Senior Project Interview Questions

1. What is your name and what is your specialization in the therapy field?

2. What made you want to be a therapist?

3. How do you feel the Diagnostic and Statistical Manual of Mental Disorders (DSM) labels children
with ADHD too easily?

4. Do you think children diagnosed with ADHD should receive stimulants such as adults? Why/why
not?

5. How might early use of stimulants affect a child as they grow older?

6. Behavioral therapy is an option for children with ADHD, how is this beneficial for children
compared to medications?

7. People often argue that young children diagnosed with ADHD are being “kids”, how do you feel
a doctor may confuse ADHD symptoms with the attitudes of children?

8. As children become teenagers how do you think the over-prescription of these teenagers
contributed to the popularity of non-medical use of stimulants such Aderol?

9. Many individuals don’t believe that ADHD is a mental illness, how do you feel societal
perceptions of ADHD have affected children who are diagnosed with it?

Email Interview

Bonnie Poli

1. Bonnie Poli PT, Pediatrics

2. Chose field due to my activity level and desire to work with children
3. The dx is made based on a behavioral checklist which can be subjective.
4. When children are given stimulants, we have no way of determining the physiological impact on
brain structures or changes.
5. When behavioral changes occur, there is no reason to look for and fix the root cause.
6. Behavioral approaches work well in concert with drugs, but again the root cause is not changed.
 7. Pediatricians have limited time to understand the patient, his total medical condition and his
environment. Poor sleep, respiration problems, esp. during sleep, poor visual processing
development, a chaotic home situation or other health problems like chronic allergies can cause
attention problems. What is normal?
8. The pressure to fit in, understand who they are relative to their peer group and the parental and
school’s pressure to succeed may make teens rely on drugs to achieve the emotional state and
success desired.
9. Anything involving our brains/mind is a “mental” illness. Any piece of highly technical and
complicated machinery is likely to have a malfunction somewhere. Our brains cannot be
simplified. We are tinkerers and should be very wary of any interventions due to our profound
ignorance.

Personal Interview

Micah: Hi Ms. Grace, thank you for taking your time to have me interview you.

Ms. Grace: Hi Micah, it’s no problem

Micah: Our first question is what is your name and what is your specialization in the therapy field?

Ms. Grace: my name is Grace Dixon and I am a pediatric occupational therapist. I have specialty and
advanced training in: sensory integration, listening therapy programs (TLP, iLs), Handwriting Without
Tears, neurological facilitation techniques, modalities for pain management (ultrasound, e-stim/TENS,
diathermy), Interactive Metronome (IM) for neurological re-training, low vision training, community
mobility training, preliminary DIR/Floortime training and mentorship completed, SOS Approach to
Feeding trained Feeding Therapist, and advanced evaluation training.

Micah: Wow that’s a lot of specializations

Ms. Grace: Yeah, you've only seen me with some of my specializations

Micah: Well what made you want to be a therapist?

Ms. Grace: I had a pediatric OT visit my 8th grade class to discuss how she uses science, technology, play,
and education to help children become more independent. I was hooked on the field and volunteered
with OTs in my community throughout high school before declaring myself early decision for the field of
Occupational Therapy.

Micah: That one OT really made an impact to you at a young age.

Ms. Grace: Yes, she did, and I hope to do that with you.

Micah: With a focus on ADHD how do you feel the Diagnostic and Statistical Manual of Mental Disorders
(DSM) labels children with ADHD too easily?

Ms. Grace: I believe that it is important to identify the symptomology of ADHD behaviors because of the
functional impact on the school day. I think that ADHD can frequently be misdiagnosed for other less
common diagnoses; such as Central Auditory Processing and some forms of Sensory Processing
Disorder. ADHD is more recognizable therefore it becomes the more commonly assigned diagnosis.

Micah: Do you think children diagnosed with ADHD should receive stimulants such as adults? Why/why
not?

Ms. Grace: Pharmacology is not the jurisdiction of Occupational Therapy, and the law says that I am
unable to provide healthcare advice regarding medications. My personal opinion is that each case must
be reviewed thoroughly, looking at multiple factors and facets before deciding on traditional
medication, holistic options, therapy, or no treatment. I have seen children success with almost every
option and always respect the family’s decision.

Micah: How might early use of stimulants affect a child as they grow older?

Ms. Grace: Hormonal balances are delicate as children are developing and their systems must be more
closely managed than adults, who have a wider therapeutic window for the medication. The body
always works towards homeostasis; imbalances can affect the body’s long-term ability to produce
appropriate hormone levels and develop the brain fully.

Micah: We just learned about homeostasis in anatomy.

Micah: Behavioral therapy is an option for children with ADHD, how is this beneficial for children
compared to medications?

Ms. Grace: Seldom is there only one solution to a problem, therefore best outcomes are often a
combination approach. The most frequently reported problems in ADHD are impulsivity, poor attention,
hyperactivity, and inattentiveness. Behavioral therapy can look at providing solutions to hyperactivity; a
sensory diet with input from OT, to impulsivity; behavioral flow chart to think about outcomes before
acting. Behavioral therapy will not change the root cause, which is neurological, but can provide real-life
support for managing challenging behaviors and teaching long-term coping strategies.

Micah: People often argue that young children diagnosed with ADHD are being “kids”, how do you feel a
doctor may confuse ADHD symptoms with the attitudes of children?

Ms. Grace: I have found in my practice that people frequently do not know the developmental
milestones for cognitive and social development, as a result people often have unrealistic expectations
for how a three-year old should behave/ attend to a task or they make excuses for inappropriate
behaviors. Education on typical child development is important to improve the referral process for
ADHD testing and for clinicians to diagnose or refer appropriately.

Micah: As children become teenagers how do you think the over-prescription of these teenagers
contributed to the popularity of non-medical use of stimulants such Aderol?
Ms. Grace: People often look for a “magic pill” that will solve their problems, whether to lose weight or
focus well for a big test, rather than do the hard work. We are a society of slackers, so I am not surprised
at all that people turned Aderol into a non-therapeutic drug. People will use an excessive resource to
make money, therefore the over-medication created excess supply and the market demand rose for the
product.

Micah: Many individuals don’t believe that ADHD is a mental illness, how do you feel societal
perceptions of ADHD have affected children who are diagnosed with it?

Ms. Grace: People have limited understanding of ADHD, they know it affects attention and it runs in
families. The presumption is often that your family and your children must be “bad” or “stupid” to have
this neurological disorder which creates stress, anxiety, conflict, and loss of participation at times. I
believe we are finally shifting to a more supportive, multi-disciplinary approach in healthcare and
eventually society will follow. I believe it’s important to advocate for these kids, so they develop a
positive self-image as a person with a disability and grow up with healthy coping strategies.

Micah: Wow this is really good information for my project, thank you again for taking the time to answer
my questions.

Ms. Grace: Oh no problem, I hope this will help your project.