Notes on Real Stuff
PJ's Personal Archives
Children and Ritalin
Here is what began my interest in 'Children and Ritalin':
My daughter Ry began 1st grade. In the first two weeks of first grade, I got notes sent home - formal notes that required signature and return (!) - for offenses she had committed. These included (1) playing with an eraser while the teacher was talking: "Not paying attention." (2) Braiding her friend's hair while they waited in line (her friend in front of her): "Invading the personal space of another student." (3) Running in the hall.
I was baffled that such things would be considered serious enough violations even to get her in "real" trouble (she has missed recess, stood in the hall, and other disciplines), let alone to get a formal note sent home about it.
But the part that made me feel weird about it was the formal nature of it. My career has been in business management, and the minute a manager begins documenting the slightest infraction by an employee, it is almost certain that they are intending to do something with that documentation.
But for a small child, in their first year of public school, in the first two weeks no less -- and in this case, they moved my child from one school to another, then back again in the same day, then transferred her to another teacher, so her second week was actually chaotic. But a child her age -- what on earth would be the purpose of that documentation? I spoke with her teacher in person and via email about this stuff, so she knows I am aware -- but the signature-required documents had to be returned.
I ended up searching on the internet for "documenting behavior of first grade" and ended up reading about ritalin abuse all day. Holy cow!
I was nonplussed. This seemed hard to believe. So I thought I would do a websearch, and I found more than I bargained for. The issue ties into many surprisingly different subjects. It's worth reading.
excerpts from news articles, website articles, book reviews, and more. If you want refs, do your own web search. This is just my collection of notes. :-)
A reaction is underway against drugging children because they are behaving like children, especially boy children. [...] One reason for the vote is that some school violence has been committed by students taking psychotropic drugs. [...] Consider the supposed epidemic of attention deficit/hyperactivity disorder (ADHD) that by 1996 had U.S. youngsters consuming 90 percent of the world's Ritalin. Boys, no parent of one will be surprised to learn, are much more likely than girls to be diagnosed with ADHD. In 1996, 10 percent to 12 percent of all American schoolboys were taking the addictive Ritalin. (After attending classes on the dangers of drugs?)
One theory holds that ADHD is epidemic because of the modern acceleration of life--the environmental blitzkrieg of MTV, video games, e-mail, cell phones, etc. But [...] cross-cultural study of ADHD that included observation of two groups of English schoolchildren, one diagnosed with ADHD, the other not. He observed them with reference to 35 behaviors (e.g., "giggling," "squirming," "blurting out") and found no significant differences between the groups. "Children," he says, "tend to talk, fidget and fool around--"all the classical ADHD-type behaviors. "If you're predisposed to label any child as ADHD, the distracted troublemaker or the model student, you'll find a way to observe these behaviors."
Earlier a school nurse practitioner [...] decided the Carroll's seven year old son, Kyle, was suffering from attention deficit/hyperactivity disorder (ADHD) because he was restless in class. A physician, under contract to the school (whom had never "examined" Kyle) prescribed Ritalin for the youngester. [...] [sep article] By second grade, 7-year-old Kyle was sleeping just 5 hours a night, eating only one meal a day, and showing significant personality changes. Concerned about the drug’s side effects, the Carrolls informed the school that they were going to take Kyle off the drug on a trial basis until they could have Kyle examined by their own physician. A school administrator reported them to Child Protective Services. The school had accused them of child abuse for ordering the school to stop administering Ritalin to their son. They not only found themselves facing Family Court Judge Gerald Maney but also later discovered they had been "posted" on a statewide list of alleged child abusers. The charge against them by the school was "educational neglect" not child abuse.
There was no defense. The hearing, requested by the "Law Guardian" who argued the school's position, was not a fact-finding hearing in which the school board would have to support, with medical evidence, that the child did, indeed, have ADHD. The Carolls believed they would be able to contest the administration of a very addictive psychotrophic drug to their offspring without their own family physician examining him and either agreeing or refuting the school nurse practitioner's "diagnosis." They were wrong on both counts. This was not to be a hearing where actual evidence was examined. Judge Maney told the Carrolls if they did not agree to the school's demand that their son be placed back on Ritalin, the court would order their children removed from the home and placed in the foster care system.
Child abuse proceedings are notorious for their lack of due process, immediate presumption of guilt, unethical investigative techniques, and social workers’ unchecked ability to traumatize children by removing them from their homes. Even innocent parents fear them with good reason. In court and threatened with the theoretical loss of their child, the Carrolls agreed to continue the drug. (Note: CPS is considered outside the criminal justice system. Every 'right' you might think you have means nothing in any encounter with such agencies. Don't get me started, this is a scary area even to read about. - PJ)
Only after they found a doctor willing to testify that non-medical approaches to Kyle’s reading problem would be more effective were they allowed to act in his best interests.
