This article was just emailed to me. Scary :-o
Roll Call — http://www.rollcall.com/pub/48_88/vested/1460-1.html
Vested Interests —Kennedy Takes Aim at Ritalin Provision
By Emily Pierce, Roll Call Staff
May 7, 2003
Psychiatrists and at least one lawmaker are taking on the Church of
Scientology’s support for a provision in a House special education bill that
seeks to prevent teachers from requiring students to take medication for
attention-deficit disorder.
“It’s a wolf in sheep’s clothing,” said Rep. Patrick Kennedy (D-R.I.) of the
provision that was added to the Individuals with Disabilities Education Act
reauthorization, which passed the House last week. “I suspect it probably
had its antecedents in the community that believes that all medication for
kids with [attention-deficit disorder] is wrong.”
Kennedy and members of the psychiatric profession say the provision, which
has been aggressively backed by the Scientology-founded Citizens Commission
on Human Rights, is an attempt to achieve what opponents charge is
Scientology’s broader goal of abolishing the field of psychiatry altogether.
The provision, sponsored by freshman Rep. Max Burns (R-Ga.) and supported by
Speaker Dennis Hastert (R-Ill.), is intended to address highly publicized
cases in several states of teachers pressuring parents to medicate children
with Ritalin and other psychotropic drugs.
Burns said he was aware that the provision was backed by CCHR, but said his
goals were far different from those of the Church of Scientology and CCHR,
which dispute the American Psychiatric Association’s determination that
attention-deficit/hyper-activity disorder, or ADHD, is a medical condition
that sometimes requires medication.
“I did not go out and solicit that support,” said Burns. “We’re not trying
to take away the scientifically based treatments that we have. But we don’t
want to over-diagnose or misuse some of these treatments.”
Another group supporting the provision is the largely grassroots Parents for
Label and Drug-Free Education, which has chapters in several states and has
been working closely with CCHR. President Bush’s brother, Neil Bush, has
also publicized the issue of misdiagnosed ADHD through his education
technology company, Ignite! Learning, which he founded in 2001 after his
son, Pierce, was erroneously diagnosed with the disorder.
But psychiatric organizations that oppose the provision — including the
American Academy of Child and Adolescent Psychiatry, the American
Psychiatric Association, the Federation of Families for Children’s Mental
Health, the National Alliance for the Mentally Ill, and the National Mental
Health Association — claim supporters have been duped into supporting a
measure that they say could prevent teachers from even talking to parents
about the possibility of their child being evaluated by a mental health
professional.
“It’s all an organized campaign to discredit the mental health profession
and disavow the existence of childhood mental disorders,” said Clarke Ross,
CEO of the nonprofit Children and Adults with Attention
Deficit-Hyperactivity Disorder.
CCHR spokeswoman Marla Filidei countered that her organization has been
fighting for the provision because of hundreds of stories from parents about
teachers and school districts that have urged or pressured parents to put
their nonattentive children on drugs, such as Ritalin, to address what may
be simple behavior problems or the boredom of a gifted child.
“We’re not saying behaviors don’t manifest themselves in some ways. We’re
saying it’s not medical,” said Filidei. “This is a list of disorders that
were voted into existence by the American Psychiatric Association.”
CCHR’s Web site states that the group was formed in 1969 by the Church of
Scientology and State University of New York psychiatrist Dr. Thomas Szasz
to “combat psychiatry’s oppression” and to “expose and help abolish any and
all physically damaging practices in the field of mental healing.”
Filidei said CCHR’s “ultimate goal is for the mental health profession and
those who support it to admit that there is no medical evidence to support”
these disorders.
Psychiatric professional organizations say they have been placed in the
untenable position of trying to block a measure that they acknowledge
appears to be well-intentioned.
“We’re not opposed to the policy objective that no school should require
children to be on medication,” said Ross, whose group is funded in part by
pharmaceutical companies, including the makers of Ritalin. “It’s put [us] in
an awkward defensive position, and that’s what we’re hearing from
legislators, that ‘Well, I’m not going to be the one to stand up and oppose
this.’”
Kennedy agreed that it was difficult for lawmakers to come out strongly in
opposition to the provision.
