- The Washington Times - Monday, March 3, 2003

The latest research ends all doubt, if any remained, that U.S. children are going on psychiatric drugs at a frightful rate of increase. The question is what people in authority in the public and private sectors are going to do about it.
In a study released this week examining data for almost 900,000 youths who were enrolled in several states' HMO or Medicaid programs, Dr. Julie Magno Zito and her associates at the University of Maryland found a 200 percent to 300 percent increase in use of behavior-altering drugs between 1987 and 1996. By far the largest increases occurred after 1991 and therein may lie a valuable lesson for policymakers who are concerned about the widespread drugging of American kids.
It was in 1991 that federal funds first were made available to treat what's called attention deficit hyperactivity disorder (ADHD). Before a child gets the psychiatric drug, he gets a label often a preliminary one of learning disabled from school authorities, and then ADHD or simply ADD from a physician. The prescription commonly given is Ritalin, a powerful stimulant that is supposed to help its users focus their mental energies.
Authorities including the National Institutes of Health recognize that the long-term (defined as two years or longer) effects of these drugs on children have not yet been proven. Ritalin's manufacturer warns it should not be administered to children under the age of 6, when the developing brain is continuing to undergo major changes. But the University of Maryland researchers confirm that the number of children under age 5 being placed on Ritalin and other powerful stimulants has risen drastically since 1991.
There are other long-term risks for children who are wrongly identified as disabled. They become part of a second tier of education, less likely to graduate high school. Often the only reason these children become labeled in the first place is that their schools did an inadequate job teaching them to read. And when state and federal funding gives schools financial incentives to overidentify children as disabled, these problems only get worse.
In coming months, Congress will be reviewing the Individuals with Disabilities Education Act (IDEA), the federal special education law that may well have encouraged the wild increases in labeling and drugging of kids. The special ed system itself has become so problematic that until it receives major changes, the problem is likely to continue to get worse.
Washington can change the incentives, but it can't solve the problem by itself. A large part of the answer must come from parents, the medical community, and teachers and principals. Some critics believe schools pressure parents into putting their children on Ritalin so they are more docile and teachable. However, there are honorable exceptions.
One is Children's Success Academy, a charter school in Tucson, Ariz., that was set up specifically to help "behaviorally challenged" children, in particular those with ADHD diagnoses. The K-5 academy uses the Nurtured Heart Approach, a positive behavior modification program developed by Howard Glasser, an Arizona family therapist. Nurtured Heart helps parents and teachers steer hyperactive children from using their intensity in negative ways to using it in creative and constructive ways. The program actively discourages the use of Ritalin or other medications.
In addition, the Children's Success director, Dr. Nanci R. Aiken, has used her academic studies in nutrition to develop a complementary character-forming program called the Nurtured Body Approach. This consists of an emphasis on healthy eating specifically, no sugar or sugar substitutes, use of whole grain breads and vegetables, and only 100 percent fruit juice or water.
What children who have behavior problems have in common, says Dr. Aiken, is that they are bright, bored and have been fed "tons of sugar." She firmly believes proper nutrition makes a huge difference in easing hyperactivity and could significantly reduce the medicating of children with psychiatric drugs.
Hiding the sugar bowl may not be the whole answer. Tough love sensibly administered discipline may be another piece of the puzzle. If they have any role at all, psychiatric drugs ought to be a last resort, not the quick fix too often sought when a child seems to be out of control.

Robert Holland is senior fellow and Don Soifer is executive vice president at the Lexington Institute in Arlington.

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