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Archive for Saturday, December 4, 1999

SICK

December 4, 1999

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— A reaction is under way against drugging children because they are behaving like children, especially boy children. Colorado's elected school board recently voted to discourage what looks like drug abuse in the service of an ideological agenda. The board urged teachers and other school personnel to be more restrained about recommending drugs such as Ritalin for behavior modification of children, and to rely more on discipline and instruction.

One reason for the vote is that some school violence has been committed by students taking psychotropic drugs. But even absent a causal connection between the drugs and violence, there are sound reasons to recoil from the promiscuous drugging of children.

Consider the supposed epidemic of attention deficit/hyperactivity disorder (ADHD) that by 1996 had American youngsters consuming 90 percent of the world's Ritalin. Boys, no parent of one will be surprised to learn, are much more likely than girls to be diagnosed with ADHD. In 1996, 10 percent to 12 percent of all American school boys were taking the addictive Ritalin. (After attending classes on the dangers of drugs?)

One theory holds that ADHD is epidemic because of the modern acceleration of life -- the environmental blitzkrieg of MTV, video games, e-mail, cell phones, etc. However, the magazine Lingua Franca reports that Ken Jacobson, a doctoral candidate in anthropology at the University of Massachusetts, conducted a cross-cultural study of ADHD that included observation of two groups of English schoolchildren, one diagnosed with ADHD, the other not. He observed them with reference to 35 behaviors (e.g., "giggling," "squirming," "blurting out") and found no significant differences between the groups.

Children, he says, tend to talk, fidget and fool around -- "all the classical ADHD-type behaviors. If you're predisposed to label any child as ADHD, the distracted troublemaker or the model student, you'll find a way to observe these behaviors." So what might explain such a predisposition?

Paul R. McHugh, professor of psychiatry at Johns Hopkins, writing in Commentary, argues that ADHD, "social phobia" (usual symptom: fear of public speaking) and other disorders certified by the American Psychiatric Assn.'s "Diagnostic and Statistical Manual of Mental Disorders" are proliferating rapidly. This is because of a growing tendency to regard as mental problems many characteristics that are really aspects of individuality. So pharmacology is employed to relieve burdensome aspects of temperament.

"Psychiatric conditions," says McHugh, "are routinely differentiated by appearances alone," even when it is "difficult to distinguish symptoms of illness from normal variations in human life," or from the normal responses of sensitive people to life's challenges. But if a condition can be described, it can be named; once named, a distinct disorder can be linked to a particular treatment. McHugh says some experts who certify new disorders "receive extravagant annual retainers from pharmaceutical companies that profit from the promotion of disorders treatable by the companies' medications."

The idea that most individuals deficient in attentiveness or confidence are sick encourages what McHugh calls pharmacological "mental cosmetics." This "should be offensive to anyone who values the richness of human psychological diversity. Both medically and morally, encumbering this naturally occurring diversity with the terminology of disease is a first step toward efforts, however camouflaged, to control it."

Clearly some children need Ritalin. However, Ken Livingston, of Vassar's department of psychology, writing in The Public Interest, says Ritalin is sometimes used as a diagnostic tool -- if it improves a child's attention, ADHD is assumed. But Ritalin, like other stimulants such as caffeine and nicotine, improves almost everyone's attention. And Ritalin is a ready resource for teachers who blur the distinction between education and therapy.

One alternative to Ritalin might be school choice -- parents finding schools suited to their children's temperaments. But, says Livingston, when it is difficult to change the institutional environment, "we don't think twice about changing the brain of the person who has to live in it."

This is an age that tries to medicalize every difficulty or defect. Gwen Broude, also of Vassar, believes that the rambunctiousness of boys is treated as a mental disorder by people eager to interpret gender differences as personal deficiencies. Danielle Crittenden of the Independent Women's Forum sees the "anti-boy lobby" behind handwringing about the supposed dangers of reading the Harry Potter novels which feature wizardry, witchcraft and other really neat stuff.

The androgyny agenda of progressive thinkers has reduced children's literature to bland gruel because, Crittenden says, there is "zero tolerance for male adventurousness." The Potter books recall those traditional boys books that satisfied boys' zeal for strife and adventure. Today, Crittenden says, that zeal causes therapists -- they are everywhere -- to reach for Ritalin.

Harry is brave, good and constantly battling evil. He should point his broomstick toward Colorado, where perhaps boys can be boys.

-- George Will is a columnist for Washington Post Writers Group.

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