Medicating Special Needs Children

When you are faced with a difficult decision in life, it is made all more difficult when it involves your child. When you are the one with a special needs child, it's in your hands to decide what, if any medications will be used.

About 5-8% of young children have severe behavioral and emotional disorders ranging from mild attention deficit disorder to severe cerebral palsy. Recent medical reports show drastic increases in the number of children taking stimulants, antidepressants and other psychiatric drugs. It has doubled from 1998 to 2002. The most common prescribed drug for all children is Ritalin.

These increases include preschool children aged 2 to 4. Children with ADHD are often disruptive in school or groups, have trouble sitting still and act impulsively resulting in lots of pressure for parents from others, and even pressure on doctors from parents.

The debate over the use of stimulants and other psychiatric drugs in the toddler age group focuses on how in particular we distinguish between variations of the extremes of a "normal" behaving young child, versus that of a disorder requiring a medication. There are no "tests" for most psychiatric conditions and the diagnosis is essentially the judgment of the evaluator, so it is wise to seek multiple opinions, and talk to other parents who have experienced the same issues.

There is very little information available on the benefits or safety of stimulants in this young age group, because testing on children is obviously deemed unethical. Reports however, suggest that toddlers and preschoolers experience more frequent side effects, and that their rates of improving are in fact lower compared to school aged children on such medications.

These children are highly responsive to changes in their environment. However many physicians and even teachers often urge and even pressure parents to medicate their children, and to not bother even experimenting with alternative methods of treatment.

One M.D. says "If one can work with the parents, daycare, or preschool to develop a form of parenting that is most suited to these children's personalities and behavior, one can see changes as dramatically positive as if they were taking some sort of medication. In the long term it is believed that these children and their families will be better served by developing strategies within the home than depending on medication." He also says "It should be a very rare child that requires medication below age five."

For some children, however, behavioral interventions will be insufficient, and careful use of medication may be needed. For those, these medications may be lifesaving, and are being used as a last step by parents and physicians after other options have been exhausted.

Terri, mother of an 11 year old child with ADHD says she felt strongly pressured to medicate her son. "We went to a psychologist once" she said, "who supposedly specialized in behavior, hoping to get some tips, and his advice was: If you'd just medicate him, you wouldn't have to deal with all this other stuff."

Another mom said she not only feels pressure from doctors but also from teachers, but "I rather like him the way he is quirks and all!" She argues.

Some parents are even desperate to get their children on meds. But many children are not properly diagnosed and evaluated to be medicated. One doctor who specializes in the area, says she was shocked to hear some parents more than pressing for their special needs child to be placed on medications, and not willing or even interested in alternative treatments, when she felt that medication was not needed.

What do you think about this? Should children deemed as special needs be evaluated by, say, 3 different doctors before being advised a treatment? What should a doctor do when a parent is pressing for a child to unnecessarily be put on meds? How would you advise a mom who is coping with pressure from doctors and teachers to medicate her child when she feels it's not needed?