Drugging our children
ADD and Drugs
Jerry Pournelle
Sunday, September 16, 2001
I open with the letter that caused this page:
Dr. Pournelle,
Oddly enough, though I've been a fan of yours for about 15 years, and I've been surfing the web for about five, this is my first visit to your site. I have to compliment you on the layout. It's very quick to load on my system, which is always a bonus.
Looking over your last weeks e-mail, I feel as though I could become a regular contributor here. There is a plethora of topics hit upon here that I feel deeply about, from computer systems to quack medicine to the state of our education system.
It's the last topic that's compelled me to write at this late hour. My oldest son almost became a victim of the "drug 'em into submission" philosophy of our local school system. He's eleven and has always had behavioral problems. During the past two years, they've become worse and my lady and I have had a hell of a time dealing with them and him.
The school system here in North Carolina was of little help. There were a couple of individual teachers that tried, but the prevalent attitude was summed up by a particularly noxious school counselor who called my lady at work one day last year to scream "You've got to get your son to a psychiatrist today or we'll have to expel him!"
It seems that Rick's behavior (fidgeting, not paying attention, inappropriately straying from his seat, purposely ignoring the teacher) were classic symptoms off ADD. To top it all off, Rick had a nasty habit of telling highly improbable tales of his life at home, on the streets, at school, all designed to bring more attention to himself.
We never did take him to see a pshrink that day, but we did visit the counselor and lay down the law. He was not to talk to Rick anymore. If any of his teachers had a problem with him, they were to let us know and we would deal with it at home if they couldn't find a way to discipline him at school.
Several days later, we were informed by the Guilford County Department of Social Services that we were the subjects of a child abuse investigation and would be receiving a visit from a social worker. We were told this was because of a bruise the guidance counselor had noticed on the back of Rick's neck. Rick told the counselor that he had thrown a tantrum at home and while trying to stop him, I had grabbed him by the shirt collar. All this was true, but the counselor, who would now only talk to us with the principal present, cited this as a sign of further physical abuse, and sicced the social workers on us. To this day, you would be hard put to convince me that this counselor wasn't trying for a little vengeance after Rebecca and I told him that he wasn't worth the paper his bachelor's degree was printed on.
Well the social worker came and went and Rebecca and I both got nice letters clearing us of any suspicion, and life went on.
This year, as Rick entered sixth grade and middle school, his behavior got worse. Most notable were two incidents at school where he threatened a teacher that he would shoot her and told another to f*** off and die.
Before things could get worse, Rebecca and I decided to cut the problem off at the pass. We went to the school and told the teachers and counselors the same thing we had told them the year before at the elementary school. Teach him, discipline him, notify us if you can't control him, but leave off the counseling. He's smart enough that counseling does no good; he just plays games with the counselor.
Rebecca then took him to see a pshrink recommended by our pediatrician. Apparently, the pshrink took fifteen minutes to diagnose Rick not as a victim of ADD, but as bipolar, and prescribed medication based on his diagnoses. I was a little skeptical, at first, about the validity of a fifteen minute diagnoses, but went along with it.
Fortunately, the meds are actually helping. He's still eleven, he's still slower than molasses on an Old Forge morning and he still gets into more than his fair share of trouble, but he's no longer the moody, morose and occasionally violent hood he had been turning into.
The meds haven't made him dull and lifeless as I've seen Ritalin do, they haven't taken away his imagination, and they haven't taken away his dislike of doing the dishes.
In a backhanded way, I suppose, the muttonheads at the school did help, just not the way they would have liked to. I shudder to think of the students whose parents they have convinced to drug their kids with Ritalin because they were behaving like Rick. Not only are they causing these kids to walk through life like zombies, but if they actually do have a problem, like Rick apparently does, it's not being treated as it should.
Now, don't get me started about the education these kids are getting.
Sincerely,
Paul Ë. Lewin
caermon@mac.com
Visit my websites at: http://home.earthlink.net/~caermon/index.html or http://sites.netscape.net/caermon/pelworld
Catch me on AIM as Caermon or on ICQ (#38393471)
I have a long and not well written letter from a psychology student (level not specified) saying that Dr. Breggin is an idiot and his pop article a work of folly. That's a free translation: the letter is more polite. Here is some of it:
I was very disappointed to see the space that you recently gave to a letter which made many powerful statements about ADHD. I know you personally don't believe in the disease. However, as you are a respected scientist, I'm finding it hard to see how you could believe the letter in question.
