Attention Disorder or Not, Pills to Help in School

Bryan Meltz for The New York Times

Amanda Rocafort and her son Quintn in Woodstock, Ga. Quintn takes the medication Risperdal. 

CANTON, Ga. — When Dr. Michael Anderson hears about his low-income patients struggling in elementary school, he usually gives them a taste of some powerful medicine: Adderall.


The pills boost focus and impulse control in children with attention deficit hyperactivity disorder. Although A.D.H.D is the diagnosis Dr. Anderson makes, he calls the disorder “made up” and “an excuse” to prescribe the pills to treat what he considers the children’s true ill — poor academic performance in inadequate schools.

“I don’t have a whole lot of choice,” said Dr. Anderson, a pediatrician for many poor families in Cherokee County, north of Atlanta. “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.”

Dr. Anderson is one of the more outspoken proponents of an idea that is gaining interest among some physicians. They are prescribing stimulants to struggling students in schools starved of extra money — not to treat A.D.H.D., necessarily, but to boost their academic performance.

It is not yet clear whether Dr. Anderson is representative of a widening trend. But some experts note that as wealthy students abuse stimulants to raise already-good grades in colleges and high schools, the medications are being used on low-income elementary school children with faltering grades and parents eager to see them succeed.

“We as a society have been unwilling to invest in very effective nonpharmaceutical interventions for these children and their families,” said Dr. Ramesh Raghavan, a child mental-health services researcher at Washington University in St. Louis and an expert in prescription drug use among low-income children. “We are effectively forcing local community psychiatrists to use the only tool at their disposal, which is psychotropic medications.”

Dr. Nancy Rappaport, a child psychiatrist in Cambridge, Mass., who works primarily with lower-income children and their schools, added: “We are seeing this more and more. We are using a chemical straitjacket instead of doing things that are just as important to also do, sometimes more.”

Dr. Anderson’s instinct, he said, is that of a “social justice thinker” who is “evening the scales a little bit.” He said that the children he sees with academic problems are essentially “mismatched with their environment” — square pegs chafing the round holes of public education. Because their families can rarely afford behavior-based therapies like tutoring and family counseling, he said, medication becomes the most reliable and pragmatic way to redirect the student toward success.

“People who are getting A’s and B’s, I won’t give it to them,” he said. For some parents the pills provide great relief. Jacqueline Williams said she can’t thank Dr. Anderson enough for diagnosing A.D.H.D. in her children — Eric, 15; Chekiara, 14; and Shamya, 11 — and prescribing Concerta, a long-acting stimulant, for them all. She said each was having trouble listening to instructions and concentrating on schoolwork.

“My kids don’t want to take it, but I told them, ‘These are your grades when you’re taking it, this is when you don’t,’ and they understood,” Ms. Williams said, noting that Medicaid covers almost every penny of her doctor and prescription costs.

Some experts see little harm in a responsible physician using A.D.H.D. medications to help a struggling student. Others — even among the many like Dr. Rappaport who praise the use of stimulants as treatment for classic A.D.H.D. — fear that doctors are exposing children to unwarranted physical and psychological risks. Reported side effects of the drugs have included growth suppression, increased blood pressure and, in rare cases, psychotic episodes.

The disorder, which is characterized by severe inattention and impulsivity, is an increasingly common psychiatric diagnosis among American youth: about 9.5 percent of Americans ages 4 to 17 were judged to have it in 2007, or about 5.4 million children, according to the Centers for Disease Control and Prevention.

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Comment by Tara on October 11, 2012 at 11:51pm

This shit pisses me off!!! Sorry for cursing so much all but I have personal experience with the worst kind of drug pusher... the The Big Pharma Whores! I have a close family member ruined by them and many of my daughters friends, I have come to find out are on some kind of pyschotropic medication. It is mind boggling.

WTF happened in the last 20 years since I attended school? All of a sudden... if a child displays any signs of hyperactivity, not listening in class, talking too much with friends, talking too loud, boredom, ectera... the children are deemed unruly and should be medicated because of it. That's insane!!!

Damn... I was bored as hell in school, got in trouble quite often with teachers, was overly fidgety and bored and had a hard time concentrating. I never was put on any damn pills for it though. It was what it was and the teachers and parents dealt with it accordingly.

Boy... how things have changed and much for the worse. Talk about wanting to dumb the children down and keep them in line with serving the State (our Big Government gone rogue)... what better way than to do it through a supposed magic pill. Unfortunately, the parents don't understand that the pill will eventually kill ya. If they only knew!  

