Doctor Michael Anderson doesn’t pretend that his young patients come to him to cure a disease, but that doesn’t mean he puts away his prescription pad. On the contrary, when parents turn to him to help their children who struggle in school, he is willing to put them in Adderall even though he believes that the disease the medicine is meant to treat – attention deficit hyperactivity disorder, or ADHD – is “made up.”
He said that the ADHD diagnosis is a band-aid that desperate parents are trying to apply to fix a systematic ill: that their children are floundering in schools not meeting their needs. Anderson feels that in light of the fact that the society seems disinclined to do much to improve schools that cater to the most needy children, the parents’ only option is to medicate their child.
Dr. Anderson is one of the more outspoken proponents of an idea that is gaining interest among some physicians. They are prescribing stimulants to struggling students in schools starved of extra money — not to treat A.D.H.D., necessarily, but to boost their academic performance.
It is not yet clear whether Dr. Anderson is representative of a widening trend. But some experts note that as wealthy students abuse stimulants to raise already-good grades in colleges and high schools, the medications are being used on low-income elementary school children with faltering grades and parents eager to see them succeed.
Similar reports of doctors using medication not to heal but to improve academic performance have been trickling in according to Dr. Nancy Rappaport, a psychologist from Cambridge, MA who works primarily will low-income kids. She calls the approach a “chemical straightjacket,” saying that it just provides an excuse for communities to roll back investment in education and programs that provide academic and emotional support to students from low-income families.
Although Anderson thinks that ADHD is an invention, the experiences of some of his patients seem to say otherwise. Jacqueline Williams, one of Anderson’s patients whose three children take Concerta, a long-lasting stimulant, says the difference between how they acted on medication and off it is night and day. Prior to going on Concerta, Eric, 15; Chekiara, 14; and Shamya, 11 had trouble maintaining focus while listening to instructions or doing schoolwork. She said that her kids don’t like the side effects of the drug, but have grown to accept it after they saw the difference in their grades.
There is certainly a split opinion about proscribing stimulants like Adderall, Risperdal and Concerta for black-box usage like this. After all, it is a powerful medication that is meant to treat a serious medical condition, and shouldn’t be treated as a study aid.
Dr. William Graf, a pediatrician and child neurologist who serves many poor families in New Haven, said that a family should be able to choose for itself whether Adderall can benefit its non-A.D.H.D. child, and that a physician can ethically prescribe a trial as long as side effects are closely monitored. He expressed concern, however, that the rising use of stimulants in this manner can threaten what he called “the authenticity of development.”