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Why Are We Drugging Our Children?


Why are we drugging so many of our children, and what effect is this having on their well-being, wonders Julian Weissglass, director of the National Coalition for Equity in Education, in his Sept. 26 Education Week Commentary. The use of antipsychotic drugs to treat children and adolescents in the United States increased by more than five times from 1993 to 2002, Weissglass writes, with the sales of ADHD-related drugs increasing by nearly 500 percent from 1991 to 1999.

In comparison with the rest of the industrialized world, the United States accounts for 85 percent of the world's methylphenidate—the compound in Ritalin and other brand-name drugs often prescribed for young people labeled with ADHD. Weissglass suggests that much of the increase in prescriptions of psychiatric drugs is because children's behavior and emotions are difficult for adults to handle.

What do you think? Is growing use of psychoactive drugs for children a problem? Can educators help solve it?


I am so grateful to Julian Weissglass for addressing this question. As a parent, grand-parent and former public school teacher, who is currently a psychologist and family therapist, I have seen dozens of children and adolescents who are diagnosed with a "disorder" or "mental illness" simply because of the absence of adequate information and resources about alternative ways of seeing and treating "difficult" young people. I have noticed over the last five years particularly as I have taught seminars in family therapy for graduate-level interns in psychiatry and psychology that any reluctance to join in the practice of diagnosing and medicating young people is increasingly frowned on as un-professional. Much of the funding for medical schools is coming from pharmaceutical companies, so this practice is perpetuated by that desired income
Meanwhile, some schools, families, and professionals have been exploring and writing about workable alternatives. I am deeply grateful for these.

Self-regulated control of the muscles into voluntary movements (gross and fine motor)are developed through sensory-motor-perceptual development. This expontential growth of uncoordinated children has not only led to increased BMI measurements(childhod obesity)and Type II diabetes, but there are small children with limited psychomotor coordination of the limbs, field of vision, proproception of mucles and nerves and the balance of the body through vestibular sitimultion. Open your eyes and connect the dots America! The schools continue to hire OT/PTs; speech pathologists; and Special Education teachers at higher rates too. That clearly shows that schools are getting children who cannot move; they cannot talk; and the processing rates/abilities are different. All of these cognitive and motor abilities are determined my vestbular and proprioceptive development, when integrated and coordinated with sensory-motor-perceptual development. Piaget told us a longtime ago that higher order thinking is rooted in movement experiences at early ages. But, in America drugs can focus the frontal lobe, while the body continues to be like that of a jello jiggler.

It is well past time for this debate, but it is still a necessary one. Medicating behavior has become nearly epidemic. Okay, I may be overstating the problem, but more and more children are leaving classrooms for medication than even just a year or two ago. There appears to be a growing number of children indentified as ADHD or ADD or as chemically out of balance.
Ironically, the use of strong, psychoactive drugs to control behavior is being recommended for children that are just beginning or have just finished the D.A.R.E. program. The D.A.R.E. program, usually presentd in about 5th grade, encourages students to resist drugs and violence, while school councelors, pediatricians and even many teachers are suggesting that students use particular drugs.
Personally, I believe that the less chemical modification introduced, the better.

Although I agree with many of those posting comments about the rise in the use of medication to help students with attention, hyperactivity, and mental health disorders, I must bring up the fact that for some children medication makes it possible for them to focus and understand the concepts being presented to them at school. Many years ago, I had a student whose homeroom teacher came running down the hall to ask me what she should do for him. He was hitting his head against a concrete block wall as a result of not taking his medication that morning. For that student and many others I have taught in two plus decades of teaching, medication CAN be a mini-miracle. This boy knew that he could focus and comprehend better while medicated. He was, however, one of the exceptions. Many students are medicated as a convenience for their parents, caregivers, or teachers.

I am so glad to hear a discussion on this important topic. As a mother of two boys, our oldest was diagnosed with ADHD through a teacher's recommendation and our doctor's diagnosis. What was bothersome was there wasn't a true overall evaluation of his physical and mental health evaluation. We tried medication for about a week and were disturbed not only with having to put him on drugs, but also with the quick diagnosis from the school and medical community. We read medical reports about the problems with these drugs and stopped immediately. We decided to take his condition into our own hands and had extensive evaluation that resulted in a different diagnosis, he has Asperger's Syndrome, which can’t be treated through ADHD drugs, or any drugs for that matter.

