It’s one of those “unintended consequences” of a government program started with the best of intentions — help the poorest of the poor families in our society get adequate treatment for their severely disabled child.
Yes, I’m talking about Supplemental Security Income (SSI) and The Boston Globe ran an in-depth investigative piece yesterday about some of those consequences, including rampant diagnosing of very young children and the over-prescribing of medication for them. “Many cash-strapped parents have come to believe that if only they can muster the necessary array of medical records, their children have a good shot at this benefit, even if it means carrying the stigma of the word “disabled.””
A program that was supposed to help only a small minority of children — those with serious health or mental health disabilities — is now serving 53 percent of the 1.2 million children who qualify for SSI benefits, according to the article.
The number one “disabled” diagnosis? Attention deficit hyperactivity disorder, or ADHD.
Now, don’t get me wrong. This is a good program that indeed does serve the needs of many poor families with severely disabled children. But because of losing a legal case in 1990, the program now has expanded to include things that aren’t automatically “disabilities” in any traditional definition of the term.
Indeed, one of the most disturbing parts of the program seems to be the mandate by federal government officials who administer the program that in order for a child to be considered seriously disabled (at least in the government’s eyes), they need to be on psychiatric medications — whether the parents wants them to be or not:
To qualify, a child had to be disabled. And if the disability was mental or behavioral — something like ADHD — the child pretty much had to be taking psychotropic drugs.
Fielding never liked the sound of that. She had long believed too many children take such medications, and she avoided them, even as clinicians were putting names to her boys’ troubles: oppositional defiant disorder, depression, ADHD. But then, as bills mounted, friends nudged her about SSI: “Go try.”
Eventually she did, putting in applications for her two older sons. Neither was on medications; both were rejected. Then last year, school officials persuaded her to let her 10-year-old try a drug for his impulsiveness. Within weeks, his SSI application was approved.
Why do poor parents do it? Sometimes it comes down to basic economics — you get more money from the government if your children are labeled as being “disabled.”
For many, the motivation to apply comes down to economics: SSI payments can be a lifeline in a bad economy, and they beat welfare checks in almost every way. For a Massachusetts parent with two children, welfare pays a maximum of about $600 a month. If one of those two children is approved for the SSI program, the total government benefit can be twice as much.
Of course, the reality is that most children who have attention deficit disorder aren’t anywhere close to the classic definition of “disabled.” And even serious mental disorders can be treated just as readily with psychotherapy and behavioral treatments as they can with psychiatric medications. But that won’t get the SSI office to open up their pocketbooks. So parents are caught in an unintended reward situation where if they agree to medicate their child, they find they suddenly qualify for more money from the government.
Perhaps this might explain the discrepancy in diagnosis of children with attention deficit disorder — those who are poorer (on Medicaid) have a larger percentage of ADHD diagnoses:
A 2008 study found, for example, that 12 percent of children on Medicaid were diagnosed with ADHD, compared with 8 percent of children on private insurance. Other national studies using Medicaid data have found that poorer children with behavioral and mental diagnoses are also medicated with ADHD drugs and antipsychotic medications at higher rates.
All of this is both eye-opening and a bit disturbing. The article goes into some detail explaining why the program has ballooned like it has to cover virtually any poor child who qualifies for SSI benefits, once they agree to be medicated. It’s worth the read.
Read the full article: With SSI program, a legacy of unintended side effects
22 comments
Your headline is incorrect: POVERTY Encourages Families to label healthy children as disabled…
did you ever think kids on medicaid have had a harder life, more negetive experiences, might have had drugs in utero? more parents on medicaid have mental problems did you ever think that that might be one of the reasons they are on medicaid. adhd is hereditary. yes. rich people got alot of nerve judging people with financial difficulties, step into their shoes for a moment. I bet you couldnt buy the guts to.
I have children on medicaid because I can not afford health insurance through my job. I am NOT a drug addict and never was so the comment that kids on medicaid have this disorder because they had drugs in utero is absoultely wrong get your facts before you post rude comments
Yet another one of the systemic issues driving health care, especially psychological health care. This is what you get when any and every human difficulty, distressing behavior, or troubling emotion is viewed as a “disease” and is thoroughly pathologized and medicalized. The psychiatric-pharmaceutical-legal complex exploits it to the fullest – just follow the money – and people with few other resources come to see it as both a lifesaver and an entitlement.
