iternalizing kids-croppedThis weekend a mother published a New York Times column about how her son came to be diagnosed with ADHD and became a member of the ballooning "Ritalin Generation."

"Just a little medication," the teacher told the boy's mother, "could really turn things around" for the boy, who was having trouble focusing on class worksheets and lining up quietly for transitions between classes.

When the mother firmly responded that she and her husband weren't going to medicate their son, the teacher backtracked, sounding mock-horrified.

She wasn't explicitly suggesting medication, she said. The law prohibited such a thing. She just didn't want him to fall through the cracks - and thus was was merely suggesting the boy's parents have him evaluated by a psychologist.

The boy was evaluated, and sure enough, he ended up on Ritalin for a short-time, though he quit it on his own a year later, matured out of his former inattentiveness, and eventually ended up a well-adjusted, school-loving honor-roll student - and medication-free.

Such stories are commonly invoked as cautionary tales about the alleged over-diagnosis of ADHD and other behavior disorders and over-prescribing of drugs like Ritalin to keep children's behavior in check. Teachers recommending meds for disruptive students often feature prominently. In fact, the debate over school involvement in medicating disruptive children showed up as early as the early 1970s.

Yet the hand-wringing persists. Media outlets keep publishing warnings about the pitfalls needlessly - and ineffectively - medicating such kids.

But hidden between the lines of these stories is another kind of cautionary tale: about what's lost when teachers, parents and society at large focus too much on the allegedly over-diagnosed hyperactive, disruptive children and overlook their more quietly troubled classmates.

These children are distracted from learning, too, just not always in ways that are evident to teachers trying to manage a roomful of children.

They often fail to attract the teacher's attention because their anxieties, obsessions and compulsions, or thoughts of hopeless or worthlessness are covertly destabilizing or tormenting, rather than overtly disruptive to the teacher's ability to manage the class and conduct lessons.

And in the same way, they often don't attract parental concern, either - or at least not enough concern for parents to get the children some form of treatment.

Because problems like anxiety disorders and depression can show up very early in life, it's not unusual for kids to go years before receiving treatment - pharmaceutical or otherwise. Many don't enter treatment until adulthood.

Problems can worsen significantly, though, even if they go untreated for just a few years. Kids may grow phobic about social interactions or attending school, socially isolated and cut off from activities they enjoy, tormented by bullies, wracked by secret, shameful-feeling obsessions and compulsions, or even suicidal thoughts and urges.

To have such troubles take up years of childhood and adolescence is a terrible shame.

So here's a call for teachers to tweak their approach to "troubled kids." Being alert to hyperactive and obviously distracted kids is fine, but not if it keeps them from identifying the silently suffering kids.

Perhaps a new generation of teachers who themselves have taken medication from a young age for conditions like OCD, depression, and generalized anxiety will be more attuned to a wider array of students, beyond the ones who create blatant disturbances in class.

In shifting their attentions just a tad to a broader range of students, teachers may even be a little less quick to recommend medications for the class cut-ups. They might even end up advocating a wait-and-see approach, or one that incorporates school accommodations or behavioral therapies instead of, or in addition to meds.

Meanwhile, they could do a real service to the kids whose suffering slips under the radar at school and often at home, too.


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    Last reviewed: 20 Aug 2012

APA Reference
Bell Barnett, K. (2012). Medicating Class Cut-Ups But Overlooking the Rest. Psych Central. Retrieved on December 19, 2014, from http://blogs.psychcentral.com/my-meds/2012/08/medicating-class-cut-ups-but-overlooking-the-rest/

 

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