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 »

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 »

What is the Focus-MD Way?

Rather than taking a behavioral or psychological approach, Focus-MD is a medical practice that treats ADHD as the medical problem that science has proven it to be. Dr. James Wiley practiced general pediatrics at Dothan Pediatric Clinic in Dothan AL for almost 20 years before moving to Mobile in 2008 and founding Focus. While in Dothan he was able to work with a number of patients having ADHD. He believed ADHD patients needed a better way to handle there disorder and he believed he could help. Born out of years of personal and professional frustration with the standard of care in ADHD management, focus approaches the ADHD problem head on. When Dr. Wiley opened Focus-MD he designed the practice from the ground up, personalizing the most current professional guidelines for diagnosis and treatment to reflect what his patients have taught… Read More »