April 10th 2000 - 11:50 p.m. BST
Updated - April 13th & 14th
The long awaited BBC TV Panorama program "Kids On Pills" was broadcast this evening and proved not to be so heavily critical of Ritalin and ADHD as so many had feared. It wasn't positive but wasn't too damaging either in our view. However, certain aspects were worrying e.g. the suggestion that side effects to Ritalin were severe and commonplace which is certainly not the case, otherwise the medication would have been withdrawn long ago. This aspect of the program formed part of the report in the Observer Newspaper on 9th April and our story on that can be read by clicking here.
Also as expected, Panorama researchers appeared to attempt to discredit Dr. David Foreman (for our previous article on Dr. Foreman click here) in spite of being supplied with full details of the diagnostic procedure followed by him when treating the 150 children in question. We understand that Dr. Foreman gave a full statement to Panorama, much of which they apparently decided to ignore. In contrast American psychiatrist Peter Breggin, M.D was given plenty of airtime on his theories surrounding ADHD, whilst nothing was mentioned about how these theories are hotly denied by many senior medical professionals in his own Country. Leading US ADHD specialist Dr. Russell Barkley, Director of Psychology and Professor of Psychiatry and Neurology at the University of Massachusetts Medical Center, said after reviewing Breggin's book "Talking Back to Ritalin: What Doctors Aren't Telling You About Stimulants for Children", "What was so dismaying to me as a professional by the end of the book was the knowledge that Dr. Breggin took an oath as a physician to "first, do no harm." In my opinion, his book has violated that sacred oath". Dr. Foreman has just given an exclusive interview to Health Reporter, Dave Blackhurst of the Sentinel newspaper. The report ends by saying "In the past two months, a number of parents have contacted the Sentinel to back Dr Foreman saying their children have benefited from Ritalin almost immediately". Panorama apparently decided that these parents weren't worth listening to.
It was also interesting to note that the time given to Dr. Peter Jensen of the New York State Psychiatric Institute/Columbia University in support of Ritalin was much less compared to Dr. Breggin. And yet Dr. Jensen was the only one to back up his side of the argument with hard evidence i.e. his study, "14-Month Randomized Clinical Trial of Treatment Strategies for AD/HD", published last December and performed by 6 independent research teams in collaboration with the Division of Services and Intervention Research, National Institute of Mental Health, and the Office of Special Education Programs, US Department of Education, Washington, DC. More information on the study can be found by clicking here.
Helen McDougal of Forth Valley ADD/ADHD Support Group, Scotland wrote to us saying: "On Tuesday morning I had 2 parents phone me very concerned about Ritalin and very much wanting to stop giving their children the medication. I tried to reassure them and told them to go back to their own specialist for further advice.
Ritalin does work as I can attest to. My friends say that since my daughter had meningitis I've become a very over protective parent and I would never give anything to my daughter if I was not 100% sure that the benefits outweighed the side effects, no matter who was recommending the medication.
Some of the members in my group use a combination of approaches. Ritalin combined with herbal remedies to help depression or aggression and also behavioural strategies to help organisational skills.
I found most of Panorama highly inflammatory and very frightening for any parent of a child very newly diagnosed or waiting for a diagnosis. There appeared to be more people speaking against Ritalin than for it. Even the parents who did say something positive then started to say how bad the side effects were, making it sound like side effects were to be expected with every child put on Ritalin. The specialist at the Stoke clinic did not appear to use any recognised diagnosing criteria i.e. Connors Rating scale when diagnosing these children, (Dr. Foreman did use Connors and other rating scales but the bias of the program shows that the two second, almost subliminal cut, of a behaviour chart was missed by most and no verbal mention was made of it - Ed) or neither was it shown how he decided the amount of medication each child should be given. There are recognised guidelines about the level of medication a child should receive.
