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An ADHD epidemic

The following editorial appeared recently in the Philadelphia Inquirer:

As much as teaching has changed over the past 50 years, its basics, as typically applied in American elementary school classrooms, are essentially the same as they were in 1963.

Two dozen boys and girls, give or take a few, sit in arranged rows or a circle of chairs with desks and interact with a teacher presenting lessons involving reading or math.

The routine is repeated class after class, hour after hour.

That could get boring 50 years ago, leading students to nod off, gaze out the window, pass notes, or trade punches when the teacher looked the other way.

Imagine how much more boring it must be for today's children, who the night before, if not that morning, were likely engaged in all manner of electronically stimulating activity — from watching TV, to downloading I-pad games, to trying to beat their PlayStation at tennis.

Is it any wonder that many children who come to school with their minds so stimulated find it hard to concentrate on the monotonous spiel of an adult equipped with few props beyond a chalkboard to draw their interest?

Sometimes children, boys in particular, act up so often a teacher recommends medical intervention. Some children, maybe too many, are subsequently diagnosed with Attention Deficit Hyperactivity Disorder.

More than one in 10 American schoolchildren, 6.4 million between ages 4 and 17, have been diagnosed with ADHD, according to the U.S. Centers for Disease Control and Prevention.

Two-thirds of these children have been prescribed drugs like Adderall and Ritalin to calm them down by improving their concentration.

It's not known whether a recently reported 41 percent increase in ADHD diagnoses since 2003 is due to more parents and teachers recognizing a child has a problem that requires medical treatment or because parents, teachers, and physicians, too often apply the ADHD label to a child who is overly active for reasons that don't require a prescription.

There's no blood test for ADHD, so that diagnosis is typically based on observation alone.

With so many children on ADHD drugs — including one in 10 high school boys — easy access has led to the drugs' abuse. Teens sell Adderall to other teens to get high. Younger children, whose schools in most cases don't give them recess to let off steam, are instead doped up.

It is becoming increasingly clear that many diagnoses of hyperactivity in children are being made too quickly, and that when ADHD is diagnosed, more care must be taken in prescribing and monitoring the use of drugs.