Dear FRONTLINE,

I am a Licensed Clinical Social Worker with ten years experience working with preschool age children and families. An important difference between psychiatrists, psychologists and clinical social workers is that clinical social workers take a broader view of the client. A social worker's assessment of a young child includes looking at the child in his environment. Psychiatrists and psychologists assess only the child's behavior. They do not consider environmental factors such as, diet, side effects of other medications (i.e. asthma meds.),amount of outdoor fun, housing conditions, parenting skills, etc.

In the ten years that I have worker with young children I have recommended medication for one child. In contrast, teachers are very quick to recommend medications to parents. What I say to that is keep in mind that most pre-school teachers and teacher assistants do not have a college degree and behavior problem children make teachers work harder. I view the classroom as treatment - behavior modification. The goal is to teach children how to behavior in a classroom setting and how to get along with peers. It is in the preschool classroom that children learn impulse control through turn taking and other classroom activities. The classroom is also the perfect place to manage children who are prone to obsessive thoughts. I.e. when's mommy coming, when's mommy coming, when's ......; this is an example of a child prone to obsessive thoughts. With coaching from a trained clinical social worker the teacher can set limits to the question asking, monitor the child and eventually change the behavior. Guess what, it takes work, hard work. The job of a pre-school teacher is just that - a teacher. Not a baby sitter. Not just keeping the children busy until the parent(s) take them home. The preschool years are the most important years of life because of the social and emotional development that takes place. Other than being a parent the job of a preschool teacher is most important to society.

As members of society we should demand that preschool teachers are better educated in early childhood and behavior management. They should also be given a hefty raise. To the MD who said treatment is not possible at age 4, I say hogwash!!! I am of the opinion TREATMENT FIRST medications as a last resort.

Sheila Capece
West Greenwich, RI

Dear FRONTLINE,

Watching this show made me feel physically ill; my husband and I have a 2-year old daughter and I can't think of medicating her unless she specifically shows major signs of illness, I won't do it. I think the United States in particular has fallen into a dangerous and casual attitude towards pharmaceuticals and a lot of people don't question what doctors recommend. When it comes to our child, we ask a lot of questions, do a lot of research and carefully weigh pros and cons.

I see the drug companies as powerful corporations that are only interested in one thing: making as much money as they can. This is our future at stake here. When people give their children drugs that may adversely affect them for the rest of their lives, if not now, they're playing Russian roulette with a human life!

Sunnyvale, CA

Dear FRONTLINE,

I am disappointed with the response of some of your viewers. My son was diagnosed with bipolar disorder last year after several years of misdiagnosis, ineffective talk therapy, then medication for anxiety rather than bipolar disorder. The misdiagnosis (or change in diagnosis) finally resulted in a psychiatric hospitalization for him for violent behavior. This hospitalization was a blessing because it enabled him to get a proper diagnosis.

My family is upper middle class, highly educated and we certainly cannot attribute my son's problems to our parenting style. It's quite clear to us that his problem is biological and genetic, and a history of mental illness (aunts, uncles and cousins) on both sides of our family backs this up. I'm particularly upset that a self-reported doctor would come up with such inaccurate generalizations. Now that my son has an accurate diagnosis and is on a better medication regime he is able to deal with school and day to day pressures he faces. We know this medication is to some degree "experimental" for adolescents, but it enables him to live his life without painful depression and rages.

Watertown, MA

Dear FRONTLINE,

This program gave us a glimpse into children and medication. The keyword is "glimpse"; those of you making judgements about the children, parents and doctors in the show are not in a position to make a judgement because you saw brief, edited clips about complete strangers.

Why does everyone assume these parents have jumped from nothing right to medication? How do you know they haven't tried years of diet modification, talk-therapy, a multitude of parenting strategies (including good old spankings)? And why the assumption the parents are medicating their child to make their own lives easier, to the detriment of their child's health? These parents are trying to save their child's life, or at least make it bearable enough for the child to want to live. Why are so many of you assuming the worst about people you don't even know?

Manchester, New

Dear FRONTLINE,

Judging by the wonderful comments of pall those who have written in, you're certainly on the FRONTLINE with this one! It's something that needs to be talked about - How is it that we haven't talked about this more?

As a candidate in modern psychoanalysis I see some of my patients in a low-cost urban clinical setting, where they come in on a regular basis, lie on a couch, and talk. Patients that stay in treatment with me get better. Some need time to work on the things that have troubled them for most of their lives, but there are noticeable improvements in many after a few months.