“I think people can dismiss this as an innocuous amendment that on a
superficial level sounds reasonable,” said Kennedy. “[But] it was obviously
written with the intended effect of stopping kids from getting the needed
treatment that’s out there.”
Still, opponents of the provision are hoping to find allies in the Senate to
prevent the provision from becoming law.
One lobbyist for the psychiatric profession said they have already targeted
a number of Democrats on the Senate Health, Education, Labor and Pensions
Committee, such as Sens. Edward Kennedy (Mass.) and Jeff Bingaman (N.M.).
Psychiatric groups also plan to contact Republicans friendly to the mental
health profession, such as Sens. Pete Domenici (N.M.) and John Warner (Va.).
“They’re not too worried about it getting into the Senate [Individuals with
Disabilities Education Act] bill,” the lobbyist said of conversations with
Kennedy’s staff. “Conference committee is where we’ll be focused in the
end.”
The lobbyist acknowledged that inclusion of the measure in the IDEA bill
caught the psychiatric community off-guard. They are now working diligently
against it, but still appear to have an uphill battle.
Burns and other proponents of the legislation say there is a national
problem of teachers pushing Ritalin and other ADHD drugs.
Filidei noted as one example the case of Patricia Weathers, who has been
travelling with Filidei to lobby the issue in Congress. Weathers heads the
New York chapter of Parents for Label and Drug-Free Education.
Weathers said her son was having trouble reading when officials at the
public school he was attending told Weathers to put him on medication for
learning-disabled children.
Weathers said she complied at first, but that negative side effects caused
her to terminate the treatment. When she took her son off the medication,
Weathers said the school called child welfare officials who threatened to
charge her with medical neglect of her son.
Weathers said she escaped legal action, however, by obtaining a letter from
a private psychiatric professional who asserted her right to explore
alternative therapies for her son.
“There’s no evidence that it’s an actual abnormality,” said Weathers. “And
the school didn’t let me know that I was labeling my son as mentally ill” by
putting him on medication.
It’s stories such as Weathers’ that prompted 19 states and now the federal
government to pursue laws prohibiting teachers from requiring students to
take psychotropic medications. Five states — Connecticut, Illinois,
Minnesota, Utah and Virginia — have enacted laws designed to protect
parents’ rights to refuse to medicate their children, according to CCHR.
However, both sides agree that there are no national statistics on how
prevalent the practice is.
Kennedy argued that the problem is not as widespread as CCHR makes it seem.
“Clearly, it’s a legitimate issue, but as I said, it’s a mischaracterization
of the situation to think that it’s not the exception rather than the rule,”
he said.
“The question is whether this is a national issue that requires a national
bureaucracy,” added Ross. “It’s all based on these highly publicized
situations. … [Weathers’] situation is a very sad experience, but whether
Patricia Weathers’ experience is typical — that’s just not been our
families’ experience.”
Filidei disputed that notion. “It’s ludicrous to say that legislators would
be passing laws based on isolated incidents,” she said.
Re: Kennedy Takes Aim at Ritalin Provision
I think ADHD is kind of a catch-all diagnosis. The diagnostic criteria for the disorder is ambiguous at best.
What also sems to go unexplained is the dramatic increase in diagnosis of ADHD in the past 20 years. Why do you think that is?
ADHD and medication
I think the article kind of misses the point. There are many valid approaches to ADHD-type behavior that do not involve drugs. I have effectively applied non-drug behavioral approaches with my kids, two of whom would clearly have met all the diagnostic criteria earlier in their lives. Neither would probably meet the criteria any more. We didn’t even use nutritional supplements or neruofeedback or anything except creative discipline and skill building applied over the course of several years’ time.
The point of the legislation is that parents have a right to decide on appropriate treatment, and the school has no right to tell them what they should do about what is ostensibly a medical problem. The school’s job is to let the parent know what the issues are, and perhaps to present them with some options. The parent is responsible for the outcome of any treatment, so they must be empowered to make the choices that make sense to them. I would agree, however, that all children should be subjected to reasonable disciplinary expectations regardless of their diagnosis or what treatment the parents choose. I just want the parents to be able to choose without any pressure or propaganda in the direction of a particular option. I can tell you that there is nothing anyone could have said that would convince me to put my kids on medication. I believed in our approach, and it has worked great for us. Not everyone has our beliefs or our resources. But everyone deserves the right to make a truly informed decision.