Off the drug and in a different school, Kyle’s grades improved and he recovered both his appetite and his outgoing nature.
Faced with a 7-year-old eating just one meal a day and sleeping only 5 hours per night, any reasonable person would agree with the Carrolls in concluding that a drug holiday is called for to protect their child’s health. The poor judgment of the officials involved in the case, and the power they had to overrule parental wishes, is especially alarming in view of the well-documented fact that it was the stimulants, not the untreated hyperactivity, that posed the health risk.
Classified as a Schedule II controlled substance along with cocaine and amphetamines, the stimulant known clinically as methylphenidate has the potential to cause psychological and physical dependence. Possible effects, according to the DEA Internet site, include "increased alertness, excitation, euphoria, increased pulse rate and blood pressure, insomnia, and loss of appetite." Withdrawal symptoms, according to the Internet description, consist of "apathy, long periods of sleep, irritability, depression, and disorientation." Hallucinations, convulsions, and death can result from an overdose.
Woodworth added that data has proven "neither animals nor humans can tell the difference between cocaine, amphetamines, or methylphenidate when they are administered the same way at comparable doses. In short, they produce effects that are nearly identical."
Recent research by Volkow et al. at Brookhaven National Laboratory has demonstrated that Ritalin (methyphenidate) is more potent than cocaine in its effect on the brain’s dopamine system.
In 1998 the National Institutes of Health convened a consensus conference on the diagnosis and treatment of attention deficit hyperactivity disorder. The consensus statement that emerged concluded that "there is no evidence regarding the appropriate ADHD diagnostic threshold above which the benefits of psychostimulant therapy outweigh the risks," that "an independent diagnostic test for ADHD does not exist," and that "there is no information on the effects of long-term treatment [with psychostimulent] (treatment lasting more than 1 year)."
A...study (James Swanson et al.) was published in 1993 summarizing the results of the thousands of studies done regarding the effects of Ritalin on children: It was shown that all children, diagnosed or not, as well all animal on which testing was done, react in exactly the same manner to the drug. For all tested subjects, psychostimulants seemed to increase concentration and effort while minimizing impulsivity and increasing obedience for a short initial period of 7 to 18 weeks, to subsequently lose all effectiveness. Medication does not improve complex abilities like reading, or social interaction. Results in school can be improved but the medication cannot correct any learning disability. No improvement has been noted for any significant emotional problem. There exists no evidence of long term improvement for children submited to psychostimulant prescription regarding an improvement of their academic results or a decrease of their antisocial behavior. The possible unwanted side effects of medication are a decrease in appetite, dificulty in going to sleep, harmful effects on cognition (creativity and spontaneity diminished) and on self image, stereotyped behavior, restlessness, nervousness, emotional instability, and occasionally, exacerbate or cause the emergence of verbal or motor twitches or mannerisms, and psychotic behavior. The long term effects are unknown. Depression and psychological dependence symptoms have been noted, as well as a thwarting of the growth curve, head and belly aches.
The widespread use of stimulants to treat ADHD, however, really didn't begin until the late 1950s, spurred on in part by research underwritten by Ciba-Geigy, a company that held a patent on methylphenidate hydrochloride, a stimulant brand named Ritalin. Because most researchers used methylphenidate, Ritalin became the drug of choice for the treatment of the disorder. Pharmaceutical companies have introduced new stimulants. Today, ADHD is also treated with Dexadrine and Adderall, an amphetamine derivative initially developed as the weight-loss drug Obitral.
ADHD and the use of psychotropic drugs have generated storms of controversy. In the 1980s, an group launched a campaign implicating Ritalin in brain damage, high blood pressure, confusion, murder and emotional disorders. A $150-million lawsuit alleged that Ritalin made a child violent and suicidal. That suit was tossed out in 1988.
After the massacre at the Columbine High School in Littleton, Colorado, those investigating all of the pieces of the puzzle concerning school violence discovered there was only one common thread found all of the instances of school violence: all of the "shooters" had been prescribed some form of psychotrophic drug, usually Ritalin, Dexedrine, Aventyl, Syban, Lucox or Prozac as a "mood control" devise to make it easier for the teachers to "manage" them in the classroom. Eric Harris was on Luvox. T.J. Solomon and Shawn Cooper were taking Ritalin. Kip Kinkel was taking both Ritalin and Prozac.
