Classroom Pushers

About five years ago, teachers heard the welcome news that small doses of amphetamines and other psychoactive drugs could turn hyperactive children into willing learners. As a result, an estimated 300,000 children now are taking these drugs--and many of them should not be. Last week the Committee on Drugs of the American Academy of Pediatrics proposed regulations to the U.S. Food and Drug Administration to prevent abuses such as these:

> In Garden City, Mich., a teacher persuaded a father to get a physician to prescribe Ritalin to calm his restless six-year-old daughter Joanie. The drug made her so withdrawn that she would sometimes sit for hours doing nothing. "One day I got panicky," her father said. "I had just said her name softly, and she started sobbing uncontrollably." A battery of tests disclosed that Joanie was perfectly healthy. What she needed was drill in basic reading, not drugs.

> In Palo Alto, Calif., nine-year-old Kent's teacher and the school psychologist talked his parents into administering drugs to control the boy's mischievous and belligerent behavior. The amphetamines, however, only made Kent depressed. Frequently he complained of feeling persecuted by other children and cried himself to sleep. His parents took him to a psychiatrist, who concluded that all the boy needed was more activity to use up his frenetic energy.

The psychoactive drugs actually are helpful for a condition known as hyperkinesis, a restlessness that some experts believe derives from minimal brain damage or chemical imbalances. But what distresses parents and physicians alike is that it is far too easy for a teacher to mistake normal childhood restlessness for hyperkinesis or some other ailment requiring treatment by drugs.* An alarming number of unsophisticated teachers seem to be doing just that. For this small group, drugs are the panacea for all behavior problems. In Berkeley, one teacher recommended drug therapy for nine of her 28 pupils because their spirited behavior convinced her that they were brain-damaged.

Fully 15% of Omaha's 70,000 schoolchildren were on the drugs until doctors spread a warning that indiscriminate use could be dangerous. In Scituate, R.I., one doctor told a mother that her unruly second-grader did not need drugs, but "to please the school, why don't you give him them anyway?" She wisely refused--but many parents have not. Dr. Eric Denhoff, an early researcher in the field, estimates that at least half of the 6,000 children on amphetamines in Rhode Island should not be. In Seattle, one researcher found several children taking the drugs when their restlessness actually was caused by poor eyesight or allergic reactions to the glue or dye in their schoolbooks.

Relying on drugs to control fidgety children is a dangerous course for any teacher, no matter how well-meaning he may be. Even trained specialists sometimes find it hard to diagnose hyperkinesis, since symptoms of the disease include, as Berkeley Psychologist John Hurst puts it, "almost everything that adults don't like about children."

Thus the drug committee of the American Academy of Pediatrics in its proposals included detailed guidelines to help doctors be more certain that a child's problem is indeed hyperkinesis.

That might end the more flagrant abuses. Even so, some experts like Child Psychiatrist Mark Stewart of the University of Iowa have lost their early enthusiasm for using drugs to control unruly children. To Stewart, the real danger is not side effects but that "by the time a child on drugs reaches puberty, he does not know what his undrugged personality is and, even worse, his family does not know how to accept it."

*All too reminiscent of the late 19th century, when many parents commonly calmed their irritable or overactive children with opium-based elixirs such as Winslow's Soothing Syrup, which were readily available without prescriptions.

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