A critical review of the letter shows it to be emotionally charged, short on facts, disingenious, and sometimes utterly impossible to believe.
As a psychology major, and a person with Adult ADHD, this letter incensed me, because people might believe you were endorsing this viewpoint. I hope that's not the case -- and if it is, I hope you'll take the time to read my comments, and reconsider.
I tried to read his comments, but frankly the length made that difficult, and it has been a very difficult week anyway. It is full of things like (a long quote from Dr. Breggin's article)
Notice that the author does not provide specific cases. The mythical "they" is used, suggesting a conspiracy.
Do things like what is described occur? Probably.
Is it a rampant problem? It's hard to tell without hard numbers, which aren't provided.
Since Breggin was writing an article for popular consumption, not a peer-reviewed journal article, and used anecdotes from his own practice, I am not sure that the same standards need to be applied. Awhat appeared to me to be an anecdotal letter, I never thought it claimed to be "science". As to numbers, when a significant percentage of the boys in schools are given drugs, and we got along all right without doing that until recently, I would think it a matter of concern.
Here is another example:
> Stimulant drugs, including methylphenidate and amphetamine, were first > approved for the control of behavior in children during the mid-1950s.
Notice the loaded wording: "control of behavior in children."
One could also say "approved for treatment of hyperactive disorders in children," which has a much different emotional connotation. It's also more accurate from a scientific point of view.
There is considerable more, and much on a par with this. If there is a significant point other than "I disagree" I didn't have the patience to find it.
I invited this correspondent to send me something shorter and to the point, but what I got in reply was
> This isn't lengthy it is unreadably long. What is your point?
My point, sir, is that you posted this letter to your site without comment, apparently in agreement. Further, that the letter was written by someone who was at best a misinformed paranoid, and at worst a rabble-rousing agent provocateur.
I have had great respect for you. I cannot say that your apparent support of pseudo-scientific tripe such as Dr. Breggin's message continues that respect.
The letter simply does not stand up to reasonable inspection.
And on that score I will simply have to leave matters as an exercise for the reader. I am prepared to believe Dr. Breggin is wrong. I am not prepared to believe that something about 15% (my wife says it's much higher than that) of the boys in schools suffer from some disorder that wasn't even dreamed of when I took my graduate work in psychology in the 50's. Now admittedly my field was more engineering psychology than clinical, but I had a heck of a lot of study in personality theory, and like everyone else I had to have a year of abnormal psychology and clinical studies. My textbook was the standard medical school psychiatric text "A TEXTBOOK OF PSYCHIATRY" and I still have it, and I can't find ADD listed either as a diagnosis OR AS A SET OF SYMPTOMS needing treatment.
This is significant: either some really severe problem has developed since the 1950's, or -- well or what? That prior to 1950 we managed to educate boys sufficiently that conscripts were nearly all able to read, which was not true by the time conscription was ended; but we did that without realizing that a very large percentage of those boys should be drugged to get them properly through school? This could be true but it seems unreasonable.
I make no doubt that something like ADD exists, just as true dyslexia exists. But true dyslexia is very rare, down under 1%, yet 10% and more of children are diagnosed as "having" dyslexia. Most cases of "dyslexia" are maestragenic: they kid didn't learn to read because the kid wasn't taught to read. I do not know what the corresponding numbers for ADD are, but I would be astonished if "true ADD" amounted to more than 10% of the boys in schools. I truly would.
I give one more example of the complaints raised against Dr. Breggin:
> Stimulant medications are far more dangerous than most practitioners and > published experts seem to realize. Animals and humans cross-addict to > methylphenidate, amphetamine and cocaine.
Dr. Breggin appears to be saying that almost everyone other than him is an idiot and hasn't seen some danger in Ritalin. I find that hard to believe.
I am willing, indeed eager, to see some proper debate on the use of Ritalin in the US; but I do not think the above contributes much to understanding. And I continue to wonder why, if 10% and more of the boys in US schools need drugs today, we managed when I went to school in the 30's and 40's to drug none of my classmates; and to wonder if, given my restlessness and boredom -- when you are in 8th grade having been in the 7th grade in two grades/classroom school so you have heard every word that is going to be taught in 8th grade, and you could pass the 8th grade tests the day you came to the 8th grade, you are going to be bored and restless -- I wonder if I would not have been drugged if drugs were available.