(Separately) School authorities have admitted that Mitchell Johnson and Andrew Golden, the Paducah, Kentucky shooters, were both taking Schedule II drugs, but the name of the specific drug they were taking has never been released. There can be no disputing the fact that each of these juvenile shooters were under the influence of a Schedule II, mind-altering drug that should never have been prescribed to an adolescent.
That opinion is shared by a large percentage of physicians who argue that the side affects of these drugs on an adolescent (and many times on an adult as well) sometimes aggravate the problems it was prescribed to correct.
Prescribing Ritalin to a child is tantamount to abuse, Breggin said, describing the known effects of stimulant drugs on animals tested in laboratory settings. "It's worse than beating a child on the behind," he said. "It's more like beating the child on the brain. "If you give stimulant drugs in relatively small doses to any animal, they crush all spontaneous behavior, like escape attempts, exploratory activities, socializing, grooming," he continued. "When you do this to a child, it's the same. Basically, the medication only works by disabling the brain of the child. The only reason you want to prescribe [stimulant drugs] to the child is if you want him in the disabled state." Ritalin also stunts a child's growth, Breggin said, by suppressing the appetite and "disrupting" the ability of the growth hormone to function.
Some research has indicated that ritalin use in children can lead to symptoms similar to Parkinson's Disease in the 30's and 40's. Officials say nothing. "The long-term effects of stimulants remain in doubt," the National Institutes of Mental Health reportedly concluded in 1992. The organization recently stated that "a great deal of research is still needed to determine the effects and benefits of medications in children of all ages."
Some feel the government's own statistics are seriously underreported. But even according to government statistics, use of Ritalin more than doubled in the early 1990's alone, leading to current estimates of nearly 9 million reported cases of ADHD in the school system -- it was only nearly 4 million just a few years prior -- medication is assigned from ages 2 to 18.
The use of Prozac and other anti-depressants for children under 18 was up 74%, for ages 7-12 up 151%, and for children six years of age and under, anti-depressant drug use rose a shocking 580%. IMS Health, a company that tracks and reports the latest trends in medication usage for the pharmaceutical industry, compiled the statistics. (Not the 9 mil above - just this para. - PJ)
Some parents, teachers and doctors operated under the mistaken assumption that Ritalin would only work on children with ADHD. If a child responded to Ritalin, the logic went, that proved the child had ADHD. This is just flat wrong. "Stimulant medication will enhance the performance of everybody," said Ross, the CEO of CHADD.
Why are there suddenly so many cases of ADHD? A decade ago, ADHD was a virtually unknown malady. But then, a decade ago ADHD was not a "covered illness." In 1991 Congress passed the Individuals with Disabilities Education Act [IDEA]. Included in that plan was a provision that provided a greatly enhanced allotment of federal dollars for each ADHD student within the public school system.
In other words, the more kids with ADHD that were enrolled in the public schools, the more money that school system got from the taxpayers' pockets. The funds, of course, were supposed to be used to provide special classrooms and special educational programs for children with attention defict disorders so they would not fall behind. In reality, very few school systems created a special environment for students with ADHD because, frankly, very few schools had any students that actually had ADHD. They had disruptive, undisciplined students who refused to pay attention in class. But, these were discipline problems, not medical problems. However, each of these kids was worth their weight in gold...or, better stated...each was worth their weight in tax dollars. All they had to do was diagnose them as having ADHD, and they would get a double portion of tax dollars.
ADHD was suddenly everywhere. Pre-schoolers, who usually have very short attention spans anyway, were suddenly victims of ADHD. And, every unruly kid in the public school system was suddenly "discovered" to be suffering from the same malady. The old school "nurse" was replaced with nurse practitioners. School boards recruited physicians to handle what was soon to be an epidemic. And, the federal dollars poured into the public school systems like flood water through a hole in a dike.
It is no coincidence that ....a Dallas, Texas law firm of Waters & Kraus filed a class-action lawsuit against the Swiss manufacturer of Ritalin, Novartis. The suit also includes the group Children & Adults with ADHS and the American Psychiatric Association. The suit alledges that Norvartis, with the help of these groups committed fraud by deliberately overpromoting the diagnosis of ADHD, and its treatment with Ritalin.
In the Soviet Union, government psychiatrists had prescribed psychoactive drugs to control political dissidents who were regarded as enemies of the state. Ironically, in America, schoolchildren and even toddlers are being hounded to take psychoactive drugs -- as if they were enemies of state.
