Hyperactive kids 8212; the debate rages

The use of stimulants on children thought to be suffering from ADHD has been widely criticised in the West. For instance Time magazine in an article titled Ritalin for Toddlers in its March 20 issue said that there is nothing clear about ADHD. 8220;The diagnosis is based on a checklist of subjective judgements 8212; rating a child8217;s inattention, distractability impulsivity and so on. It8217;s hard enough for doctors to distinquish between an energetic teenager and one who has a behaviour disorder. How can they make those judgments when the patient is still learning to talk?8221;

8220;But for parents and teachers driven to distraction by a hyperactive kid, psychotriopic stimulants like Ritalin have been a godsend; thousands of students who couldn8217;t sit still long enough to learn have been able to calm down, pay atention and get the job done thanks to Ritalin,8221; Time says.

But, doctors here say, our problem is not the same as the problem in the West.

8220;There, the problem is that of over-diagnosis. Even normal children are labelled hyperactive and put on medication,8221; says Dr Shobha Srinath, a psychiatrist from NIMHANS, Bangalore who was here recently. 8220;As a result, 5 to 7 per cent children are on medication for hyperactivity,8221; she said.

8220;In India, on the other hand, even genuine cases are not treated,8221; she said. Doctors admit that the stimulant itself has no curative value. 8220;It cannot treat a patient but can make him submit and respond to counselling and other methods of dealing with the disorder,8221; says Dr Savita Malhotra a psychoatrist from PGI Chandigarh.

Dr Srinath said that if left untreated, hyperactive children will grow up to be dropouts, drug addicts, aggressive, delinquents, fidgety, abnormally fast drivers and problem cases in society.

Scarier than the disease is, however, the criterion for considering a child as being hyperactive. Srinath says a hyperactive child is one who would watch TV but will not study. Asked if watching TV was not a sign of the child8217;s ability to concentrate, she replied in the negative. She said that if the child could draw or paint or play but not study then he was normal.

Malhotra, however, said that it was 8220;a very risky business8221; to put children on psychotropic drugs. She said that drugs should be the last choice and parents could at least take the help of psychologists to help their children. Even if drugs are not taken, advice can be taken on change of environment or for intervention at school or home, she said. 8220;Behaviour therapy may or may not help but at least you can be sure that there are no side effects,8221; she says.

Symptoms of a hyperactive child are that he or she will not be able to concentrate on anything and will suffer from constant inattention and distraction.

Nagpal said that the disorder causes severe social maladjustment and should be controlled.

Asked about possibilities of wrong diagnosis, he said that parents have to be made aware of all aspects of the issue which will prevent over-medication.

And here is how Time concludes its piece on ADHD: 8220;ADHD is a tough disorder8230;The first step in treatment is to be as certain as possible of the diagnosis. Then if you decide to use medication, proceed with caution until researchers figure out what effect these drugs might have on young developing bodies and brains.8221;