Current Issue » Cover Story

Are American children overmedicated? The more I researched this article the less clear the answer became. Mental Disorders are not like bacterial infections that can be identified and obliterated with antibiotics. Voila a cure! Psychological disorders forge messy paths through children's lives and require ongoing treatment. When a child is suffering, parents feel the impact and experience significant dismay that they can't make their child better or find a treatment that seems to be an easy choice. 

Chilling media reports of prescription madness that blare tales of children who are fatally overdosed and seem to be testaments to overmedication are contrasted by the other extreme stories of under-medicated and undertreated children whose futures are dim due to unchecked mental illness.

Complicated and unwieldy - like mental disorders in children - it seems that the information thrust into the public arena is often incendiary and, though it may be factually correct, the way it's packaged is not always useful to parents who need it most. So, are we overmedicating children? Well, it seems the answer depends on whom you ask and on each individual case. But, with measured consideration and the advice of good doctors, parents can make informed choices that result in a full and happy life for the child they love so much.

Two cases - two treatments:
Attention Deficit Hyperactivity Disorder -
In 2002, Richard K. Nakamura, PhD testified before the United States House of Representatives regarding the seriousness related to diagnosing and treating ADHD.

According to Nakamura's testimony, "Failure to provide appropriate treatment for certain disorders - including ADHD - poses a risk to brain integrity and function...Failure to receive and properly process cognitive and emotional stimuli during critical periods when the brain is undergoing rapid growth and maturation may result in damage with lifelong consequences."

Sierra and Ralph Sandini - Anthony (10) Nick (8) Sarephina (4)
Anthony Sandini was like many preschoolers displaying bursts of energy and endless movement. But he was four and that kind of thing was expected.

As Anthony progressed to kindergarten the Sandini's realized something wasn't right. "He was compliant and sweet, but 'out there,' in some ways. We could call his name six times and he'd never turn our direction. Our younger son, Nick, would turn his head with the first call. But, still, there were plenty of children who displayed similar behavior. We certainly weren't ready to say Anthony had a problem."

But, by first grade it was clear Anthony had issues that needed to be addressed.

"He bounced off walls, but was not purposely defiant. He would ask the teacher to repeat directions, but he couldn't follow them the second or third time. He was clueless - he didn't know he didn't know."

"We had long discussions with our pediatrician and he convinced us to begin the process of eliminating possible diagnoses by filling out questionnaires. When he said Anthony had ADHD I was scared to death for what that meant. We weren't ready to dive right into the medications. He's just a child! So we worked out a behavioral plan. I was comfortable making educational adaptations. But, after trying behavioral interventions it became clear that he needed something else. I cried, my family cried. I didn't want him to take daily medication, but we knew what needed to be done."

So why was it so hard to consent to using medication if that was clearly what Anthony needed?
Sierra says, "The stigma is there, that your child needs medication - it took a while to sink in that Anthony had a biochemical disorder that required more than we could do behaviorally. The medicine just took the edge off his behavior, allowed him to be a little still, listen to directions, complete his work, and it made him happier and more confident. And I don't mean happier in that 'happy pill' kind of way. He was able to function better and actually learn."

Even though the Sandini's have found the optimal level of medication for Anthony, they are vigilant. They revisit the doctor every 3-4 months to check Anthony's behaviors, height, and weight.
"Even with the medicine, Anthony still has adaptations at school and requires a lot of motivation and structure.  His teachers let him stand, take frequent breaks and he's making a lot of progress. We feel like we're doing the right thing for sure."

Obsessive Compulsive Disorder (OCD)
Most people don't think of children when they think of obsessive-compulsive disorder. More often, images of an adult repeating actions like hand-washing spring to mind. But, OCD is an anxiety disorder that has a wide range of symptoms and can at first glance mimic other disorders making it difficult to diagnose, especially in children.

Simone and Henry Stanley - Henry (10) Mandy (5 1/2)
Simone and Hank Stanley noticed their son Henry experienced chronic anxiety as well as intense, panicked episodes that didn't always look like anxiety at the time.  Like many parents, it took the Stanleys a while to realize the anxiety was not just a phase he would easily pass through and to find the right avenue to manage it. 

Part of the difficulty in pinning down just what was fueling Henry's fear was that he was harassed by an ever-changing catalog of triggers. At one point it was thunder and lightening, then it was fire alarms, and he became compulsive about the foods he ate.  "He wouldn't eat at new restaurants because he feared the food was poisoned. He wouldn't eat off of plastic and would say things like, "I feel this (some pain or sensation) in my body, am I going to die?"

Sometimes Henry's fears were paralyzing and other times panic compelled him into danger like when he ran into the street during a storm in order to go home.

This left the Stanleys exhausted and sad that their son seemed so easily disturbed by a world that other children navigated with minimal concern. Confusing the issue further was that at times Henry's behavior appeared to be simple childhood obstinacy.

For the rest of the story, pick up a FREE COPY of Pittsburgh Parent Magazine today!