Not All Children Benefit from Taking ADHD Medicine: Controversy and Ramifications

While it is true that some children respond favorably to the administration of taking Attention Deficit Hyperactivity Disorder (ADHD) medications which may allow certain children to better manage symptoms with few side effects, negative results and associations give evidence of unhealthy side effects, diagnostic controversy, and adverse policy ramifications in general. The administration of ADHD medications for children may not be the blanket cure-all many in society have been led to believe. It could potentially lead to a lifelong obsession with pill-popping. As far back as 1998 author Bower, as reporting in “Science News” in quoting panel Chair and psychiatrist of the University of Pittsburgh observes that “there is no consistency in treatment, diagnosis, or follow-up for children with ADHD,” further adding that there is no “sufficient evidence to define a diagnostic threshold for starting stimulant treatment or to develop strategies for ADHD prevention (343). In light of the controversy surrounding the notion of whether such ADHD treatment is beneficial to some children, several aspects herein shall be explored. Three key concerns involve policy ramifications, the diagnostic controversy itself, and a challenge to the assumption that ADHD medications are right for every child in the first place. 

There are a number of disturbing factors associated with the administration of ADHD medications to children which include bio-physiological side effects, false diagnosis, and parental pressure that may subtly or otherwise coerce guardians of children to consent to its drug therapies. A good place to begin in consideration of the first key concern is a focus upon the policy ramifications. Policy ramifications surrounding the controversy with the administration of ADHD medicines to children reflect a three-fold interest. Tied to policy ramifications are issues pertaining to medical, educational, and legal involvements. 

Policy ramifications within themselves are huge. In the medical sense, as the authors of one Harvard Review Of Psychiatry note carry a plethora of such ramifications that recognize “almost 8% of youth aged 4 to 17 years” have such a diagnosis of this so-called deemed “pediatric mental disorder” of which as a result have been prescribed psychotropic medicines or stimulants to alleviate behavior problems (Mayes et al.). Some argue, however, that parents have the responsibility of teaching children proper behaviors. Many probably recall the medicine applications to children with behavioral issues dating back as far as the 1970s, however, the escalation in this type of drug administration in children has skyrocketed in the 2000s. Everyone most likely knows of someone, if not their own child family members, who have been recipients of ADHD control prescription medications. 

The policy ramifications in terms of medication administration to children are so vast because the commonplace acceptance and increasingly widespread pharmaceutical drugging of children can suggest agreement among decision-makers. Such agreement among decision-makers might include those within the health insurance sphere, pharmaceutical industry proponents, and federal advocates in positions to make mandatory policy with regards to children so diagnosed. In fact, such a policy move helped to propel to “trigger the surge in ADHD diagnosis and [its] related stimulant use” with the policy change to implement the Supplement Security Income program in conjunction with Individuals with Disabilities Education Act according to authors (Mayes et al. 152). Right away you can easily see how great an impact can be made within the area of medicine alone, in terms of the possibility of required medication administration to children thus diagnosed. Policy matters. 

The policy ramifications in the field of education is enormous. It seems as though once your child is classified or pegged within the system as regarding he or her abilities or level of intelligence such labeling may be hard – if not impossible – to shake down the line at a later time. In other words, once your child has been identified within the rubric of the educational system as perhaps being gifted, mentally challenged or retarded, or simply of being of an average or mediocre capability of intellectual brings a whole other Goliath, as it were, to the table. It is difficult at best or impossible at worse to try and fight against any sort of educationally documented labels by so-called experts placed upon your child. It seems as though once such labels have gained a foothold in documentation and reporting, it may not be easy to escape the implications of such labeling. 

All parents overall strive to cultivate the best in their children. Despite this forward drive to attain the best educational opportunities for their children, some believe that medical science or clinicians have used the diagnosis of ADHD in children as a kind of social construct in the realm of mental health. Mayes et al. interject that one reason why the diagnosis of ADHD “has been criticized is that many, if not most, children can display behavioral characteristics of inattention and hyperactivity/impulsivity (153). How many times has an adult caregiver of a child placed that child all dressed up in their Sunday best in front of the television, perhaps in an effort to wait for the rest of the family to get dressed in order to leave for an event – only to discover that the child has fallen asleep due to boredom. Would this be characterized as a mental disorder? One would hope not. 

Diagnostic controversy as the last of three key concepts within policy ramifications holds the idea that there is no proper, so-called diagnosis in the first place. The proponents of administration of ADHD medications to minors admit that its treatment is more based upon art than medical science according to a recent report in WebMD. This fact alone in consideration of children being administered Ritalin or other quite possibly harmful pharmaceutical therapeutics, speaks volumes. In fact, this declaration is stunning. What on earth is being done to children in the name of medical science, when the diagnosis is so unclear? 

The diagnostic controversy can extend far beyond the auspices of the research report considerations herein. For example, consider the safety of any FDA-approved pharmaceutical drug for the usage of children who clearly are still in the developmental stages of life. This aspect alone provides much fodder for contemplation in terms of medical and scientific responsibility, safety and policy analysis. The whole question in this vein revolves around diagnosis and evaluation. Clearly, some children have issues with developmental disabilities in the first place, whereas other children have no such deficiencies in their capacity or capability to learn to extremely high degrees. As a further point to consider, it is fairly common knowledge that Albert Einstein was diagnosed as supposedly mentally retarded in the years prior to his fame as a scientist of worldwide renown. 

The point being made here is clear. What if a wrongful diagnostic evaluation is made upon a child who is otherwise exceedingly capable of learning on a gifted level? That child may then be in danger of having their youthful bio-physiological functions at risk. According to Deutsch et al. it is still difficult to measure intellectual deficits in terms of epidemiology in those groups identified as having intellectual developmental disabilities (IDD) as they emphatically claim that “we currently do not have good estimates of the base rates of ADHD symptoms in IDD” (286). Furthermore, there is a question as to how to contrast this modeling group with individuals supposedly manifesting symptoms of ADHD, but who are otherwise capable learners with IQs in the normal range. 

