Pt. I: The Truth of “10,000 Toddlers Medicated for ADHD”

Toddlers Medicated for ADHD

To the uninitiated, it sounds horrifying: Toddlers medicated for ADHD!  

But if you understand the ADHD-associated range of physical symptoms—and physical risks—the reasons are obvious.

The latest “clickbait” from The New York Times’ Alan Schwarz recently appeared May 16, 2014:  “Thousands of Toddlers Are Medicated for ADHD, Report Finds, Raising Worries”.  (I provide the link for background if you are unfamiliar with the paper’s reputation, but I discourage clicking; it only encourages them.)

I held my breath. Reverberations would be horrendous—and immediate. Perhaps the most shocking part? That so many of my journalistic peers would once again choose vainglory over compassion, fear-mongering over science. “Legitimate” news sites and clickbait sites alike would rush to catch in on the bounty.

For years now, we’ve expected this kind of behavior from publishers focused on the bottom line. The new and shocking part is the reporters and editors joining in instead of holding the line.

When National Newspapers Deny Science

No question:  This is the era of clickbait.  When it comes to anti-ADHD clickbait, no paper has acted with more sociopathic fervor than The New York Times. Particularly the front page and the opinion-editorial section—and for many years now.  Yet, to be fair, The New York Times magazine has not climbed on that bandwagon; it has a different staff and editor.

In case you are unfamiliar with newspapers’ inner workings, the sections have different editors. Editors work with reporters in choosing stories and crafting angles; typically, they have the final say on what runs.

In modern times, though, these editors are increasingly pressed to do the publisher’s bidding. Many good editors have quit when faced with making such compromises. That means….you guessed it: Editors with lesser ethical fiber flock to fill their places.

Yet iduty-t is also true that some editors — and reporters, too—operate from a bedrock of antiquated and harmful assumptions about the brain and its relation to mental health.

Update: The fallout proved even worse than I anticipated. Resulting political pressure applied to the CDC resulted in new, baseless, and medication-stigmatizing guidelines. Russell Barkley, PhD, and I wrote about it here: Hey, CDC, Why Promote Misinformation on ADHD?)

TODDLERS TAKING STIMULANTS?

Now, back to the “10,000 Toddlers” phenomenon.

A friend wrote to me:

Wait…TODDLERS? That blows my mind.

How could anyone even diagnose a toddler with ADHD?

I took our 2-year-old to a storytime thing at the library. The toddlers were expected—no lie—to sit nicely in one place and listen to songs and stories for over 30 minutes.

I managed to get him to do this somehow. But he had a total meltdown afterward. I carried him home apologizing to him for not knowing what we were in for and subjecting him to such a developmentally inappropriate activity.

He absolutely cannot sit still and be inattentive for any length of time. But my armchair diagnosis for that is “being a toddler.” And that’s with the knowledge that he has two ADHD parents.

[Update: Five years later, my friend’s child definitely has ADHD and has joined his parents in treating it medically.]

My Response To My Concerned Friend:

Yes, if a toddler were diagnosed and treated on that basis, that would be very wrong.

I agree with your stance on the library situation: Two years old is too young to sit still for 30 minutes. Even for children who do not have ADHD. That constitutes cruel and unusual punishment! I hear about similar in preschools, pushing the developmental envelope with 3, 4, and 5-year-olds.  It’s nuts.

With this article, though, we’re talking about a very complex phenomenon.  It reminds us: We cannot view ADHD solely through the reductionist lens of behavior.

Nor can we assume we know the facts from reading Alan Schwarz’s ongoing screeds in The New York Times. Much was missing in that article.

Here’s how that story came about:  

Schwarz showed up unannounced at a state-wide mental-health conference in Georgia, at the Carter Center. (Sneaking into events is against journalistic ethics.) A CDC researcher named Susanna Visser presented unpublished data on Georgia children only.

Schwarz took numbers compiled for Georgia and extrapolated them to the rest of the country. He failed to consider complicating factors. For example, did these children have other physical health conditions? Were their ADHD symptoms severe enough to present a serious potential threat to their health and safety?

Did he fail because he knew absolutely nothing about ADHD—or because he led with his ambition? Perhaps both. He likes to brag about his abilities with statistics.  And, in my communication with him, he was absolutely arrogant.

Make no mistake: His leap to conclusions was unacceptable on any level. It was beyond the pale for any newspaper, much less the former “paper of record.” 

