Sunday, April 27, 2008 | News
Growing up on drugs

America’s increased focus on standardized test scores has meant more widespread use of drugs for ADHD—whether kids need ’em or not

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Learn more:

“Your Child’s Strengths: Discover Them, Develop Them, Use Them”
Book signing by author Jenifer Fox
Wednesday, April 30
7:30 p.m.
Wordsmiths Books
404-378-7166
www.wordsmithsbooks.com

By Stephanie Ramage

Over the past few weeks, many thousands of Georgia elementary and middle school students sharpened their No. 2 pencils and waited for the teacher’s signal to turn over their answer sheets and hunker down to business on the Georgia Criterion Reference Test. Most did so without being under the influence of drugs, but some had been “juiced” for the test well in advance, perhaps even months or years in advance, through the use of drugs prescribed to treat attention deficit hyperactive disorder (ADHD).

Jennifer Fox, author of “Your Child’s Strengths: Discover Them, Develop Them, Use Them,” has seen the phenomenon herself. Fox, who is president of The Purnell School, a boarding school in New Jersey, describes a student she calls “Kate” (not her real name) who was extremely effervescent. She smiled a lot. She laughed a lot. She played a lot, even in class. Teachers complained that she wasn’t focused, so her parents had her put on a drug that was supposed to treat ADHD, and she lost that bubbly personality. It was as if the life “had been sucked out of her.”

“Kids are rushed to get diagnosed as learning-disabled so they can get extra time on tests and they can get put on drugs to perform better on tests,” says Fox, who is scheduled to sign her book at Wordsmiths in Decatur on Wednesday, April 30 (see box). “What we have in this country is a system that puts kids on drugs and gets them hooked on drugs for the rest of their lives.”

Though Fox acknowledges that there are children who definitely need medication, the problem, as she sees it, is an unhealthy focus on standardized test scores—a focus that parents often share with teachers, one that puts performance ahead of a child’s health and well-being.

“The schools are failing. The standardized tests are failing. And we are putting kids on drugs to try to overcome that,” she says. “That, to me, is like child abuse in a way.”

Fox points out that “Kate” had a strong suit—that bubbly personality that the drug erased. She says that she envisioned Kate someday working in a profession that required that kind of energy and vivaciousness. But since that strength was drugged out of her, who knows if Kate will ever make the most of the gift that she naturally had? Though Fox admits that there are kids who need medication to treat ADHD and other disorders, she adds, “I believe that it may be that these drugs are getting rid of the very thing that is best about these kids, something unique that the world needs.”

“Before You Take That Pill”

In his book “Before You Take That Pill: Why The Drug Industry May Be Bad For Your Health,” which hit bookstores in March, J. Douglas Bremner, a professor of psychiatry at the Emory University School of Medicine, explains that although its exact causes are not known, some scientists think that ADHD is related to alterations in the brain chemical dopamine, which modulates attention. Nonetheless, he views with skepticism the popularity of a plethora of stimulants used to treat ADHD, including Ritalin, Adderall and, a slow-release version of Ritalin, Concerta.

In his book, Bremner writes: “An entire generation of kids who cannot pay attention is being diagnosed more and more frequently (and sometimes inaccurately) with Attention Deficit Hyperactivity Disorder, or ADHD. It seems strange that it has been increasing so dramatically over the past few years. Certainly in the last generation many children with concentration problems were simply labeled unintelligent or ‘problem kids.’ However, with current competition for children to excel in school having reached such a fever pitch, it is no longer acceptable to let children fall behind. The elimination of recess, the lengthening of the school year, and the insistence that children remain rigidly fixed in their chairs without making a peep flies in the face of the realities of normal childhood.”

Bremner cites a three-fold increase in Ritalin prescriptions in the four years between 1991—which just happens to be the year that the U.S. Congress agreed that an ADHD diagnosis should qualify children for extra time on tests—and 1994. He goes on to point out that fully 10 percent of boys in America are prescribed some kind of stimulant for ADHD or other mental conditions.

On a recent weekday morning, Bremner, a soft-spoken man with a reserved demeanor, balances a laptop across his knees at a coffee shop, accepts an offered cheese cracker and explains his skepticism: “Do all of the kids who are taking Ritalin meet the requirements for ADHD? Probably not.”

