Medicating Our Children to Nowhere
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Expectations like these can have a pathologizing effect on normal childhood behaviors like being active and noisy, which may be one contributing factor in the rise in diagnosis rates. Though we seem to have convinced ourselves otherwise, children are not, by nature, quiet and reserved; they’re curious, filled with life and – at their best – actively engaged with their environment. These are the traits that lead to learning for many children, especially those with tactile learning styles who need to physically interact with their surroundings to absorb information. They are not, however, the traits that make it easy to run a classroom -- especially a classroom overfilled with students who, like all children, need individual attention from their teacher.
In a conversation with AlterNet, pediatrician Vicki Soloniuk noted how difficult school environments have become for many children, not to mention for teachers and other school personnel, who can wind up frustrated by the limitations of the system. Teachers “don’t have the time,” Soloniuk says, to provide the individual instruction and mentoring some kids need to succeed, even though many have a profound desire to help their students. Consequently, some teachers end up referring children for medical workups even when those children don’t have clear signs of learning disabilities. And this, in turn, can result in the prescription of pharmaceutical fixes for issues that might be better addressed through other means.
This issue is particularly acute in low-income school districts, which have suffered a catastrophic loss of funding in recent years, particularly for disability services. Low-income children are hit particularly hard by these cuts; while wealthier districts and parents can often afford non-pharmaceutical interventions, the options for low-income students generally are far more limited. Medicaid, for example, will pay for ADHD medications, but not non-drug options, and it certainly won’t pay for aides and other options in the classroom that could help these students succeed without the use of medications.
As Jen, who spent 14 years working in special education, recalls:
It really was heartbreaking to see kids who struggled so hard to fit into the mold the majority of their peers fit into, and then were made to feel as though there was something wrong with them when they didn't succeed. Our school system is set up for kids who fit into that mold and, ideally, anyone whose learning style or ability fell outside that window of ‘normal’ would simply be taught in the way that best matches whatever their unique needs were.
It’s a more humane approach to learning, without a doubt. But assessing such students and meeting their needs is both costly and time-consuming, and as school budgets are continually slashed, it is rare indeed to find small or overburdened school districts that have the capacity to put such an ideal into practice. Instead, medication becomes the answer, with doctors giving their tacit approval by signing on the dotted line.
As many doctors will tell you, ADHD and ADD can be significant learning disorders, with diagnostic criteria that require careful evaluation for a successful diagnosis and equally careful treatment planning to achieve the best outcome for the child. For her ADHD and ADD patients, Soloniuk often recommends numerous non-pharmaceutical treatment measures -- like notebooks to track homework and tasks, and sticking to strict schedules to help children who need routine stay focused. She also works closely with parents to create a productive home environment, pointing out that ADHD is familial, and often one or both parents have it as well. In these cases, treating the family as a whole often helps to create a more stable environment to support the child.