Sunday, April 16, 2000
Local experts speak out
Here's a sampling of what several Cincinnati experts said about psychiatric drugs for children in interviews with Linda Cagnetti:
Doug Ris, pediatric neuropsychologist, Children's Hospital Medical Center:
• “The increased use of these medications (particularly stimulants) reflects in part our growing knowledge and faith in them. We understand much better now that they can be effective for certain conditions . . . The rise in the use with school-age students is legitmate and valid. But we need a lot more scientific data on use with preschoolers.”
• “I feel that some of the (public) alarm created around this issue is not justitified. But if it spurs the government to fund more research on it, we'll all benefit — as long as we maintain unbiased positions and look at the data in a fair and even-handed way and not just as political fodder to support someone's preconceived notions.”
• On early identification of potentially violent kids: “Mass testing assumes we can fairly accurately identify these kids. I know no existing scientific evidence that says we can do it. Until we can identify them with high degrees of accuracy, the process may do more harm than good.”
Tom D'Erminio, clinical social worker, co-founder of The Affinity Center (ADHD specialists), Cincinnati.
• “Some problems are neurological, but not all. What I've seen happen is that many kids have come to our center who are unhappy with past treatment. Their medicine, they say, makes them feel terrible. Or they're on just enough to sedate them, not help them. Many come in with two to three combinations of medications, or the wrong doses or they're unaware of the side effects of the drugs they're taking. Other people come to us after a diagnosis and they're not happy with the treatment. They're looking for alternatives.
“We stress a multidisciplinary approach — careful diagnosis, counseling, behavior therapy, etc., and individualized solutions and, where possible, working with the family and child as a team. We consider medication one treatment tool. It often opens a window of opportunity for a child to make changes he couldn't otherwise; it may make him more able to benefit from other interventions. You have to be sensitive and judicious with it.”
• “The White House approach seems to assume that the problem is children who are mentally ill and need to be "managed' with medications. Nobody is asking what we are doing (as a society) that may make inappropriate demands on children. Nobody (especially insurers) is asking about other treatments besides medicine. Nobody is saying this (child crisis) is a much bigger problem than medicine. Let's have this debate, but let's be more inclusive in what the real and underlying problems may be.”
• “I think we have a lot of depressed kids. We can't discount the world kids have to operate in nowadays. Very young children may have a very structured day. We drag them around place to place, from day care to after-school care. Then to sports and other activities ... Many parents are overly involved in needing their kids to be successful or fit a mold. There is pressure for performance, for high grades . . . So kids just don't fit. We may medicate to fit a square into a round hole. That approach concerns me.”
Mark Helmick, psychologist, Springer School and private practice, speciality ADD and learning disabilities.
• “A White House conference that would get my applause would look carefully at what kinds of services and treatments (not just medications) are most effective for children with learning and attention problems, and then determine as a nation what we're doing to prioritize these services to children and make them happen.”
• “The problem with this debate is the extreme positions at one end or the other; neither is all right or all wrong . . . There's also danger that people who are working through treatment with children, giving careful consideration to different and several interventions, all of a sudden begin to fear they're doing something terribly wrong . . . They're not. The best treatment for children with learning and attention problems is mutli-disciplinary and complex. We know they aren't short-term and won't be answered with a quick, single or simple response.”
• “My advice is . . . always become as informed as possible about the pros and cons of the medication prescribed for your child.”
Drugging our kids
Local experts speak out
What we're talking about
