Monday, November 21, 2011

Must Aussies Drug Their Kids?

There's a kerfuffle in Australia regarding these Attention Deficit Hyperactivity Disorder (ADHD) guidelines from the National Health and Medical Research Council. Family support groups are upset because the guidelines include this language: "As with any medical intervention, the inability of parents to implement strategies may raise child protection concerns." Critics are interpreting this to mean that parents will be forced to medicate their hyperactive kids, or risk losing custody of them. I think the criticism is overblown. First, it's just true that failing to help treat your child's mental health problems can indeed amount to child abuse, and can merit state intervention. Moreover, the language doesn't apply only to drug interventions, but to the full scope of ADHD interventions (psychosocial, educational, drug, and combination) which the guidelines contemplate. In fact, the real story here seems to be that these guidelines are not pushing Ritalin as a one-stop approach to ADHD symptom control, but are instead taking a nuanced approach to ADHD's situation within the child's broader mental health status. In this way they differ from previous draft NHMRC guidelines--guidelines which were ditched last year because they relied heavily on the work of a professor (Harvard Med’s Joseph Biederman) who was sanctioned for failing to declare conflicts of interest.

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