Caffeine is the most widely used drug in the world today. It is a central nervous system stimulant whose effects range from mild increase in alertness to jitteriness, hyperactivity, heightened anxiety and even agitation. It also depletes calcium in bone and can cause diarrhea and increased urination. Its regular use can be habit forming, users experiencing withdrawal symptoms 12-16 hours after the last dose, such as drowsiness, headaches, lethargy, irritability, disinterest in work, and depression.
The International Olympic Committee lists caffeine as a restricted drug. Urinary levels above 12 mg/liter are viewed as achieved through a deliberate attempt at doping and disqualify the athlete from performing.
The American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders-IV" list four types of "Caffeine-Related Disorders," including "Caffeine Intoxication" and "Caffeine-Induced Anxiety Disorder." According to statistics from the Beverage Marketing Corporation, in 1970, annual soda consumption was 22.4 gallons per person, and in 1998, it was 56.1 gallons per person.
Companies such as Coke and Pepsi offer schools districts a percentage of their sales in exchange for the exclusive right to sell their products. In the District of Columbia, for example, such a contract earns the school system "profits as high as $50,000 a month." In Colorado Springs, the school system has a "10-year, $8 million to $11 million contract with Coke." Hundreds of school districts across the nation have chosen Coke or Pepsi as their exclusive soft drink purveyor.
Dispensing sugar & caffeine in vending machines is apparently ok; compelling children to take Ritalin is apparently ok. But a 16-year-old high school student who gave her friend two Midol tablets to ease her menstrual discomfort was suspended for five days for carrying over-the-counter medication in her purse.
Under the pretext of protecting children from "dangerous drugs," we jazz them up with caffeine, calm them down with Ritalin, then tell them to "Just say no to drugs."
The use of Ritalin in toddlers underscores the point that, in the view of contemporary mental health experts, the very nature of the young child, especially if he is a male, is a disease requiring treatment.
In New York a school district was threatened with a loss of state aid for failing to meet immunization quotas. They suspended children without hepatitis B vaccinations. After denying these children access to public classrooms, it threatened to report any parents who complained about it, to child protective services.
Note that no one was concerned about a hepatitis B outbreak. The real issue was the power of the school to protect its financial position by threatening those who did not agree with it with the loss of their children.
Those who advocate more state control of children’s medical decisions must also take into account the numerous financial incentives and public pressures that may serve to cloud official judgment. Private programs that create incentives for state officials to act in accord with specific private agendas are also a problem. Making the Grade is a program to promote school-based health clinics funded by the Robert Wood Johnson Foundation. In 1993 the foundation began funneling millions of dollars into state agencies interested in creating of school-based health clinics. In 1994, Colorado officials applying for a grant from the program promised to take steps to transfer responsibility for a child’s "physical, psychological, social and educational" health from parents to "health centers" in public schools.
Throughout the 1990s, school-based health care supporters worked to pass legislation enabling school-based programs to tap into state Medicaid programs. Legislation in some states created an incentive to participate by allowing school districts to keep a percentage of their Medicaid claims for their own use. Given public school performance in other operational areas, it should come as no surprise that the U.S. General Accounting office found that "some school district and state practices appear intent on maximizing their receipt of Medicaid funds through suspect financing methods."
As things now stand, school budgets benefit when educators find something wrong with a child. More income accrues from prescribing and overseeing "treatment." Given that children are generally in good physical health, mental health care has become a school district honey pot. Objective diagnostic tests for mental health disorders are generally lacking, with the result that mental health diagnoses often represent little more than someone’s opinion about a student’s behavior. Teachers complain about unruly students, schools are under attack for graduating functional illiterates at great expense, and psychotropic medications are now sophisticated enough to use as "chemical restraints."
Another note: (see cpswatch.org)
Children died as a result of abuse in foster care 5.25 times more often than children in the general population.
Children who received "services" from CPS died as a result of abuse 16 times more often than children in the general population.
Children were abused and neglected 3 times more often by state caregivers than by parents (and children are eleven times more likely to be sexually abused in state care than they are in their own homes).
