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article imageStudy shows thousands of U.S. toddlers medicated for ADHD

By Martin Laine     May 19, 2014 in Health
Data compiled by the Centers for Disease Control and Prevention show that more than 10,000 two- and three-year-olds, especially in poor families, being medicated for attention deficit hyperactivity disorder, violating established medical guidelines.
“It’s absolutely shocking and it shouldn’t be happening,” said Anita Zervigon-Hakes, a children’s mental health consultant, in an article in the New York Times.
The CDC findings were presented last week at the Georgia Mental Health Forum at the Carter Center in Atlanta, Georgia, by Susanna N. Visser. She oversees ADHD research at the CDC and compiled the data for the report.
The problem of overdiagnosing and overmedicating the nation’s children for ADHD has received a lot of attention, but mainly as it relates to older children. This report is among the first to try to determine the extent of ADHD diagnosis in children under four.
The American Academy of Pediatrics does not discuss diagnosing ADHD in children under four, primarily because hyperactivity and impulsivity — behaviors associated with ADHD in older children — are considered normal for toddlers.
Most children diagnosed with ADHD are prescribed Ritalin or Adderall, or one of their generic equivalents. Only Adderall has been approved by the Food and Drug Administration for children under six. While helping to keep the children calm, side effects can include hallucinations, insomnia, and growth suppression.
The American Academy of Pediatrics does authorize its use in four- and five-year-olds, but only after all other efforts have failed, and not for children any younger.
“People prescribing to two-year-olds are just winging it. It is outside the standard of care, and they should be subject to malpractice,” said Dr. Lawrence Diller, a behavioral pediatrician in Walnut Creek, Calif.
Ritalin is a controlled drug used for treatment of ADHD.
Ritalin is a controlled drug used for treatment of ADHD.
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Visser based her report on Medicaid data from Georgia and private insurance data nationwide. She found that very young children whose families were on Medicaid were significantly more likely to be prescribed one of the ADHD medications than those who receive care through private insurers. However, she said she could not explain why this is so.
Some experts suggest that in some cases, when there are parents who can’t cope, for whatever reason, it’s the child who gets medicated.
“Some of these kids have really legitimate problems,” said Dr. Doris Greenberg, a behavioral pediatrician from Savannah, Georgia. “But you have overwhelmed parents who can’t cope and the doctor prescribes as a knee-jerk reaction. You have children with depression or anxiety who can present the same way, and these medications can just make those problems worse.”
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