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As has been detailed in previous New Research, Attention-Deficit (sometimes Hyperactivity) Disorder and its treatment are something of lightening-rod issues. Jonathon Leo of Western University of Health Sciences reminds us why they are so very important, beginning, "Ritalin is the drug of choice for Attention-Deficit Hyperactivity Disorder (ADHD) and every year, more of our children are taking it. American physicians, who prescribe 90% of the Ritalin produced worldwide, believe that this is all based on 'science.'"
While one might be willing to grant that ADHD is a legitimate diagnosis and that Ritalin may be the appropriate therapy, as Leo reminds us, these are for older children, not for preschoolers--even as young as two- and three-years-old. The fact is, however, that "the number of preschoolers taking medications for ADHD increased 300% from 1990 to 1995" even though, "Ritalin has never been officially approved for children under six," and there have "never been any experiments on the effects of Ritalin in such young children."
Perhaps even more troubling are the attitudes prevalent among proponents of Ritalin as a treatment for ADHD, including the denigration of other forms of therapy, the assumption that those children left untreated are "at risk" and will become failures in school and in life, and culminating "in the view of Ritalin advocates [that] withholding medication from these kids is irresponsible and even verges on child abuse."
Numerous studies have been undertaken to examine ADHD and Ritalin. Leo points out that in one, detailing the difference in effectiveness between behavioral therapy and medication, who was doing the evaluation, rather than method of treatment, was the key difference: "1) the parents, who were most biased, found Ritalin to be the winner; 2) the teachers, who have a broader background in child behavior than the parents, found that Ritalin did not help in terms of hyperactivity/impulsivity, and; 3) the outside raters, the only unbiased group, found no difference between Ritalin and behavior management." Leo notes that while teachers said Ritalin did improve attention, this is a red herring, since "we have known for several years that Ritalin will improve anyone's attention."
"Is Ritalin quick, easy, and cheap?" Leo asks, and, answering his own question: "Yes. Will it work? Probably, if all that is meant by work is that the children are easier to control. But the real question is, will it help children? No one is going to disagree that Ritalin will make kids easier to control or that it improves their ability to pay attention. What we don't know is how Ritalin affects a child from within."
Leo concludes, "The major ethical question is not, 'Is Ritalin safe?' but, 'Is it right to drug little children because we don't like their behavior, or because they don't fit in?'" What are we saying about the nature of children when those who do not fit into a preconceived mold--even at such an early age--are medicated in order to be more "compliant"? What does this say for our future?
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