by Tracy R. Walsh
Pediatrician Russell Saunders is alarmed by the finding that thousands of American two- and three-year-olds take medications for ADHD:
Because the behaviors that typify ADHD are common and normal in toddlers, thus contraindicating treating them with medication, there is little study on the effects of treatment at this age. However, the side effects of these drugs are well known. Among others, they include interference with sleep and suppression of appetite. Toddlers and preschoolers typically need lots of sleep, including daytime naps, so giving a medication that throws their ability to sleep into disarray is ill-advised. (Sleep deprivation can make ADHD-like behaviors even worse.) Further, they are often picky eaters under the best of circumstances, and curbing their appetite during a period of crucial growth can have a significantly negative outcome.
What’s more, using medication rather than consistently and patiently helping these children learn self-control robs them of a necessary part of cognitive development. Parents need to help their kids learn boundaries, behavioral expectations, and how to control their own impulses (I usually recommend a simple and sensible approach like “1-2-3 Magic”), and replacing this education with Ritalin does them a grave disservice with potentially long-term behavioral ramifications.
KJ Dell’Antonia notes that poor children are “disproportionally represented” among the medicated:
Medication for some toddlers can seem like a cheap and fast fix, and one that parents who are probably already struggling may welcome. Many toddlers on Medicaid live in single-parent homes, where the time to put into alternative programs may be as scarce as the programs themselves. For black parents, other considerations come into play: even in preschool, black students are more likely to be suspended; children with ADHD behaviors often find school difficult; and parents of children on Medicaid who are lucky enough to have a preschool placement for their children (particularly during working hours) may have a lot at stake if that place is lost.
It’s not hard to see what may lead a parent and a doctor to choose to medicate a toddler’s ADHD-like behaviors under those circumstances. What is difficult is addressing the vast set of inequalities that underlies this particular example of the increasingly large gap between the childhoods of low-income children and those of children whose circumstances are more fortunate. For now, we’re left with one of the ironies of income inequality: a rare instance of poor children getting more of something than they need.
Recent Dish on ADHD here.
The Dish 