More pre-K, more ADHD

More pre-k could lead to more ADHD diagnoses warn Berkeley researchers Stephen P. Hinshaw and Richard M. Scheffler  in a New York Times op-ed. 

Introducing millions of 3- to 5-year-olds to classrooms and preacademic demands means that many more distracted kids will undoubtedly catch the attention of their teachers. Sure, many children this age are already in preschool, but making the movement universal and embedding transitional-K programs in public schools is bound to increase the pressure. We’re all for high standards, but danger lurks.

Early intervention helps kids who really have ADHD, the professors write. But millions of children with ADHD labels — and prescriptions — don’t truly have the disorder.

Our research has revealed a worrisome parallel between our nation’s increasing push for academic achievement and increased school accountability — and skyrocketing ADHD diagnoses, particularly for the nation’s poorest children.

“By age 17, nearly one in five American boys and one in 10 girls has been told that they have ADHD,” Hinshaw and Scheffler write. That’s a 40 percent increase from a decade ago.

19% of teen boys diagnosed with ADHD

Nineteen percent of high-school-age boys and 11 percent of school-age children overall have been diagnosed with attention deficit hyperactivity disorder (ADHD), according to the federal Centers for Disease Control and Prevention. Diagnosis rates have soared by 53 percent in the last decade, reports the New York Times.

About two-thirds of those with a current diagnosis receive prescriptions for stimulants like Ritalin or Adderall, which can drastically improve the lives of those with A.D.H.D. but can also lead to addiction, anxiety and occasionally psychosis.

“Those are astronomical numbers. I’m floored,” said Dr. William Graf, a pediatric neurologist in New Haven and a professor at the Yale School of Medicine. He added, “Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy.”

Fifteen percent of school-age boys and 7 percent of girls now carry the ADHD label.

ADHD medications such as Adderall, Ritalin, Concerta and Vyvanse “can vastly improve focus and drive” for students with mild or nonexistent symptoms, reports the Times. An ADHD “diagnosis has become a popular shortcut to better grades, some experts said, with many students unaware of or disregarding the medication’s health risks.”

Ann Althouse wonders about possible side effects of “viewing youthful spirit as abnormal” and “skewing academic competition with performance-enhancing drugs.”

Do charters serve fewer disabled students?

Charter schools are doing a better job serving special-needs students than reported, according to a New York State Special Education Enrollment Analysis by the Center on Reinventing Public Education.

Nationwide, charters serve fewer special-ed students, according to a General Accounting Office (GAO) report. However, the New York study finds “important variations in the enrollment patterns of students with special needs,” said Robin Lake, CRPE director.

In New York, charter middle and high schools enroll more special-needs students than district-run schools, according to CRPE. Charter elementary schools enroll fewer.

Some district-run elementary schools offer programs for special-needs students, the report noted.

Charter schools at the elementary level might also be less inclined to label students as needing special education services. This raises a troubling question: are charter schools under-enrolling or under-identifying students with special needs, or are district-run schools over-identifying them?

Instead of setting statewide special education enrollment targets, policy makers should set “school or regional targets that pay careful attention to those very specific factors that influence such enrollment choices as locations, grade-spans, and neighborhoods,” the report advises.

Setting targets assumes that every school should include the same percentage of disabled students. I’d like to see more schools (charter or district-run) designed for students with specific special needs, such as attention deficit disorder or autism, and more designed for academically gifted students.

School is tough? Take a pill

Some doctors are prescribing medication for Attention Deficit Disorder to low-performing children, even if they don’t fit the diagnosis, reports the New York Times. Well, at least one doctor is.

CANTON, Ga. — When Dr. Michael Anderson hears about his low-income patients struggling in elementary school, he usually gives them a taste of some powerful medicine: Adderall.

The pills boost focus and impulse control in children with attention deficit hyperactivity disorder. Although A.D.H.D is the diagnosis Dr. Anderson makes, he calls the disorder “made up” and “an excuse” to prescribe the pills to treat what he considers the children’s true ill — poor academic performance in inadequate schools.

“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.”

“It is not yet clear whether Dr. Anderson is representative of a widening trend,” reports the Times. That means they could find only one doctor willing to admit he’s handing out ADHD pills as a performance enhancer. However, there’s some evidence that affluent students “abuse stimulants to raise already-good grades in colleges and high schools.”

