Are more and more pre-school children being dosed with methylphenidates? A new survey suggests soIt may have been a quieter Christmas for some UK families, but at what cost? According to research carried out by the University College London Institute of Education (IoE) and the British Psychological Society (BPS) more than a fifth of educational psychologists say they know of pre-school children being given methylphenidates such as Ritalin, contrary to National Institute for Health and Clinical Excellence (NICE) guidelines.
While the full details of the survey are yet to be released, pre-Christmas reports in the Guardian, the Daily Mail and The Independent will further alarm professionals concerned about the increasingly pervasive use of drugs as a first resort when treating children diagnosed with behavioural problems such as Attention Deficit Hyperactivity Disorder (ADHD).
Professionals say this flight to drugs is fuelled by the under-resourcing of alternative treatments recommended in NICE’s guidelines. One educational psychologist who took part in the study is quoted as saying, ‘Our biggest difficulty is that children’s and adolescent mental health services and paediatric teams are so short-staffed they go straight to medication and completely ignore NICE guidance.’
NICE published guidelines on the identification and treatment of ADHD in 2008 and updated them in March 2013. The revised guidelines say that, ‘Parent-training/education programmes are the first-line treatment for parents or carers of pre-school children’ diagnosed with the condition, and that, ‘Drug treatment is not recommended for pre-school children with ADHD.’ It adds that if parent-training/education programmes prove ineffective healthcare professionals ‘should consider referral to tertiary services for further care.’
The original guidelines also make clear that methylphenidate and atomoxetine do not have UK marketing authorisation for use in children younger than six years and that where drugs are used they should ‘always form part of a comprehensive treatment plan that includes psychological, behavioural and educational advice and interventions.’ Vivian Hill, Director of Professional Educational Psychology Training at the IoE and one of the study’s authors, told the Guardian:
‘It is very alarming to discover that terribly young children who often have not had access to alternative treatments are being put on medication. It is almost certainly to do with the fact that the whole of children’s mental health services is incredibly underfunded. It’s quick and easy – one off the waiting list, one intervention in place. To work with a child or a young person and their family over time is much more costly, but much safer and likely to have much better results. Medication has a short term impact. It will not make the difference long-term.’
The survey involved 136 educational psychologists from 70 local authorities. The findings will be presented at the BPS’s Division of Educational and Child Psychology (DECP) Annual Conference in Durham in January 2015. DECP Committee Member Dave Traxson told Special World,
‘With the supportive data from such surveys I feel very optimistic that we can make progress in significantly decreasing, and hopefully stopping, the unacceptable use of potentially toxic psycho-active drugs with toddlers. The concern of professional bodies such as the Association of Educational Psychologists (AEP) and the DECP is that the brains of very young children have not yet finished developing and toxic pharmaceuticals may harm their normal growth.’