Such a lack of diagnostic certainty and standards of evaluation leaves much room for inquiry as to the validity of administering ADHD medicines to children across the board, and not considering that there may be a substantial portion of children thus diagnosed who simply may not benefit from drug therapies prescribed. The possible negative impacts upon children who do not thrive on ADHD medication administration may be mild to severe. Mood changes, difficulty in sleeping, or a noticeable lack of appetite are just several possibilities in adverse symptoms that can ride in on the heels of taking ADHD medications. Parents should be consulted in terms of collaboration in any so-called diagnosis of their child since common sense says that they know their own child better than someone looking from the outside in. 

The administration of ADHD pharmaceutical drugs being given to children as a mainstay of therapeutic correction for behavioral problems is a bit ridiculous if applied to most children who have not had major issues with learning abilities or severe episodes of outbursts of anger. Granted, there may be situations in which severe mental retardation may play a role or in cases wherein children have known outbursts of violence that endanger all those around him or her. In any case, it seems as though caution should be of a high priority when consideration of giving any pharmacological therapeutic solutions to a child. It may be possible to incur more damage than good upon persons who are still in the developmental stages of their young lives. 

Pharmaceutical remedies may have a high standard of results in some circumstances when applied to those with IDD. In fact, it is true that authors Deutsch et al. found from one study that “successfully higher methylphenidate doses were associated with gains in cognitive task performance, with optimal performance noted at the highest dose” (287). However, that said, even if a child has delayed developmental issues this does not mean every child can necessarily benefit from taking ADHD medicines. Each child is different and certainly has his or her own set of environmental issues, family circumstances, and issues pertaining to individual learning task attainments. 

It seems as though children ought not to be so rigidly judged in terms of their behavioral responses. Some children may not like certain subjects, and therefore display certain habits of impatience during the course of that subject. Why are so-called experts sometimes so quick to label a child as abnormal or flawed if he or she is simply bored with a subject, or simply may be a bit more tired that day? Behavioral observations can also be accounted for in terms of nutrition, moods resulting from home-life circumstances, or just the fact that a child may be day-dreaming. There are probably more times than can be enumerated when every adult remembers his or her own childhood, and day-dreaming about doing their favorite sports activities or fun things to do. 

In the case of younger children around the ages of 5 to 7, it seems that a diagnosis of ADHD maybe is even more ridiculous. The reason why is because this very young age group of children has just passed from the preschooler and toddler stage whereby all in this age bracket are easily distracted. Author experts proclaim this to be the case when informing “It is rare that preschoolers are not easily distracted by things around them, not impatient and challenged by having to wait their turn, and not described by parents as” being on the move constantly (Mayes et al. 153). Even given the fact that older children should have a certain mastery over patience and boredom, the aforementioned experts have drawn out the criteria of five components for diagnosing ADHD. It is doubtful that such detailed criteria are actually followed with most children being treated with pharmaceutical remedies. The list of criteria nevertheless is interesting to note.

The first component in the set of criteria looks at the age-appropriate behaviors associated with developmental stages and demands that such behaviors are absent for a period of at least six months. The second criterion requires that signs of ADHD have been observed in the child prior to age seven. The third criterion would document evidence that there exists “significant difficulty” in the child's setting both at home and at school (Mayes et al. 153). Fourth would be further signs of deteriorating impairments, with the fifth criterion which rules out symptoms associated with another disorder. The point is that it is highly doubtful that such a comprehensive protocol for symptoms proving a diagnosis of ADHD exists in each and every case. If there is no such detailed attention to finding out for certain if the child has ADHD in the first place, it is likely to be unfair that a child should be relegated to receiving any pharmaceutical drugs which may easily cause adverse reactions thereby being detrimental to the child's mental or physical health and well-being. 

In conclusion, there has been a myriad of considerations under discussion about the fact that not all children necessarily benefit from taking ADHD medications. The policy ramifications have been explored which included the medical implications, educational implications, and legal considerations. These three aspects of the policy all demonstrate how important labeling and categorization of children can be in the educational system, too. Policymakers and other stakeholders in decision-making can have a great impact on forcing or recommendation of giving ADHD drugs to children. The legal aspects can be very critical as well, particularly when considering any federal mandates in place. 

Legal aspects can lead to sticky situations merely because the public health laws, and educational mandates for children can play into a complex mix of statutes. Perhaps the best course of action for any parent is to find out as much as you can pertaining to the state laws that govern ADHD children, with regards to diagnosis, treatment, and medication mandates. Furthermore, it would not hurt to investigate your child's rights and consumer protections in terms of the administration of drugs to minors along with a thorough exploration of possible side effects.  

Diagnostic evaluations must be re-visited, as the guidelines do not appear to be uniform enough in meeting any accurate or appropriate diagnosis. The diagnostic controversy can actually be extended to approaching the situation in terms of behavioral approaches, or by using drug therapies. The bottom line is that one must be careful and sensitive to the reactions of children to such medications.

Works Cited

Bower, B. “Kids' Attention Disorder Attracts Concern.” Science News, vol. 154, no. 22, 1998, p. 343.

Deutsch, Curtis K., et al. “Attention Deficits, Attention-Deficit Hyperactivity Disorder, And Intellectual Disabilities.” Developmental Disabilities Research Reviews, vol. 14, no. 4, 2008, pp. 285-292. 

Mayes, Rick, et al. “ADHD And The Rise In Stimulant Use Among Children.” Harvard Review Of Psychiatry, vol. 16, no. 3, 2008, pp. 151-166.