My son is grown now. During his childhood we were very poor. We had 3 boys, and my husband was suffering a degenerative disease & died when the boys were still young. One son was very different from the other two. I just knew something was different by the time he was 2 days old. I spent everything I could scrounge in my effort to determine why this child was prone to extreme outbursts if we tried to take him somewhere in a different car, or if a small bit of crust came off his sandwich – it was the end of the world. He didn’t attend high school, but was accepted to college without need of remedial classes. When he was 6 he was diagnosed with ADHD. Instead of daily medications, we developed strategies to help him manage his behavior. When he was 12 he was diagnosed with Asperger’s Syndrome, in addition to ADHD. He decided to try medication after he reached adulthood & has had some success. He is grateful that I did not medicate him during his childhood. If he could have received SSI during his childhood, it would have been a great help. If required to medicate him to get that money – I would have lied. Medicated or not, these children need additional assistance that many families cannot afford: vision therapy, biofeedback training, group therapy, etc. My Father & Grandmother provided funds for these activities – they called it my birthday or Christmas & it was the best gift I could receive: Help for my son!
I was a single parent of four sons, one of whom is now getting SSI as an adult. I didn’t make a lot of money when my kids were younger but just enough to put me over the threshold of the financial limit. It had nothing to do with whether or not my son had a disability; it was based purely on my income. And they don’t tell you what that limit is. I had insurance but it didn’t cover a lot of things he needed. My other children suffered as a result of the expenses related to my disabled son. He was finally able to get SSI as an adult after he had been in residential care the last 8 months of his 17th year. Melissa who posted before is right. I didn’t really consider myself in the poverty range by any means but I wasn’t rich. And had we had an SSI payment coming in each month, things would have been a lot better for my other children. Also, I’m not sure where the number comes from in the article that a single child recipient would bring in twice as much as $600 in welfare. My son is receiving $674 a month and has been since 2008 (the last increase). He can’t live on this. Unless there is a large state subsidy (and my state does not have one) I can’t imagine any child receiving $1,200 a month for being disabled.
One matter is the poverty and something very different is to live, use and expose your child to these situations so you don´t have to work and you could live out of the goverment.The economony gets crash by both extreme the millionaers that commit corruptions and steel money in big scales and these other gruop the ¨mantengo¨group who made the middle class paid for the shopping at 99 cents stores.
SSI Encourages CPS/DCYF to label our healthy children ADHD disabled. Their worth more money to them once they start drugging them!
My son was approved for SSI based on a diagnosis of Verbal Apraxia, PDDnos, and characteristics of ADHD with a history of seizures and secondary diagnosis of Asthma and allergies with recurrent infections.
He was not on ADHD meds or any Psychiatric meds. He has since then started clonidine (technically a blood pressure med but used in autistic children to help with sleep and sometimes for ADHD)
To be approved for SSI a child must either meet a listed impairment or have a marked limit in function such that the child is significantly prevented from functioning in an age appropriate way. If a child attends a significant number of rehabilitative therapies, ie a child with ADHD severe enough to be considered a disability may attend occupational therapy, ABA therapy, and cognitive behavioral therapy on a weekly basis for several hours per week. This would meet the definition of marked impairment and would qualify without medication. The requirement is not medication it is that the condition require treatment. Do your homework before you write. I realize my own child has listed disabilities not just ADHD, but I am quite familiar with the determination process.
I do feel the need to say yes, he was on asthma medication but asthma is not his primary disability. The developmental disabilities are.
Yes another way for everyone to make money but, what’s really sad the children pay for it. And to Melissa Spraitz shut up you sound slow by saying pepole on Medicaid use drugs. Just because you are on Medicaid don’t mean you are on drugs or you sit home doing nothing. Grow up! Children are being used for money. 50yr ago you never heard of half of these problem. Now it’s like every child in the public school system has something!
I have a question, my son and daughter have both been diagnosed with adhd, my son is on a small does of adderall and my daughter isnt on anything yet, due to her just recently being diagnosed. Everyone always tells me that I should apply for diability. I dont believe that my kids are completely disabled. Now I am a single mother and Im afraid that if I were to apply for them, then they will be stigamitized for the rest of their life. Now the money would be fantastic for extras like tutoring (since that is the one thing that I cannot afford)but it terrifies me that by me getting them disability could possibly cost them a job or whatnot in their future. Can someone tell me if this is possible. Also my sons doctor said their is a great chance that my son could grow out of it. Is that possible as well? Any information would be helpful, being I seem to be at cross-roads. Also I at first was against the meds, it took me about 2 months to research and research before I agreed to it. But his grades are good when he is on his medication but when he is not on it, he can not stay focused long enough and does poorly. Thank you
Does anyone know if there are any federal or state programs to financially assist a family with minor children when the single parent is on ssi and receives no other income? I just got approved for ssi, but now it seems I’m almost worse off because My food stamp benefits go down, my rent goes up, and I lose energy assistance. The ssi amount doesn’t provide enough to financially take care of 2 children ages 12 and 13 after all the changes. Thanks in advance for any help on this subject.