Instead I was disciplined but also allowed to read books, books that were not assigned to others, and I could even get away with reading them during lessons so long as it wasn't a lesson requiring recitation. Incidentally, being required to recite on a regular basis was one of the best things that could have happened to me. I gather they don't do that much in schools now. Pity.
I have run on enough on this. I am not endorsing Dr. Breggin, but I can't denounce him either. I think we drug far too many of our children. I am glad I and mine escaped this trend. It may be appropriate for some but I cannot believe it is the proper treatment of 10% and more of American boys. More below.
Dear Dr. Pournelle:
For what it's worth, I forwarded the article by Dr. Breggin on ADD/ADHD and meds to a friend of mine who has three kids. The eldest was nearly wrecked by overmedication, before my friend and her husband caught on (the story if you are interested: the public school told her and her husband that her son had ADD and needed Ritalin. They acquiesced. Later they recommended he be switched to Thorazine, at which point they balked. It transpired that *one-quarter* of the parents in this particular class had been given the same story. Note that this is in an Arlington County, Virginia public school with a reasonably middle-class profile. It took their son quite a long time to recover from all that, and in some ways he has never recovered--the only good news is that now he is extremely averse to *all* drugs, so hopefully he won't get caught in that game when he goes away to college...)
I do not know what this other fellow has to say about Dr. Breggin that could alter the underlying realities, which you have ably presented in your own comments. I give you this as both an additional piece of (admittedly anecdotal) data and as a further testimonial.
Please feel free to include my name and email, but not that of my friend.
Very respectfully,
David G.D. Hecht
Which is not inconsistent with many other such stories reported here. Once again: I make no doubt there is such a thing as "ADD", and I am willing to be persuaded that it is more prevalent now than when I was younger. I am willing to be persuaded that in some cases drugs in general and Ritalin in particular will be the proper treatment, particularly when alternatives are severely limited by circumstances. I am not willing to believe absent a great deal more evidence than I have seen that more than 10% of the boys in America have this problem and must be drugged before they can be taught. I am very much of the opinion that I would have been drugged had the authorities the power to do it prior to my falling into the hands of the Christian Brothers, who basically offered me the alternative of working to my capacity or having my life made unpleasant, and of behaving myself or having physical blows applied to my posterior (and I got to thank them for each whack; it did not take more than two such sessions to persuade me that there were better alternatives than smarting off, after which my punishments consisted of things like being required to go find the poem Ivan Skavinsky Skivar and write it out and recite it to the class; an assignment I could have refused but the alternative was again the pounding on the posterior and that I wanted to avoid...) And for the record, if Broter Robert, or Brother Fidelis, or Brother I. Vincent, or Brother Henry, or Brother Daniels are listening this side of the grave or beyond, "Thank you, Brother."
But I ramble. As I said, I can believe in ADD, but I can't believe the drugs are needed in the quantities they are used. And I wonder: we needed Freon until just before the patent expired after which we not only didn't need it but it was evil and we needed something else which had just been patented; is this to be the fate of Ritalin? But that is a mere conjecture put forth in ignorance of any facts.
> So do you think, you could make money taking 100 students and $800,000 for a > year? I could get rich on it.
Hmmm, I tried putting together a budget:
Item # $/per $ --------------------------------------- teachers 4 50,000 200,000
administrator, janitor/cleaning service, facility (5 rooms), instructional materials, special ed., insurance. To replicate what most schools provide you would have to also provide sports, art, music, etc.
...and found too much I didn't know. I did notice that I figure 4 teachers at $200,000. Schools typically spend %60 ($480,000) on teachers. So why am I way off? With 100 kids do I have expect one class (10 kids) of special ed.? Even so, add in a $60,000 special ed. teacher and I have $260,000 spent on teachers, still way lower than typical.
So, I would like to see a real school budget.
It can't be as easy as it looks. Baltimore experimented with privatizing schools in the 90's while I was in living there. They gave 9 schools to Education Alternatives and gave them a lot of independence. The company promised better education and was given the same money other schools in Balt. received. After 4 years, students didn't seem to be learning more, and company was fired. The company made some money, but not a huge amount.
Do you find the absolute cost high, or do you find the education provided for the cost high? Or both? Bad schools can cost as much as good schools, a bridge most of the way across a river costs nearly as much as a complete bridge but transports no people.
Jim Lund jiml@stanford.edu
I don't have to do a budget. I merely know that Pinecrest and other private schools do get rich on a lot less than $8,000 per student, and Catholic schools operate at about half that. What man has done, man may aspire to.