Another point was not mentioned. That is if someone who knows about ADHD starts seeing children at a clinic then there is bound to be an increase in the diagnosing rate. Perhaps what happened before at Stoke was that no one previously knew very much about ADHD and rather than diagnose ADHD they said that it was something else.
People seeing this programme are now going to be prejudicial against all people with ADHD and ADD, labelling them as aggressive, antisocial misfits. As I say these kids are not problems but do get frustrated by the lack of understanding they experience. A few minutes spent talking to an ADHD child can make a big difference to that child and to your understanding about ADHD. These children are not thick, unteachable or social misfits, just misunderstood.
In Scotland recently we have had several news items discrediting Ritalin as some sort of demon addictive junkies drug. As anyone will know who has done research on it Ritalin is NOT addictive and the quantities of amphetamines are no where near the levels of speed etc.
I may be very new to ADHD, my daughter was only diagnosed last December, but I have very strong feelings about the problem.
Pamela from Dundee wrote to us saying...
I like many others watched Panorama last night and was slightly disturbed that some people were being given Ritalin instead of being properly seen by psychologists. I live in Dundee, I have two children. My daughter was diagnosed as having ADD and was put on Ritalin. However, we have not seen the psychologist since December last year, therefore the only control of her medication is through my husband and myself. Therefore Ritalin in my case is not properly monitored which as it should be as the program says. The psychologist has only visited the school once since she started taking the medication. The whole situation of kids and Ritalin should be properly administered. I believe that we should be campaigning for all kids to be reassessed as happened in one health authority- according to Panorama - to ensure kids are not taking too much medication.
Amanda Curry of the Sussex Downs ADHD Support Group UK said...
Re: Panorama 10th April: To the lay-man (and by that I mean someone who is either not ADHD aware or somebody who is unfamiliar with the very clever way that media, particularly television, operate, the programme on ADHD and the treatments of it WOULD have seem like a balanced view. However, it was NOT balanced and below, is a copy of the letter I sent to them explaining why it was an unfair representation. If you have taped the programme, watch it again yourselves - this time, take notes. There are many other instances in the programme like those I wrote about below. THEN, make up your minds again.................
TO: Panorama.BBC Television.
Dear Sir / Madam
Right, I have so many issues that I feel I really MUST put to you regarding your programme, I can only list a few. However, I do hope that you read them all and take each one seriously.
I am so very very angry at the way the programme was presented on ADHD and feel that the researcher was un-fair in her representation and extremely biased and one-sided. Here are some points raised in the programme:
It was mentioned that 2% in one school in America were on Ritalin:- The scientific evidence (that states approximately how many children suffer with ADHD) is suggested as being between 2 and 10%, so the number your quoted as being high, is actually BELOW the amount of children suffering with ADHD. Your researcher said that there is no evidence that children under 5 benefit from Ritalin - THERE IS EVIDENCE, the proof is in the pudding. I know several children and I have personally been amazed at the difference.
Your researcher said that children under 6 SHOULD NEVER HAVE BEEN ON MEDICATION - the reason, and the main reason that children under 6 are often NOT prescribed it, is due to the licensing laws in this country. How about you look at the licensing laws around medication to see what I mean? Your researcher often said "experts fear....." - what is fear often stemmed from? I would suggest that it is lack of knowledge about a given situation. Their fears have NO SCIENTIFIC GROUNDS.
Mr Baldwin - the supposed British Expert - I would suggest is no expert. Infact, quite often, it was only his 'opinion' that was given, never was it backed up by EVIDENCE, only his opinion each time.
Side effects of the medication were mentioned. There was NO MENTION however, of side effects that other medications have par-for-course. i.e. Ventolin / Antibiotics / Insulin etc etc. Without these drugs, many people would not survive at all, it can be like this for those with ADHD.
There is NO EVIDENCE to PROVE that dysfunctional families are to blame for ADHD - BAD BEHAVIOUR, YES MAYBE - BUT ADHD, NO, NO EVIDENCE. I certainly object to being hinted at as being a BAD PARENT and having POOR PARENTING SKILLS. I actually lecture on POSITIVE parenting, I am a GOOD parent, I have a stable and close family unit.
