Gifts Special Needs and Issues - Ritalin: Keeping Kids Cool And In School

Ritalin — also known as methylphenidate — is the most popular drug prescribed to treat children with behavior disorders. The drug is a stimulant, in the same class as amphetamines and cocaine. It works by stimulating the neurotransmitters in the brain and helps the child with attention deficit/hyperactivity disorder (ADHD) focus and become less fidgety. Ninety percent of all Ritalin is produced and used in the United States.

Labels for hyperactive children change. In the 1940s, children who were hyperactive, inattentive or too impulsive were said to have Hyperkinetic Disorder of Childhood. In 1968, the American Psychiatric Association published a section on children in its handbook of mental disorders for the first time; they used the term hyperkinetic to describe rambunctious children. The term Attention Deficit Disorder (ADD) began to be used in 1980. This label put a finer point on the problem: a child who could not focus or pay attention. In 1987, the term Attention Deficit/Hyperactivity Disorder began to be used, a term that casts a bigger net (and label) over problem children in the classroom. An ADHD child can show a variety of symptoms: can't sit still, can't concentrate, performs poorly academically, is hyperactive, is difficult to control.

The disorder was not discovered the way illnesses are. It was voted into existence by the American Psychiatric Association for its official book of mental disorders. What causes ADHD? No one is certain. In 1998, the National Institute of Mental Health attempted to quell debate about the disorder by finding a biological reason but was unable to do so. Experts have pointed their fingers at nearly everything: stress at home, hearing/vision problems, and lead poisoning have all been thought to play a role (including being gifted and becoming bored with material the child already knows). There is no test for ADHD; a child is diagnosed by being observed. If a child exhibits a collection of symptoms — can't sit still, can't listen, can't follow directions — he may be diagnosed with ADHD.

According to the Drug Enforcement Administration, about 80% of the 11 million prescriptions written for Ritalin each year are for childhood ADHD. Roughly 3-5% of school-age children are thought to be affected by this disorder. Disturbingly, no one is certain how many children are actually on Ritalin. The panel shows what are considered good guesses: an estimated 150,000 children were on the drug in 1970, with figures roughly doubling each decade (according to some estimates). There are currently an estimated 5 million school-age children on the drug. Another 2 million children are thought to be on other psychiatric drugs, such as Adderall and Dexedrine. Production of these drugs has grown 2000%, according to the Drug Enforcement Agency.

Some sources cite such contradictory numbers that the issue of the drug being overprescribed becomes difficult to address. In 1996, the National Association of School Nurses claimed 3 million school children took Ritalin, while a study in Pediatrics that same year put the figure closer to 1.5 million.

Another point needs to be made: Ritalin is a useful tool for some troubled students. Children on Ritalin have shown improved levels of concentration. A study in the journal Experimental and Clinical Psychopharmacology found the drug improved the social skills of ADHD teenagers and improved their test scores an average of 17%.

What's going on here? An increasing number of parents and physicians are calling the treatment of (and, indeed, the ADHD disorder itself) into question. We seem to expect a classroom of 30 children to behave in the same way and learn at the same rate. Of course, some children have real problems that need to be addressed biochemically. But one can't help but wonder if we're more interested in changing the behavior than the reason for it. Dr. Lawrence Diller, author of Running on Ritalin, claims that Ritalin can help "roundand octagonal-peg kids fit into rather rigid square educational holes." Are these children with "special needs" that we aren't addressing? Is hyperactivity and inability to concentrate the problem, or are they the symptom of one?

The next panel will look at a different segment of special education — gifted students.

Sources: Chart data comes from "Children and Psychiatric Drugs: Colorado's Concern Should Be Ours As Well." Retrieved from http://www.wildestcolts.com; Sax, Leonard. "Ritalin - Better Living Through Chemistry." World and I, November 2000, p. 286; "Alternative Treatments for Children Who Have Been Prescribed Psychiatric Medication." Retrieved May 3, 2002 from http://www.alternativementalhealth.com; "Statistics Confirm Rise in Childhood ADHD and Medication Use." Retrieved from http://www.education-world.com; "What is behind the Alarming Increase in Ritalin Use Among US Children?" Retrieved from http://www.wsws.org. "Better Children Through Chemistry." Retrieved from http://www.columbia.edu; "Does ADHD Even Exist?" Retrieved from http://www.naturalchild.com; "ADHD Statistics." Retrieved from http://www1.adhdguide.net.