Last week’s New York Times editorial titled “Ritalin Gone Wrong” by Professor L. Alan Sroufe illustrates a troubling and recurring trend in American psychology: In the absence of clear evidence and research-based data, mothers and the environment are repeatedly blamed for whatever problems surface in children.
Professor Sroufe notes the significant increase in the use of stimulant medications to treat what he calls “troubled children” and questions the effectiveness of – as well as our growing reliance upon – pharmacological treatment.
Those of us who have actually worked with children in the classroom and have lived with children in our homes know that there is indeed a real condition, a set of “traits” as Dr. Ned Hallowell calls them, called ADD/ADHD. While it may be mislabeled (I don’t think of it as a deficit) and quite often misunderstood (children with the condition are often seen as willful and disruptive in class), it is real… and it is indeed disruptive to children’s learning and functioning.
Those of us who work with children everyday understand that solutions to complex problems are usually not simple and not easy.
Professor Sroufe uses the example of childhood diabetes:
“Back in the 1960’s I, like most psychologists, believed that children with difficulty concentrating were suffering from a brain problem of genetic or otherwise inborn origin. Just as Type I diabetics need insulin to correct problems with their inborn biochemistry, these children were believed to require attention-deficit drugs to correct theirs…”
Professor Sroufe then goes on to mischaracterize and misinterpret the research regarding the use of stimulant medications in the treatment of ADHD.
Here at Lawrence School where we specifically serve children who have learning differences and challenges focusing attention, we find that about one third of our students have a diagnosis of ADHD – and often these children are well served by a combination of medicine and effective programs (at school and at home) to support the development of time management, organizational and executive skills.
We would agree that there is no pill that will completely treat the symptoms of ADHD – just as most physicians would not propose that insulin alone is a “cure” for diabetes. Good therapy in many medical situations relies on both medicine and treatment programs to support good habits that, together with medical treatments, achieve positive results and outcomes.
Recently, Dr. Ned Hallowell spoke to parents at Lawrence. He compared the use of eye glasses to correct near-sightedness to the use of stimulant medication to treat ADD. He noted that neither eyeglasses nor Ritalin are cures for the underlying conditions – but both can be extremely effective at mitigating symptoms.
Noted local child psychiatrist Dr. Stephen Grcevich wrote a response to Dr. Sroufe, which we link to here.
Finally, what troubles me deeply is not that Professor Sroufe might question the data supporting stimulant medications to treat ADHD, but that he could be so indifferent to his own supposed standard of research by casually suggesting that the real cause of attention challenges in children comes from “family stresses like domestic violence, lack of social support from friends and relatives, chaotic living situations including frequent moves and, especially, patterns of parental intrusiveness that involve stimulation for which the baby is not prepared.”
This is an example of psychology gone wrong.
I invite Professor Sroufe to our school to meet some of the families and children he so off-handedly dismisses with conclusions that have no basis in research.
After meeting these families, I would defy him to not come to very different, positive conclusions not only about these children—but about the indefatigable, knowledgeable, and caring parents who support them.