Kids Iíve Seen On Ritalin
It Is A Mistake to Medicate Them
Massachusetts News--March, 2000
By Ron Schneebaum, M.D.
March 1--In the past few years, I radically transformed my approach to ADHD.
I will try to detail some of the thinking that took place as I underwent my evolution. I was always quite traditional in the way I diagnosed and treated these children. The evaluations in my office were thorough, and my medical management was at a very high level. If I had questions, I reviewed them with recognized experts in the field. My reputation spread. People came to get my thoughts and opinions, even if their children werenít in my practice.
The more I got to know the kids who were diagnosed with ADHD, as well as the kids I evaluated because of teacher and parental concerns, the more I saw that these were great kids. I asked parents to describe the strongest qualities of these children. Kind, sensitive, insightful, enthusiastic, lover of nature, were the words used in over 95% cases, confirming my impressions about who they really are. I began to call it, "Enthusiasm and Love of Life Disorder," thinking they werenít the ones with the problem.
These children had some of the very traits we work so hard to cultivate in young people and yet, we were putting them on medication to change them. I began to wonder why. The common assertion that these children had a neurological disorder for which medication was the answer no longer fit.
I wondered what the sages of our civilization might have said on this subject? What guiding words did they leave? Each spoke of having confidence in oneís presiding genius, a far different starting point than drugs to alter oneís personality.
Who Are These Children?
These are some of the children in my practice who were diagnosed with ADHD by other authorities and would have been so diagnosed at the office of anyone who treats children for ADHD. Their stories are typical, reflective of a great many others. They are included because this was what led me to look at the issue differently. Some of the details have been changed to protect privacy.
ē John was a seventeen year old who had the best summer of his life in a wilderness survival program. He came back exhilarated. He learned a lot about who he is and what he values by confronting physical challenges in a natural setting. When he came back, he saw his friends and his activities from his heightened perspective. This window of opportunity closed rapidly, however. School started and he fell back into his former routines. School wasnít motivating. He was eventually referred to a psychiatrist who put him on both Ritalin and an antidepressant.
A great many kids with ADHD find wonder and renewal in nature. School doesnít recognize this. Learning takes place indoors for some six hours a day and assignments at home often take another few hours. This goes on for ten months a year and some want this extended. Gandhi said of his school days, "They were the most miserable years of my life." He had no aptitude for lessons and rarely appreciated his teachers.
ē Bill was an eighth grader who came to me because of the concerns raised by his school. He wasnít performing up to expectations. When we chatted in private, I was impressed with his thoughtfulness, his sincerity and his intelligence. Little that he saw in his teachers, in his texts or in his assignments touched lifeís important issues. Even though he was told that he needed to learn the assigned material for later success, it wasnít sufficient for him. He could have done the work but just didnít see the point.
After chatting for a while, I knew that medication would help him be more attentive (and medication would have been prescribed in any other physicianís office), but I wasnít sure that Iíd be doing him a favor. Einstein, who was a terrible student, wrote of these same school experiences, "I preferred to endure all sorts of punishments rather than to learn gabble by rote."
ē Alice was known to me since birth and is typical of others who are brought to the diagnosis. She was a demanding first child who unsettled her parents. If she said, "Jump," they would only ask, "How high?" As she got older her parents became frustrated. At times theyíd yell before they gave in. I liked her. She was sweet, fun loving and had a remarkable sparkle in her eyes. I wanted the parents to seek help. Their parenting difficulties were connected to many interpersonal issues. They differed about child rearing. Frequently, one was away overnight because of work. I knew that sooner or later the issue of ADHD would be raised because of her inability to do anything that went against her grain. A surgeon they knew recommended a neurologist at one of Bostonís prestigious hospitals who then saw this child. The father wasnít at the appointment. I wasnít called or consulted. After a forty-five minute visit, a prescription for Ritalin was written. A name to this childís problems was given. Medication and its dosing has become the primary focus of this childís behavior management. A real chance to understand her needs and her familyís dynamics was missed.
ē Betty is a born leader. Her mother sensed this since she was born. Raising her has been a real challenge, though with firm, loving, and gentle patience she has made real progress. Now, in second grade, the school is suggesting that she be evaluated for ADHD, because she has a difficult time sitting quietly during circle time. Her mother, who sees things differently, feels that this girl needs greater mental and physical challenges. She asked whether her child might spend time working with the schoolís maintenance team. This suggestion was accepted by the school and it has worked wonders for her.
Excel In Other Areas
Kids who have been diagnosed with ADHD often excel in other activities. While they have difficulty sticking with things that donít interest them, they often have great tenacity for that which they love. Iíve seen that many accomplished musicians and artists who are so diagnosed will practice for an incredible number of hours. School work doesnít captivate them in the same way. Picasso left school at the age of ten. He couldnít remember the sequence of the alphabet or learn arithmetic as a boy. He only wanted to paint.
We canít understand the majority of kids who have the diagnosis of ADHD completely without examining our schools. The driving force behind our present system of education is simple and straightforward: certain skills must be learned if todayís students are to find a place in the job market of tomorrow.
Our nationís best and brightest must excel in science and math if we are to maintain our dominance in technology and business. Every student in the country is, therefore, expected to learn certain material by the end of each school year. There is little room for genuine diversity. Students are akin to machines, taking in certain information so they can move along in the system. Educationís mechanization has removed the human heart.
A teacherís love for a subject can no longer be his/her guiding star. Required curriculum has become the master, replacing genuine enthusiasm when necessary. A teacher may follow the interests of a class, but the material covered canít go too far astray. Teaching in an unorthodox fashion faces these same strict limits.
Our current method of educating children began near the turn of the twentieth century when our nation was still expanding its borders and we were struggling to assimilate millions of immigrants from all over the world. Rigidity and uniformity in education might have had a place then, but its dominant role is a far outdated relic of this past.
Letís Look At Our Schools
Letís look at our present approach to education from another angle and give it a simple test. Since nearly everyone in our country has been educated in this school system, and since the basic direction of this system hasnít really changed in the past one hundred years, the society its graduates have produced is an objective measure of the success of its approach.
With such a test weíd see exactly what we expected. The scientific achievements, the technological marvels, are astounding. We have literally changed the face of the earth. These achievements have led to problems, however, problems that are greater than we have ever faced. Our earth, the atmosphere, even the very air we breathe and the water we drink are in grave danger. We complain that we donít have time for the things that matter most. We are less happy with the course of our daily lives and feel we have less control over it. We are becoming less compassionate. Those who donít have access to money and power are becoming further removed from those who do.
Why is this relevant to the diagnosis and treatment of ADHD? It is because we put so much faith and believe so strongly in the correctness of this system of education that we are willing to medicate our children and let doctors tell us that they have brain defects, because they arenít working hard enough in school. If we truly want our children to be kind, loving and creative, we must ask why we are giving them drugs that enhance a certain kind of base practicality, when itís possible that these drugs perform at the expense of the very traits we cherish.
We need answers that are truly inspired. We need
answers that come from a different source. The time has come to listen
to our hearts. The time has come to act out of what we know is right. The
time has come to take a stand. Our children expect it. Our world depends