RITALIN NATION: RAPID-FIRE CULTURE AND THE TRANSFORMATION OF HUMAN
CONSCIOUSNESS
Richard DeGrandpre W W Norton, UKP 9.95, pp 284 ISBN 0 393 32025 1

If children's behaviour becomes "out of hand" it is understandable that
parents may seek a diagnosis to explain it away. There are several to hand.
Ritalin Nation looks at one such diagnosisattention deficit disorder.
Richard DeGrandpre proposes that US culture has medicalised child
development and that attention deficit disorder is a child strategy for
coping with the "go faster" ethos of modern life. In a medical model the
disorder is a deviance from the norm, and the underlying biological changes
require a biological treatmentmethylphenidate (Ritalin).

DeGrandpre, a psychologist, takes issue with the way in which attention
deficit disorder is attributed to an underlying medical cause. Development,
he argues, includes a continuous process of learning how to handle
responsibility. Is attention deficit disorder being used as a medical
solution to relieve parents of guilt, and children of responsibility for
their actions?

Ritalin Nation discusses the issue of how much stimulation is good for a
child. Intrusive parenting based on adults' parameters and timing, says De
Grandpre, is overstimulation, and it is associated with biological changes
in children such as a change in brain amines. The book's central thesis is
that when adults dive into child rearing from 6 pm to 9 pm, work
permitting, they put their children at risk of developing attention deficit
disorder.

Although the book has some interesting data on the psychosocial aspects of
the disorder, it fails to present a balanced biopsychosocial model of what
is a complicated condition. As with schizophrenia nearly 30 years ago, the
time has come for the World Health Organization to look at the different
prevalence of attention deficit disorder in different countries. The
diagnosis clearly has biological correlates and is also associated with
child abuse and neglect.

The author's mission is to encourage Americans to slow down. The Sami in
northern Norway say that time is always coming rather than going. Perhaps
De Grandpre should persuade the United States to take on the Sami's view of
time. But who knows whether this would protect children from attention
deficit disorder?

Simon R Wilkinson, consultant in child and adolescent psychiatry.

Oslo, Norway