The education and medical community were so quick to put the ADHD label on our son and try and medicate him, without a true and complete evaluation. It seems with such an increase of the drugs being given over the years, the true beneficiary of these medications is the drug companies, not our children. For parents, when a teacher recommends your child has ADHD and to take medication, I would strongly recommend a second opinion. Your child’s well-being is at stake.

Look at what kids are eating these days. Everything they stick in their mouths have mounds of sugar. The start their day out with a coke or premixed liquid someone calls juice because it is orange. Then they eat sugar coated cereal.. how does anyone expect them to sit still in a boring classroom after all that sugar? The solution is simple, but no one wants to fix the problem because that might mean having to fix a hot breakfast, lunch or dinner at home. Somehow it got to be politically correct to never eat a homecooked meal. Shame on parents and doctors for not admitting the problem. Check out what everyone eats, not just kids. With this sort of diet, the first class in the morning should be PE so they can work off some of the sugar buzz.
Wake up everyone,.......... YOU ARE WHAT YOU EAT...

I believe if the parents would step up to the plate and discipline their children, teach them how to behave by showing them a good example, and show them they are loved we would have less difficulty with our children. My own son is rowdy at home when the time is appropriate, but at school, his teacher says he does as he is told when he is told. He is disciplined at home with restriction (taking away his play station) and if warranted, spanked. No matter what the punishment, a conversation takes place explaining why he is punished and that he must take responsibility for his actions. But most of all he is told no matter what, HE IS LOVED.
As a teacher, I see all kinds of children everyday. No matter what, they leave my class knowing I teach because I love them and I want them to succeed!

Great topic and discussion. It seems that one of the underlying problems is our society's "quick-fix" mentality. Productivity and efficiency demands push parents and children to the limits. There is so little infrastructure support or encouragement for open communication and collaboration between our children, parents, schools, and health care providers that the "default" program is simply to place children on medication. Non-pharmacologic treatment of difficult behaviors in children can definitely be more expensive and time-consuming, yet just as effective as medication. However, these are the very things that we, as a society, choose not invest in and support. Medication is a "life-line" for many children, but should it be? Or, should we shift our societal priorities and invest more time and money into education and child behavior and development specialists to help our children?

Excellent article--and a needed conversation. As we work with schools all over the US, this is a conversation we start with teachers, parents and communities. The more dialogue the better, and the more parents become aware of the potential long-term negative consequences of drugging young children the more chance we will have of really addressing this issue. If we begin early in life modeling for our children that drugs are the way to deal with life, is it any surprise that they turn to drugs when they have problems later on?

Thanks for an excellent article.

And let's clarify this topic: We are 5% of the world's population and our kids we are taking 85% of these drugs. Most telling, however, is that 90% of all of these drugs taken in this country are taken by boys.

A typical scenario is one that a colleague recently shared about her second grade son. The school's "ADHD expert," a second grade teacher without any clinical or formal training to provide any kind of discrete diagnosis, had recommended her son for Ritalin because she was convinced that he had ADHD. There was a time when a trained Psychiatrist would have given this diagnosis; today, anyone's family physician can do it in a 15 minute visit, one which is often prompted by complaints from teachers and administrators who still don't fully understand the physiological differences between boys and girls well enough to realize that boys of all ages are generally more active and more easily distracted than their female peers. Yes, medication is sometimes an important treatment option for some children with ADHD, but when one looks at the big picture in this country the unmistakable inference that should be made is that we are WAY overmedicating our kids, especially our boys.

Articles and books have been written to address the shorcut medical use of the DSM to "diagnose" ADD, etc. Horror stories abound of serious organic conditions, missed, when a formal physiological workup is ignored in favor of a "quickie" questionaire. It seems that, every year, someone expresses concerns similar to those voiced by Weissglass, yet very little is done. I lay much of the blame on teachers, who, anxious to escape the challenge of children at the edges of the "bell-shaped-curve", "play doctor" at parent conferences. Shame! This is unprofessional and unethical. When I was a school staff participant in such conferences, I was quick to point out to parents that NOBODY in the room had an MD or DO degree, and all we could do was to give information about classroom performance we had observed.

If my own children were under assessment by a physician for anything like ADD, and the first thing to materialize was the DSM, instead of an exhaustive workup, my family would "hit the road".