As for treating young children for ADHD, think about it: At its core, ADHD is about problematic dopamine transmission.

At its most obvious, ADHD manifests in “behavior problems.” But ADHD’S potential challenges extend far beyond behavior into myriad health challenges and risks—especially in the more severe presentations. In short, let’s examine this story with more logic than sensation.

My Friend Had Her Blind Spots, Too

The friend making comment above has ADHD. So does her husband. She personally knows the benefits of ADHD medication. But when it comes to children, she had a blind spot.

It’s understandable. There is so much about ADHD that falls beyond the intuitive grasp of even well-educated people with ADHD. Especially if they’re not thinking of very sick children.

Here’s what the public largely fails to understand:  ADHD involves so much more than one’s school performance, behavior,  inability to “conform to society,”  or whatever preconceived notion one harbors about the condition.

Overview Of This Post:

  • In addition to key cognitive traits such as impulsivity and inattention, ADHD often presents biomedical issues.
  • Stimulant medications improve the transmission of the brain chemical called dopamine.
  • Dopamine affects far more than “reward” and “focus.” It affects physiological systems, including respiratory and cardiovascular functioning as well as all the senses (touch, hearing, vision, taste, smell).
  • Poorly reported news stories hurt children (and parents) who are already suffering.
  •         Many news outlets are opting for non-science-based anti-psychiatry clickbait over legitimate reporting. If we click, even if to complain, we are voting to have more of it. Resist the click!
  • Please help me to educate the public and the medical community. Share this post wherever you might find it useful.

ADHD As BioMedical Issue, Not “Behavior Problem”

ADHD also carries with it a risk of physiological adverse effects, and these can begin very early on:

  • Dopamine also controls motivation, movement, and emotional regulation.
  • Dopamine affects important physiological processes, including respiratory and cardiovascular function.
  • ADHD is associated with higher rates of enuresis and encopresis, asthma and allergies, heart arrhythmia, obesity, and sleep disorders.
  • Finally. Guess what? There are many sick children for whom ADHD is the least of their problems. This includes children with spina bifida and others. Each year, about 1,500 children are born in the U.S. with spina bifida alone, according to the CDC.

dopamine molecule

As first a print journalist in my career and now an ADHD author, advocate,  and educator, I must counter The New York Time’s ongoing anti-psychiatry campaign. It is too influential a paper to ignore. Hence, this two-part blog post, with Part II here. I address the paper’s poor choice of opinion pieces on ADHD but also a well-known figure in ADHD world who reacted to the headlines with attention-grabbing recklessness.

Heads up! It is not a quick read. You’ll need several examples and much context to truly understand this phenomenon But if you make it to the end, you will possess rare knowledge–knowledge that could save someone’s life, counter nonsense, and help to move us all into the 21st Century.

 

toddlers medicated for ADHD

Skewed News Harms Children

One thing was clear: The New York Times, The Daily Beast, Consumer Reports, The Today Show, and other “news outlets” that glommed onto the “10,000 Toddlers” meme were not interested in ADHD’s medical reality. I share a few screenshots of the headlines below.

Theirs was a split-level nonsensical  angle:

1. On the one hand, children with ADHD are out-of-control “brats” with ineffective parents. It’s clear in the illustrations, typically photos of screaming, angry children. (For this post, I chose more compassionate and accurate photos of these children.)

2. On the other hand, they depict these children as the captive pawns of Big Pharma and the Industrialized school system, making children into drones and little boys into little girls. “Pathologizing childhood.”

Not Schwarz’s Or Paper’s First Attack on ADHD

The “10,000 toddlers” story marks at least the second time that Schwarz, a sports reporter with no apparent life-science education, reported on AHDD in a shockingly sensationalized manner.

The first that came to my awareness was in 2013.  The front page featured a highly irresponsible article about Adderall abuse, including one young man in particular.  I provided a wider view in this post:  The Tragic Truth of Adderall, or Madderall.

The opinion and editorial pages have long sought notoriety with contrarian nonsense from fringe figures peddling a book or a platform. The editors should be soliciting timely opinion pieces from legitimate experts. Instead, this is what I am sure is happening, given my years in the newsroom: They sit back and wait for PR firms to hand them a ready-to-go piece.

I wrote about one here:  The New York Times’ Unnatural Opinions on ADHD

Leading ADHD experts tell me they have implored the paper’s editors to provide balance and to choose writers with legitimate expertise on the topic of their opinion. They have offered to write counterpoints. The answer was clear: No.

