Medicating Preschoolers for ADHD: How “Evidence-Based” Psychiatry Has Led to a Tragic End

This article by Robert Whitaker has been published by Mad in America. It begins:

“In its May 25, 2021 issue, JAMA published a report on the comparative efficacy of two medications for treating preschoolers diagnosed with ADHD. Both methylphenidate and guanfacine were deemed to be beneficial, and in an accompanying editorial, JAMA told of how this retrospective review of patient charts added to the evidence base for this practice.

The editorial’s first paragraph, which was written by Tanya Froehlich, a professor at the University of Cincinnati College of Medicine, set forth a medical context for the study:

“Recognition of attention-deficit/hyperactivity disorder (ADHD) in the preschool age group is on the rise, with an increase in preschool ADHD rates in US nationally representative samples from 1.0% in 2007 to 2008 to 2.4% in 2016. Having a preschool-age child (i.e., 3-5 years) with ADHD is associated with numerous negative outcomes in the home (e.g., disordered parent-child relationships, elevated family stress), as well as out of-home settings (e.g., impaired preacademic skills, peer interaction difficulties, expulsion from preschool and childcare settings), underscoring the importance of identification and treatment. Guidelines from the American Academy of Pediatrics and the Society for Developmental-Behavioral Pediatrics (SDBP) recommend behavioral interventions as first-line treatment for preschool-age children with ADHD. However, behavioral interventions alone do not sufficiently improve ADHD-related symptoms and impairment in a large percentage (>80%) of children.”

That opening paragraph makes a number of ‘evidence-based’ assertions: that ADHD is a valid disorder; that it can be reliably diagnosed in preschoolers; that there is progress being made in recognizing this disorder in this age group; that untreated ADHD in preschoolers leads to bad outcomes in home and childcare settings; and that behavioral treatment fails to resolve ADHD symptoms in most preschoolers. There is scientific reason to conclude that there is a pressing need to study drugs being prescribed to preschoolers so diagnosed …”

You can read more from here.

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