An alert student suggested that we look at a recent report of Ritalin (methylphenidate) use among preschoolers.
One out of 100 preschoolers in the US have been prescribed Ritalin (methylphenidate), in spite of recommendations that the drug not be used on anybody under the age of 6 years. Personally, I’m not a fan of using these drugs at any age.
I must confess that the DSM IV criteria for Attention Deficit/Hyperactivity Disorder are among my least favorite. Here is one of the criteria that will result in your being labeled as having this psychological disorder:
“Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).”
Okay, there may be two or three students on the planet who adore doing homework and ask for more, but are the rest really disturbed and in need of medication?
Or how about this one:
“Often gets up from seat when remaining in seat is expected.”
Wouldn’t it be easier to change one’s expectations about how long small children should remain seated than to drug them? After all, we do have a childhood obesity epidemic.
As my students know well, I am uncomfortable with the notion of medicating developing nervous systems. On top of that, we have cautionary notes from Angold et al. (2000), who conclude that “stimulant treatment was being used in ways substantially inconsistent with current diagnostic guidelines.” [1] The British medical community is much more cautious about AD/HD and stimulant treatment, and take us to task regularly here in the US for our love affair with magic bullets.
Before we jump to the drug route, I hope parents are looking at what is going on in their preschooler’s life. Do you talk to your child, or are you too busy yakking with your friends on the cell phone? Do you have the television on all the time and expect your child to entertain himself/herself while you catch up on your favorite programs? There is a real problem that is AD/HD, but in my view, I wish drugs would be a last, last, last resort.
[1] Angold, A., Erkanli, A., Egger, H.L., & Costello, E.J. (2000). Stimulant treatment for children: A community perspective. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1004-1007. PMID: 10939226
14 Comments
mdavies · October 20, 2006 at 6:15 pm
Do you believe that TV and our modern technology/culture has an effect in increasing ADHD/ADD in children today and that might be why younger children are being medicated more?
cableguy · October 22, 2006 at 3:20 pm
I certainly agree with your assessment of the situation. Giving my three year old daughter medication would certainly be a last resort. I am always nervous that my ‘peanut’ is watching way too much TV. I have heard that fast paced cartoons (and especially comercials that have a lot to say in a limited amount of time) can diminish a child’s ability to concentrate for prolonged or even normal periods of time. Are you aware of any studies confirming this? Thank you
MunkeyChowFan · October 24, 2006 at 4:58 pm
Preschool just seems way too young of an age to be medicating. I hate to sound cynical, but could drug companies have a hand in this push for early medication? It seems like they’ve already taken care of most pre-adolescents and adolescents. My parents considered medicating my brother, but instead opted for year-round sports. Get the kids outdoors!!!
tommy_truong · October 25, 2006 at 12:47 am
I agree with how the criteria is a bit too general. Like this one, “failing to follow instructions or finish tasks”. That would mean all stupid or lazy kids have attention-deficit. Another too broad criteria to be hyperactivity-impulsive behavior is to “frequently feeling restless” or have “Excessive speech”. I don’t think those are criterias for the ADHD at all because a kid that is energetic and like to talk could be a great leader or have an out-going personality in the future, and not having a problem like ADHD. To be honest, kids that are hyperactive or don’t pay attention is due to bad parenting. When i was a kid in Vietnam, if my dad said something and i don’t listen or do something at inappropriate times, he would hit me with a wooden ruler till i do listen. (keep in mind this was vietnam and hitting kids was the norm). It teach me to listen and respect my elders. It worked on me for a while, and i turned out alright. So my dad’s technique worked. Though his technique put me in line and i alway pay attention in class till college, i eventually found out he is what kids called an abusive parent in america when he hit me for no reason or for some bogus reason he make up just so he can hit me. But that is off topic. The point is that parents need to use a bit of force to get kids to act right. You can’t expect kids to behave if you don’t show them the painful consequences if they misbehave.
amycarl · October 25, 2006 at 10:14 am
I agree very much with this article. Many children are often misdiagnosed because it is the easy way out for parents and teachers. My younger brother was diagnosed with ADHD only because he was loud in class. I believe that we need more pyschiatrists that arent so eager to perscribe medicine, and more who are willing to take a look at what is wrong. It seems like there is an epidemic in the United States with giving young children medication. If any of those people looked at the facts of how damaging it can be to a developing nervous system, it would not be so common. I think if parents and teachers become more informed this would not be as big of an issue.
Hepkatbritt · October 25, 2006 at 10:51 am
I Deffinatly agree that preschoolers and young children should not be medicated. I wonder if the schools are making the big push on parents to drug their kids because teachers are getting lazy. It is much easier to teach a class of small zombies who stay in their seats than it is to teach the normal active child. Focus is a learned skill, in my opinion, and by drugging children it seems that they are doing more harm for their attention span in the long run.