Only somewhat related physically, but related morally:
In No More Wacos: What's Wrong With Federal Law Enforcement and How to Fix It, authors David B. Kopel and Paul H. Blackman point out that the original ATF raid and the April 19 FBI tear gas assault were justified by accusations of child abuse. However, the FBI attack was directed at the children (p. 161). Harvard professor (and Justice Department reviewer) Alan Stone noted that gassing the children, who could not be protected by gas masks, was a "'conscious strategy ... to stir up the maternal instincts of the mothers' by causing their children's suffering". Amnesty International has called this tactic (giving parents the choice of surrendering or watching their children suffer) the type of abuse you would expect in a totalitarian regime. The FBI Hostage Rescue Team was at Waco, but the FBI were the ones taking the hostages, evidently. The FBI's actions were an example of what some scholars call the Rodney King syndrome (p. 165), which is when police become frustrated, angry, and then violent when they fail to bring a situation under their control using the techniques they had been taught. The Davidians had "thumbed their noses at law enforcement." The authors state (on p. 159) that the Davidian children, who were supposed to be protected by all this, suffered a similar fate to the children of Auschwitz: "gassing, followed by cremation."
LeFever, assistant professor at Norfolk Center for Pediatric Research, never intended to throw bombs, but her studies are still reverberating around the country. LeFever demonstrated there are hotspots where ADHD is diagnosed at exaggerated rates, suggesting widespread misdiagnosis and overmedication.
In that first study, she found that 20 percent of fifth grade white boys in Virginia Beach were taking daily doses of ADHD drugs, far more than appeared justified. "What .... is shown quite clearly is that there are pockets of extraordinarily high Ritalin use and that the use of Ritalin is not contingent on neurological factors," says Dr. Lawrence Diller. "Even the most hardcore Ritalin enthusiasts acknowledge that 20 percent rates are too high."
Some make it sound as if LeFever implied that ADHD was non-existent and that Ritalin should never be used. LeFever bridles at that. "I am absolutely not anti-Ritalin," LeFever says. "I have been working in the area of pediatric psychology and developmental disabilities for 15 years. Over that time I have referred hundreds of physicians back to talk about medication."
At the same time, many physicians, psychologists and other researchers went to great lengths to poke holes in her statistics. Nobody has succeeded. A yearlong investigation by the Cleveland Plain Dealer, published in 2001, culled data from the from the U.S. Drug Enforcement Administration and confirmed LeFever's contention, that there are pockets around the country where unusually high percentages of school children were taking Ritalin. Even some of her harshest critics began to accept this as fact and to express concern about the "variance" in diagnosis nationwide.
But LeFever's research hasn't stopped. "The longer you stay with this, the more jaded you become," she says. "Some of the numbers that seemed so shocking to me before don’t' seem as shocking now." Her new research may be even more explosive. "We've gone and gotten an indication of medication use that takes into account what goes on outside of school," LeFever says.
A new study in Norfolk shows that 33 percent of white boys in Norfolk Elementary schools have been diagnosed ADHD. Eighty-four percent of them have taken medication. Seventy-four percent were medicated at the time of the study, during summer months, when some children are on drug holidays.
"Ridiculous," responds Dr. Jeffrey Katz, a clinical psychologist at Clinical Associates of Tidewater, a frequent critic of LeFever. "That's not possible." LeFever insists that it is, and that the number is growing. "There is just so much misinformation out there," LeFever says.
In the midst of all this, pharmaceutical companies bombard parents with millions of dollars in ADHD drug advertising, largely making matters worse.
LeFever is certainly not the first to cause controversy over ADHD and Ritalin-type drugs. When she began her study, she now says, she was "naïve." "At the time I set out to do this study ADHD was not in one of its controversial phases," she says. "Now that I've spent a lot of time studying this area you go back in time and you see that every ten years or so ADHD becomes very controversial."
LeFever decided to do a comprehensive survey in Portsmouth and Virginia Beach. She would examine the records of all elementary school students during the 1995-1996 school year. Because school nurses often administer Ritalin doses during the school day, LeFever used school nurse records to determine the percentage of children being treated.
"[Back then] there was some discussion in the public media that ADHD diagnoses were being used to suppress black boys, that black boys were being unfairly diagnosed and being encouraged to go on medication to curb their behavior," she says.
What she found stunned even her. Not only was that theory shot down, she found that whites tend to receive Ritalin almost twice as often as blacks. Over all, 17 percent of white boys received drugs like Ritalin compared to 9 percent of black boys; 7 percent of white girls were medicated and only 3 percent of black girls. In Virginia Beach, during the school year, 20 percent of white fifth grade boys were receiving Ritalin or other psychotropic drugs.
The overall statistics were shocking enough, but details were even more disturbing. When she launched her study, for example, LeFever assumed that children who had failed a grade would be more likely to be diagnosed with ADHD. To calculate this, she tabulated statistics by age. The data confirmed that pupils too old for their grade were diagnosed with ADHD at a slightly higher rate. What stunned her was that children who were too young for their grade were far more likely to be diagnosed and medicated. A whopping 62.7% of Virginia Beach children [who were younger for their grade, I think - PJ] were taking ADHD drugs.
