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Q: I understand that Ritalin® is a common way for treating children diagnosed with ADD. I am personally worried about this drug and its effects on young children. I feel that it makes children feel that there is something wrong with them, makes them retreat into themselves. There is also the fact that it ruins children's appetites. Ritalin® does not appear to help treat the condition, it just covers up the symptoms. Am I wrong? Please tell me the truth about Ritalin®.
A: There are several important questions within your question. When a child is properly diagnosed as having Attention Deficit Hyperactivity Disorder (ADHD) by an experienced team of professionals, use of the medication Ritalin® can be very helpful to the child.
It is technically correct to say that the medication does not treat the condition in the sense that it does not cure the condition. However, this is true for many medications that are far less controversial. My point here is to note that different attitudes about taking medication can sometimes interfere with carefully evaluating the value of any medication.
ADHD includes difficulties paying attention and/or difficulties with self-control in a child at home, at school, and/or on the playground. Not all children who have difficulty paying attention have ADHD; nor do all children who have trouble with controlling themselves have ADHD. I believe it is useful for a child to be evaluated by a clinical team including the child's pediatrician, a pediatric neurologist, and a clinical psychologist or child psychiatrist. It is also important for the team to have information from parents and teachers. Often, a child's ability to learn in school or make friends on the playground becomes a problem as a result of ADHD. An experienced team makes sure that a child is being evaluated in keeping with knowledge about ways children behave as they mature. Often, children with ADHD have had problems with inattentiveness and impulsivity for a long time and these problems get them into trouble with other children and with adults. For example, these children may have had difficulty sleeping as infants, are very active as toddlers and are unable to sit relatively still and pay attention when they go to school. A range of specific conditions, other than ADHD, can also cause attention deficits and/or hyperactivity. This is another reason for a diagnostic team with different perspectives.
It is true that Ritalin® can decrease hunger. However, to me it is an exaggeration to say that it "ruins" a child's appetite. This is another reason for continued monitoring of a child's health whenever a child is using any medication. It is helpful when children know the purpose of the medication is to help them concentrate and ought not to focus on something being "wrong." When you ask about the medication making children "retreat into themselves," it sounds like you believe that children will withdraw from others and daydream more as a result of the medication -- these are not common results. It is true that Ritalin® can cause serious behavior problems when used by children who do not have ADHD but appear to be "hyper" or inattentive.
In addition to medication, children with ADHD often need educational help in school and psychological counseling or psychotherapy, and parents may need to find new ways of behaving in response to a child's behavior. The children are also likely to benefit from more orderliness in their lives at home and at school. To stay well informed about the latest information, I suggest that you contact CHADD (Children and Adults with Attention Deficit Disorders). CHADD has local chapters throughout the United States and there is also CHADD-Canada.
Stanley D. Klein, Ph.D.
Licensed Clinical Psychologist
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Stanley D. Klein, Ph.D., is the former Editor in Chief of Exceptional Parent magazine. A clinical psychologist and editor, Klein cofounded the magazine in 1971. Klein serves as a Research Associate in Medicine (Pediatrics) at Children's Hospital (Boston), where he teaches health care professionals about working with the parents of children with disabilities, with particular focus on the challenge of delivering difficult diagnostic news.