The furor began in October when Dr. Michael Anderson, a
pediatrician who treats mostly children from low-income families in
Georgia, said that he routinely prescribed ADHD medications for kids
struggling in school.
Red flags went up more recently when the Centers for Disease
Control and Prevention released data last month that said Missouri
is second only to Mississippi in the percentage of kids who are
prescribed medication for attention deficit hyperactivity disorder
The study indicated that Missouri doctors also may be making the
ADHD diagnosis too frequently. The data show that nearly 9 percent
of children in Missouri have been diagnosed with ADHD, and that 80
percent of them take prescription drugs for the behavioral disorder.
Dr. Ramesh Raghavan, a child mental-health services researcher at
Washington University and an expert in prescription drug use among
low-income children, said there are circumstances in which
prescribing medication is a doctors only recourse to help a child
struggling in school.
But he added that society should not force doctors into those
situations, and should make available other methods to improve
school environments and help families and children who are finding
it difficult to thrive academically.
Dr. Raghavan said drugs are the first line of treatment for a
reliable ADHD diagnosis, but making the diagnosis can be difficult.
Frequently a child will have an underlying problem such as a
reading disorder or a learning problem that looks like ADHD but
isnt, he added.
In such cases, the stimulants prescribed for ADHD will not help
the child and may result in the child not being treated for the real
Adequate treatment for behavioral disorders and learning
difficulties, including easy access to mental health care, is
critical, Dr. Raghavan said. Availability should not depend on
geography or income, he added.
Its really immoral. We absolutely should be making investments in
our kids. They should be able to have early and rapid treatment, and
it should be sustained through childhood and adolescence, he said.
It is unfair that a child in poor circumstances does not have the
same access to treatment as a child in better circumstances. Where
you live should not determine the care you get.
Dr. Anderson, the Georgia pediatrician, explained that he
diagnosed kids with ADHD so he could give them the medicine. But he
said the real problem is bad schools and a culture that refuses to
spend the money needed to fix them. …