The whole “SSI abuse” situation is quite ridiculous. But I do disagree with some of your points. My mom was diagnosed with Breast Cancer when I was 15 years old. She worked as a nurse for over 20 years and was the financial supporter of our household, and once she got really sick, me & my dad were both eligible for benefits. She passed away a year later, and I received those benefits until I turned 18. I can’t really explain how much that extra money help my family. Once my mom passed away, my dad was out of a job for about a year and a half. & although I was working part time. There would have been no way we would be able to make it without the extra support. That money has helped us with our bills and even some college expenses.
Once I got into College, that time was incredibly frustrating for me. I was a full-time student, and continued to work part-time as well. I had all the intentions of doing great through school, but something was really holding me back. I knew that I had always had a hard time concentrating in school when I was younger, and I didn’t have the best grades. But once it came time for me to actually apply myself, the process of trying to attend college was incredibly overwhelming and difficult. I ended up giving up my first semester, and failed my classes.
During that time I was being seen by a behavioral health specialist, and a couple other doctors. The diagnosed me with ADD, and offered medication but I declined, because I have heard pretty bad stories about prescription drug abuse. Being off of meds, school was not my only struggle. I was extremely reckless. I would never pay attention when I would drive, I was always distracted. & wouldn’t realize that I was even speeding! I ending up getting quite a few speeding tickets & my insurance rates went through the roof. It eventually got to the point where I got in a car accident, because of my failure to be attentive. At this point, I knew that something had to change. I was not only ruining my college transcript, but I could have been very close to ending not only my life, but somebody else’s as well.
I’m almost 20 now, and have been on the medication for over a year now. I can see why doctor’s are extremely careful when giving out these medications can be very controlling and the side effects are pretty intense. I got back into school right away, and noticed a complete transformation, both good and bad. I was finally aware of the things I was able to accomplish and my reckless behavior has been long gone. However, knowing the main cause of why I never did well academically, also made me aware of the many types of learning disabilities that had always affected me. Believe it or not, but I am now doing great in school. I am taking my prerequisites for Nursing, and will be applying for schools this fall. I have actually managed to receive one of the highest grades in my Biology classes. I honestly couldn’t be more proud of myself. After going through 13 years of grade school being known as the “stupid girl”, and always being underestimated, it feels good to prove everyone I know, including myself wrong.
As I progress further into my college education, I learned just how hard I will have to work to get what I want. & my learning disabilities are now more visible and challenging than ever. I write slower than the average person, because I learned to write my letters in the opposite direction, not only making it more uncomfortable, but extremely illegible. I am very slow at processing information, and usually forget information right after it is given to me. I’m unable to listen to my lectures and take down notes at the same time. All of these problems are keeping me from doing as well as I know I could do, and need to do. I am constantly falling behind on lectures, and have to take longer than my classmates on exams, not even being able to complete them. I’m not analyzing things carefully enough and that causes me to make careless mistakes. More and more lately I find myself not being able to keep up to speed with my classmates, having to try much harder to receive the grades I need, and becoming more and more overwhelmed by all of this. It has gotten to the point where I have isolated myself from pretty much everybody. Causing me to become emotionally unstable, anxious, and lowering my self esteem and confidence dramatically.
I have been trying everything I can to make things less difficult. I have been training myself in many ways, and have gotten in contact with the disabilities office at my school so I can find the best ways to deal with this. I feel like the only way I can now fix things is to stop working, go through psychiatric care, and therapy sessions. I don’t want to give up on school, especially after i’ve already accomplished so much. But being out of a job, means being out of school for me as well. My dad can hardly even support himself financially, and relying on him to support me is not an option. I have saved up a good amount of money specifically so I would be able to afford school, but it’s no where near enough.
I have the option to receiving SSI until I am 22 because of my ADD and all of the other disabilities that go along with it. I honestly believe that in situations like this it is acceptable to receive federal assistance. This disorder is now keeping me from being able to keep a job and from getting my education.
