For almost two decades now, I’ve been criticizing the diagnosis of ADHD and the use of Ritalin and other psychostimulants with children (see, for example, my book The Myth of the ADD Child). Now, a new report in The New York Times today, says that physicians are starting to prescribe these drugs to poor children who don’t even have ADHD, to help them with their schoolwork.
I’m dumbfounded. And yet, in a deeper sense, I’m not so surprised at all. Over the past fifty years, there’s been a creeping medicalization of children who don’t learn or behave in ways that parents and teachers expect them to. Back in the 1960’s, only a few children who displayed symptoms of inattention, hyperactivity, or impulsivity, were diagnosed as having ”organic brain syndrome.” In the 1970’s, ADHD was, for all intents and purposes, ”invented” by Virginia Douglas at McGill University and became fodder for best-selling books and daytime talk shows (for a comprehensive history of the “disorder”, click here). Suddenly large numbers of kids were being given Ritalin, Cylert, and other behavior-controlling drugs.
And the trends have continued. According to the Food and Drug Administration, over the past 10 years, prescriptions for children diagnosed with ADHD have gone up 46%. That’s for kids who are actually diagnosed with ADHD. Then, there are those kids from upper-middle class homes, caught up in the race for better grades, higher test scores, and improved chances for admission to highly selective colleges, who have been using ADHD medications without prescription as pedagogical steroids. This summer, The New York Times reported that “….[a]t high schools across the United States, pressure over grades and competition for college admissions are encouraging students to abuse prescription stimulants, according to interviews with students, parents and doctors.”
Now, according to today’s report, there are doctors, supposedly driven by pure motives of social justice, who want kids from low socio-economic backgrounds to have the same chances as these rich kids to take “smart pills” to level the pharmaceutical playing ground. “I don’t have a whole lot of choice,” said Dr. Anderson, a pediatrician for many poor families in Cherokee County, north of Atlanta. “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.”
The problem here is that these pills are Schedule II drugs according to Federal law. To give you an idea of what this means, cocaine and opium are also Schedule II drugs. And ADHD drugs have been linked to a wide range of serious side effects, from high blood pressure and stunted growth, to rare incidences of psychosis. In fact, today’s New York Times article profiles one disadvantaged child taking Adderall who had a psychotic episode, presumably from the effects of the drug. The article also quotes a superintendent of schools who observed that as school funding has decreased, the diagnosis rates for ADHD have increased.
In a chapter I wrote for a book published in Great Britain on alternative perspectives on ADHD, I suggested that this country’s massive rush toward greater ”accountability” in the schools (i.e. higher test scores), may represent one good reason for an increase in the number of kids with ADHD (and it will get only worse with the adoption in 2014 of a “national curriculum” called the Common Core that will create even more accountability pressures). Compared with most other countries in the world, the U.S. prescribes by far more prescription drugs for hyperactive children (see chart). There is a pernicious trend going on here. As the educational environment becomes less hospitable to the spirit of childhood, the solution is seen, not in making our schools better places for kids (see my book The Best Schools for examples of what that looks like), but instead, in dosing students who react to this failure with powerful addictive drugs. We’ve made children the scapegoats of our own institutional shortcomings. Isn’t this a form of child abuse?
For strategies to help kids with ADHD diagnosis, see my book: The Myth of the ADHD Child: 101 Ways to Improve Your Child’s Behavior and Attention Span Without Drugs, Labels, or Coercion.
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