http://www.house.gov/ed_workforce/hearings/106th/ecyf/ritalin51600/pryce.htm

 

Testimony of the Honorable Deborah Pryce (R-OH-15)

Hearing on "Ritalin Use Among Youth: Examining Issues and Concerns"

United States House of Representatives
Subcommittee on Early Childhood, Youth and Families

May 16, 2000

Thank you, Mr. Chairman and Members of the Subcommittee, for holding this important hearing and for giving me the opportunity to testify.

At the outset let me offer a disclaimer. I certainly am not an expert on Ritalin, psychiatric drugs, or child development. Instead, I appear before you as an elected official and representative to Congress who has heard from constituents who are very concerned about the increased use of Ritalin among children. I would like to describe for you their views as they relayed them to me.

In my position as a Member of Congress, the first time concerns about Ritalin were raised with me was in 1995, when I met with the Ohio State Board of Pharmacy. They were concerned about an increase in the use of Ritalin among school-aged children in Ohio and the pressure placed on school nurses and parents to put children on this drug. They suggested that some perverse financial incentives may be in play, in that schools receive more funding if more students were diagnosed with attention deficit disorder. Another concern the Board of Pharmacy had was that the increase of Ritalin as a street drug was due to the over-prescription and misuse by some. Ritalin, intended for attention deficit children, was making its way to the "street corner."

More recently, I have been contacted by parents of school-aged children. The father of a six-year-old wrote to me because his child, who he described as a "handful" but "not out of control," was diagnosed with Attention Deficit Hyperactivity Disorder, also known as ADHD. Interestingly, this parent claims the teacher provided the diagnosis, and the school is pressuring the parents to put their child on Ritalin. The parents have tried to find alternatives to Ritalin that may change their son’s behavior, but apparently the effects of these remedies are not dramatic enough to assuage the school’s concerns about the boy’s behavior. Therefore, my constituent remains under pressure to put his child on Ritalin, and he is under the impression that unless he complies with the school’s suggestion, his son may no longer be able to attend school. According to the parents of this young boy, they are not alone in their predicament or concerns. They have met several parents locally who have had similar experiences.

Another constituent who wrote to me has an 11-year-old son who is active and, according to his mom, has trouble "sitting still in class." However, this mother does not believe her son has a behavioral problem, as he is respectful of adults and authority. The school has a different impression. A few years ago they began sending this mother pamphlets on ADHD. This mother claims that she was forced to take her son to the doctor, and he now takes drugs to control the problem. In the view of this parent, the school’s pressure on her is due to their inability and unwillingness to discipline children, which in her view, is partly driven by the laws we legislators pass.

This particular parent makes another observation, which has also been reported in the press, which is that the use of these drugs may be related to violence in schools. My first thought is that it is not surprising that children prone to violence may also be candidates for the use of psychiatric drugs. However, one doctor who is opposed to the use of Ritalin told CBS news that she believes Ritalin, which she says is almost identical to cocaine, can cause dangerous behavior. This is a bold statement about a drug that has been in use for 40 years and which most physicians would probably tell us is safe. However, I bring it to the Subcommittee’s attention because I know you have been studying the causes of school violence and working on legislation to reduce it.

I am not interested in placing any blame or judging these parents, their children, or the school personnel that must deal with mischievous and delinquent children. However, I do believe that my constituents raise issues that are worth further examination, including the role schools play in diagnosing ADHD and suggesting treatment.

This issue presents an interesting dynamic among schools, parents, and the medical community. At first blush, you would think that Ritalin is a medical issue, but the input from my constituents reveals that schools are very much involved. Unfortunately, doctors often cannot observe the behavior that prompts school personnel to suggest that the child may have a medical problem. Even the parents cannot see how their child behaves when he or she is out of their control and in a classroom environment among peers. It seems to me that making this type of health diagnosis is quite difficult and time consuming, yet I am not sure that anyone but the teachers have spent the time observing the behavior in question before children are diagnosed. I am pleased that the Subcommittee has also invited a teacher to testify today to provide a school’s perspective.

I also am not prepared to question the effectiveness of Ritalin or other psychiatric drugs, nor do I have a comment about the doctors who prescribe these drugs to children. I am sure that these drugs have been proven quite effective in many cases. However, after receiving these letters from my constituents and reading recent reports about the growing number of very young children who are using psychiatric drugs nationwide, I felt congressional inquiry was warranted. I am sure that the Subcommittee is well aware of the report published in the Journal of the American Medical Association (JAMA) in February, which found that from 1991 to 1995, the number of 2- to 4-year-olds using such drugs, including Ritalin and Prozac, increased by 50 percent. I think this trend raises another important issue, which is relevant to the federal government’s role in drug safety, though perhaps not in this Subcommittee’s jurisdiction. And, my concern here is not just as a federal legislator, but also as the mother of a child who took numerous drugs and underwent very serious medical treatments for her illness. I think it is very important that we devote resources to study and provide better information to parents about the long-term effects of drugs on children.

It was just a few years ago that we heard about important discoveries in the area of brain development in children ages 0 to 3. In fact, studies show that 75 percent of brain growth development is in the first three years of a child’s life. From a layman’s perspective, it seems somewhat alarming to me that children as young as 2 years are taking psychiatric drugs, and I believe it is incumbent on the government to determine the risks of prescribing such drugs to very young children. In the FDA Reform Act, Congress provided an incentive to drug companies in the form of market exclusivity for testing their products on children. I think this is probably a good start. There are, of course, challenges in conducting medical studies on children, and I understand that it is not necessarily this Subcommittee’s charge to sort out these issues, but I feel compelled to take this opportunity to mention the concern.

I want to reiterate that I am not here to cast judgement on individuals or the efficacy of any drug. However, it appears to me from the first-hand accounts of people in my community, that there is adequate public concern to warrant our attention. So, I thank the Subcommittee for holding today’s hearing, which I hope will be helpful in improving our understanding of the many issues surrounding the growing use of psychiatric drugs by our children.

Thank you, Mr. Chairman.

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