Also Targeted: Pediatric Bipolar Disorder

Considered this tidbit. A few years before the paper’s anti-ADHD campaign, its target was bipolar disorder in children. Perhaps you read and remember the series of articles in 2008-9 leveling allegations of financial improprieties against pediatric bipolar researchers.

At that time, Benedict Carey and Gardiner Harris were on the “public health and pharmaceutical” beat. As such, they furthered Senator Chuck Grassley’s (R-I) agenda in making pariahs of two highly cited pediatric psychiatric researchers in particular.

The backstory and the players involved make for a fascinating (if scary) story.  I won’t go into the details here, about what happens when a newspaper forms an unholy alliance with a grandstanding politician whose major campaign donors include insurance companies. But let me assure you: it was manipulative, ugly, and unjust.

I’ve spoken to those targeted researchers and others caught up in Grassley’s dragnet. They told me of FBI agents showing up at their offices, unannounced, and demanding lab notebooks from 20 years ago.  One whose family escaped the Holocaust said, “I never thought I’d see in the United States the same kind of anti-education, anti-science propaganda my parents’ described of early Hitler’s Germany.”

I wrote to Carey and Harris, pleading for more balanced reporting. They responded with arrogance. I called them on the phone.

One said, “Bipolar in children, Gina? Seriously?”

“Yes, bipolar disorder in children,” I said. “Why not? Why wouldn’t this brain disorder with strong genetic links manifest in childhood? The emerging science means we must update outdated notions.”

”Gina,” he said, dismissively, “these children aren’t blowing through credit cards and having promiscuous sex.”

Yes, he said that.  He failed to understand that most psychiatric conditions appear at “developmentally appropriate levels.” That is, the symptoms differ among young children, adolescents, teens, and adults. It is important to recognize bipolar early before the symptoms intensify and pose a great danger—and to distinguish bipolar symptoms from that of ADHD, depression, or other neurobiological conditions.

I find it interesting to note that historically, ADHD and bipolar have suffered from opposite misconceptions.

  • With ADHD, it was for a long time assumed that because children outgrew physical hyperactivity, they outgrew the condition. Over the past four decades, we have learned that no; with maturity, the symptoms become less physically overt, more internal and affecting cognition
  • With bipolar, it was long assumed to be only a condition of adulthood. These days, medical experts know the symptoms can appear much earlier—if we know how to recognize them. Gardiner and Harris were not interested in updating their assumptions.

August 2019: Gardiner Harris recently left the paper to become communications director at a venture capital health fund based on “Big Data.”

Gina, Surely You’re Being Hyperbolic?

I get it.  The New York Times and all the copycat news outlets are wrong and I, a journalist turned ADHD advocate, am right? I must be paranoid and fanatical about ADHD, right?

Actually, no. I am a diligent reporter who researches primary sources and knows how to vet experts for interviews. Plus, I have no bottom-line minded publishers breathing down my neck.  (Been there. Did that. Got the three repetitive-use injuries.)

There’s only one way I can explain this: the front-page editors and these reporters represent the belief system commonly seen in the far-left leaning population. They view psychiatry as a tool of big pharma, asserting that mental illness (except perhaps in its most extreme examples) is caused by poverty and oppression and childhood trauma.

Journalists are by nature skeptical, and that’s mostly a good thing. But when skepticism hitches itself to science illiteracy, all reason is lost.

The skeptics I’ve spoken with (and pled with) assert this antediluvian notion: Children who survive birth are, de facto, mentally healthy. As if the brain, that most vulnerable of organ, is protected from all that can befall the heart, lungs, limbs, and every other organ that pales in complexity to the brain. It is “society” that inflicts the damage, they assert. Mothers, in particular.

The scientific facts tell us otherwise. Some children with ADHD are extremely impaired.  It is up to the evaluating physician to decide how the child should be treated—not Alan Schwarz, sports reporter, or Carey and Harris, pharmaceutical reporters.

Where is the compassion for sick children? All I see is self-serving clickbait targeting a largely science-illiterate reading public.

ADHD New York Times
The lead image for my response to yet another ADHD-fearmongering piece in the NYT’s opinion section. Including a response from Thomas E. Brown, PhD

Update: August 10, 2019

With Schwarz’s second article, it became obvious: He was aiming for a Pulitzer and writing stories to be collected in a book.  Yep, that book turned out to be  A.D.H.D. Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic.  A “yellow journalism” title, if there ever was one.