Especially in my circumstances, it has nothing to do with receiving Medical Insurance. My father has retired from the air force, and we are so blessed to have free medical. However, now that I am no longer a minor, I have to stay a full-time student, in order to keep my medical insurance.
I’m not saying that everyone that’s eligible for SSI is actually deserving of it. Because in some circumstances, people will do whatever they have to to get money, even if that means taking advantage of what other people worked hard for. And the fact that there are people who lie about their condition, or their child’s level of disability to receive money truly disgust me. Not only are they making mental disorders like ADD/ADHD and all learning disabilities seem like conditions that shouldn’t be taken seriously. But they are medicating their children with very powerful drugs, for a disorder they might not even have.
There are many disgusting people who actually are gladly taking money away from those who actually need it. But that doesn’t mean that everybody with mental health issues aren’t considered to be true disabilities. In many cases, people with mental disabilities are more likely to have their conditions worsen far more, than those with physical disabilities if they don’t receive the care they need.
Fascinating. Per Russell Barkley, ADHD is one of the most disabling neurological/psychological conditions known – more than depression, anxiety, etc.
It sounds like you’re trying to shift the definition of “disability” around so that legitimately disabled people are characterized as “healthy.”
I am a single mother of three. My younger two children both have ADHD. No, I do not have them on SSI. However, I can see how something like an SSI check could be needed. People think “Oh your child has ADHD a wont sit still. Big deal.” Boy, are they wrong. I can’t tell you how hard it can be. We’ve been kick out of more daycares than you could think of with no notice at all. I have to be able to leave work as soon as the school calls. Then, there is all the doctor bills. Counciling is also very costly and guess what? It’s like a weekly thing that you then agane need to miss work for. I got lucky and now have a boss that has a son with ADHD and understands how hard it can be, so I am able to leave work often. So all you jerks that can sit back and judge others. Maybe you should have to ware their shoes for a day. It’s not so easy when you have to support your family, and also be there for your children when they need you.
I AM A SIGLE MOM OF FOUR KIDS AND I UNDERSTAND YOU MY SON HAS ADHD AND HE IS ON MEDS THE MEDS DONT SEEM TO WORK I GIVE IT TO HIM IN THE MORNING AND AFTER SCHOOL AND STILL HE IS A CHALLENGE EVERY DAY I WORK AND I GET AT LEAST 10 OR 20 CALLS A DAY ABOUT MY SON WHILE I AM AT WORK I FEEL LIKE I AM GOING CRAZY AT TIMES NOBODY KNOWS UNTIL THEY WALK IN OUR SHOES AND BELIEVE ME HALF THE PEOPLE COUNLDNT DO WHAT WE DO SWEETIE WE TRY TO DO THE BEST THAT WE CAN FOR OUR KIDS BUT IT DOES GET HARD AT TIMES STAY STRONG SWEETIE
I can see what you are saying. However, ADHD is a problem. For years, my middle son ran me from son up to son down (pun intended) just to make sure he didn’t hurt himself climbing things or running around. When I tried to talk to him, he did not make eye contact, but stared into space, as though I wasn’t connecting with him at all. He did not like for us to hug or kiss him. He would not sit still to be read to. And Oh, when the school years came! In preschool, I was constantly being called in because he had hit someone. I dreaded picking him up, because I would see the teacher and she would say, “I need to speak with you….”. Then in kindergarten, it was notes sent home everyday for him not being able to stay in his seat, for him yelling at teachers, and all kinds of different things. He received two out of school suspensions! In kindergarten!
For years and years, I wondered where I had gone wrong with raising my child. Might I add that I have one son older than this one and a younger daughter, who did NOT act like this. Finally, over this past summer, his pediatrician and I talked about it, and she referred him to a psychologist, who did diagnose him with ADHD and Oppositional Defiant Disorder, along with an impaired working memory. He is on medication and needs to be in therapy, but I cannot afford therapy.
So yes, I have applied for SSI. Why shouldn’t I try to get help if it is available? My son will have this for the rest of his life, and will inevitably need skills to learn to deal with this.
I know there are many who abuse the system. I know ADHD is over-diagnosed, and many healthy children are “labelled and drugged.” But may I remind you that there are those of us who are sincere in our efforts to give our children a better life. It is not their fault we are poor. It is our fault, as we have not made sound life decisions. I am just trying to give my son the tools he needs to make it.