Let's talk about the dangers of NOT taking prescribed medication for a true diagnosis of ADD/ADHD, etc: being so impulsive to run out in the street and get hit by a car, not being able to focus on instruction resulting in failing and a poor self esteem, peer relationship problems resulting in limited friends and low self esteem, impulsive inappropriate classroom behaviors resulting in discipline actions leading to poor self esteem, etc. There are many children who do benefit from the use of these medications. We certainly wouldn't withhold medications for diabetes, cancer, or some other medical diagnosis. I can agree that some doctors jump the gun and do not get enough information before prescribing, BUT let's not write off the benefits that the medications can provide. It is usually not a matter of lack of discipline for these children. We should look at the amount of junk food (sugar) that these kids ingest, and the amount of t.v. that they watch along with video games. Parents need to limit these things or their child will develop an issue with paying attention to the teacher in the front of the room.

There is a very great need for much more interaction between the medical, mental health, and education communities on this issue. Sending Connor's Scales to be filled out by teachers who are already looking for a medical solution simply doesn't give enough objective information to make a responsible diagnosis. Even DSM specifies that the determining behaviors for ADHD should carry over into 3 different environments.

It should also be pointed out that their is some significant overlap between the symptoms of ADHD, bipolar disorder and RAD. It took many years to arrive at a diagnosis of bipolar disorder for my son, beginning with a trial of Ritalin in first grade--at the school's strong urging. The pediatrician noted that the scales from school and the scales from home gave two different pictures.

I recall my son banging his head against the car window in agony during the ride home from latchkey (an environment where he also did not display problems) as he was "coming down" in the evening. He wasn't frustrated because the drug helped him focus and now he couldn't--he was on a merry-go-round of good feelings followed by bad feelings caused by the medication's ebb and flow. In retrospect we know that stimulants exacerbate bipolar symptoms.

The fact that he is bipolar is due to genetics--something that a complete psychological workup might have pointed to (although the history in his birth family was undiagnosed). But I have to wonder if the early onset was brought about by that "trial" of Ritalin.

Once off of Ritalin, the next step was anti-depressants (also risky with bipolar), which ultimately led to a stint of residential "treatment" before the final diagnosis of bipolar, and appropriate treatment with mood stabilizers. I will always regret the hell he had to live through--first with the stimulants and then with the anti-depressants--before really getting help. And all the while he was moved further and further away from regular classrooms, punished, rejected and blamed more and more, and his family life continually called into question.

There is very little research into most of the pediatric uses of mental health medications. There is very little conversation between prescribers and schools, and unless you are very lucky the behavioral experts move in a different world than either one.

This is a great discussion and timely. I feel we need more emphasis on the development of classroom management skills in teacher training programs and ongoing skill development training during the course of the career. I've talked to parents who don't want their children drugged but are being pressured by ed. authorities to do so. I hope that training is ramped up nationwide.

I think Nancy Williams has missed the point of the discussion. We aren't talkng about a student whose ADHD might cause them to "run out in the street and get hit by a car." First of all a true ADHD diagnosis would not include a child who, without medication, might run in front of a car. This sounds much more like an autistic spectrum child, which represents a whole other issue. The point is that 85% of the world's use of these types of drugs for ADD and ADHD are prescribed in THIS country, and 90% of those are being given to boys. There is NO research data to support the idea that we are somehow right and everyone else is wrong; in fact, if anything, just the opposite exists.

To compare these subjective overprescriptions to cancer medications is silly. No one had suggested that truly needy individuals be denied these drugs, but we have known since 1975 that labratory animals, when given the choice between Ritalin and Cocaine, make NO distinction between the two, and our use of the drug has SKYROCKETED since then despite the absence of decent research about the long-term effects of these drugs' use on individuals.

As a teacher I have never diagnosed a student or encouraged the use of Ritalin or any other medication. I have directed parents to seek medical advice when behaviors cannot be modified within the classroom, if academic problems persist without the presence of a learning disability or if the student has intense interpersonal problems. I would never presume to tell anyone how to treat their child even with a diagnosis of ADD/ADHD. I must say that I have witnessed remarkable results with students who have taken Ritalin and I have seen disaster when parents have taken them off of the medication without consulting a doctor. I have also found that for some students the medication presents side effect such as sleeplessness, appetite suppression and other problems and I have also seen students given structure, routine and consistant expectations able to deal with their symptoms of ADD/ADHD. The answer lies in a medical diagnosis and caring professionals working with parents and students to find the right solutions for the individual student rather than the quick fix, one size fits all approach.