The book was published in September 2016, only three years ago.  But today, Amazon ranks Shwarz’s book A.D.H.D. Nation at 362,000. That is so low as to be off the radar entirely. Turns out, all those PR-placement NPR radio interviews where Schwarz practiced his breathlessly dramatic storytelling failed to make a lasting impact—at least insofar as book sales and popularity.

By contrast, Is It You, Me, or Adult A.D.D.? came out a decade ago without NPR talk-show round fanfare. It now ranks at 16,000. The moral? Write with accuracy, honesty, and compassion if you want your work to be an “evergreen” book.

Schwarz has since left the paper. I heard he was teaching high school math. Then a friend shared a website where he was offering to sell his gripping writing style to CEOs, to produce their bios or such.

You might have noted: he refers to himself as a “Pulitzer Prize-Nominated” author. Yes, it sounds impressive but only if you don’t understand this: Any book can be nominated. It’s the winning that matters.  You can read more at The Atlantic: Journalists, Please Stop Saying You Were ‘Pulitzer Prize-Nominated’.  Excerpt from this report by Alexander Abad-Santos:

“To call that submission a Pulitzer ‘nomination’ is like saying that Adam Sandler is an Oscar nominee if Columbia Pictures enters That’s My Boy in the Academy Awards.

Many readers would realize that the Oscars don’t work that way — the studios don’t pick the nominees. It’s just a way of slipping ‘Academy Awards’ into a bio.

The Pulitzers also don’t work that way, but fewer people know that.”

Example: The Insatiable, Unhappy Toddler

By the way, the FDA acknowledges that sometimes stimulant medications can be used for young children. Click here to read the guidelines: “Stimulant and Related Medications: Use in Pediatric Patients.”

One issue that might surprise you—but won’t when you understand that dopamine is called the “reward” brain chemical: Many toddlers and even babies with ADHD are chronically unhappy, about everything. Their distraught parents can do nothing right. That’s because the problem is not on the outside but on the inside, within the neural pathways.

I wrote in my first book about how ADHD can make some adults insatiable. That is, chronically dissatisfied.  There’s never enough of anything to make them happy.

Take a minute to think about what insatiability would look like in a baby or a toddler.

Toddlers Medicated for ADHD
Parents become distraught over a child’s unhappiness that has no apparent cause

I’ve met babies whose ADHD makes them chronically unhappy, often crying. I love babies and toddlers and typically have a way with them. These kids? There was no getting through. They broke my heart. Imagine being a parent unable to console a child, despite your best efforts. Imagine feeling to blame for your child’s unrelenting unhappiness. Imagine seeing therapists and physicians who haven’t a clue.

Example: The Sleepless Toddler

Moreover, sleep is so difficult for many of these children. They awaken at the slightest noise when they finally get to sleep (and that can be extremely difficult). They climb out of their cribs and become a danger to themselves. In the crib, they begin the lifelong sleep debt that will plague them for the rest of their lives. I’ve met adults who once were these children.

This will come as news to some “attachment theorists”: Some of these babies cannot sit still long enough to nurse. They cannot direct their gaze long enough at their caregiver to form that all-important connection. Uninformed critics are always yammering that the babies “need more than medication.” But what if nothing else will work until the medication is in effect? And that is exactly what study after study suggests.

Their young lives are miserable. Anyone with a heart can clearly see it.

  • What kind of start in life is this?
  • Who cannot feel compassion for such a child?
  • Who wouldn’t want to help instead of inflicting the worst kind of ignorance on the child and family?

Example: Toddler Turns Blue—and Faints

Several moms of children with ADHD have told me of a “hyperactive” fetus—constantly kicking. ADHD is also associated with a higher rate of prematurity. In other words, the neurobiology can make itself known early on.

Those babies can and often do grow up to be toddlers who will walk out the front door and into traffic, or crawl out of windows. They die or become maimed or brain-injured.

There are even toddlers whose emotional dysregulation is so severe they develop a type of pediatric syncope. That is, they turn blue and faint.  I’ve witnessed this. I found it horrifying— to feel so helpless at a child’s severe distress. What kind of long-term impact does this feeling have on the child?

I learned about this fainting phenomenon while seeking to help a friend’s child. My friend is an incredibly attentive, empathic, loving, and patient mother. She’d done everything “right.” Still, her baby had hardly ever been happy, hardly smiled, and had tremendous difficulty sleeping. Now that he was walking, the fainting began.

