Read a 2008 update on Nicolas

In December 1999, Yolanda DuPerret received a phone call from the principal at her son's preschool. Three-year-old Nicolas was "acting up," and "disrupting class." The principal, Cindy Oberdier, wanted the DuPerrets to come in for a meeting because she suspected that Nicolas had attention deficit hyperactivity disorder (ADHD). "He really stuck out like a sore thumb," said Oberdier. "His approach was to bombard everyone with his presence."

Nicolas's father, Cyrille DuPerret, is from France, where children are rarely diagnosed with mental disorders. It didn't occur to him that there was anything wrong with his son. "He's just a boy and he's very active and ... we didn't think much of it," said Cyrille.

After discussing their son's situation with the school, the DuPerrets met with psychologist Ed Cable, an ADHD specialist. At first, Dr. Cable thought Nicolas might be attending the wrong school. But after he saw a videotape of Nicolas in the classroom, he said, "It was pretty apparent that he was below average in his ability to just stay in one place." In order to determine if Nicolas had ADHD, Dr. Cable proposed using a standard diagnostic tool--the Conners Rating Scale, a checklist of 28 behaviors like "restless in the squirmy sense," "overly sensitive to criticism," "childish and immature," and impulsive.

The DuPerrets chose not to formally test Nicolas for ADHD. "The psychologist suggested he might be ADD or ADHD, which were new acronyms for us. And then he suggested also the use of medication. For us, it was like a cold shower," said Cyrille. "He's a handful," said Yolanda. "He is more intense. He is more active. ... I could never understand how that would translate into my son having something wrong with his brain."

The DuPerrets chose not to medicate Nicolas. Instead, Cyrille and Yolanda are trying to spend more time with their son. They decided it would be best if they did not both work full-time, so for six months, Cyrille stayed home to take care of Nicolas and his baby brother.

		Read a letter to viewers from Nicolas's Parents.

   Read a 2008 update on Noelle

"I was pretty happy until fifth grade," said Noelle Demo. "Fifth grade is when it all crashed. That year was one of the toughest years of school. I didn't feel like I fit in. I didn't really pay attention 'cause it didn't really interest me that much." Throughout grade school, Noelle Demo struggled with more than just paying attention. There were not only bad grades, but fights and suspensions. For her parents there was an endless string of tense parent-teacher conferences.

"I cried through a lot of them because it was rough," said Noelle's mother, Carol. "I mean, she's a great kid ... I just couldn't figure out for a long time what the deal was."

Then, when Noelle was in the fifth grade, she asked her mother if she could take Ritalin. "I said, 'Mom, I don't think I'm doing real well in school and maybe it [would help] if I tried the medicine,'" said Noelle. Carol was hesitant. She tried other alternatives, and continued reading about Ritalin. Noelle's doctors assured Carol that Ritalin was safe, that it had been studied more than any other medication, and that it had helped many kids.

Finally, Noelle was prescribed Ritalin by Jim Grubbs, a psychiatrist. "The Ritalin changed every aspect of Noelle's life," said Carol. "Her self-esteem improved. She went from Cs, Ds and Fs to As and Bs." Ritalin did more than help Noelle academically. It appeared to make her a better athlete. Although Ritalin is a banned substance in international competition, Noelle's gymnastic league allows it. While taking Ritalin, Noelle won a slot to compete at the state championships. "I'm not saying the medication makes her score well," said Jo Beth Mosher, Noelle's coach. "It makes Noelle concentrate and want to perform well."

Noelle took Ritalin throughout the sixth grade. But a few weeks into the seventh grade, she began to have some doubts. She stopped taking Ritalin. "When she stopped taking Ritalin, it went back to the way it used to be," said Carol. After only a month off Ritalin, Noelle started taking her pills once again. She received straight As last semester, and in December 2000, her team won Colorado's State Gymnastics Championship.

   Read a 2008 update on Alex

In many cases the diagnosis of ADHD is complicated because doctors often believe it coexists with other psychiatric ailments. Twelve-year-old Alex McCarty is one of those cases. His parents, Diane and Tim McCarty, were first concerned about Alex's depressed attitude. Diane began to worry that it was more than just a case of pre-adolescent moodiness.

She took Alex to see Asa Yancey, a psychiatrist, who diagnosed Alex with depression and prescribed a low dose of Effexor, an antidepressant. Three months later, while still on Effexor, Alex attempted suicide. The suicidal thoughts and depression finally went away after his Effexor dosage was increased, but Alex's problems at school continued. "Toward February or March it became clear that some people really thought he had an attention problem," said Dr. Yancey. "Those people included one of his teachers [and] one of his parents."

Dr. Yancey had three of Alex's teachers and both his parents fill out a variety of child behavior checklists. The results were inconclusive. In an effort to clarify, Dr. Yancey tried another kind of test, a computer program called Test of Variables of Attention (TOVA). This time, Dr. Yancey didn't question the results.

"[Dr. Yancey] said there is a chemical imbalance in my brain which doesn't allow me to concentrate correctly," said Alex. "So he gave me some medication for that and told me that a lot of times attention deficit disorder can be linked to depression. So if I get rid of the ADD, I get rid of the depression."

Alex took his first dose of Adderall on his 12th birthday. "So far Alex has improved a lot over the time of this school year," said Lynn Sis, Alex's teacher. "When he came, he was not doing too much work at all. Over the course of the year, he is doing most things on a modified scale." Alex gradually noticed the effects, too. "I liked to do school, and I wrote stories and concentrated more in math," he said. "So I felt better about myself."

Alex is still taking his medications. He plans to stop taking Effexor in the summer of 2001, but his doctor says he will likely be taking stimulants for the foreseeable future.

   Read a 2008 update on Robin

Robin Day spent his early childhood in what was apparently a loving and nurturing home. His mother says that it was the happiest time of her life. But the happiness didn't last. "I think [Robin had] this natural creativity, impulsiveness, aliveness that didn't quite cut it in the classroom," said Barb Day.

Robin was diagnosed with ADHD in the fourth grade and put on Ritalin. His teachers and his parents noticed improvements, but Robin didn't like the medicine. His mother persisted. "By the time my son was in sixth grade, we [had] tried Ritalin, then Ritalin-SR, then Cylert, then Wellbutrin, then Dexedrine, then we added Zoloft to Dexedrine," said Barb. "Then we went to Adderall."

The Days kept searching for answers. In the sixth grade Robin even spent two days on the psychiatric ward at Denver Children's Hospital. "We began to treat Robin like a disorder, as a pathology," said Barb. "I started to look at everything as a crisis."

When Robin refused to take his medication, Barb Day went as far as getting a court order to force Robin back on Adderall. "It kind of pisses me off that she made me take the medicine even when I didn't want to, even when I told her that I didn't want to and that I didn't think it helps," said Robin. Eventually, the continuing struggle took a toll on the family. FRONTLINE was there the day Barb Day moved out of the house.

Now, Robin says he never wants to take medications again. He resents the fact that so many adults have insisted that psychiatric drugs were ever the answer.

		Read Barb Day's letter to FRONTLINE viewers.