Youngest in class twice as likely to take ADHD medication

The use of Ritalin and other stimulant drugs to reduce unruly behaviour among children goes back a long way now -- around 5 decades or more.  And there has always been disquiet about the practice

And underlying the issue is treating certain behaviours as an illness: ADHD.  Behaviours that once would simply have been dismissed as "naughty" are now an illness.  No doubt there are some pupils who are appropriately and usefully medicated but too often medication can be a lazy way to cope -- a way of avoiding addressing real underlying issues and problems that the pupil may have.

And the findings below reinforce the view that what is going on in much alleged ADHD is not pathological at all -- unless youth is a pathology!

The process of growing up is a process of socialization:  Children learn to control their impulses in order to get on with others.  So the younger a child is, the fewer will be its internal restraints.  It will be less docile.

I remember fondly a little boy when he was aged 3.  He was a demonstration of perpetual motion --  always running around with a fair bit of screeching thrown in.  Now that he is 5 he often just sits quietly playing with his toys.  He still enjoys running around and screeching as part of a game but he is quite a different boy from when he was aged 3.  If you didn't know his age when he was 3 he would easily be described as an ADHD sufferer. But he was not.  He was simply young.

So the finding below that the youngest kids in the class had a lot of ADHD may simply have been an hilariously wrong diagnosis.  The researchers were misdiagnosing behaviours characteristic of younger kids as an illness!

There is a useful discussion below of problems with ADHD diagnosis

It may be worth mentioning that there was in the 1960s an "anti-psychiatry" movement including Thomas Szasz, R. D. Laing and others who also challenged conventional diagnoses of mental illnesses.  The movement still has some adherents but it was up against the fact that some people really are mad:  They do see and hear things that are not there.  But the movement did succeed in considerably narrowing the definition of what is mentally ill.  It would seem that their work is not done yet

New research has found the youngest children in West Australian primary school classes are twice as likely as their oldest classmates to receive medication for Attention Deficit Hyperactivity Disorder (ADHD).

Published in the Medical Journal of Australia, the research analysed data for 311,384 WA schoolchildren, of whom 5,937 received at least one government subsidised ADHD prescription in 2013. The proportion of boys receiving medication (2.9 per cent) was much higher than that of girls (0.8 per cent).

Among children aged 6–10 years, those born in June (the last month of the recommended school-year intake) were about twice as likely (boys 1.93 times, girls 2.11 times) to have received ADHD medication as those born in the first intake month (the previous July).

The ADHD late birth date effect was first demonstrated in four large scale studies conducted in the US, Canada and Taiwan. The prescribing rate for children in the WA study was 1.9 per cent, slightly larger than that reported in the Taiwanese study (1.6 per cent). The late birth date effects identified in WA and Taiwan were of similar strength to those in the three North American studies, where the reported prescribing rates were much higher (4.5 per cent, 5.8 per cent and 3.6 per cent).

Questioning ADHD as a diagnosis

The late birth date effect is not the only factor creating unease about ADHD. Multiple studies, including the WA study, have established boys are three to four times more likely to be medicated for ADHD. If, as is routinely claimed, ADHD is a neurobiological disorder, a child's birthdate or gender should have no bearing on their chances of being diagnosed.

Other risk factors for receiving medication for ADHD include race, class, postcode and clinician, teacher and parental attitudes; none of which have anything to do with a child's neurobiology.

In addition, sleep deprivation, bullying, abuse, trauma, poor nutrition, toxins, dehydration, hearing and eyesight problems, giftedness (boredom), intellectual disadvantage (frustration) and a host of other factors can cause the impulsive, inattentive and hyperactive behaviours central to the diagnosis of ADHD.

Another common criticism of ADHD as a pathological condition is that the diagnostic criteria "medicalise" normal - if somewhat annoying - childhood behaviours. Critics contend teacher and parent reports of children "often" fidgeting, losing toys and pencils, playing loudly, interrupting, forgetting, climbing or talking excessively, being disorganised and easily distracted, failing to remain seated, and being on the go (as if driven by a motor) should not be construed as evidence of a psychiatric disorder best treated with amphetamines.

Proponents counter that stimulant medication for ADHD children is like "insulin for a diabetic" or "eyeglasses for the mind". There is no doubt low dose stimulants often make rowdy children more compliant. However, a 2010 WA Health Department study found ADHD diagnosed children who had used stimulants were 10.5 times more likely to fail academically than children diagnosed with ADHD but never medicated.

As evidenced by rapidly increasing child ADHD prescribing rates in Australia and internationally, ADHD proponents seem to be winning the very public and ongoing ADHD debate. But history has taught us that as societal values change, definitions of mental illness change. It wasn't long ago that the inventors of ADHD as a diagnostic entity, the American Psychiatric Association, classified homosexuality as a disease treatable with electric shock and other forms of aversion therapy.

Perhaps in the future playing loudly, talking and climbing excessively, fidgeting and disliking homework will no longer be regarded as evidence of a psychiatric disorder, best treated with amphetamines and similar drugs.


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