Mothers in my online ADHD communities told me about the same phenomenon among their ADHD children. Their physicians were clueless. Even at “famous” clinics.  There are other potential reasons for pediatric syncope, but this association deserves attention.

Toddlers Medicated for ADHD
Children with ADHD suffer traumatic brain injuries at higher rates

Example: Sleep Apnea

We know that dopamine is involved with adult sleep apnea, a potentially life-threatening disorder common among adults with ADHD. Why would it not also affect newborns, toddlers, and young children?

Another friend and her husband (who has severe ADHD, now well-managed) were grief-stricken when their newborn displayed what appeared to be sleep apnea. Little Henry simply stopped breathing at the hospital. Who wouldn’t be apoplectic? They hired a round-the-clock nurse to monitor when they brought the baby home.

Let me make this clear to NYT reporter Alan Schwarz: The parents didn’t worry about the baby misbehaving or speed-learning differential equations. They worried about him surviving!

hypotension in preterm infants receive dopamine

The Lifesaving Role of Dopamine

No one suggests cavalierly giving stimulant medication, which acts on dopamine neurotransmitters, to a newborn or baby for ADHD.

Yet, guess what?  Vulnerable babies are given dopamine itself (the neurotransmitter targeted by the stimulants) in the hospital!

Consider this 2011 tidbit from Nature: Brains Breathe: Dopamine’s Role in Preterm Infants.

A 2009 paper published in the journal Intensive Care Medicine reports that dopamine, widely used to maintain blood pressure in very preterm infants, facilitates flow-metabolism coupling in the preterm brain.

In other words, dopamine apparently aids in keeping preterm infants’ cerebral oxygen demands in touch with cerebral blood flow.

Do you read sensationalist headlines about other health interventions for young children—blood transfusions, surgeries to repair holes in the heart, organ transplants, cancer treatment, etc..? No, in fact, we see national scandals made of parents who refuse these medical interventions.

Unfortunately, the stimulants often don’t even work that well in young children, but it can be critical to try.

When the public blindly reacts to click-bait from The New York Times or some other self-promoter with an agenda, however, it hurts children by scaring away desperate parents and poorly informed physicians.

Toddlers Medicated for ADHD
Bed-wetting is more common in children with ADHD

“They’ll Grow Out Of It”

Typically, my friends’ pediatricians didn’t understand the many ways in which ADHD can manifest in young children—the sleep and sensory disorders, the hearing problems, the poor motor coordination, and the like. The physicians would head pat and reassure, “The child will grow out of it.”

Here is what actually happened:  The behavior often morphed into a more developmentally appropriate expression of the same problem as the child grew.

For example, when it came to pediatric syncope, the pre-verbal toddler who got so frustrated that he fainted became the verbal four-year-old who yells and screams in frustration. On it goes up the developmental ladder. The pediatric syncope (fainting) didn’t go away; it simply moved to a more developmentally advanced mode of expression. All this is to say nothing of the neurocognitive problems that form the more universal experience of ADHD.

Unfortunately, however, the ADHD diagnosis comes much later for many of these children. It comes long after so many bad habits and failures and blows to self-esteem have taken root. It comes long after years of sleep disorders and perhaps injuries that have further circumscribed their lives.

The mother of a 17-year-old boy told me this: He has long had problems with both enuresis (involuntary urinating, as in “bed wetting” and sometimes “pants-wetting” at school) and encopresis (involuntary defecation).

Her San Francisco-based pediatrician has explained the problem as a “small bladder” issue and a “bowel disorder.”  This same pediatrician dismissed any concerns about ADHD as “mild at most” and said the greater problem was “auditory processing disorder”—despite APD being a common “side effect” of ADHD and one that often responds to medication.

Yet, all it takes is one (more) sensationalistic story from The New York Times‘ Alan Schwarz, quoting low-level clinicians and publicity-hungry fringe players. And, suddenly there is the SHOCKING story that 10,000 toddlers are being given ADHD medications.

Toddlers Medicated for ADHD
Physical injuries of all types are more common in young children with ADHD. Vision problems, too.

“10,000 Toddlers” is Only A Guesstimate

How many U.S. toddlers are medicated for ADHD?  We don’t have a firm number.

It’s important to understand: That 10,000 figure was only an estimate. Schwartz simply extrapolated—from the preliminary Georgia state-based figures provided by CDC official Susanna Visser to the nation. In other words, he reported his own amateur analysis of the CDC data and tried passing it off as professionally parsed. [Where was the front-page editor?

