|KATE FALLON LEADS CHALLENGE ON THE USE OF PSYCHOTROPIC DRUGS ON YOUNG CHILDREN|
Why give Ritalin to four-year-olds with ADHD, say experts.
Children as young as four should be given Ritalin for Attention Deficit Hyperactivity Disorder (ADHD), according to experts.
By Stephen Adams, Medical Correspondent
6:30AM GMT 17 Nov 2011
One in 12 children now suffers from the condition, say doctors who are advising that preschoolers should be checked for signs of the condition.
The updated guidelines are from the American Academy of Pediatrics (AAP), an influential body whose pronouncements are studied with great interest by child health experts in Britain.
The guidelines were presented yesterday (SUN) at the AAP's annual conference in Boston, by lead author Dr Mark Worlaich, professor of paediatrics at the University of Oklahoma College of Medicine.
He said: "Treating children at a young age is important, because when we can identify them earlier and provide appropriate treatment, we can increase their chances of succeeding in school."
He and colleagues advised that a doctor "should initiate an evaluation for ADHD for any child four through 18 years of ago who presents with academic or behavioural problems and symptoms of inattention, hyperactivity, or impulsivity".
Doctors "should recognize ADHD as a chronic condition", and those diagnosed with it should be regarded as having "special health care needs".
Physicians "may prescribe methylphenadate" - the generic name for the branded drug Ritalin - to four or five-year-olds if "behaviour therapy" fails, they wrote.
Such children could even be put straight on Ritalin if "behavioural treatments are not available".
The updated US guidelines bring down the age at which children should be assessed and treated for ADHD from six to four.
Sue Morris, director of professional training in educational psychology at Birmingham University, said the guidelines would help fuel a "maelstrom of concern" about prescribing Ritalin to children.
She said: "The British Psychological Association (BPA) and the Association of Educational Psychologists (AEP) are already extremely worried about cavalier prescribing of psychotropic medication to children."
She believed any move towards wider prescribing to pre-schoolers was "something that would find very little support in Britain".
Ritalin is not licensed for use in children under six in the UK, although the National Institute of Health and Clinical Excellence (Nice) has issued guidance that it can be used in very limited circumstances.
Earlier this year, David Traxson, a child psychologist, said at least 100 children aged three to five in the West Midlands were on "potentially addictive" Ritalin or similar drugs.
In total, about 660,000 Ritalin prescriptions for children are made every year, a sevenfold increase since 1997.
Kate Fallon, general secretary of the AEP, said she had "serious concerns" about widening prescription to under sixes, due to the "very sensitive nature of children's brains".
She said: "These medications are very powerful. We advocate caution because there are no long term studies looking at their effects on developing brains.
"This is part of a wider issue of concern, of the medication of behaviours we don't like.
"Rather than resorting to medication, we should be using environmental influences such as good nurturing support from adults."
Dr John Houston, a consultant paediatrician based at Lorn and Islands Hospital in Oban, and a spokesman on ADHD for the Royal College of Paediatrics and Child Health, said while British experts took note of the AAP, their guidance came from Nice.
He said: "In the UK we are more reluctant to medicate our kids, and I think that's a very good thing."
He also said the American classification of ADHD was much broader than the British approach, under which about one child in 100 was diagnosed.
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