‘The current diagnosis of ADHD is a mess’

Posted 5/4/12

At age 85, Dr. William Carey still helping hyperactive children by Jane Lenel Time was when a good hearty spanking was considered the cure for a kid’s stubborn “No I won’ts.” Time was when …

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‘The current diagnosis of ADHD is a mess’

Posted

At age 85, Dr. William Carey still helping hyperactive children

by Jane Lenel

Time was when a good hearty spanking was considered the cure for a kid’s stubborn “No I won’ts.”

Time was when teachers put kids in the corner for inattention, whispering or blowing spitballs. Worse, some time ago the whip was considered the cure-all for bad behavior.

[caption id="attachment_13177" align="alignright" width="300" caption="Dr. Carey has done extensive research, teaching and lecturing here and abroad, and he has written, co-authored and edited numerous books and articles on the subject of hyperactive children. And he still works part-time at age 85 as a pediatrician at Children’s Hospital of Philadelphia. (Photo by Eleftherios Kostans)"][/caption]

Such measures were usually used as quick-fix punishment for misdeeds, though on occasion, some may have believed that they would change offenders into angels — or at least become more obedient.

Thank heavens things have changed due not only to good sense but to the behavioral science findings of a variety of observers and in great part to the extensive work of Dr. William B. Carey, pediatrician at Children’s Hospital of Philadelphia.

The outcome of his initial inquiries and study was a recognition that children’s behavior springs from the interaction of their largely inborn qualities and abilities — temperament — with their specific environments.

This approach, initiated in 1956 by Drs. Stella Chess and Alexander Thomas in New York, was promoted by Dr. Carey’s extensive research, teaching and lecturing here and abroad, and his writing, co-authoring and editing of numerous books and articles on the subject.

Also, with a team of psychologists, he facilitated the practical application of the research by developing a set of five clinical questionnaires to assess the traits of children at various ages from one month up to 12 years that have been widely used throughout the world.

A graduate of Harvard Medical School, Dr. Carey did his post-graduate training at Philadelphia General Hospital and Children’s Hospital of Philadelphia, and has been a part-time physician at Children’s Hospital and on the pediatric faculty at the University of Pennsylvania Medical School since 1960.

He spent almost 30 years in full-time primary care general pediatrics in Media, PA. Along the way, he received honors and awards for his work from the Institute of Medicine of the National Academy of Sciences and two from the American Academy of Pediatrics.

“When parents bring their sons or daughters in with an ailment or for a well visit,” he says, “I question them about problems their children may be experiencing: sleeplessness, fussiness in eating, difficulty in potty training or at school:  restlessness, frequent fighting, lack of attention or interest.”

Dr. Carey also asks parents to describe their children’s personalities: what they like most and least about them, and the quality of their relationship. “A competent, trained pediatrician asks such questions,” he says.

About the use of Ritalin as a cure for large numbers of school children diagnosed with ADHD (Attention Deficit Hyperactivity Disorder), Dr. Carey declares, “I think the current diagnosis of ADHD is a mess and has been wildly overdone. It blames a variety of symptoms entirely on the child’s brain and ignores the child’s environment and the interaction with it.

“My job as a pediatrician is to help parents understand the source of their concerns, especially their child’s largely innate temperament and its reactions to the setting. Then we should offer ways to reduce the stressful interactions. As kids get older, I also try to teach them strategies for improving the relationship.

“It’s then up to parents to try to interact with their children as harmoniously as possible without surrendering their authority.” It’s also important, he explains, for parents to recognize the impact their own reactions have on their child, and how they may be adding to the child’s problem.

At age 85, Dr. Carey is now living at Cathedral Village in upper Roxborough with his wife Ann, after almost 50 years in Swarthmore. Ann is a former third-grade teacher and reading specialist.  Their three daughters live in St. Paul, MN, New York and Philly; the latter is studying pathology at Temple University. Dr. Carey continues at CHOP, working part time with trainees and parents, trying to help them be more skillful at changing children’s “I won’ts” to “I wills.”

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