As an aside, I spent a long time talking with Visser at a conference. I was shocked at what I perceived as a very superficial understanding of pediatric ADHD.

Toddlers Medicated for ADHD

Veteran Journalist Takes Issue with NYT’S Schwarz

 

Veteran journalist Paul Raeburn questioned the first occurrence at the M.I.T.Knight Science Journalism Center’s Tracker (“peer review with science journalism”) on April 3, 2013:

The story, by Alan Schwarz and Sarah Cohen with reporting contributed by Allison Kopicki, did not say that the figures came from an announcement or publication by the CDC. It said that the Times had “obtained the raw data from the agency and compiled the results” itself.

That’s tricky. The CDC could make a mistake compiling and interpreting its own data; such things happen. But for my money, I’d rather have the CDC doing that than entrust the job to Schwarz and Cohen.

Where did they get the data? What form was it in? What did they have to do to come up with the figures they report? Did they enlist a scientist from the CDC or elsewhere to check and validate their analysis?

We are not told.

The first quote in the story comes from a Yale neurologist who says he is “floored” by the rise in the diagnosis and treatment of ADHD. It’s not a terribly insightful comment; I suspect most readers did not need an expert to tell them that the statistics were remarkable.

The story, published on March 31, now has a string of corrections appended to it. It picked up its first correction on April 1, another yesterday, and another one today. Each of the corrections fixes a misstatement concerning the statistics.

If Schwarz had told us more about how he got that data and what it looked like, and if he’d brought in a scientist to help him analyze it, perhaps he would not have made those mistakes.

Toddlers Medicated for ADHD

Back To The Main Story

Thanks to The New York Times and the worldwide copycat media who picked up the story,  readers grabbed their pitchforks. They prepared to hunt down Big Pharma, the doctors doing the prescribing, the lazy parents wanting the “quick fix,” and every other villain involved with “drugging children”.

Based on such misinformation.

Without any of these facts, without

knowing exactly how many young children

are diagnosed and treated

vis a vis the estimated prevalence,

without even knowing if the

treatment is working, we know

absolutely nothing at all.

 

Strangely, what seemed to enrage readers the most was that the children receiving the medication were on Medicaid. At the Times’ companion piece (the Motherlode column entitled “The New Inequality for Toddlers: Less Income; More Ritalin”), they reacted with fervid blaming of “lazy” parents and “schools drugging children.”

The New York Times columnist KJ Dell’Antonia writes about her children in a blog called “Raising Devils” (ahem). She claimed that the children Schwarz reported upon were being “drugged” only because they were poor.

Toddlers Medicated for ADHD

NYT Blogger Questions Basis for ADHD

Neither Dell’Antonia nor the readers commenting (including a self-described pediatrician) seemed to understand one critical point:

ADHD is a risk factor for poverty.  These children might be suffering from the most severe ADHD symptoms, compounded by their parents’ ADHD and other risk factors such as substance abuse disorders.

Understanding this context would require the kind of sophistication missing among bloggers such as Dell’Antonia. She writes: “Particularly given that there is still a debate among practitioners and researchers regarding whether ADHD has a biological basis, or is a label given to a collection of symptoms.”

With so many good journalists out of work, how do such uneducated, unsophisticated individuals get hired?

Data Remained Unexamined

You can download mention of Visser’s Georgia presentation in the minutes of Georgia’s Behavior Coordinating Council for 2014 here.

Absolutely nothing is publicly known about what kind and how much medication these alleged children are receiving, and what other services or interventions.

Until the CDC decides to share with the tax-paying public, consider these Medicaid enrollment figures from a factsheet on Medicaid published by the American  Academy of Pediatrics:

  • 30.6M infants and children through age 18 (that represents 50.2% of all Medicaid enrollees, 38.9% of all US children through age 18)
  •  2.4M infants (4.0% of all Medicaid enrollees; 56.6% of all US infants)

In light of these huge numbers, 10,000 children being treated medically for ADHD—as having ADHD severe enough to merit treatment at a younger-than-average age—no longer seems so “outrageous,” as one headline put it. Does it?

We know absolutely nothing at all on this topic without knowing critical facts, including:

  • How many children are diagnosed and treated vis a vis the estimated prevalence?
  • For how many children is the treatment working?
  • How many of these children have other health conditions that are highly associated with ADHD, including neural tube defects such as spina bifida?

