Take a chill pill: Exploring the prevalence of child medication for ADHD
- Ella Ekstrom
- Dec 1, 2018
- 4 min read
Despite its discovery in 1902 by Sir George Frederick Still, the diagnosis of Attention-Deficit Disorder (ADHD) in children was relatively rare before 1980. In the last few decades, ADHD has skyrocketed in both diagnosis and pharmaceutical prescription — rising from an estimated 1 percent in the 1970s to now having more than 11 percent of children diagnosed with ADHD and 7.5 percent on medication.
Is it simply a symptom of modern culture’s effect on children? Is it a self-fulfilling prophecy driven by frustrated parents and teachers? Is it a fabricated phenomenon fueled by opportunity for profit? Is it even a disorder?
While the factors contributing to this abrupt upsurge in ADHD remain uncertain, these are all questions that should be considered.
Is ADHD a consequence of modern culture?
While nearly one tenth of children are diagnosed and medicated for ADHD in America, in France that statistic drops to be less than 0.5 percent. If modern culture is the reason for this psychological epidemic affecting our children, why is it almost nonexistent in a culture saturated with the same technologies? The difference seems to lie in how ADHD is perceived. In France, when a child presents symptoms for a behavioral disorder such as ADHD, it is not regarded as a problem with the child’s brain, but rather as an issue stemming from the child’s social context. Therefore, when choosing treatment, French physicians almost always apply psychotherapy or family counseling.
Is medication the most effective treatment?
The Center for Disease Control and Prevention in fact recommends that behavior therapy should be the primary treatment for most ADHD diagnoses. However, an overwhelming majority of young patients receive medication as a quick solution, receiving little to none of the required therapy.
Is ADHD over-diagnosed?
Inconsistencies in physician diagnosis of ADHD range from a rushed diagnostic process to parental pressure to intentional misdiagnosis for academic improvement. While proper diagnosis takes time, there is an unfortunate occurrence in rushed diagnoses, in which physicians “have little time for extra information gathering” and do not incorporate “the inherent psychological biases involved in the parents’ reports of the child’s behavior,” leading them to “quickly check off 6 out of the 9 symptoms listed to get to the diagnosis." Furthermore, there is the prevalence of physicians deliberately misdiagnosing children in hopes that the medication will aid them in academic settings.
“We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.” Those are the words of Dr. Michael Anderson, a pediatrician in Canton, Georgia whose interview appeared on the front page of the New York Times. Dr. Anderson believes that the real problem facing troubled school children is low grades stemming from unsatisfactory schools. His solution for this problem: Adderall. Dr. Anderson prescribes Adderall to his low-income patients not to treat attention deficit hyperactivity disorder (“ADHD”), which he believes is “made up,” but to improve their academic performance. He does not prescribe Adderall to patients “who are getting A’s and B’s,” he prescribes it to children with lower grades whose families cannot afford tutoring or other methods of assistance.
Recent findings even indicate that a significant proportion of children diagnosed with ADHD are simply the youngest in their class.
What are the effects of prescribed ADHD medications on children?
In 2008, the Therapeutics Initiative at the University of British Columbia published a letter summarizing evidence that Central Nervous System (CNS) stimulants:
improve teacher and parent ratings of hyperactive/impulsive disruptive behaviour;
do not improve children’s ratings of anxiety nor measures of academic achievement;
do not change the incidence of delinquency or substance abuse at 3 years;
decrease height and weight at 3 years;
have not been studied for their long-term effects on standardized exams, quality of life, school completion, employment, longevity and future health.
Shockingly, those who most benefit from ADHD medication are not the children being medicated, but rather the parents and teachers who interact with the children. In fact, the children endure the same rates of anxiety and academic performance and suffer from physical impediments in height and weight — not to mention the potential long-term effects that are still unknown.
While ADHD is a pervasive component of today’s culture, our understanding of exactly what it is and how it should be diagnosed and treated still remain ambiguous. Between its constantly revised definition and the profuse profit margins for pharmaceutical companies cashing in on new drug developments, there remains an underlying doubt as to how authentic the newfound prevalence of ADHD seems to be. There is also controversy regarding whom the main benefactors of medicating children are. Still, there have been dramatic shifts in society between the 1980s and today, especially with regard to the integration of electronic media into our culture. Yet, the manifestation of ADHD as a result of modern culture is not a universal trend, neither is how ADHD should be approached and treated, given the disparity between America and France. Furthermore, the issue of over-prescription continues to loom, as the convenience of simple medication prevails over the recommended behavioral therapy. This is especially concerning since the stimulants used for the treatment have yet to be tested in the long-term. Overall, the ambiguity surrounding the perception and treatment of ADHD, as well as the unstudied long-term effects of the medication, are concerning. Fortunately, there is a growing awareness for the potential issues regarding the over-diagnosis and over-prescription of ADHD.
Here are some articles for those interested in further reading:
The Washington Post
CDC warns that Americans may be overmedicating youngest children with ADHD
By Adriana Eunjung Cha
May 3, 2016
New York Times
The Selling of Attention Deficit Disorder
By Alan Schwarz
December 14, 2013
Wall Street Journal
Are ADHD Medications Overprescribed?
By Dr. Koplewicz
February 14, 2013
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