The Age

One in 40 children drugged: survey

By Julie Robotham
The Age (Melbourne)
July 1 2002

One in 40 Australian children has received medication for emotional or behavioural problems, according to the first comprehensive national survey on the issue.

Ritalin and similar behaviour-modifying drugs, used to control attention deficit hyperactivity disorder (ADHD), were overwhelmingly the most common. The disorder is believed to affect 11 per cent of children, and the new survey found 13 per cent of those were taking stimulants.

But of all the children identified as taking stimulant medicines, one in four did not have a diagnosis of the disorder. Instead, they were taking the drugs for other problems such as autism or aggressive behaviour.

"Regrettably, ADHD medication doesn't fix aggression, it doesn't fix most of the other problems," said the study's coauthor, Joseph Rey, professor of child and adolescent psychiatry at the University of Sydney.

Medication was clearly valuable in children with severe ADHD, in which both poor concentration and over-activity were present. But the diagnosis had recently been expanded to include poor concentration or impulsive behaviour alone.

"Should all those kids be treated? . . . a child who has his or her head in the clouds could be for a variety of reasons that may not be ADHD," Professor Rey said.

The value of stimulant drugs in the inattentive-only version of the disorder was unproven, he said, but the drugs would certainly boost the concentration of any child or adult. That could raise the spectre of parents seeking the diagnosis of a disorder in order to improve a child's academic performance.

The study - an offshoot of the the Commonwealth-funded Australian National Survey of Mental Health and Wellbeing - sampled a representative group of almost 3600 children, aged six to 17 years, whose parents completed detailed interviews.

It found boys with ADHD were at least twice as likely as girls to be treated with Ritalin or dexamphetamine, the other major drug in the category, and up to six times as likely if their condition largely showed up as inattentive behaviour. Younger boys with the condition were also more likely to be prescribed the drugs.

Seventeen per cent of those aged six to 12 were on medication compared with 12 per cent of 13 to 17 year olds. But the situation was reversed for girls. In the younger age group, four per cent of girls were on stimulants, compared with 10 per cent of adolescent girls with ADHD.

Children taking Ritalin were more likely to be from low-income families with less-educated parents, perhaps because the disorder was more common in some social groups, said the study's lead author, Professor Michael Sawyer, head of child and adolescent psychiatry at the University of Adelaide.

But, he said, it also raised the question of whether "children (are) being treated with stimulants because they have a condition that might respond to them, or because they conform to particular demographic characteristics".

"What we want to know next is, amongst those children who receive medication, what dosage do they receive, over what period of time?" he said.

Copyright 2002 The Age Company Ltd.