Yet, the online world is bursting at the seams with the scurrilous headlines.  This is what happens when reckless papers and other news outlets self-medicate with provocation, without thinking of consequences.

Toddlers Medicated for ADHD

Newsflash: ADHD Can Create Entrenched Poverty

Left unaddressed over the generations, ADHD can result in miserably entrenched poverty, substance abuse, and more.

In other words, the people suffering the most adverse effects of ADHD are often stuck at the lower rungs of society; Neurogenetic nature and environmental nurture compound the trauma generation after generation.

Yes, absolutely. No question. Our economic structure is further oppressing these people. Head Start programs have been cut. Yet, they’ve been shown to be beneficial and cost-effective, not to mention humane. And all the rest.

This fact remains, however: Even with better circumstances, many of these young children will still have ADHD. Their parents will have it. Most likely, their grandparents will have it, too.

Having a “hand up” is important. Improving pre-conception and pre-natal nutrition is important. Yet, a certain percentage will be unlikely to make good use of opportunities until their ADHD and commonly co-existing conditions are managed. This is as true for highly impaired children in the lower rungs of the socioeconomic strata as well as those in the highest rungs.

Toddlers Medicated for ADHD

The Bottom Line:

There are legitimate reasons for treating very young children medically for ADHD. Moreover, we simply do not know the particulars behind this story—how many children at what ages are being medically treated and for what reason. We only have Schwarz’s cherry-picked report and the intended ensuing hysteria.

The only thing we know for sure is this: Our most disadvantaged children who have ADHD deserve comprehensive help, including screening the parents and providing treatment for them, too (the “genetic donors” so they can best help their child and break the generational cycle.

These children and parents also deserve that you, me, and alleged journalists counter hair-trigger emotions and make a sincere attempt to comprehend what is truly happening. These children deserve better than shameful self-serving and Olympic-sized leaps to the conclusion that lead only to more disastrous consequences.

Mostly, we need news outlets to care more about these people than they do their own “clickbait” profits and fame—not to mention reporters who have at some point have taken a biology class.

Alan Schwarz would not dare to publicly bully children born with heart defects, malformed lungs, and limbs, vision problems, diabetes type I, hemophilia, or asthma. Yet, when it comes to the most vulnerable, delicate organ of all—the brain—and the most documented psychiatric condition of childhood—ADHD—he finds it fair game.

Update 2019: the next we heard from Schwarz was his appearance in another piece of self-serving sensationalism: “Take Your Pills,”  a “documentary” from Maria Shriver and her daughter on Netflix. Shriver claims that her daughter took Adderall to complete her education. Now that she’s out of college, though, her career path is anti-ADHD evangelizing.   I wrote about it here: Netflix’s “Take Your Pills”: Anti-Science—and Mean

Continued in Part II:

I welcome your opinions on this topic. It’s easy. No annoying codes to enter.

Gina

 

12 thoughts on “Pt. I: The Truth of “10,000 Toddlers Medicated for ADHD””

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  4. Gina Pera thank you so much for sharing these articles. They hit home for us.

    In our household we have a very adhd toddler and a 10 yr old adhd tween. We have watched the same behaviors play out in both of our children. We are awaiting the day of diagnosis for our 3 yr old but till that time comes we experience so many feelings of shame brought on by the public and uneducated family for ever considering a diagnosis for our toddler at such a young age.

    They don’t live in our home nor do they really have a clue as to what her own impulsivity does to her own safety.

    Its frightening for me to leave my toddler with others because:

    They underestimate her ability to outsmart the child safety gates and door protected handles.

    They believe they can get her to take a nap and that its our lack of ‘trying’ that is keeping her from getting a nap and that is what is causing her rambunctious behavior and energy. (She has refused to nap from 2 onward)

    That when she eats anything with dyes yellow and red to expect this energy to become times infinity! AND our personal favorite: we are just looking for an easy way out and are stifling her “creative energy and growth” by looking to have her diagnosed at such a young age.

    1. Hi Danielle,

      Thank you so much for sharing your experience.

      I know of many parents in your situation. They love their children. They are not trying to “subdue their children into submission” by seeking ADHD treatment; they are trying to protect them.

      It is no secret to anyone who reads the literature: children with ADHD are more vulnerable to head injuries (from taking outsized risk in sports, climbing trees, etc.) and to behaviors such as running out into traffic.

      These are life-threatening behaviors. Not to mention the sleep deprivation that ADHD neurobiology itself can cause.