PinkShades05 · October 25, 2006 at 10:18 pm
I also agree that young children shouldn’t be medicated with Ritalin. There is more pressure from these pharmaceutical companies to sell these medications than there are children who need them. Just watching commercials on tv, sometimes they won’t reveal what the drug does, but asks you to consult your doctor about taking it! How do you know if you need it if you don’t know what it does? While some medications are really important, I can’t imagine all of the ones being advertised to us are necessary. What I can imagine is new parents looking at their child’s burst of energy and thinking, ‘Oh no, he/she is hyperactive!’ In reality, most of these cases are probably typical in young children and exhausted parents just forget how they were like at that age! We can’t expect children to be perfect and we can’t expect them to pay attention to every word we say!
Laura Freberg · October 26, 2006 at 11:11 am
AD/HD or the equivalent has been noted in the medical literature for hundreds of years, but it is possible that elements of modern culture are contributing to higher frequencies. Although it might be easy to blame TV and other media for a host of child problems, in my view, the problem is not so much the media as its being substituted for social interactions with parents, siblings, and peers. Kids need time to just PLAY.
esbranti · October 30, 2006 at 10:47 pm
This is especially disturbing to me, due to the fact that i have a cousin that has ADHD. Just knowing that he has been exposed to these drugs for years, possibly unnecessarily is very alarming. It seems that part of my cousins issues might have to do with his parents divorce when he was at a young age, and could have been perpetuated by his neglective father, as well as single-mothers’ demanding work schedule and therefore lack of attention provided by either parent. The qualifications for a child to be prescribed such a drug do seem absurd to me! A child that can’t sit still? Are there any children that can? Either way, it seems that if the drug has been deemed innappropriate for children under the age of 6, then there should not be exceptions made for any circumstance. It seems to me, that these pre-schoolers are in desperate need of some good parenting and loving attention, not drugs!
kcrusePSY340 · October 31, 2006 at 3:24 pm
Another psychology professor of mine suggested that ADHD is the most misdiagnosed disorder among children. This country thinks that there has been a rise of children with ADHD in recent years of epic proportions, but more likely it’s the number of kids falsely diagnosed that has risen. This rise probably correlates with several things. One is that advances in child psychology and biology that lead to more diagnosable disorders is a double edged sword. Though it gives us great insight, it provides more and more excuses for lazy and/or selfish parents and teachers to account for the results of their bad parenting and teaching skills by slapping a label on the child, and subsequently medicating them. The second is that our education system has not been updated to accomodate for all the things we now know about how children develop, learn and socialize, and what we should expect from them. Expecting a child to do or not do things that are developmentally out of their scope would surely lead to many unwarranted ADHD diagnoses.
Laura Freberg · November 1, 2006 at 7:28 pm
I think that one improvement to our understanding will be the separation of cases of ADHD-like behavior from similar syndromes that result from fetal exposure to alcohol and other drugs. I’m also hoping that improved imaging will help physicians make more appropriate diagnoses.
By the way, it’s important to remember that I do have a bias here that I warned you about. I happen to believe ADHD is over-diagnosed. Many psychologists just as adamantly believe it is UNDER-diagnosed. So be sure to keep your critical thinking hats on when reviewing this topic.
jejabe13 · November 14, 2006 at 5:22 pm
I have a difficult time with this article. I have much apprehension about medicating young children, but I think Ritalin has medicinal value. My cousin, who is now with fourth grade, suffered from severe from ADHD, OCD and Selective Mutism (a psychology refusal to speak) has benefited greatly from medication. It took a while for his psychiatrist and parents to find the right amount of Ritalin for his body, but once the right amount was determined, Ritalin has done wonders for him. Along with behavioral therapy, medication has helped allowed him to concentrate and maintain friends (he previously had a hard time sitting and playing with classmates). We’re still working on helping him become more social, for if it were up to him he would play computer games 24/7, but all our family and those who know him can agree medication has helped tremendously.
AshleyGrinchis · December 5, 2006 at 7:22 pm
I definitely agree that the criteria for being diagnosed with ADHD and ADD is way too general and unclear. I was tested for ADD myself and the test consisted of about 60 questions that asked things about how often you had trouble concentrating and finishing tasks, questions that 90% of the people I know would answer frequently and most likely be diagnosed with ADD. This is even scarier for young children because many children are diagnosed with ADD or ADHD when the problem is really something else and they are given medications like Ritalin and they are too young to communicate to their parents exactly how these medications are making them feel. Something needs to be done to improve testing for ADD and ADHD.
triciagordon3213 · December 5, 2006 at 9:58 pm
I’m suprised that ritalin is being prescribed to preschoolers. I don’t know any preschool child who doesn’t have a hard time concentrating or gets up from their seat often. This is part of being young, kids are going to be wild and have way to much energy, this doesn’t mean they have ADD or ADHD. Even if they do have signs of one of the two when they’re that young I would think there are other solutions besides prescribing a drug especially ritalin.
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