The Evolution of Medication Use and Misuse for Young Children and Infants: Changing the Roles of Early Childhood Specialists and Educators to Meet New Challenges and Concerns

Article excerpt

The science and clinical practice of using medications with young children and infants has important implications for the study of development and psychopathology. The investigation of interventions for developmental disabilities is not complete without consideration of medical management of behavior, cognition, and concurrent health issues (Jackson & Martin, 1998). The study of children with medical issues requires understanding of medications, including their side effects and treatment outcomes. The study of typical development requires information on the intended and unintended effects of vaccinations, widely prescribed medications for common maladies, and other common medical procedures (Paul, 2007). The challenge is that medication use with young children and infants is growing rapidly, and often outpaces research examining efficacy and risks of these medications with young children. This means that researchers, clinicians, and advocates must also keep pace with the rapid evolution of medication use to ensure that medications are developmentally suitable for young children and minimize adverse effects.

Prescription Practices for Young Children and Infants

The number of prescriptions for pharmaceuticals of any type for children from birth through 5 years of age has increased five-fold since 2001 (Lasky, 2009). Moreover, over-the-counter drugs such as anti-inflammatory medication, cold and flu remedies, and sleep aids have increased six-fold since 2001 (Crockett, 2005; Taylor-Zapata & Mattison, 2007). Prescriptions for psychotropic medications to address emotional, behavioral, and psychiatric conditions in young children have doubled in the past two decades (Gleason et al., 2007). There is also evidence of a large increase in complementary and alternative therapies, such as homeopathy, vitamin and mineral therapies, Ayurveda (a traditional medicine native to India), and other nutrition-based treatments for medical and behavioral issues (Ente, 2004). Because the use of medication has become pervasive in North America, the study of development and psychopathology without considering medication use and related issues is incomplete (Stevens, 2007).

Despite potential for misuse, increased use of medications to treat chronic and acute illness and injury have resulted in an overall higher quality of life for children (Gazarian, 2009a). However, the increase in prescriptions for medications to address the mental health issues of typically developing children and children with developmental disabilities is far more controversial. The prescriptions of psychotropic medications have increased at a rate higher than medications in general (Hoppu, 2008). For children from birth to age 5, the use of stimulants has risen 300% since 2001 (Mayes, Bagwell, & Erkulwater, 2009). The use of mood stabilizers, anti-depressants, anti-anxiety medications, anti-seizure medications, and anti-psychotic medications has increased significantly for young children and infants (Lasky, 2009). Although many parents and mental health professionals report that the increased use of psychotropic medications has improved the quality of life for many children with difficult to control behaviors, there are also reports of dangerous side effects and worsening behavioral symptoms. Moreover, there is controversy as to whether the use of psychotropic medications are imposing societal expectations on young children, identifying poor parenting or schooling practices, and allowing parents to select a child's personality. The perception of acceptability of psychotropic medications has relevance to modern society, yet a rational investigation requires a review of the science underlying psychotropic medications, including their efficacy and risk (Shaw, Sharp, et al., 2009).

Science and Improved Clinical Practice

There have been significant improvements in the science of medication development. Medication regimens have improved in the areas of chronic illness, acute illness, and mental health. …