MEDICATING OUR CHILDREN

April 2000
		Are we overmedicating our children? When should doctors prescribe psychiatric drugs for kids? Should there be restrictions imposed for younger children? Experts answer your questions.

Forum introduction Ritalin for children under 5. Diagnosing ADHD Diet and ADHD Is our definition of 'normal' accurate? Adults and medication Additional Comments     Health Spotlight: Attention Deficit Hyperactivity Disorder March 24, 2000: Treating ADHD The NewsHour's Health Spotlight. More NewsHour health coverage.	Lucie Slater of California, MD asks: What is the difference between ADD and just 'little boy' annoying behavior? Dr. Jensen responds: There is a great deal of difference between being a "normal little boy" and ADD or ADHD. ADHD when appropriately diagnosed only affects a small fraction of children, perhaps 3% of children regardless of age. When diagnosed appropriately, such children in fact have great difficulties in home, preschool/school, and other settings, and cannot do the kinds of things that "little boys" (and little girls) can normally do without difficulty...get along in small play groups, inhibit severe levels of aggression, listen to a story, etc. An early diagnosis of a behavioral or emotional disorder should not be confused with normal behavior. But such a diagnosis should be made by an expert, such as a child psychiatrist or developmental/behavioral pediatrician who has had extensive training in distinguishing between normal "little boy" behavior versus early, severe disturbances in mood, behavior, and/or personality. Dr. Diller responds: This question again reflects the problems of diagnosis referred to in the previous answer. Despite attempts at standardizing both the diagnostic criteria and evaluation process, ADD remains very much an "eye of the beholder" diagnosis. Wildly varying rates of Ritalin use in this country attest to factors other than neurological which lead to the ADHD diagnosis and treatment with Ritalin. Official criteria insist on the notion of "impairment" of function in significant areas of life but unfortunately that also remains a judgment call. Depressed mothers rate their children as more hyperactive than non-depressed mothers. Special education teachers rate the same child as less hyperactive compared to regular classroom teachers. In extreme cases of ADHD you don't have to be a specialist to recognize there's something "wrong" with the child. It's the Tom Sawyers and Pippy Longstockings who receive medication that cause the controversy.