Amphetamines in the Treatment of Hyperkinetic Children

Abstract

The authors review research on the effects of amphetamines on children, particularly hyperactive children in the classroom. They point out that there is no clear evidence these drugs should be prescribed as often as they are. The "hyperkinetic syndrome" remains vague both in its diagnosis and its etiology, and the mechanism of amphetamine action is unclear. The assumption that amphetamines have a paradoxical,calming effect on hyperactive children, unlike the stimulating effect they exert on adults, may accurately describe the apparent effects of the drugs on attention and other aspects of socially accepted classroom behavior, but it does not justify the interpretation that amphetamine effects are qualitatively different for children than for adults, without the same potential for harm. The authors conclude that the possible adverse effects of these drugs and their unknown long-term risks require that we consider the present policy of amphetamine administration in the schools.

The equivocal nature of special education interventions

“…Although the medical community considers stimulant medication an effecacious treatment (American Academy of Pediatrics, 1975), negative evaluations have been drawn from reviews of extant research (e.g., Adelman & Compas, 1977;Sroufe, 1975) and from political, ideological, and moral attacks (e.g., Grinspoon & Singer, 1973;Schrag & Divoky, 1975). In sharp contrast, the Feingold diet (Feingold & Feingold, 1979) has been reported to show 40%-70% improvement for hyperactive subjects (Feingold, 1976), and has received a favorable and enthusiastic response as a natural treatment (Feingold, 1975).…”

Naturalistic Assessment of Neurological Diagnoses and Pharmacological Intervention

“…Current estimates suggest that drugs are employed with as high as 15 to 20% of elementary school-age children (Grinspoon & Singer 1973). &dquo;In the 1950s educators ... began to encourage parents to seek such psychopharmacological help from the child's physician.…”

Public Education and Personal Liberty

“…After reviewing the medical research , which is mixed as to the nature of hyperkinesis and the benefits of the use of these drugs, Grinspoon and Singer say: "Once one appreciates the confusion within the medical community surrounding hyperkinesis, it is frightening to see the self-assurance with which educators and the drug industry have promoted the use of drugs in the schools." 12 In a look at the ethical use of drugs for the purpose of controlling children , Grinspoon and Singer cite Ladd who points out that forcing young children to take any kind of medication may constitute an infringement of their civil rights, no matter how expedient such measures appear to school personnel attempting to cope with day-to -day disruptive behavior. He emphasizes that the only objectionable behavior that a school has any legal right to control or modify is that which it must police in order to "accomplish its job and protect persons and the institution."…”