Are there side effects to these medications? Yes, there are.

Raising the Ritalin generation

We’re way too quick to label active boys as hyperactive, writes Bronwen Hruska in Raising the Ritalin Generation.

Will did not bounce off walls. He wasn’t particularly antsy. He didn’t exhibit any behaviors I’d associated with attention deficit or hyperactivity. He was an 8-year-old boy with normal 8-year-old boy energy — at least that’s what I’d deduced from scrutinizing his friends.

But the third-grade teacher suggested an evaluation.

. . .  once you start looking for a problem, someone’s going to find one, and attention deficit has become the go-to diagnosis, increasing by an average of 5.5 percent a year between 2003 and 2007, according to the Centers for Disease Control and Prevention. As of 2010, according to the National Health Interview Survey, 8.4 percent, or 5.2 million children, between the ages of 3 and 17 had been given diagnoses of attention deficit hyperactivity disorder.

There’s no test for ADHD, she writes. Teachers’ impressions —  they’re asked to rate “squirminess” on a scale of one to five — make a big difference.

Will was diagnosed as being inattentive in distracting situations, such as school, and prescribed Ritalin. “It was not to be taken at home, or on weekends, or vacations. He didn’t need to be medicated for regular life.”

He took the drug in fourth grade and had a great year, but quit in fifth grade. He’s done fine without it. “For him, it was a matter of growing up, settling down and learning how to get organized,” writes Hruska. “Kids learn to speak, lose baby teeth and hit puberty at a variety of ages. We might remind ourselves that the ability to settle into being a focused student is simply a developmental milestone; there’s no magical age at which this happens.”

 

 

No waiting for hyperactive kids

To prevent tantrums, British amusement parks let hyperactive children go to the front of the line, reports the Times of London. Children with attention-deficit disorders “cannot cope with the stress of waiting,” tourist boards say.

Teachers have criticised the scheme, saying that it undermines their efforts to encourage patience and it would be better for children with ADHD, attention deficit and hyperactive disorder, to learn how to wait.

Via Nothing To Do With Arbroath.

Better brains through chemistry

Neuroenhancing drugs, such as Adderall and Ritalin, are  popular with college students who want to study and party, but not necessarily sleep or eat, writes Margaret Talbot in The New Yorker. Research in 2005 estimated 4.1 percent of undergrads “had taken prescription stimulants for off-label use; at one school, the figure was twenty-five per cent. ”

 . . . white male undergraduates at highly competitive schools—especially in the Northeast—are the most frequent collegiate users of neuroenhancers. Users are also more likely to belong to a fraternity or a sorority, and to have a G.P.A. of 3.0 or lower. . . .  they are decent students at schools where, to be a great student, you have to give up a lot more partying than they’re willing to give up.

 Most students who use stimulants get them from an acquaintance diagnosed with Attention Deficit Hyperactivity Disorder who has prescription. Since students have grown up with classmates on ADHD meds, they assume they’re safe.

For us elders, “smart pills” may prevent cognitive decline — or make it possible to work harder for longer. The undrugged may not be able to compete.

Via This Week in Education.

ADHD drug debate

In the short run, children with attention-deficit hyperactivity disorder benefit from drug therapy, researchers say.  They do much better than kids treated with talk therapy alone or routine medical care.  In the long run — more than two years – ADHD drugs lose effectiveness. And kids who take the drugs for three years or more end up shorter than those who quit earlier.  Some scientists accuse others of downplaying the long-term trend, reports the Washington Post:

One principal scientist in the study, psychologist William Pelham, said that the most obvious interpretation of the data is that the medications are useful in the short term but ineffective over longer periods but added that his colleagues had repeatedly sought to explain away evidence that challenged the long-term usefulness of medication. When their explanations failed to hold up, they reached for new ones, Pelham said.

. . . Pelham, who has conducted many drug therapy studies, said the drugs have a valuable role: They buy parents and clinicians time to teach youngsters behavioral strategies to combat inattention and hyperactivity. Over the long term, he said, parents need to rely on those skills.

Nearly all parents will try behavioral strategies — if they’re offered before the family doctor suggests drugs, Pelham said.  If drugs are offered first, most parents won’t go on to try behavioral approaches.