A Rush to Medicate Young Mind

Issues and Action in Education

An e-letter produced by EdWatch, a nonprofit organization.

October 24, 2006

ELIZABETH J. ROBERTS, a psychiatrist who treats children and adolescents and the author of Should You Medicate Your Child's Mind?'' published an article for the Washington Post (October 8, 2006). In this article, she states:
"The changes I've seen in the practice of child psychiatry are shocking. Psychiatrists now misdiagnose and overmedicate children for ordinary defiance and misbehavior. Temper tantrums are increasingly being characterized as psychiatric illnesses. Using such diagnoses as bipolar disorder, attention-deficit hyperactivity disorder (ADHD) and Asperger's, doctors are justifying the sedation of difficult kids with powerful psychiatric drugs that may have serious, permanent or even lethal side effects."
Roberts goes on to report "a staggering jump in the percentage of children diagnosed with a mental illness and treated with psychiatric medications...[In 2002] some 10.8 million prescriptions were dispensed for children ... 19 children died after taking prescription amphetamines ­ the medications used to treat ADHD. These are the same drugs for which the number of prescriptions written rose 500 percent from 1991 to 2000."

"What was once a somber, heart-wrenching decision for a parent," states Roberts, "and something children often resisted ­ medicating a child's mind ­ is now widely used to parent a belligerent child. Some of my colleagues in psychiatry brag that they can make an initial assessment of a child and write a prescription in less than 20 minutes. Some parents tell me it took their pediatrician only five minutes"

"Medicating a child, based on a misdiagnosis, is a tragic injustice for the child," Roberts stated. Read the whole article here.


Written testimony by Dr. Karen Effrem to Congress' Committee on Education and the Workforce
regarding pending federal legislation to expand early childhood home visiting programs (HR 3628) will be posted on EdWatch .org soon.

Home visiting programs "are being held up as model programs as a way to improve infant and early childhood social and emotional development (mental health) and behavior," Dr. Effrem states.
Early detection and treatment of mental disorders.
As the mental health field becomes increasingly able to identify the early antecedents of mental illnesses at any age, interventions must be implemented, provided in multiple settings, and connected to treatment and supports."

The 2004 New Freedom Commission Report mentioned the Nurse-Family Partnership:
 "Early detection and treatment of mental disorders can result in a substantially shorter and less disabling course of illness.144; 145 As the mental health field becomes increasingly able to identify the early antecedents of mental illnesses at any age, interventions must be implemented, provided in multiple settings, and connected to treatment and supports. Early interventions, such as the Nurse-Family Partnership, and educational efforts can help a greater number of parents, the public, and providers learn about the importance of the first years of a child’s life and how to establish a foundation for healthy social and emotional development."
In her statement, Dr. Effrem demonstrates the lack of evidence, however, for "understanding the cause of mental illness, much less the early antecedents.  Nor, is there any real agreement on diagnostic criteria, especially in young children; evidence for interventions; or outcome measures."

One example she uses is a 2005 National Center for Infant and Early Childhood Health Policy report on infant mental health which admitted the following barriers to implementing the planned infant mental health system.

These would also apply directly to carrying out the proposed legislative state activities, such as “adopt a clear, consistent model that is grounded in empirically-based knowledge related to home visiting and linked to program determined outcomes;” or providing parents with “knowledge of age appropriate child development in cognitive, language, social emotional, and motor domains;” or “provide referrals for eligible families, as needed, to additional resources available in the community, such as center-based early education programs…mental health services…social services…”
§         “Diagnostic classifications for infancy are still being developed and validated…”
§         “Lack of longitudinal outcome studies”
§         “There is neither a systematic data base, clear criteria for [medication] treatment or dosage recommendations that have been identified or standardized for pediatric use (Greenhill et al. 2003).”
§         “Broad parameters for determining socioemotional outcomes are not clearly defined”
“Little research has been conducted to study the effectiveness of psychosocial interventions in young children, and the long-term risk-benefit ratio of psychosocial and pharmacologic treatments is basically unknown.” (Vitiello, 2001)

Dr. Effrem provides recommendations to lawmakers to address public concerns about scientific validity and, privacy, and parental autonomy. They include:
  1. The confidentiality of medical records and privacy rights of targeted mothers;
  2. Truly informed and voluntary consent for participation in the program;
  3. The prohibition of home visitors from presenting information that is not scientifically supportable or violates the government’s duty to maintain neutrality regarding deeply held personal beliefs;
  4. Insuring that home visitors make their investigative role clear to parents and obtain informed consent to the “search” of the home that is implicit in the home visitation concept;
  5. Insuring that home visitors use legal definitions of child abuse and neglect as the standard for making reports to Child Protective Services as opposed to personal opinions about the propriety of spanking as a form of child discipline or other issues in the realm of parenting philosophy;
  6. Insuring informed and voluntary consent is obtained before personal information is entered into a database, and that sufficient safeguards are placed on the use of this data and its ability to be accessed by other individuals and government agencies.

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See also Brave New Schools, Chapter 2: The International Agenda