"So if you started kindergarten at four instead of five you were very likely, according to the data, to be diagnosed as having ADHD," she says. This suggests that doctors ignored guidelines stipulating that children be diagnosed according to their age, not their grade. These children were saddled with an ADHD diagnosis and given psychoactive drugs "when in fact, maybe, those young children's inattentiveness and hyperactivity is developmentally appropriate," LeFever says.
LeFever sent the results of her study to the journal, Pediatrics. Editors had "no methodological complaints" but refused to publish it.
"All three reviewers rejected the manuscript because it suggested possible overuse of Ritalin and I'm like, 'Yeah, that's right,'" said LeFever. Rather than fight the rejection, submitted the article to the American Journal of Public Health. "This is really a public health issue," LeFever said.
Because her statistics flew in the face of nationwide surveys by the ADHD experts, The American Journal of Public Health had two outside statisticians review her numbers. Both confirmed LeFever's findings.
With all the wrangling, her article didn't appear until 1999.
Her study invalidated others studies that looked at nationwide medication rates. If the rates varied so much by region, nationwide rates were essentially worthless.
Pediatricians, ADHD support groups and bigwigs in ADHD researchers launched a full-court press to discredit her study. But independent researchers began to confirm those findings.
"If 25 to 35 percent of the children in a school are perceived as 'disordered' you've really got to wonder," LeFever says. "If 35 percent of the children aren't meeting your 'normal' expectations, then maybe your 'normal' expectations are off. Maybe you need to change the environment."
Without question, [some] children suffer from ADHD and require medication and intervention.
Yet there are those like Sarah, (whose parents openly enforce) taking Ritalin to stay in her honors classes. There are others like those Virginia Beach kids -- 62.7 percent! -- too young for their grade, diagnosed with a "disorder" and placed on ADHD drugs. How many similar children are diagnosed and medicated so they can face the pressures of school a few months early? Today, such pressures are increasing. In places like Manhattan, parents compete to get children into elite preschools. Even here, as school reformers press for more standards, children are expected to read earlier, learn faster, and be smarter, even if that means playing Mozart to them in the womb.
Despite clear guidelines to the contrary, teachers have often told parents that their children had ADHD and recommended drugs like Ritalin, not only in Virginia but around the country. Connecticut, Minnesota, Arizona, New Jersey, New York and Oregon have been forced to enact laws to stop this practice.
Like those laws, the legislation puts into law what teachers should have been doing all along. Under the law, teachers can point out disruptive or inattentive behavior. They can suggest a psychological evaluation. But they cannot "diagnose" ADHD or tell a parent a child needs Ritalin. (Note - now you see why my search engine query pulled up this subject. -- PJ)
The psychiatric label ADD/ADHD (Attention Deficit Disorder/ Attention Deficit and Hyperactivity Disorder) stems from another label, that of "minimal brain dysfunction" which originates in a non-conclusive American study done in the 1960's that was attempting to link some brain anomaly (never found) to some behavioural or learning problems that attracted attention in the cases of a few children. Despite the failure of this first study in the 1960's, the idea lived on and over time, a wide range of behavioral traits were associated to the various labels that were used... [the] label still in used today was finally adopted in 1980.
Finally, after 30 years of groping, studies and experimentations, the final text of the Concensus Conference on ADD/ADHD held from November 16th to 18th of 1998 at the National Institute of Health in the U.S.A., declared unequivacally that: "There are no data to indicate that ADD/ADHD is due to a brain malfunction.". Moreover, there exists no objective testing procedure allowing to single out the children that are assumed affected by this problem, the official diagnostic criteria of ADD/ADHD being strictly behavioral.
Despite these conclusions, more than 5 million American children in 1997 (9 million in 1999) and tens of thousands of French-Canadian children are needlessly treated with Ritalin or other drugs to control behavioral traits for which no medical cause was ever discovered. And the trend is gaining in popularity.
A preliminary study carried out in Québec in 1997 (Doré & Cohen) revealed already that the tendency to diagnose and medicate more and more so-called "hyperactive" children originated from the school system. The study also reveals that parents and physicians alike were subjected to enormous pressure from the school system to medicate these children.
Ritalin has.... demonstrated inefficiency regarding any improvement in the state of children, and ... no data whatsoever has ever permitted associating ADHD to a brain disfunction. ...this handy means... to calm "troublesome" children... seems to have become the ... tool of choice in the school system, to insure that order will be maintained in the classrooms at the elementary level, because children medicated in this manner become passive, that is, "cease being troublesome"... and are afterwards apparently systematically left to themselves, without complementary help.
