Published in San Francisco Chronicle (CA) - March 18, 1999 - page A25
IN 20 YEARS of practice as a behavioral pediatrician, I have seen some 2,000 children for their
behavior and school problems. I've written many prescriptions for Ritalin, the stimulant used to
treat Attention Deficit/Hyperactivity Disorder. ADHD is a condition of excessive inattention,
distractibility, impulsivity and sometimes hyperactivity, primarily affecting children.
In the early 1990s, I began to see a new kind of ADHD candidate: younger than 6 years old,
teenagers and adults. Many of the children seemed far less impaired by their personalities
compared with the previous generation of patients. Nevertheless, their parents and teachers were
I wondered if Tom Sawyer or Huck Finn were brought to my office, would I, after reviewing their
home and school environments, prescribe Ritalin.
I am not the only doctor writing more Ritalin prescriptions these days. The production and use of
the drug has increased by 700 percent since 1990. In 1998, the United States used 84 percent of
the world's Ritalin. What's behind this increase and why us?
Demands on children have grown while the strength of their social supports -- school and family --
has decreased. Today, there is a rampant educational paranoia that declares everyone must have
a college degree to succeed. Children are expected to learn earlier and learn more, yet we have
higher student-teacher ratios in the classroom. Parents are working harder and longer. That
means less time for their children and more structured day- care and latchkey kids.
Parents are additionally handicapped by a "politically correct" parenting philosophy which appeals to
conscience and conflict avoidance when disciplining Johnny. "If you know how to talk to Johnny he'll
listen to you." Unfortunately, from my experience, if you try talking to attention-defict Johnny he's
halfway down the street before you've finished your first sentence.
More managed health care means more "quick-fix" medication. Being "labeled" attention deficit
gets you special services at school.