Parents, Schools Face Off Over Ritalin
Breggin's opinion, however, is not universally shared. To Peter Jensen, MD, director of the Center for the Advancement of Children's Mental Health at Columbia University in New York, refusing to give medication to children with ADHD is comparable to withholding asthma drugs from a child who needs them.
Jensen, the former top government expert on ADHD research and treatment while at the National Institute of Mental Health, says science has made a clear case that Ritalin is an appropriate medication for a child with ADHD. "If the parent doesn't want to put a child on medication, we say, 'OK, let's try behavior modification,'" he says. But if that doesn't work, he says, the parents should turn to medication.
He says any school -- and any physician -- has a duty to report a child who is thought to not be getting appropriate medical care. To do otherwise, he argues, is to risk being sued for failing to protect the child.
"These medications are safer than asthma medications, and they, by and large, have fewer side effects," Jensen says. Untreated ADHD "has life-long consequences."
Ross Greene, PhD, a psychologist, author of The Explosive Child, and an assistant professor of psychology at Harvard University School of Medicine, says medication alone is not the solution for children with ADHD. Medications may help a child concentrate, but they won't teach problem-solving or social skills, which these children usually need.
"I don't think you can ever eliminate all the symptoms," he tells WebMD. "The goal is progress, and to help the child achieve at the highest potential, to reduce negative adverse effects to the greatest extent possible." He stresses that making the child 'normal' should not be the goal; instead, it should be to reduce negative behavior so the child can function better in his environment.
Greene, whose treatment strategies involve both parents and children, says he isn't sure whether Ritalin and other stimulants are overprescribed for children, but he notes that Americans fill more prescriptions for these drugs than do people in other countries. "Perhaps we have a great emphasis on 'sit still and listen,'" he says.
"Medication can be very helpful if parents are comfortable with it," Greene says. "I certainly respect people who are not jumping for joy at medicating their children. If this is not something that is for them, then we probably place a greater emphasis on classroom modifications and adaptations. There are ways to run a classroom so that a child with ADHD doesn't have to stick out like a sore thumb."
For more information from WebMD, see our Diseases and Conditions page on ADD/ADHD.