      The real experts know what you are up against. The phony experts, the ones with high-powered PR firms to place them on TV shows, are pandering to the ignorant public. They should be called out firmly and loudly.

      Thanks!
      g

  5. Patty@homemakersdaily.com

    I know that my 4-year-old granddaughter has ADHD. I have it. My two kids have it. I see it in her. I don’t care what any health professional might say, I know she has it. I spend a lot of time with her and the symptoms are there.

    Recently she was tested to see if she would qualify for a pre-school program at the early learning center where her younger brother goes (he’s autistic). It’s a peer model program. She had to score 75%. Ivy is extremely intelligent but I was a little bit worried because kids with ADHD tend to score badly on tests. So I warned my daughter-in-law. She asked if she should tell them my theory. I said no. Ivy was tested and her score was 8%. We couldn’t believe it! But a few of the questions and answers they shared with us confirmed what I told my daughter-in-law. Ivy likes to be called “Funny Bunny” so when they asked her name, that’s what she said. That was wrong, obviously. And they asked her a question about what she would do if a fly came towards her. They were looking for swat it or something like that. She commented that it might land on her. So her answers weren’t WRONG but they weren’t within the test’s range for normal.

    The bottom line is that she gets to go to school in the “regular” program. It’s not a big deal because maybe they’ll recognize her ADHD and prepare her for kindergarten.

    But don’t anybody try to tell me you can’t tell when younger children have ADHD. Maybe you can’t always tell – but I can sure tell in her.

    Thank you for the article.

    1. Exactly. No legitimate expert would say that severe ADHD in young children is hard to tell– or benign.

      Hallowell dismisses ADHD in young children as “children being rambunctious” and he shames these parents.

      But severe ADHD symptoms can have life-threatening consequences to these children.

      He simply is not connected to outcome. Low empathy. An appalling attitude, given that it’s vulnerable children we’re talking about.

      take care,
      g

  6. Pingback: ADHD Roller Coaster: "Is It You, Me, or Adult A.D.D.?" · Pt. II: ADHD In Toddlers, From A Real Expert

  7. P.S. Paul, last night at our Adult ADHD “Salon” in Palo Alto (a monthly discussion group I’ve let for many years), one new member said on this topic: Americans don’t like to think about ANYTHING, do they?

    It’s true. For Americans or people in other countries, thinking is hard. That’s why humans resist it.

    This idea is laid out beautifully in The Invisible Gorilla, by two cognitive scientists.

  8. Dear Gina,
    Thanks for a well thought out and written piece. As well as Penny Williams response.

    In my own thinking, (whether it is connected to my ADHD or not), it highlights the increasingly missing aspect of journalism, and even politics. “Completeness”, that is, the ability to portray a wide spectrum of an issue in a human format, with truth being sought and explained to disseminate information from and to multiple viewpoints, rather than imposing selected information with an agenda or result to be promoted, through what can best be described, as parroted information intended to be duplicated.

    Knowing that truth itself can often be variously perceived in the eye of the beholder, as a human trait, relying on human foundations, complicates matters for me.

    “Labels” or “groups of traits” regarding people. are very difficult for me to comprehend, as the borders are never well understood, or seem to be ever changing, and often are defined by those who seem to have “power”.

    Stereotyping individuals with ADHD, their treatment, or any “difference”, WITHOUT A DESIRE TO UNDERSTAND the known and possible underlying factors, including the resulting social factors, especially the internal and external struggles and self perceptions, from toddler to young adult to adulthood and even old age, does little to help those who deal with it themselves, or those who are truly trying to help. It does not help society at large either. The big picture must begin and continue with the people, individuals, who are often standing right next to you.

    The possible reasons that form or cause the tendency for the labels or group of traits and the resulting treatments or solutions are far more interesting, and of solution value, than the labels themselves. Thanks for bringing them forward.

    1. Thank you for that eloquent response, Paul.

      Even though I do not have ADHD, I have many, many MANY friends with ADHD — and a husband, too.

      I was also raised to value education. The funny story about my mother first meeting my husband is that, unfortunately, her stroke dementia meant that she was not fully herself by then. Still, when she asked my husband his line of work and he said, “Scientist,” she paused and said, “Oh, a holy man.” 🙂

      She liked my sisters’ husbands, but she never called them holy men!

      What’s more, I studied to become a journalist because I recognized the important role of the “watchdog.”

      It saddens me beyond all measure to see the “watchdog” turn into the “attack dog” on the principles and the people I love and admire.

      best,
      g

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