The study reveals that no effective help is given to the overwhelming majority of children medicated in this manner beyond the prescription itself, even if it has been demonstrated beyond the shadow of a doubt, that the medication alone induces no improvement whatsoever in the state of children.
It has also been observed that the increase in psychostimulant prescription, mainly Ritalin, is so rapid in North America, including the province of Quebec, that the most recent statistics systematically become obsolete even before they are published in scientific journals.
More and more children who "disturb the peace" in class on account of too much enthousiasm, or who attract attention because they feel bored in class, are henceforth at risk of being mis-diagnosed ADHD, without them having the opportunity that their case be medically examined by competent professionals, before it is too late for them, and before irretrievable intellectual dammage is caused to them.
Another note: http://pages.globetrotter.net/srp/ritalina.htm
In the very first year of school, teachers identify various problems as possible symptoms of ADD/ADHD: inattention, disturbance in the classroom, behavioral problems, failure. The teachers refer the child for psychological evaluation, and suggest to parents to have the child evaluated by a physician. In fact, teachers are the initiators of the whole process of initial refering of children, but their involvement is afterwards minimal. [...] Physicians are forced by circumstances to diagnose on the basis of incomplete or unsatisfactory psychological or psychosocial evaluations. They are overloaded with cases and are sensitive to the pressure exerted on the parents by the school.
..."Family physicians and specialists alike are unanimous regarding the pressures exerted by the school on parents for them to consult a physician. Consequently, parents understand that they must consult a physician, or else their child will be removed from the class and suspended from the school." The requirement of the school for parents to have their child be prescribed psychostimulants is so intense that in some cases parents go so far as to ask their physician to "reassure" the school personnel on the intellectual abilities of their child.
The intensity of the pressures exerted by the school on parents is a major worry for physicians and specialists, as well as the pressure exerted directly on themselves by the school, those who do not prescribe the medication ending up not being refered children any more by schools, who would rather provide references to names of physicians that are more open to medicate.
Frontline physicians and specialist assert that once medicated, the school witdraws all support to the child and his family. One of the physicians party to the study went as far as stating that "a school problem has been medicalized because the school has abandoned its primordial role towards children." It is observed that medication should not be the only action taken, but that it factually is.
...The final conclusion is so damning that the authors have expressed it in the form of a question: "Is medication used mainly to restore "order" and "calm" in the system?".
It can also be wondered if the extremely restrictive budgetary policies applied for years to all levels of the schooling system by our governments could be an important factor in this explosion in the number of "declaration" of cases of hyperactivity. It coincided with the establishment of these policies. The amounts allocated to schools to support children "declared" in difficulty is superior to the amount allocated for children who are not declared in difficulty, and this applies even if the diagnosed children receive no extra service besides the actual psychostimulant prescription, for which the school incurs no costs at all.
Because children often require multiple doses of the drugs and it is difficult to insure compliance, the drug firm Noven Pharmaceuticals, Inc., of Miami, Florida, is now researching a kids one-a-day Ritalin, as well as a Ritalin patch.
Even the propensity of boys to run and jump, let alone engage in rough-and-tumble play, is now suppressed in many schools, to the point of it becoming a movement to abolish recess -- this at a time when health activists continue to lament the overweight and inactive lifestyles of American children. If sedentary and junk-food nourished children are to be denied free outdoor exercise, there must be some powerful reason for doing so. The reason, indeed, is that the boys behave differently from the girls. This cannot be allowed. [...] Ritalin may do for the time being... Of course, the doped-up and denigrated boys then hit adolescence, the hormonal rockets are lit off, and we find resentful, angry, and unsocialized youth bouncing around the landscape. ...One begins to wonder why the futility and nastiness of the whole project is not generally recognized.
[When that doesn't work, they] then must face what to do when the brainwashing doesn't take and the little boys turn out to be not quite so malleable after all. Well, that's easy, what you do is call the police. All the permissiveness of "progressive" education is completely forgotten the minute that a child can be credibly accused of a gender/sex crime. Sommers relates the case of a nine-year-old boy who drew a picture of a naked woman in art class, after a visit to the National Gallery of Art (there are nude pictures there, you know), and then rubbed up against a girl in the cafeteria line. The boy was literally arrested, handcuffed, fingerprinted, and charged with "aggravated sexual battery". Charges were eventually dropped... Sommers cites the case of a three-year-old boy who had been reprimanded and punished for "having hugged another child." His mother was told, "He's a toucher...We are not going to put up with it."
