Further, it is irresponsbile to perseverate the notion that vaccines are a cause and to choose not to have your children vaccinated. Dad Question:  How did you keep your promises to your wife and kids about being at games, etc?  How did you handle it if you had a work emergency to attend to? Robertson: As a physician, I learned that I needed to take every opportunity to control my schedule.  I also did a great deal of reading early in my years as a Dad about what I would call "unintentional narcissism:, i.e. the notion that my presence at work or with my patients was essential. If one is not careful, this is an easy trap into which one can fall, regardless of your profession. In the final analysis and in almost every situation, work was the place where I was most replaceable, not home.  There are no "do overs" with your wife and children.  Time accelerates as your children grow and I did not want to be like many of my colleagues whose careers were successful, but their personal and family lives were in ruins. I made an effort to schedule everything and then to stick to it.  That way, when there truly was an emergency, it was understood and accommodated.  I also worked very hard to make no promises that I was not able to keep. The other thing to keep in mind is that prioritizing family over one's work should not be considered a sacrifice!  This is your wife for all time and your children.  How could you not value them above all else! Have a question for Dr. Robertson?  Send your questions to me via email (tony at savvydaddy dot com).