One point that does not appear to be brought up to parents at these school discussions is this: there is NO evidence that the decision to medicate or not actually affects the long-term outcomes for children, at least in a general sense. There may be specific children that do better long-term as a result of medication, but the research suggests that if there are kids who improve, there are just as many who do worse, because all the reviews of long-term outcome studies I have read reach the same conclusion: kids on meds don’t learn more, don’t have better self-concept, and don’t engage in less delinquent behavior that kids not on meds. I am not denying that these kids are rough to have in the classroom, and that the meds can really make some seem more reachable, but in the long run, insisting on medication as vital to their survival is really not supported by the literature. Even Russel Barclay would agree with me on this point, as he did one of the first reviews of this issue back in 1978 or so, and drew the same conclusions. So why is there such a push to get kids on medication?
As to it being a matter of isolated incidents, I have heard these stories from many people in different school districts around the area and around the country. It is a problem, or there wouldn’t be people talking about it in Congress. If this happens to fit in with the designs of some folks who want to do in psychiatry altogether, and they support it for that reason, well, that’s totally understandable. But this legislation is NOT being pushed by a small group with an agenda. These stories happen all over the country every day. I work with a woman who ran an advocacy program in the schools in the midwest, and she said this was one of the most common issues.
We ought to face the fact that ADHD is and will remain a controversial diagnosis, and that the treatment is even more controversial, for very good reasons. Putting a child on psychoactive drugs is a BIG DEAL decision, which can in some cases have drastic consequences, including a small but not insignificant number of documented deaths caused solely by long-term stimulant use (resulting from heart damage). When the long-term outcome studies are not supporting univeral drugging, we should not be pushing this intervention in any way whatsoever. Parents should be informed of this as one of many available options, and if they choose not to use it, that should be that. That’s all this bill is saying. Kids are NOT necessarily being harmed by NOT taking these drugs, and we shouldn’t assume that they are essential for the child’s success. We should work with each family and their value system to design a plan that works for everyone. That’s what IEPs are all about.
–- Steve
Re: Kennedy Takes Aim at Ritalin Provision
You know, I believe that ADHD is real. I do not believe I have ever supported over diagnosing. I have had two children in my program in the past who were taken off the meds. because of feedback we provided to parents.
However, there are very extreme cases of ADHD out there, I can personally attest to them. Yes, these are the youngsters who never give their teachers and classmates a minutes worth of rest. They are in constant motion and their mouths blurt and interrupt steadily. It is very, very hard to teach when you have to deal with even one such child.
Do most classrooms have a child this extreme? I don’t think so. But in the elementary school of 800 where I worked for 10 years there were always a few peppered about here and there. They wore out their teachers. I have known superb teachers to find the experience of having such a child in her classroom to be physically and emotionally exhausting.
Then when I read what I read on some websites:
“I don’t send my child to school to make your job easier!” “My child is not to be punished for any manifestation of his disability and impulse control is the disability.”
What is a teacher to do?
Why am I on this kick right now? Well, we do need to have some rights and so do the rest of the kids in our classes
I have a 10th grader who is horrible. He has the diagnosis and doesn’t take the arahaic meds (10 mg. of ritalin, 3 times per day). Even when he does take it, at his size 10 mg. barely takes the edge off his ADHD.
He is nasty, he harrasses other students, he makes it very difficult to teach my class and when he is absent (one day per week), the class is wonderful.
Yes, there are other things that can look like ADHD. One, for example, is childhood bi-polar. I have had 2-3 of these, thankyou very much. They are almost always extremely hyperactive in addition to being depressed which may manifest in nastiness toward others. Or manic behaviors. You know what, sometimes these students end up on meds for ADHD and meds for depression.
Are there a few other things? Surely. Do I believe that there is a nutritional basis for this condition? You bet I do. Our American diets are some of the worst in the world! We depleted foods full of sugar and chemicals. Do I think this diet, over years, makes a subtle difference in brain development and chemistry that exacerbates what is called ADHD? Yes, I believe it may frequently be the case.
