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Home
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Drug Therapy -- Behavior Modification for Children with
ADHD
by A. Ross, M.A. in Speech, Education
It is important to stress once again that good ideas and
excellent advice given by the most experienced professionals,
or printed in bestsellers on child managment, do not always
work. Although they may work very well for some children,
they do not work on others. We all know that raising children
is not like using a well tried recipe and knowing the cake
will always succeed. There can be a dozen children in the
same family, eleven of whom conform, more or less, to the
rules which their parents have laid down, and then the
twelfth shows that he has no intention of fitting into the
mold. If he has an obvious disability, then at least parents
know where they stand, and accept him for what he can or
cannot do. But if he has ADD which is such a highly variable,
complex and imprecisely defined disability, they may not even
take him to have it diagnosed until the family seems to be
falling apart.
It does not seem logical to give an over-stimulated child a
stimulant medication. Yet methylphenidate (Ritalin) and
dextroamphetamine sulfate (Dexedrine) are both stimulants and
are widely used in the treatment of ADHD. The enthusiasts
criticize the antidrug activists of ignorance and of trying
to mislead the public deliberately. They claim that their
opinions do not have a scientific source. The more moderate
practitioners claim that these drugs are not sedatives, they
do not dull the child's faculities, and that parents have
nothing to lose by trying them. The Citizen's Commission on
Human Rights, and other vociferous activists, assert among
other things that "Ritalin is a dangerous, addictive drug
often used as a chemical strait jacket to subdue normally
exuberant children because of intolerant educators, parents
and money hungry phychiatrists." The question arises whether
these activists have ever dealt with one of these `normally
exuberant children' for any length of time.
In the end, the decision is up to the parents. One cannot
believe everything one hears or reads. On the other hand, can
one afford to ignore it? "He's so hurt by being shunned by
his mates, although he brings it all on himself." "He's like
a mosquito in my ear. I try to stay calm, but as he goes on
and on, my chest feels tight, my neck tenses and I want to
scream." "He is blind to mess, compelled to touch everything
and leaves a trail of lost property wherever he goes." "He
now gives up without even trying." These are just a few of
the things parents say about their beloved child.
Parents often object to the term `psychiatrist,' afraid he
will make their child into a `case,' and furthermore, that he
will be stigmatized for life. There is no easy answer to the
first fear; there are good and bad pracitioners out there. As
for the stigma, it is there already. A child with ADD is
different.
So, after much deliberation, this child is taken for
diagnosis, and given Ritalin. The following are some of the
claims reported in various journals of medicine and
psychiatry, published during the last ten years:
Stimulants reduce restlessness, improve classroom
productivity, keep the child focused on a task and increase
accuracy in his work. Children are less impulsive and
disruptive, and learn when to leave things alone. Written
work is neater and speech is less garbled. The child listens,
takes instructions and can accept reasoning. Interactions
improve between the children and their teachers, parents and
peers.
Stimulants do not increase intelligence. They do not increase
the child's natural abilities. They just allow him to make
the best use of what he has. We have not mentioned the child
who is oppositional and defiant, really wanting to hurt
others. These children have a pure conduct disorder which,
most practitioners agree, is not helped by Ritalin.
At this moment, there has been much research into the short
term benefits of stimulants. However, long term benefits are
still conjecture. It is axiomatic that happier, less negative
parents have a happier, more responsive child. A happy,
responsive child feels good about himself, and his self
esteem improves.
But what of the side effects? Addiction, if any? And how
about the reaction of maybe even a spouse or other relatives,
who are very opposed to giving stimulant drugs to children?
Interested readers with access to relevant literature will no
doubt receive answers to all the questions they wish to
ask.
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