My mom has been on my back about getting SSI for my son. I hate the idea of asking for help. currently im a stay at home mom and i volunteer every waking moment with my 4 year old daughter in tow at the elem school he attends. These poor teachers have been throw H*** with my child. Hes gone to every doctor i could afford when we had a 2 income house. All said and done he has ADHD and ODD. first off i throw a fit cause really all the crap we went throw and thats all they can say. My son is 9 years old, poops his pants at home mostly. he will go in his pants and sit in it, doesnt bother hiding it. its as though hes ok with it. he throws tantrums that but toddlers to shame. Ive had the cops called on me in store parking lots and some food stores because he will flat out throw a tantrume when he doesnt get what he wants and i promise u he almost never wins. I used to think for the longest time i was the worst mom in the world because when i was a single mom with him i worked 3 jobs just to avoid welfar and the crap they would treat me like. If i wasnt sporting gucci bags in the welfar office i was sh**. after he turned a year old i got off that train and never looked back. Anyone here remember what it was like to buy diapers for your child????? well how about BUYING THEM WHEN THEY ARE 9 YEARS OLD. my daughter is 4 years old and fully potty trained day and night, im homeschooling her for preschool because she is pretty smart on how she gets things. Due to our single “family” income we just bearly make to much to apply for free lunch(i have no problem paying for school lunch) so my daughter cant go to preschool in my area because the free lunch children get first choose….so the next person who wants to bit** about fair and free loaders i have A LOT to add. Im going to try to apply for SSI and we use Homeopathic meds that YES we pay out of pocket for because i dont believe in the crap they put in doc drugs. I just want help finding him the help he needs and for the love of god get him out of diapers before HIGH SCHOOL.
All that, yes. I am thinking of applying for SSI for my daughter even if it means having to put her on meds for a few months, which I am considering after 3 years of dealing with extreme ADHD and Aspergers, trying everything (gluten/casein free diet which helped with her severe eczema and insane tantrums/mood swings but not the inattentiveness and hyperactivity). Homeopathy. Acupuncture. Various supplements. Behavioral modification. I am actually thinking of unschooling her because, although I’m a broke working single parent, she is in 3rd grade now and just really starting to become angry, hating school and becoming even more defiant than ever (ruining her homework, tantrums every AM before school etc). She is so brilliant in art and drawing, and lots of Aspie kids have very focused talents like that. As an Aspie myself I would LOVE to save her the pain and failures I endured. I know I could do a good job teaching her and she truly needs the individual attention. Also her diet and her supps and therapies cost me a fortune. They do help but I am always needing to try new ones. I do not want to keep her long-term on meds, but I’m at my rope’s end right now and just want her to get some brief respite, a moment of relief so she can learn better habits and realize it’s not HER but her mental chemistry that is causing her so much pain. Also I want her to be in a school environment that validates her talents, doesn’t constantly knock her down and force conformity. Aspergers kids are either extreme conformists, or extreme eccentrics, both which aren’t so great. And they have obsessive special interests that they literally go crazy if they aren’t allowed to pursue. As a kid actually I had a modification in 4th grade where I was allowed to draw in class because I did detailed drawings all day and if I didn’t, I would get very anxious and couldn’t concentrate. As long as I was drawing, I was OK. But only that one teacher allowed that modification, and other times, I just suffered. In any case, it’s late and I am rambling, but in summary: I have gone through hell with my daughter, and she has gone through hell too, and YES it costs a FORTUNE more to raise kids with behavioral issues, especially if you are trying to avoid drugging them for life. Sadly, the “system” often requires that you “prove” that you are serious about treating them by showing you’ve jumped through the hoops. At this point I almost consider it the lesser of two evils, if SSI will enable me to make the difference in her life between helping her realize her potential, or grow up suicidal (which she has been sometimes because she feels like such a failure), depressed, and self-destructive. Not all cognitive disabilities are due to lower intelligence, there are SO many types of disabilities that seriously impact family finances, education and quality of life, and SSI is a blessing. If people want to cry about the tax $$ we’re wasting, well, in my case, just feel thankful that MY tax $$ are supporting your kids’ education while I plan to educate my own at my expense because the system is failing her. 🙁
I do the determinations on this case and I’m sorry but this writer is just flat wrong. There is not a requirement or benefit from a determination standpoint for a child to be medicated to receive benefits. The opposite is typically true. Children who become medicated usually see improvement and get better, making their condition less severe. “Smart” parents usually decline medication while or near the time they apply to keep their child in a poor mental state.
Amazing. Not one person in my grade had add/ADHD when I was growing up. That’s because everyone had to learn self-control or pay the consequences. Yeah, just drug your kids, that’s the ticket. Oh, and get a check, too. Sad for the kids.
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