Would i pursue a well designed nutritional approach if this were my child? I think I would. If this did not get the job done and my child was like the children I described, then off to the doctor I would go.
I don’t send my children to school to make the teacher’s job harder and to interfere with the learning of the rest of the class! (Oh, I am a parent, too, not only a teacher).
We have created a generation of parents who are among some of hte most self-centered opportunists I have even encountered (No, this is not meant to describe all parents, just the ones who say, “I don’t send my child to school to make your job easier.” Or, the ones who sue the school because their naughty child ran to the back of the playground,climbed a tree, fell and broke and arm. Or, the ones who demand the school reimburse for the IEE they obtained when they were angry the school’s evaluation did not yield elegibility for sped. Of course, the IEE didn’t either, on principle they want the school to pay for it just because they are entitled………..)
Oh, my what a night. Excuse my rant.
NO, your rant is quite well placed, Anitya...
But then, so is Steve’s. I agree with BOTH of you. And I’m from Canada, so my opinion really doesn’t matter — but since I see the same problems ‘up here’, I have to express myself.
My son is gifted in imagination and creativity but not academically. He is verbally advanced, but visually dyslexic and probably LD in math, at least developmentally. He is an ‘artist type’, not an engineer or architect or scientist — he may be an artisan, a salesman, a teacher, etc. etc. Intellectually he is ‘high average’ per the Wisc.
Yet, in February of his first grade year, I got a call from his teacher — telling me that I just HAD to get him some help, since he was ‘out of it’ during class and getting no work done, and recommending a Dr. her son saw for his ADD. I saw a child who obviously was getting NOWHERE with whole language instruction, but I jumped on the net and began reading about ADD, ADHD — this just didn’t sound like my kid. I saw kids in our beaver colony/cub group who WERE ADHD — nope, not my kid. I went to my family doctor and had a LONG talk — she agreed with me, and said she would officially refuse me a referral to a ped. since she agreed there was no need. By the time we got this far, it was April, and having little money for private evaluation which is like 3000.00 up here, I decided to take my mother’s advice and send him to ‘summer school’ at a local private school that provided Spalding, since we obviously agreed that there WAS an academic problem.
When we got there in July…this kid, who could not recognize ONE dolch word reliably, despite doing everything we had been told to do for home support (and yes, I open the backpack EVERY NIGHT!), was reading ‘Bob and Tom’ type books the first week. At the end of six weeks, we were thrilled to be reading ‘Frog and Toad Are Friends’ and other easy readers. REALLY READING — not guessing! At the end of the program, the teacher told me that in her opinion he was NOT ADD, that he was gifted, dyslexic, artistic, and MALE! She recommended tutoring and support of his gifted abilities — no need for medical intervention. Since this matched my doctor’s assessment and my own, I was now determined — NO MEDS FOR US! I might add that my son is NOT a behaviour problem — he’s a perfectly behaved window gazer who can’t finish his work unless he is capable of doing it independently. Lecture instruction is NOT his thing, either.
Yet, when we got to the fall, having (in hindsight) a problem teacher and of course still dealing with unremediated dyslexia, we ran into unhappiness — resumption of anxiety behaviours and still had no success. Teacher admitted he ‘WAS’ reading and was in the mid-level group, but insisted he was ADD. So, I spoke to the school psych, who actually tried to TALK me into meds before even meeting my child! I had to ‘broken record’ repeat THREE TIMES that my doctor DID NOT BELIEVE THAT A REFERRAL WAS NECESSARY, that we had academic problems but my doctor was NOT AWARE that there was a pill for such things!!! And the whole time this was happening, I could not believe it was happening — I felt like an urban legend!
But I’m NOT an urban legend — this really happened to me. And it happens VERY commonly, in my opinion. My husband just gets livid about this. He keeps saying: What if you hadn’t stayed home with him, and known him so well, so that you could ferret out the true cause of the anxiety behaviours? What if nobody had told you about ‘1, 2, 3, Magic” for discipline and ‘How to talk so Kids will Listen’ for behaviour management when he was just an infant, so he had no behaviour problems? What if neither of us had been academic strugglers, so we had some insight and remedies? What if you hadn’t been so active teaching sunday school, so you had an idea of what a broad range ‘normal’ kid is? What if we’d just gone to the recommended doctor, instead of getting remediation for the reading problem???? (and this is where he gets upset…!)
