Use of Ritalin to control kids' behavior debated

By Svetlana Kolchik
Gannett News Service

WASHINGTON — Sue Parry's son was still in kindergarten in Honolulu when his teachers began complaining about his behavior. The boy had trouble reading, wasn't "sitting well" and had other problems, they told her.

A few years later, Parry's son began taking Ritalin, one of several prescription drugs used to treat Attention Deficit Hyperactivity Disorder, the most widespread childhood behavioral disorder in America today.

Parry now believes there was never anything wrong with her son.

"Any child, particularly a boy, in America could be considered to have ADD," said Parry, whose son stopped taking Ritalin after he developed heart problems. "The children are normal; they are just not performing."

That view is becoming increasingly common across the country as parents and experts question the objectivity of the ADHD diagnosis and the safety of medications used to treat it.

In Congress, the House Government Reform Committee held a hearing in September to discuss whether children with symptoms of ADHD are being overmedicated.

Committee chairman Dan Burton, R-Ind., said of symptoms such as inattentiveness, an inability to focus or finish tasks, excessive restlessness and impulsive behavior: "That sounds like me in grade school. I didn't take Ritalin. I became a congressman."

Advocates of the ADHD diagnosis insist that treating the disorder with drugs is usually effective.

"I don't see a big problem with schools forcing parents to put their children on medications," said David Fassler, a child psychiatrist in Burlington, Vt., and former chairman of the American Psychiatric Association's Committee on Children, Adolescents and Families. "I am more concerned about children who aren't getting any treatment whatsoever."

But Fassler cautions that school officials should not make diagnoses and that parents should be thoroughly informed before deciding their children might need drugs for the disorder.

Clark Ross, who runs a 20,000-member support group for ADHD patients, describes the arguments against medicating as a "simplistic ideological approach," and says Ritalin and related drugs help at least 70 percent of children with ADHD.

"Millions of people have taken medications since 1954," said Ross, who heads Children and Adults with Attention-Deficit/Hyperactivity Disorder in Landover, Md. "We have only a handful of traumatic experiences."

More than 2 million school-age children suffer from ADHD, according to the National Institute of Mental Health. The disorder affects boys at two to three times the rate of girls.

Americans are the world's largest users of ADHD-related drugs, experts say. As many as 6 million youngsters between the ages of 5 and 18 take such drugs every day, according to national medical reports. That includes nearly 2 million children who take Ritalin — a 500 percent increase since 1990. The number of Ritalin prescriptions to children and adults rose from about 2.5 million in 1999 to 2.9 million in 2000, according to the National Center for Health Statistics. Doctors increasingly prescribe Ritalin and other psychotropic drugs to children as young as 2.

The Drug Enforcement Administration classifies Ritalin as pharmacologically similar to cocaine, and says it has a high potential for abuse. Possible side effects include heart problems, loss of appetite, insomnia and headaches.

Some teachers and parents call Ritalin a wonder drug. Others, such as Parry and the president's brother, Neil Bush — who says his son was misdiagnosed with ADHD a few years ago — claim Ritalin is often prescribed unnecessarily. They blame schools for failing to engage children in the learning process and for demanding too much of them academically.

Parry said that, instead of addressing her child's needs, teachers would give her pharmaceutical-company pamphlets advertising stimulants.

Mary Block, an osteopath in Hurst, Texas, and author of "No More ADHD: 10 Steps to Help Improve Your Child's Attention and Behavior Without Drugs" (Block Books, $12.00), says thousands of children are diagnosed with ADHD without medical exams.

Allergies, thyroid problems, learning difficulties, a high-sugar diet and other nutritional problems also cause hyperactivity and inattentiveness, she noted.

"Doctors are brainwashed that prescription is a magic thing," Block said.

Still, pills remain the most convenient solution for parents who complain that a shortage of child mental health experts means they often wait months for an appointment with a child psychiatrist.

Said Katherine Keough, president of the National Association for State Controlled Substance Authorities in Waltham, Mass., and a mother of two children with ADHD: "It's very easy to get drugs. It's much harder to get counseling."

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