ARE DRUGS REALLY THE ANSWER FOR HYPERACTIVE KIDS?

CHILDREN suffering from attention deficit hyperactivity disorder (ADHD) who
are treated with stimulants show almost no improvement in academic
achievement and social skills, according to an expert panel convened by the
US National Institutes of Health.

Stimulants such as Ritalin have been hailed as a breakthrough in the
treatment of ADHD, allowing disruptive children to concentrate in class.
Psychiatrists assumed that this wouid mean improved educational
performance. But that's not what the NIH panel found. "The evidence is not
very impressive," says Samuel Guze, a psychiatrist at the Washington
University School of Medicine in St Louis, Missouri. "They start lower than
average and they remain lower than average," says Naomi Breslau, director
of research at the Henry Ford Health System in Detroit, Michigan.

The NIH panel is not opposed to using drugs to control ADHD. But one expert
who gave evidence to the panel argues that drugs such as Ritalin only treat
the symptoms, rather than addressing the underlying cause of the condition.
Rosemary Tannock of the Hospital for Sick Children in Toronto suspects that
ADHD is fundamentally misunderstood. She has tested ADHD children using a
battery of tests that measure their reaction time. "These kids are
ubiquitously slow," she says. "It doesn't fit the picture of hyperactivity
and impuisiveness."

Tannock thinks the children have problems with tasks that require them to
store some pieces of information while simultaneously manipulating others,
and has anecdotal evidence that an extremely structured classroom setting
can improve their educational performance. She advocates trials to test the
effects of changing the classroom setting, but cautions that this treatment
will almost certainly be more expensive than drugs.

Alison Motluk, Washington DC

Checked-by: Richard Lake