Is TALKING a radical perspective in 21st Century America?

I'd love it if FRONTLINE could also do a feature on all of those children (& adults) who have been helped by the scientific advances we've made in modern psychoanalysis.

James Fennessy
Philadelphia, PA

Dear FRONTLINE,

I thought your program lacked the necessary insight into the children's home environment. What we didn't see was a day in the life of a child interacting with their parents. We saw some brief interactions with the families a few times. Those seemed to benefit the parents as they seemed very prepared to be on camera. What was lacking was any evidence of disturbed children. Rather, what I gained from the show was that some questionable parents were able to have their chidlren medicated for the parents inability to deal with typical childhood behavior.

Arlington, va

Dear FRONTLINE,

Thank you for highlighting this very important subject. As one who was diagnosed with 'bi-polar', and kept on mind altering drugs for over twenty years, I watched your program with great interest. It brought tears to my eyes. Unfortunately I know from personal experience that long term use of psychiatric drugs causes much more harm than good.We need to find real causes and real solutions. What is it about western society which is causing our children to have so many problems? Why are we prepared to take the happy pill so easily? Are our professionals trained to deal with the problems they encounter? etc. etc.It is understandable we all need our basic needs and security, but now it is time that we in the western world see that we are sacrificing our children and our grandchildren on the alter of success. We are losing our most important values daily for the golden calf.

Mary Ellen Maddock
Cork, ireland

Dear FRONTLINE,

Thank you for presenting this program. People have a difficult time thinking of children having these types of disorders, but if you were to spend time in some of their homes, you would find that it is a real, living hell, not some overblown temper tantrum. Raising the awareness of the reality of children with these debilitating disorders is so vital to getting the necessary services to accurately treat and diagnose children who have these types of disorders. There is a severe shortage of pediatric inpatient beds, insurance benefits and qualified, accessible professionals. If you happen to be on SCHIP programs, you have even less options. And, exactly like the adult population, every medication affects each individual differently--so it may take numerous trials of drugs and a lengthy period of time to find the most effective drug therapy for the individual.

Our journey began with our six year old writing suicidal notes at school, headaches, the loss of his laughter and smiles and escalating agitation and aggression. The first psychologist we met with spent 1 hour interviewing us, 0 hours interviewing our child, and 4 weeks telling us how to use time out. As parents who already had a developmentally delayed child at home, we knew how to deal with behavior issues; we sought treatment elsewhere. It took us three clinics, four years of escalating behaviors, a handful of diagnosis, two school districts, suicide attempts, the loss of a year of school, and finally 2 psychiatric hospitalizations -all by the age of 10--to find a drug combination that gave our child back some normalcy. I spent almost an entire year caring for my son 24 hours a day. We designed our own behavior programs. My husband and I changed the way we parented all of our children. We used the internet to research alternative therapies, talk with other parents, and find out anything that would give us hope. Our younger and older sons missed out on opportunities and were ridiculed because of their sibling. Other parents in the community wrote letters demanding the removal of our child from school. We had difficulty with law enforcement supporting us. We were even turned in to child protective services for statements made by our son while hospitalized in a pediatric psychiatric facility.

We now have a quirky child who, after a myriad of labels over the last 9 years, is diagnosed with Asberger's Syndrome and can function because of Risperdal. We still have behavior issues; but they are manageable and not life-threatening anymore. We are happy to have our son's smile and laughter back--and no cost is too great for that.

Stacy Shown
La Grande, Oregon

Dear FRONTLINE,

I was glad to see that Frontline program but it struck me that several important questions went unasked:

^ No mention was made about researching the CAUSE of these problems except that they don't know anything.

^ Drug companies make huge profits on these drugs. Let's require them to fund studies that have no strings attached so that there can be independent study. There is too much money attached to the results of specific drug testing and none available for independent tests such as the effects of diet, nutritional deficiencies, or of other methods to solve these problems.

^ Nothing was mentioned about testing for lead, mercury, etc. in any of these kids: known neuro-toxins.

^ Another issue not broached is history: Remember the generation of housewives on valium? It was fashionable until people decided that addiction was a problem. Getting out of the house was one of the best solutions. Does this look familiar to you? What will the consequences be?