There are reasons, not necessarily medical, that children might be prescribed a drug for ADHD, Bremner says. It may be that their parents want them to perform better in school, and those parents can pressure a doctor who is already pressured by pharmaceutical sales reps to write the prescription. It may also be the case that the child’s tendency to, well, be a child, is a problem.

“What we do know about these drugs and playfulness,” he says, “is that they tend to decrease playfulness.”

But how and why the drugs get prescribed isn’t the concern of the drug companies. The job of drug companies, he says, is not to make people well, but to sell drugs, and it’s a job that they do very, very well. Children, in particular, can provide a business boon, because once they’re on a drug, at what point is it OK to take them off? “Before You Take That Pill,” explores the risks of a wide range of drugs—not just those prescribed to children—and begins with the startling revelation that “Now, more than half of all Americans are taking a prescription drugs.”

All of the amphetamine-like stimulants used to treat ADHD, writes Bremner, act as appetite suppressants, and therefore may impede a child’s growth. They also “have been linked to approximately a doubling of heart-related deaths in children.” Such deaths are still rare, however. What he would like to see, Bremner says, is a little more skepticism on the part of Americans toward the extremely profitable drug companies.

Watching cartoons and drug commercials

Don’t count on the current crop of kids to be the ones to develop that skepticism. Rick McDevitt, executive director of the Georgia Advocacy for Children, says that drug use to solve problems has become an assumed part of American life, beginning when children are plopped in front of a television, where they view one pharmaceutical commercial after another. At school, he says, they are given to understand that if they do not do well on standardized tests, there might be something wrong with them that a drug can fix. Teachers tell parents their child isn’t focused and that they should seek help, and “help” turns out to be “take these pills.”

“The drugging of kids has become commonplace, the drug is a means of social control and the schools have become agents of that social control,” McDevitt says. “It’s about the test scores, it’s not about solving the problems at the source. The kids take the drugs, the test scores are better, and everyone says ‘They’re doing better.’ They’re not doing better. They are on drugs.”

Local child psychologist Sunaina Jain was listening to the radio recently when she happened upon a on a show on which people were talking about “our child-obsessed society.”

“I thought ‘What child-obsessed society?’ We don’t even like children in this society,” she says. “We do everything we can to make them become adults quickly.”

Jain, who has been in practice since before Ritalin hit the market in the late 1980s, says that the enormous use of drugs to treat ADHD is one more symptom of the need to make children become grown-ups. Although such drugs have helped many children, she says there is little doubt that they are over-prescribed. ADHD, she explains, affects about one boy in15 and girl in 25, but the number of prescriptions would seem to suggest that ADHD is epidemic in the United States.

“Part of the problem is parents who are looking for a way to improve their children’s test scores,” says Jain. “For these parents, these are ‘showcase’ children—their children’s success reflects on them. They want success, they want good grades, and if that can be obtained by popping a pill, that is what they do. There are also kids whose parents just don’t have time to pick them up from school and help them with their homework.”

The tendency to resort to drugs, she says, cuts through all economic classes. Like Fox, Bremner, and McDevitt, she points to a culture that makes it tough to be a kid. It’s a problem that affects the poor and the rich, though in different ways.

“If you have nanny-raised kids, you have the same problem that you have with poor, disadvantaged kids. With a nanny, they are not getting what they would from parents—they don’t learn how to connect with people,” Jain says. “Our strongest need is to connect with other human beings, and if you don’t learn how to do that, that’s a problem.”

The complaint she hears most from parents and teachers goes a long way in explaining what’s going on: “I don’t have time for this.”

The view of childhood as a time when competition makes or breaks one, as a screening process for winners and losers that needs to be gotten out of the way in time to join the adult world, is a view that distorts the children. Jain says the situation of children in America has steadily deteriorated since the 1980s. She believes that as a country, we have shifted away from seeing childhood as “practice” for adulthood and more as the game itself.

“But you know, you need practice to be good at the game,” she says. “A kid needs a coach, someone to say, ‘this is how you hold the bat.’ Then, after thousands of practices, one day they’re ready to go out into the world, to the game. A drug can’t tell them how to hold the bat.” SP