 

Comment by suzie on October 11, 2012 at 12:36pm

BRAVO! @Tammie ~ your are exactly right! :) 

Comment by Tammie A on October 11, 2012 at 12:29pm

School say drug them up so it will shut them up! Little zombies 

If a kid is over active or hyper they want to drug them all, with my son not one time would i let them put him on anything. The school would call and say your child is acting up today. Im like ok i will take care of it when i pick him up. I would go into the office and set down with some teachers and or principle with my son and i would let him know it is not acceptable to disrupt class and we would work it out and he would be fine. Kids know what they can get away with and if parent's would sit down at the school with their kids having a more active roll child, parent and teachers. Kids would stop most of there behavior problems. Parents don't get involved anymore they send them to school cause they have to, and they have a babysitter for around 8 hours a day.  When i would go in they would say maybe he needs to be on medication it would make him happier! I told them no it would make ya'll happier so get over it not happening and you can kiss mine if you think it is. He is 20 now in college and still doesn't need medication. I know parents that have their kids on medications cause they say it helps them. Im sure their is some cases a child might need medication but do they really or as i sit and think about it does most behavioral problems really just start at home?  

Comment by Roy Patterson on October 11, 2012 at 11:27am

It seems that doctors and drug companies have a drug for every problem a person can have. Just watch TV or read most magazines. Drug Ads are everywhere. Tell your doctor about this or that drug. Some of the drugs have worse side efects that the problem they claim to solve. There are a few life saving drugs out there, but most are junk(including over the counter crap) and really hurt you more than they help you.

I'm 71 years old and don't take any meds(including over the counter) and my health is good. I try to eat right, exercise, am not over weight and do take some nutritional supplements.

Remember, Doctors, for the most part, don't get paid unless you are sick.

Comment by suzie on October 11, 2012 at 11:12am

This subject breaks my heart ~ I am not a professional in any sense of the word nor do i have any impressive degree's all i know is that it is alarming that this ADHD seems like something akin to 'restless leg syndrome' i ask myself is there any kid any where that doesn't have an attention deficit. We have trusted MD's as if they were little gods and were nor asking the correct questions ~ #1 being what causes things that are more real like autism. Is there a connection with vaccines? Is there a connection to diet? GMO's ? WE have also not questioned the pharmaceutical companies and looked at the kind of protection these mad scientist have when promoting all kinds of drugs as 'safe' ~ I can say that all drugs have side effects if you have ever listened to the commercials they quickly rattle through the side effect and slip in 'death' as one of them and we just take these drugs anyway ~  I have watched a friend who takes care of a normal healthy child after school every day for years because his mom is working at the time he gets out of school ~ I can't be the judge of the mom or dad but i have watched for years as they pawned of parental duties to many others to do things like home work, school events, even when they are sick, as i won't go into the history this little boy 9 years old decided he didn't want to go to school this year ~ He has cried and had hissy fits saying he misses his teacher from last year ~ the school system had a lunch date with is last years teacher and has coddled this kid for since the first day of school. His mom has had to pick him up every day and what have they done? Reward him with play dates and expensive gadgets trying to bribe him has not worked ~ The school has after a month of this has had the state come in and he now is being put in a rehab center with drug addicts and alcoholics this facility has a 'behavior program' and he has to stay there for 'evaluation' of course he had a tantrum and was restrained and forcefully drugged ~ this is on going and i know that this little boy was "crying wolf" he had a nice gig going on he was being rewarded for bad behavior by everyone and he got what he wanted ~ he didn't have to go to school ~ Last i heard he told his mom he now wanted to go to school ~ It was too late he now cannot go to school and instead has become a ward of the state and his parents are under investigation ~ I don't know how this is going to end but it is tragic to me ~ I am sure he will be diagnosed with something terrible ~ This little boy who cried wolf need some discipline and not rewards for bad behavior there is a breakdown of every kind of common sense all around him and he is now in dyer straights because of his own shinnanigans  ~I am only privy to this story because i know the lady who use to pick him up from school because his mom and dad were working ~ Society is breaking down there is no real reason this 9yr old boy should be in this situation his mom and dad make a ton of money what they need is less money more time with there kids ~ This 9yr old boy has a sister who is 12 ~ 

Comment by Anthony Kimbrough on October 11, 2012 at 12:34am

I have a daughter who is going around with the system now with her 2nd oldest son on ADHD and Autism. She has a blog she started http://moms-autism-journey.blogspot.com She works with him using his diet and though not strict, she has made progress without drugs. She is working mostly as her doctor prescribed to avoid Gluten and MSG in his diet.

Comment by Patty Volies on October 10, 2012 at 9:44pm

I know as parents you listen to the doctors as we all believe they have our best intrest at heart but drugging our kids is not the answer. There are millions of Moms who have found natural ways to help their children without drugs. CafeMom.com and many other sites where a parent can get healthy safe alternatives, check for Moms groups with kids who have your childs diagnosis and talk openly and honest and the replys will amaze you. One of the biggest is something that is actually healthy for your kids. Not drugs from Big Pharma.

Comment by Amaterasu Solar on October 10, 2012 at 9:42pm

Cannabis works wonders for ADHD...  But They won't prescribe THAT.

And drugging kids just for better scores is SICK!

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