^ Are there solutions other than medications? Yes, there are thousands of people who have found a drug free solution to these problems. One is the non-profit organization Feingold.org. It works, and I recommend anyone try it before moving on to medication. It's a good place to start, and there is a lot of support from other families who can give really helpful advice that works.

Chicago, IL

Dear FRONTLINE,

As the parent of a daughter with bipolar illness, I can attest that medication saved her life. She took Lithium for 5 years but hasn't taken medication for another 5 years. She was able to graduate from college with high honors, win several scholarships while in college, work for three years and form friendships.

Fairfield, California

Dear FRONTLINE,

I watched Frontline's The Medicated Child with sadness. My son was born in the 80's and was diagnosed with 'borderline' ADD as a result of the suggestion of his 3rd grade teacher that he be tested. He was on and off medications over the years; and although my husband and I believe that his performance in school was better, we never liked giving him the medication. He became addicted to drugs over the years and we lost him last April in an automobile accident. We miss him every day and wish that we had handled his problems differently.

I would like to see a follow-up program about how these medicated children are doing as adults. How many of them have become drug addicts and homeless? How many of them have lived in 'homeless camps', something we unfortunately found out about when our son was homeless? How many have died?

Cary, NC

Dear FRONTLINE,

I was disappointed in the Frontline program examining the medication of children. The reality is that all of these children are dependents living in families. Often their families are a mess. As a children's counselor I see children from 2 to 10 who have "anger issues" and most have been diagnosed with ADHD and are on medication. While the parents often present as mystified at their child's aggressive behavior, I usually discover that the children have some very good reasons for being angry. The situations they deal with daily? Rejection from parents, being raised by grandparents, physical abuse and neglect, parent's use of drugs and alcohol, living between two houses due to divorce, step families, witnessing domestic violence, repeated stays in foster care, developmentally unrealistic expectations in pre-school and kindergarten....the list could go on. And, in spite of being medicated, the problem behaviors continue. I believe every effort should be made to change the child's situation before ever considering medication. There are therapies that are appropriate for children and their families. Play therapy is a developmentally appropriate intervention that can strengthen relationships in a family and provide a safe place for a child to feel understood and accepted. And unlike "talk therapy", it is based on the reality that play is a child's language and children can communicate and resolve many problems through play. It is very different from behavioral approaches that rely on a system of rewards an punishments. Behavioral approaches have limited affect if the source of the problem is the relationship between parent and child. I wish that Frontline would have asked the question: What about the family? Why are these children angry and aggressive? Those questions were not even considered by the experts interviewed in the show. These questions should be explored in depth (and that takes more than five minutes with a psychiatrist or pediatrician) before medication is prescribed.

Patti Greer
Alamogordo, NM

Dear FRONTLINE,

Thank you for a well balanced program, I have tears in my eyes.

I have been through the entire medication route(10 different prescriptions and combinations) with my sixteen year old daughter, which ultimately resulted in her hospitalization for tardive dyskenisia four years ago. The school system and doctors told us she had a serious mental illness when she was six years old, ...took us to court to prove the point...fortunately they were completely wrong.She is medication free and a healthly sixteen year old girl. She has learning disabilites, but with a supportive educational program, is on the honor roll and planning to attend college.There is hope...but I know not all are as fortunate as we have been, but some of these situations do work out. Wish I saw this program ten years ago, she went through way too much in her short life. Thank you for showing both sides of a very difficult issue for parents and children

Sharon, MA

Dear FRONTLINE,

I am the mother of a young son diagnosed as bi-polar, OCD, ADHD, and generalized anxiety. I regret your program did not emphasize the behavior of these children before medication.

Many homes are dominated (such as mine) by the behavior of this illness. It affects the entire family, outside relationships, abililty to work and provide for these children. Mental illness is isolating. I had no idea how devasting this illness would be to my family. I applaud all parents who are working very hard to provide their children with what they deserve most - a childhood.

Medication is not a choice anyone wants for their child but quality of life is important to these children.

Andrea Dunlop
Northampton, MA

Dear FRONTLINE,

This post is in response to Rebecca Bruce in Tallahassee, Florida. How DARE you judge us when you don't even know what you are talking about!?! I'll tell you the same thing I tell other people who judge without all the facts.... I will take him off his meds and send him to you. You deal with 3 hours of sleep a night, racing thoughts, agression, aggitation, anger and a 130 pound 12 year old coming at you with MURDER in his eyes.

Cyndi Browning
Lexington, SC