I can see every point Anitya makes, and they’re all good ones — very valid, even ‘up here’ in Canada. But I vehemently disagree that schools should EVER mention meds. Recommed an evaluation — yes. Tell you why they think you need one — yes. But talk about MEDS? NO! Anitya, you have to remember: YOU ARE THE TOP OF THE LINE — you are the Ferrari, the Lamborghini, the Delorean of teachers! YOU ARE NOT AVERAGE. What YOU do, the judgement you have, is not what is presented by ‘most teachers’ in ‘most schools’ — it just isn’t! Stories similar to mine have been repeated to me by at least half a dozen people in our local system — and I don’t have THAT wide an acquaintance!
I can see that this legislation is perhaps backed by some fringe groups as well as people like me — but I think we have to err on the side of caution. THIS NEEDS TO BE DONE. Schools need help in many areas, and are being shortchanged in terrible ways. But we have to solve the problems that exist — and the mis-diagnosis of ADHD, and especially ADD, is rampant and needs to be carefully monitored so it can be STOPPED.
When we finally got school testing, it was laughable how the written report subtly skewed your opinion towards the inattentiveness as a CAUSE and not a symptom, and mentioned that parents ‘SAY’ they see no symptoms at home, as if we were lying when completing the Connors scale!! ARGGGGHH…it has been 3 full years and I can still feel RAGE when I think of the meeting where the school psych presented her ‘results’!!!
ADHD may be a real disorder — that is for another debate and I don’t go there — but it Ain’t diabetes, folks! Meds are a private decision, and should be discussed by parents and doctors — NO-ONE ELSE. I don’t actually even believe teachers should be made aware, tho this is undoable in elementary school.
Thanks for letting me rant…
Re: Kennedy Takes Aim at Ritalin Provision
I don’t mention meds, I just talk the behaviors and perhaps mention an eval. If the child is diagnosed and prescribed meds, but taking them sporadically, then I talk meds to the parent.
I recently read a document that came from some official source here in the U.S. that recommended that an ADHD eval should only come at recommendation of the family doctor/pediatrition. This is horrible. This document is trying to suggest that schools should not even discuss the possibility of having the doctor take a look at the child. But, when the child fails the hearing or vision screening they sure demand that you see the specialist for an exam.
My issue with this recommendation that the referral should start with the doctor has many problems. Firstly, the doctor only sees the child occasionally and very briefly. Many doctors never bother to probe the parent to ascertain how things are going in school. Outside of the parent, the teacher spends more time with the child than virtually anyone and in a setting where ADHD may be more obvious than in the home, so the teacher is the person who may see extreme behaviors.
Indeed, before you are barking ADHD, you do have to try some interventions to make certain the behavior is not caused by something that can be controlled or remediated at school. We generally don’t use the language “ADHD” with parents. We are not doctors. Instead we describe what we see, esp. in relation to what the norm is for the age group (an experienced teacher will know this) and perhaps ask the parent if they have ever discussed these problematic behaviors with their doctor. If the parent is interested in doing so, we volunteer to have the parent and teacher fill-out the SNAP IV rating scale for the parent to take along to the doctor, esp. if teacher and parents rate the child’s behaviors significant. And yes, both parent and teacher do fill out the instrument. This, too, is important when we are trying to get an honest to goodness good reading on things and acutally help the family and child.
My feeling is that there are kids who are ADHD, but I think many kids are misdiagnosed. Some have APD, some have other mental disorders which have overlapping symptoms, and some are just active kids who are not well disciplined.
I am a teacher, and I have had a couple of kids who were uncontrollable without their medication. Would it be my right to control their medication? of course not. That is the parent’s right. However, on the other side of the coin, if that child’s behavior disrupts my class, then he should be subject to the normal disciplinary measures of the school and not be shielded because “he can’t help it, he’s ADHD”.
It is a difficult area, but schools cannot control medical issues. I certainly believe teachers should have the right to suggest a child be evaluated, however.
Janis