Tuesday, April 10, 2001

Wanted: Trying tots

Is your preschooler a little restless? A little overactive? Does he have trouble sitting still or shutting up? Have you ever thought he might be hyperactive or attention deficient? Has your doctor resisted prescribing him Ritalin because he's only 3? Then the National Institute of Mental Health might be looking for you.

The institute is funding a $6 million research study on the effect of Ritalin on the very young, and is looking for 300 good kids in the preschool age range to be their little guinea pigs. It's hard to know what's more troubling here -- that Ritalin is already being prescribed to kids that young without having been tested for safety, or that we're now going to test it.

Screening for the Preschool ADHD Treatment Study will be careful, to be sure. A kid who's a whirling dervish sometimes but in control others won't make the cut. Qualified applicants need to be able to speak in three-word sentences, and of course they need to be able to swallow a pill. Children whose behavior can be traced to traumatic stress or Oppositional Defiant Disorder will get the boot.

No, only kids who really have ADD/ADHD will be involved, though the medical profession is deeply divided on the question of whether you can even diagnose the thing in children so young. Researchers will put parents through a 10-week training course to try to increase their behavior modification skills, and if that brings the squirminess under control, the little test subjects will go on their way, pill-free. If not, they will be administered the medication and monitored for side effects over an 18-week period. The Food and Drug Administration is making a small-dose pill up special.

It will be interesting to see what the results of this little experiment turn out to be, but I can't say I expect anything to turn up that would keep the drug from being a regular feature in nursery schools and day-care centers across the land. Which -- without even getting into a debate here about the appropriateness of Ritalin or psychiatric medications for any child -- disheartens me greatly.

Is proper deportment now so important for 3 and 4 year olds that we must medicate them into it? There may be an argument for school-age children needing to be able to get with the program, but toddlers? Are infants who keep Mommy and Daddy awake too much next in line here? What an easy drug trial that will be -- they can screen the newborns right there in the hospital and send the teensy pills home with them.

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