"ARE WE OVERMEDICATING OUR CHILDREN?"

According to the National Institute of Mental Health, ADHD is the most commonly diagnosed childhood psychiatric disorder, affecting an estimated percent of school-age children and at rate three times more often in boys than girls.

Testifying on behalf of APA, David Fassler, M.D., a Board Certified Child and Adolescent Psychiatrist, told the Committee that "ADHD diagnosis requires a comprehensive assessment by a trained medical professional. In addition to direct observation, the evaluation includes a review of the child's developmental, social, academic and medical history.

Schools play a critical role in identifying kids who are having problems, but schools should not make diagnoses or dictate treatment. This is the proper role for the parent working with the child's physician," he said. "I share the concern that some children may be placed on medication without a comprehensive evaluation, accurate and specific diagnosis or an individualized treatment plan," said Dr. Fassler. "I am also concerned that many children with ADHD and other psychiatric disorders who would benefit from treatment - including medication - go unrecognized and undiagnosed, and are not receiving the help that they need."

"Mental illnesses harm children in a variety of ways, not just by hampering their academic performance.

Subjecting children to criticism from parents and teachers, and ridicule from friends and classmates, can harm their fragile self-esteem, leading to problems in adolescence, including an increased risk of substance abuse, adolescent pregnancy, school failure and trouble with the law," said Dr. Fassler

"Medication, including methylphenidate or Ritalin, can be extremely helpful for many children, but medication alone is rarely the appropriate treatment for complex child psychiatric disorders such as ADHD," said Dr. Fassler. "Medication should only be used as part of a comprehensive treatment plan which will usually include individual therapy, family support and counseling, and work with the schools.

The Diagnostic and Statistical Manual of Mental Disorders IV-TR provides criteria for diagnosing and treating ADHD, which is recognized by national and international health agencies (such as the World Health Organization), by insurance companies, and by government agencies (including the Centers for Disease Control and the National Institute of Mental Health).

"We need to continue our collective efforts to improve public awareness and to ensure access to comprehensive assessment services to ensure over-diagnosis or over-treatment doesn't happen in any areas or communities," said Dr. Fassler.

The American Psychiatric Association is a national medical specialty society, founded in 1844, whose 38,000 physician members specialize in the diagnosis, treatment and prevention of mental illnesses including substance use disorders. For more information, visit the APA Web site at www.psych.org.

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