Speech draft

Attention deficit hyperactivity disorder is not an illness such as cancer or influenza. It is not diagnosed through CAT scans or tissue biopsies. No blood samples will give you a straight “positive” or “negative” reading, and no echocardiogram can show you exactly where the problem lies. Despite what any doctor tells you, the study of child behavioral issues is one of the most difficult and ungratifying fields of medicine out there. An alarmingly miniscule number of cases actually fit the “text-book definition” of any given disorder, making the diagnosis and treatment of such conditions as ADHD and juvenile bipolar disorder extremely subjective and imprecise. But if accurately detecting these illnesses is such a shot in the dark, why is it that doctors worldwide have become more and more comfortable prescribing clinical medications before even sitting down to talk to a child?

The process of diagnosing childhood behavioral disorders, says pediatric psychiatrist Lawrence Diller, predictably begins with the child and his or her immediate family. The bare minimum that even the shoddiest of doctors will require is a ten to fifteen minute consultation with the concerned parent—sometimes even without the child in question present—where horrific symptoms and home-wrecking anecdotes are relayed. Brief words of the wise doctor’s theories are shared, and then the prescription pad and pen make their famous appearances. But what qualifies this physician to turn what is, quite frankly, an educated guess into a little white pill before breakfast every morning? He knows as much about your daughter and which disorder her symptoms suggest as WebMD does. And this, Diller claims, is where the problem is rooted: doctors’ inability or mere lack of desire to give several full, complete evaluations of every element of a child’s life before making a diagnosis. In 1985, about 500,000 cases of ADHD were reported in children and treated with medication. And today? Over six million. It is not enough to know the symptoms, to know that Jack threw his bowl of Cheerio’s against the wall this morning, or that Sally has trouble paying attention during reading lessons. To truly understand why a child acts the way he acts, one must know the child, his living conditions, his personality, his experiences in life. One must know that Jack’s parents recently divorced, and that Sally has an underlying learning disability. Simply put, an overwhelming majority of physicians in this country aren’t willing to put that effort forth.

Even when a conclusion has been effectively reached through extensive research and communication with not only a child, but also his parents, doctors today are at a loss in regard to where to go next. The medical world is constantly subject to diagnostic and therapeutic “fads,” says PBS Frontline’s “The Medicated Child,” that unfortunately dictate the norm for the treatment of behavioral issues. Thirty years ago, Freudian psychotherapy methods were the only commonly accepted way to go about handling these conditions. Nowadays, the Rx form dominates alternative methods to solving the issue. Between, 1990 and 1995, the number of preschool children being treated with ADHD medication tripled. Likewise, the number of adolescents aged 15-19 being treated with similar medication has skyrocketed by 327% in just fifteen years. Ritalin production has doubled in the last decade, with 80% of its prescriptions being written for minors. Disorders that could be resolved as easily as switching a child to a more specialized classroom in school are now unquestionably treated with Xanax prescriptions and Prozac dosages. Parents turn into zombies indubitably following doctor commands, feeding their children Adderall with every bowl of Lucky Charms. It’s not my child’s fault, they’re now accustomed to claiming, she has a chemical imbalance that must be treated with medication. That, of course, or your lazy doctor has not taken the time to explore alternative methods that do not require doping your daughter into a drug-induced stupor.

The scariest part of it all is the harsh reality of the world of medication—that not every psychoactive drug has been tested in juvenile subjects for harmful side effects. In fact, asserts David Axelson, M.D., conditions like bipolar and manic depression disorder had never even been the subject of child behavioral diagnoses until the last decade or so. Only recently have doctors begun to—with frightening frequency—consider these extremely adult issues as relevant to child behavioral problems, which leaves an immeasurably small time frame for the psychiatric drugs used to treat these conditions to be tested in younger subjects. In recent years, “The Medicated Child” details, more and more doctors are recklessly prescribing medications that parents are fearfully and incontestably accepting and administering to their children: medications whose side effect studies have never even begun to breach the gap from adulthood to adolescence.

Science is an inconsistent world of theories and variables, the only constant of which is that it is a world ever-changing, ever-evolving. Maybe physicians will never be completely accurate in diagnosing and treating the behavioral disorders of their juvenile patients. Maybe the parents of these children will never question the unwavering decision of doctors to push medication on anyone who exhibits even 5 out of 11 ADHD symptoms. The one thing we can change is our society’s medical “fad”—our steady reliance on medication to solve all of our problems, and our eagerness to accept answers even when we know the question hasn’t yet been fully analyzed. Because surely a child’s life and mental health aren’t worth the risk of a hasty diagnosis and a foolish prescription when more effective and safe alternatives exist.

BIBLIOGRAPHY

PBS Frontline: The Medicated Child documentary

http://www.pbs.org/wgbh/pages/frontline/medicatedchild/

Should I Medicate My Child?

by Lawrence H. Diller, M.D.

New York Daily News, "Children taking ADHD medication may be at risk of sudden cardiac death, study finds."

http://www.nydailynews.com/lifestyle/health/2009/06/18/2009-06-18_children_taking_adhd_medication_may_have_an_increased_risk_of_sudden_cardiac_dea.html

American Academy of Child & Adolescent Psychology

http://www.aacap.org/cs/root/facts_for_families/psychiatric_medication_for_children_and_adolescents_part_ihow_medications_are_used