Something to consider: ADHD has absolutely no scientific basis in fact. It is a label that was once voted on by the American Psychiatric Association - that's how they get their "illnesses" and "disorders". It is sold as an illness but is basically a fraud. Take a look at psychiatry's diagnostic manual and you will see - there's not a single normal childhood behavior that has not been labeled as a mental illness. So you ask in your article, is there a problem with drugging these kids? Well, is it okay to drug a child for a fictitious mental disorder? I think inventing desease for profiit is a crime and should be treated as such.

Good for B. Barrett! Unfortunately, I did meet more than a few teachers who suggested treatment modalities as though they had an MD or a DO after their names. Since Weisglass's concerns suggest that we have not come very far in the last five years and are STILL asking why we are drugging our children, I would suggest a 1997 book that is still quite relevant. "A Dose of Sanity: Mind, Medicine, and Misdiagnosis" by Sidney Walker, Dir of Southern Cal's Neuropsychiatric Institute. It is still listed on the book store websites and has always gotten high praise.

To Melissa, ADHD does have a scientific basis. It is diagnosable (if that is a word). The science however does not make it any more real. What is important to remember is that like many other "disorders", ADHD and ADD are conditions, not diseases. Cancer, for instance, is a disease, one for which mant different treatment strategies are available to greater and lesser effect. The common cold, or rhinitis, is also a disease with treatments. ADD and ADHD were identified as conditions or disorders at about the same time that drug therapies were developed to treat them. It is similar to the daignosis of alcoholism which, as it turns out, became an identifiable disorder at the same time that a "cure" for it was developed.
The diagnosis of any disoreder should be comprehensive. There is danger in jumping to conclusions too early and drug therapies can exacerbate hidden conditions.
It is telling that former users of drugs like ritalin tend to self-medicate, using alcohol or illegal drugs to gain the effects produced by the formerly legally used medication.
Drugs are drugs, plain and simple and their use should be carefully considered. It is one thing to battle a life threatening disease and another to modify behavior.

Has anyone else noticed the "free" breakfast doled out by public schools is often something like "count Chokula" with chocolate milk, a sausagee and waffle, with sugary syrup, not necessarily maple and a juice or juice drink?

I believe thouroughly that this all starts in the home soon after birth. I am tired of going to workshops that tell me how I need to have 26 different behavior rules and modification for my children in my classroom. It is not humanly possible!!! Parents are the ones who need classes on how to modify behavior. Every thing under the sun is blamed on teachers. We are expected to teach, entertain, educate, wipe up tears, be mommies or daddies to those who have none, etc.........The parents keep dumping their responsibilities on us. Have you seen Nanny 911 lately? I have had several in my classrooms that behave that way. I love teaching with all my heart and I love the children in my classrooms because I choose to do so. I do not advocate drugging children to modify behavior. If parents would set rules, be authorotative, stick to what they say and be consistent a lot of the behavior problems in schools would cease to exist. If parents would believe the teacher and back him or her up it would help too.

In response to Wendy:

I have in fact seen Nanny 911--it is one of my favorite shows. Let me note a few of my observations. Most of the families have two parents with an adequate income and are not beset by addiction, crime or other problems. Most of the families are white. Despite this, the parents are overwhelmed and befuddled.

This is the same population pool from which teachers are drawn. Will the teachers who received adequate behavioral training in their degree program please raise their hands?

For the most part, the interventions offered by Nanny are clear and focused, based on consistency, preventive, inclusive and explained to the children before they are implemented--and they WORK.

Personally, I would love to see a Nanny show that goes to work in classrooms. I know it would take a pretty gutsy teacher to undergo intervention on TV, but imagine the impact it could have. In fact, this is really what is needed to get away from the behavioral modification for every child nightmare you describe. I think that the folks who have done research in positive behavior support generally view specialized plans as appropriate for about 5% of students. The more generalized climate-setting should be targetted to the needs of about 80%. And without both (and about 15% of at risk kids getting preventative services), the specialized behavior plans are not going to be of much help to those kids who need them.

I have observed things in my kids schools that I knew were contributing to problems--but that doesn't mean that anyone was willing to believe me. However--one of the best of my daughter's teachers did an excellent job of home-school communication. I recall a letter coming home describing some behavioral issues that the class was having and what she intended to do about it. In fact, her first steps had to do with prevention. Bringing parents into a problem early--and involving them in the solution, is very helpful in getting support. Waiting until everyone is at the boilover point (and then blaming the parents), just doesn't help.