Any sensible person would regard these antics as insane. As Thomas Sowell already discovered about educational abuses, this is all, however, concealed from the public as much as possible. But the public has by now become aware of the bizarre fanaticism that would extend "sexual harassment" principles, originally formulated on the principle that adult male bosses could extort sex from exploited female workers, to the naive behavior of pre-teen children with their peers. What to do about it is something else, since the process is in the hands of legal and academic ideologues, whom the public never gets to vote in or out of their power.
Resorting to the National Guard, as hazardous as it is, may be less menacing to civil liberties than resorting to the National Institute of Mental Health. If a neighborhood is secured and made safe for a time by a military presence and curfews, the curtailments of liberty are relatively easy to perceive. So are the limits of using military force to solve social problems. But the dangers of medical and psychiatric interventions - cloaked in science and the language of disease and healing - can be much more difficult to discern and to resist. Promises for ultimate success may be uncritically embraced by a public eager to find seemingly humane medical solutions.
The Faustian price for turning to the social-control doctors may not become fully apparent until the "cure" has been put into place. In our desperation to find answers, we could end up with measures that are ultimately more threatening than the street violence we all deplore, and to no avail as well.
Taking a pill as a "cure" obviously is easier than confronting and dealing with the actual personal reasons for one's difficulties with their own mind and life. ... "psychiatric solutions" do not even slightly exist as true "fixes" in the first place. The "psychiatric" methods "fix" nothing at all and actually make things worse, because the "treatments" always interfere with the healthy and optimum functioning of any human mind.
The word psychology comes from the two roots "psyche" and "ology" (derivation - "logos"). By definition this means "study of the mind or soul". The "psyche" part (i.e. mind, soul) has all but been surgically removed from the fields of psychiatry and psychology. For the most part these fields claim to be involved in studying something that they actually don't even consider to exist. The mind (as a subject) has been jettisoned in favor of concern for genetics, environmental forces, social conditions, biochemistry, and biology. It would be more accurate to rename these subjects "people control", "physical duress techniques", "social behavior adjustment", "conformity management", or "biochemical manipulation", because these subjects do not involve the ideas and things that the subject names are legitimately defined to mean and involve.
The Feb. 23 Journal of the American Medical Association reported on new research by the University of Maryland which shows that the number of children ages 2-4 taking powerful stimulant and anti-depressant drugs increased 50% between 1991 and 1995. The greatest increase was in the use of stimulants (Ritalin) and the newer class of anti-depressants (Prozac, Zoloft and Paxil). Researchers believe this rise reflects an ongoing trend.
The study results have caused alarm among experts, who worry about the dearth of research on the effects of psychiatric medications on very young children. Many are concerned about the potential danger of these drugs to the developing brains of pre-schoolers. Dr. Joseph Coyle, chairman of psychiatry at Harvard Medical School, commenting in the Feb. 23 New York Times, said: "These interventions are occurring at a critical time in brain development, and we don't know what the consequences are."
The APA manual suggests that children who exhibit at least eight of 14 "symptoms" for at least six months have the disorder. These symptoms include fidgeting or squirming in seat, difficulty remaining seated when told to do so, difficulty following through on instructions, interrupting others, refusing to listen to others, and losing things necessary for completing tasks, such as pencils. Many experts say these "symptoms" sound suspiciously like normal childhood. Dr. Fred Baughman, pediatric neurologist and a Fellow of the American Academy of Neurology, calls ADHD "a contrived illusion of a disease that was invented in-committee at the American Psychiatric Association."
"Conflicts between children and adults are being redefined as diseases or disorders within the children," says Dr. Peter Breggin, International Director of the Center for the Study of Psychiatry and Psychology. "Treatment with stimulant drugs such as Ritalin will produce greater docility in any child (or animal) without actually improving conduct or academic performance. Parents are not informed that they are trading behavioral control for toxic drug effects."
The use of Prozac and other anti-depressants for children under 18 was up 74%, for ages 7-12 up 151%, and for children six years of age and under, anti-depressant drug use rose a shocking 580%. IMS Health, a company that tracks and reports the latest trends in medication usage for the pharmaceutical industry, compiled the statistics.
With a 700 percent increase in the use of Ritalin since 1990, parents have been repeatedly told that their kids probably have ADHD and that Ritalin is the treatment of choice. In the most extreme cases, parents unwilling to give their kids drugs are being reported by their schools to local offices of Child Protective Services, the implication being that by withholding drugs, the parents are guilty of neglect.
[this is the end of my current notes. -- PJ]
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