Legislature should look to science, not science fiction
This is an archived article that was published on sltrib.com in 2006, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

As a Utah native and lead investigator for the largest and most comprehensive federally funded research study on attention-deficit/hyperactivity disorder (ADHD), I am disheartened to see that the so-called "Ritalin bill" was reintroduced recently in the state Legislature.

The bill in question, HB299, could discourage teachers from communicating with parents about observations that suggest a student has ADHD, a neurobiological disorder marked by inattention and/or hyperactivity, or any other neurobehavioral problems possibly requiring medical evaluation.

As a scientist, physician and father of five, I am convinced that this bill runs counter to the science of ADHD, best medical practices and our children's interests.

Teachers spend at least 30 hours a week with students, observing their learning habits, social interactions and behavior in and out of the classroom. So it should be no surprise that what we have learned from our federal tax-supported research is that most teachers are astute observers of children's behavior. They are in a unique position to raise red flags with parents when learning and/or behavioral problems arise.

There are exceptions, of course, so it should be up to the parent to decide about taking the child to a medical or mental health professional for further diagnosis and treatment.

But legislative policies to discourage communication among parents, teachers and doctors are very misguided. As physicians, we must rely on the observations of teachers as we seek to identify the problem and determine the best treatment options for the child. If the ultimate conclusion is that the child has ADHD, further communication among medical professionals, parents and teachers should be enhanced, to increase the likelihood that all can work together to help the child succeed.

Medication, while not a panacea, is one of the many important elements in ensuring that the overall strategy is successful - but the question of medication is one that is decided between physician and parent.

Some people claim we are over-medicating our children. Actually, what we know from our research studies is just the opposite. Many kids with ADHD (about half in any given year) never get diagnosed or treated. For the half who get help, we know that treatments are often inadequate, just as if kids with diabetes were to receive only half the required dose of insulin or to follow their diet only every other day.

From the early 1990s up until recently, I was the key federal official and researcher responsible for the largest and most comprehensive study on ADHD ever conducted, sponsored by the National Institute of Mental Health, The Multimodal Treatment Study of Children with ADHD. In this study we found that medication, along with other treatments, plays a necessary and important part in reducing the symptoms of ADHD for many (but not all) children.

Thanks to this study, we now know that most children with ADHD, if identified early and properly treated, can succeed at school and at home. But kids who don't get the treatment they need, as is likely to happen if teachers are discouraged from talking to parents about behavior problems observed in the classroom and barred from involvement in treatment followup, face severe consequences: school failure, delinquency and substance use. Later in life, they face problems in the workplace and home and family settings.

I hope that Utah legislators will defeat HB299 and explore scientifically established ways to better help parents, teachers and medical professionals to identify and treat students struggling with this debilitating condition. To do this, our policymakers must turn to the science and turn away from science fiction.

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Peter S. Jensen is the Ruane Professor of Child Psychiatry and director of Columbia University's Center for the Advancement of Children's Mental Health.

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