I'm a college student, 2nd year, and I've been taking Adderall XR for several years now for ADD. While I won't say that these medications are in any way harmless or even anysafer than certain street drugs, I do know that for someone such as myself, they work wonders.

But why are so many people being prescribed these types of medications? While it may well be that this is in responce to a sudden inability for parents to cope with the natural habits of their squirrely little adolescents, there is also another theory I think should be considered:
Taken with the facts that children these days are more likely to be obese, or depressed, or any of the other "epidemics" of problems so many of them currently have, and taken with the fact that healthcare and medicine in general has been improving drasticaly over the years, could it not be possible that the reason for the sudden profusion of affected children be that more and more people who previously would have never lived long enough or well enough to procreate are now able to, and these children with their dissorders are just the natural consequence of this?

Just a theorey, of course.

From a parents perspective I think that drugging children for made up diagnosis i.e. ADD is a lazy way and easy out for parents who do not want to, or do not have the inclination to deal with their children's behavior. Also, we are now becoming aware that children have different learning styles, some learn by listening, others by seeing and some are hands on. Yet we still want to group them all into one learning environment and do not try to compensate for the difference. So when you have a child that can't sit still it may be because he needs to be taught differently. He may be a type that needs to learn by participating in a hands on activity yet you try to make him sit still and listen. Then come to the conclusion that he or she has A.D.D. instead of finding out what really going on. You then take your child to a Doctor that only agrees with you because he is in the business of pushing pills,legally I might add, to support his practice and the pharmacuetical companies that peddle the pills. It is truly a sad state that we are in.

For the past 30 years I've been involved with families whose children range in age from 3 months to 12 years of age. Back in 1976, it was very rare for young children to be on any kind of long-term medication. Children diagnosed with ADD, diabeties or asthma were the exception. Today, these conditions are almost "common".

First, I must state that I agree with the concept that a thorough physical evaluation is necessary before anyone should ever allow their child to be ingesting a long-term medication. Back in 1976, however, I can remember lining up the bottles of Antibiotics for every child who had some symptom of a cold. Doctors don't always make the best decisions. So, parents must educate themselves and choose a pediatrician who will listen and respond effectively. The Doctors have much knowledge, but the parents must be able to be heard, because there are variables affecting the frequency and severity of childhood illnesses and conditions that may not have been even considered for scientific study, that may be involved. Autism and Aspbergers Syndrom are becoming increasingly present. WHY? Children exhibiting obsessive-compulsive behaviors and psychotic rages are also on the rise. It takes alot more than just a visit to the Doctor to determine the correct course of action.

Secondly, after obtaining all the physical/medical evaluations and the child is stated to be physically well but is still having unexplained behavioral symptoms, it is time for a mental health team evaluation. Parents need to be involved in this process. After gathering as much knowledge as possible and the results of all evaluations have been discussed, parents need to FEEL confident that the final determination is correct. This FEELING component is something that's not really quantifiable but from my point of view, it is the most important variable in all of this discussion.
If the family feels that they are on the right track for helping their child, then they are!!
If a parent has a firm, passionate belief that their child is "OK", then their child is OK. I may sound like I'm crazy but from my experience, the best medicine in the world is Love. If we all just stop for a minute and think about how we feel when we are loved and accepted especially by the people closest to us, then you begin to realize that no matter what the "problem", it is solved, managed, dealt with on a much healthier level if your loved ones can see past the problem and love you and focus on all of you, not just this "problem".

Lastly, parents need to insist on re-evaluations and follow-ups because "things" can change.

The use of medication is sometimes necessary and likewise, it could just be a necessity that the parents learn some good parenting techniques. But the bottom line... a loving, supportive, positively-oriented familial bond is the stuff of miracles. Always keep this point as your focus!

Thanks for Listening.

One thing that needs to be mentioned is that schools are not supporting the needs of many of thier most gifted children. With so much focus on NCLB and the children who struggle there is little attention given to the gifted children. When these children are not encouraged and forced to do boring drills they will no doubt develop behavior or emotional problems! Many parents and teachers just see the daydreaming or lack of motivation as a symptom of disorder and never see the bigger picture. I have seen schools pushing drugs in place of gifted programming. It is easier and more prifitable to just mislabel them.

I have a mental disorder called Bipolar Disorder. I will be starting a class on dealing with Bipolar Disorder, so I may be able to return to part-time work. I believe that a good support network is so important to help cope with this disorder! WBR LeoP

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