I completely agree with you -- doctors should take the patient's entire experience into account before making rash judgments.

However, I also think that sometimes it's very difficult to do so -- and that doesn't neccessarily mean the doctor is not smart or incompetent.

For instance, my aunt was just diagnosed with crones disease. The nature of the illness is such that there is an array of symptoms that are completely different from one another -- and that if you just were to look at one of the symptoms, it would not at all point to crones. My aunt was going to opthemologists because she had eye problems; internists because she had stomach problems; dieticians because she had nutrition problems -- but, anyway, it's obvious that no one was quite able to quite give her the proper diagnosis. Only finally, after all of that, she went to a doctor who was able to take the entire picture into account and proscribed her the right treatment.

So, in my opinion, often times these things happen, and it doesn't exclusively mean that the doctor isn't that great. Diseases are complex; symptoms range. And I even think -- looking at this from a whole, idealistic perspective -- it's at least fantastic that doctors are actually DOING something about this at all, instead of standing idle.

I heard of a very similar story only the problem the kid had was some hearing disorder, but until some smart doctor figured it out they were trying to hit him with all sorts of lifelong psych disorders. I tell you parents really need to be on alert -- it's a dangerous world out there.

That reminds me of a kid I was called to consult on 30 years ago. This 4 yr old had been diagnosed as having childhood schizophrenia because he was echolalic and displayed the odd hand waving gestures that some kids with serious mental illness displayed. But something about him made his Headstart teacher doubt the assessment. I spent several hours observing him at home and in the classroom and attempting to test him. On a wild hunch, I asked that they have his hearing tested. Sure enough, the hearing test revealed he had a 75% loss in one ear and 50% in the other. The kid was acting strange because he couldn't hear! I shudder to think what might have happened with him had I not had a what seemed to me off the wall thought to have his hearing checked.

Oh, that reminds me: I stopped listening to KISS 106.1 when I go to sleep, because my favroite DJ, Keola left and now, without him, the music seems so junkie and stupid.

Anyway, now I listen to NPR's KUOW 94.9, and it's awesome! A real step up. So, last night, I was listening to this guy reading his poetry about his kid with ADHD, and he was basically saying how all the drugs that his kid was put on -- Ritilan and stuff -- were no good. Um, I kind of didn't get the rest of it, cause I was kind of falling asleep, but anyway, it was really interesting.

Anyhoo, even though it was heartbreaking to abandon KISS, I think I'm really going to enjoy KUOW becuase it makes me feel much more scholarly and intellectual. It's all good!

Good thing to bring up. I myself could not read the blackboard/chalkboard that is front of the classroom at school. It was only discovered in grade 4 (if I recall) when a teacher asked me to read the blackboard and I couldn't. Then asked me to read from a book which I could. I was frightened, I thought I was going to get in so much trouble after going to the nurses office. I was asked by the nurse to read the eyechart and after the big E that was all I could say. I waited, but the punishment never arrived. I went to the eye doctor, my parents got me some dorky glasses. Teasing from the other kids for wearing glasses is it? OK no problem.

The problem here wasn't really so much with the doc who prescribed the cocktail of mental health meds so much as the *two* ophthalmologists or eye technicians which had performed previous eye exams on the girl and missed doing this common diagnostic technique.

And that's just a problem with medicine in general -- it's not perfect, even though we expect perfection from our physicians. Humans practicing human behaviors, well, they're going to mistakes.

This is one of those odd stories of a child really being badly misdiagnosed, but it's not unexpected, is it? ADHD is far more prevalent than convergence insufficiency.

Doesn't make it right, it just helps explain this odd case.

Actually, you'd be surprised at what vision and hearing problems can manifest itself like in school kids.[and often dx as "learning disabilities".] Once I got a doc to listen that I thought my daughter was deaf--[profound in one ear, like me]she excelled as a elementary student.Had a microphone attached to the teacher--and a headset by Kindergarten. Many kids often are often frustrated in school, don't know why, and it's something like vision or hearing problems un diagnosed. It really is serious to have kids vision/hearing checked before and during the school year.It took me 2 years to get a doctor to listen to me on her deafness. It was my persistance that got that confirmed, as well as reading glasses, and a speech therapist when learning to read outloud. Parents do need to be diligent in observation.

For a few months when I was in elementary school I was seriously hampered both academically and socially by major nearsightedness. I didn't know why I was having such troubles. Luckily the school I attended regularly tested all the kids there for vision problems and it was only a few months before my problem was discovered and I got a pair of glasses.

I think routine checking for basic physical problems like vision and hearing difficulties are more likely to benefit far more children (and probably adults as well) than looking for exotic things - like rare psychiatric disorders - whenever things don't seem quite right with a person. Such regular checking for basic problems was probably more common here in the United States before we began selling our national soul for money during the past two or three decades. Or am I just delusional?

Anyway, I really believe that the reason more of these major psychiatric problems like autism are being found nowadays is just because they are being looked for so much more than previously. They are probably often found when they aren't even there (as exemplified by this case). I think it's all a perfect illustration of the saying that "if you're a hammer, everything looks like a nail." Many more mental health professionals and health officials generally nowadays seem to have the mentality of hammers than ever used to be the case.

I have a dear friend with an adopted child with this double vision thing. He was sometimes defiant and others hesitant and even sometimes violent, and always had a hard time concentrating in classes or in large groups in general. He could not read, nor write. He suffered a head trauma before he was adopted (at 9 mos old, then fostered by his great aunt (my friend) immediately after that, adopted as quickly as legally possible). Even with the head trauma, no one even considered vision difficulties until he was 6. He is 7 now, and has been undergoing a special vision/physical therapy to 'retrain' his eyes for binocular vision. His behavior and academic acheivement have improved 5,000-fold as he has begun to see more normally.

You ask how vision problems correlate with ADHD symptoms: Just put yourself in these shoes. You are a 5 year old in a preschool class of 15 kids and three teachers. You see two of everyone and everything. Try to behave typically!!!

Another story re: meds and vision. When my daughter was 12 and on Zyprexa, her eyes would roll straight up and she couldn't look down; had to go home from school a lot. The psychiatrist told me to take her to an eye doctor when I asked if it could be a side effect, he said, "eye muscle problem". Eye doc said, "nothing wrong". I went to the PCP--he looked at her med chart and said, "It's the Zyprexa, give her Benadryl." Benadryl is the cheap over the counter solution to Cogentin.[for psych med adverse effects].I later found the fine print in Zyprexa's paperwork and took the "ocular dysfunction" name into the psychiatrist, who then said, "Oh well, just give her Benadryl."--just another angle to think about re: kids in school on psych meds, and their vision checks out okay.

I second this story. A friend of mine's kid was at a second-rate school and was being fast-tracked into the ADHD/troubled category. They moved into our rural community and her new teacher enquired when was the last time the kid had her eyes checked. She's now home-schooled.