ADHD diagnoses surge overseas

Attention Deficit Hyperactivity Disorder (ADHD) diagnoses are surging overseas, as well as in the U.S. Children may be taking powerful drugs needlessly, warn researchers in the British Medical Journal (BMJ).

In Australia, prescriptions for the stimulant Ritalin and other ADHD drugs rose by 72 percent between 2000 and 2011, while in Britain and the Netherlands prescriptions roughly doubled between 2003 and 2008, said the paper.

According to the US National Institute of Mental Health (NIMH), nearly one in 11 American children aged 13-18 and one in 25 adults are affected by ADHD.

Ritalin and other drugs are appropriate only for “severe” ADHD symptoms, which occur among about 14 percent of children with the condition, the study noted. Yet 87 percent of U.S. children diagnosed with ADHD in 2010 received medications.

ADHD drugs don’t raise kids’ grades

Attention Deficit Hyperactivity Disorder medications don’t improve academic achievement, according to new studies, reports the Wall Street Journal.

Stimulants used to treat ADHD like Ritalin and Adderall are sometimes called “cognitive enhancers” because they have been shown in a number of studies to improve attention, concentration and even certain types of memory in the short-term.

. . . However, a growing body of research finds that in the long run, achievement scores, grade-point averages or the likelihood of repeating a grade generally aren’t any different in kids with ADHD who take medication compared with those who don’t.

Boys who took ADHD drugs performed worse in school than those with similar symptoms who didn’t, according to the study, which tracked students in Quebec. Girls on ADHD drugs reported more emotional problems.

Huck Finn, 2013


– Signe Wilkinson

‘I want to be a mass murderer’ when I grow up

“When I grow up, I want to be a mass murderer,” wrote Brian McGuigan in his second-grade journal. Abandoned by his father, he was an angry child who was “hated” by classmates.

The entry was a story about me as a grown-up, an emerging mass murderer with a Frankenstein combination shotgun and machine gun mounted to my arm. I was probably playing too much “Contra” then. I used the gun to shoot anyone who messed with me, not an indiscriminate killing spree but a revenge fantasy against nameless, faceless bodies, all of whom may or may not have been my father. . . . the police never caught me because a hockey mask concealed my face, like Jason’s.

His teacher called his mother, not the police. After a conference, he began weekly appointments with a therapist.

Ms. Ashley talked animated and slowly like a Teddy Ruxpin doll. We chatted about school, my mom, Nintendo, and since I had trouble sitting still, she let me play with the toys. My favorite were the cars. I could pretend I was driving anywhere. Miss Ashley asked me lots of questions — “What’s your favorite subject in school?”; “Are you a Mets fan or Yankees”?; “Do you like pizza?” but never “What do you want to be when you grow up?” Sometimes my answers were one word, and other times I’d speak at length, spinning stories around her like a tether ball, some of which probably weren’t true at all because I lied often, not out of malice but boredom.

He also started taking Ritalin, which made it possible for him to sit still and focus in class.

 As my energy decreased, my motivation did, too. I spent most weekends zoned out playing Zelda for hours, basking in the fuzzed glow of the television. My mother told me to go out and play, but I just wanted to stay inside and play video games, relaxed and focused on the task, and not bounce around the neighborhood causing trouble.

By high school, “a class clown occasionally but no longer by trade,” he was an honor roll student.  When he was caught smoking pot, his mother showed him the second-grade journal entry.

I wondered where I would be if not for my mother, Mrs. McKierney and Miss Ashley, if I would have ended up like Jason, minus the succession of campy sequels.

It sounds like the Ritalin helped too.

McGuigan lives in Seattle where he is the program director at Richard Hugo House, a community writing center.

In Los Angeles, mental health workers work with schools and law enforcement to help troubled students who might turn to violence, reports the New York Times. 

Each day, several dozen calls come in to the program’s dispatch center from principals, counselors, school security officers or parents worried about students who have talked about suicide, exhibited bizarre behavior or made outright threats.

Mental  health workers try to convince principals not to expel students who’ve made threats. “Doing so only pushes the problem onto another school or leaves a child at home with free time to surf the Internet and nurse a grudge against the school.”

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.”

 

 

Kids on welfare: The disability dilemma

Disability checks for children have become The Other Welfare, reports the Boston Globe. Low-income parents can boost their income by getting children on Supplemental Security Income (SSI), often for learning and behavioral problems such as hyperactivity. That encourages parents to get their children on drugs such as Ritalin.

Qualifying is not always easy — many applicants believe it is essential that a child needs to be on psychotropic drugs to qualify. But once enrolled, there is little incentive to get off. And officials rarely check to see if the children are getting better.

Preschoolers with delayed speech make up the fastest growing category of new SSI claims, reports the Globe. Once on SSI, they’re unlikely to leave, even if they outgrow their speech problems. Their disability status may lower expectations for their school performance.

Teens on SSI avoid taking jobs for fear of losing the payments. (Under federal law, someone who earns above a minimum amount is considered no longer disabled — even if the worker really is disabled.)

SSI for children was designed for parents raising kids with serious physical disabilities that create extra costs. But it was expanded in the ’80s. Now the majority of children on SSI are not physically disabled, reports the Globe.

The series won the 2011 Casey Medal for Meritorious Journalism.

With two Mercury News colleagues, I won the Casey Medal back in the day for our welfare series. Our teen mother supplemented welfare with an SSI check for her older son, who’d been born very early and was expected to be disabled. When he was four, the pediatrician praised the mother for her excellent care, told her the boy was developing normally and reported his healthy status to SSI. Without the extra money, the mother decided to get a full-time job instead of trying to complete a community college degree. The economy was booming and she’d done well in a work-study job, so she probably succeeded. I hope. All her phone numbers went bad and I wasn’t able to reach her again. She was 19.

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.