Why did your researcher keep saying that "others believe" when she never backed the comments that followed, up with any EVIDENCE - only opinion? I am unsure whether many parents, let alone teachers would feel that "not offering these children enough interesting things to do" is the result of these children's behaviour. I for one, find this a tremendous insult, both as a parent of two diagnosed children and as a professional that works with many. I speak to parents every day that have tried all they can for many many years before resulting to medication. Many many have a loving and supportive family unit and follow all expected guidelines on management, discipline and stimulation. Why did you keep filming parents saying "he was given......" and "they gave him.....drugs". ? The parents in ALL cases, administer the medication,. They have a choice NOT to medicate if they wish. NOBODY is force-fed their medication by a professional. Your researcher said at one point "he was weaned off drugs". Nobody had said this to her in the programme - another case of journalistic hype? For your information these tablets ARE NOT ADDICTIVE IN ANY WAY. Children do not need to be weaned off. This is NOT the form of DRUG taking that your researcher is implying. There is actually evidence to suggest that children diagnosed as ADHD and stabilised on medication can actually be prevented from turning to the more HARD STUFF TYPE OF DRUG.
The parent whose OPINION was that these drugs are "TOXIC" - was again a case of journalistic hype as it was a non-qualified persons viewpoint allowed to be screened.. Your researcher said "misdiagnosed" On what medical grounds does she make this claim???? How long has she been qualified to say such a thing? The fact that the said child was given medication before the age of six DOES NOT CONSTITUTE FOR A MISDIAGNOSIS - anyway, I notice that the very same parent only had her sons tablet reduced, she DID NOT say that he was then UNDIAGNOSED, and didn't refuse the pills. Hypocritical don't you think? YES IT IS UP TO PARENTS ACTUALLY - as parents, we have the final say. Along with the other mail that I sent you objecting to way your site represents the subject, I hope that you can see why I feel (as do many thousands of others) that your programme was unfair, biased, and based on lots of opinion, and little RESEARCH AND EVIDENCE.
By the way - the number put up at the end of the programme was 2 things in my opinion: (1) AN INSULT TO THE MANY MANY SUPPORT GROUPS OUT THERE WHO CAN GENUINELY HELP THESE PARENTS AND THEIR CHILDREN (2) UN-AVAILABLE! Infact the recorded message said, and I quote "The other caller has hung up"
ADHD is a MEDICAL, genetic condition with a neurological cause. There really should be no debate on whether it exists OR whether medication works (there is far too much supporting evidence) - only debate on whether the sceptical professionals should be 'allowed' to voice their DANGEROUS and convincing free speech to the lay-man who really knows no better and places a great deal of trust in them. What is really upsetting is that your researcher was given this scientific evidence and had access to reports on the numerous studies and research that has been done - why then, did she ignore it? Our job as parents (and professionals that work with these children) is hard enough thank you.
Finally, I would like to know what you are going to do, to rectify the areas outlined above. Isn't it your PUBLIC DUTY to give a fair and balanced view? Isn't it YOUR DUTY to ensure that the children in our country have the support and understanding from those around them - particularly those who should know better? I SUGGEST THAT IT IS - It is infact all of our duty to do the same.
Caroline Huish, Chair - Bristol Area, Family Support Group wrote to us saying...
Many of the local ADHD/ADD Family support groups were interviewed over the telephone by Lynn Railston, researcher for the Panorama Programme. Her loaded questions and aggressive tone, gave a lot of us the impression that the programme was going to be very negative regarding ADHD in general and in particular the administering of medications such as Ritalin.
In the television guides, the programme was described as giving drugs to children was an excuse for bad parenting and that families were trying to get the diagnosis for ADHD purely so that they could get Social Security Benefits!
So we were all extremely worried and concerned about the content of the programme. However, when it was aired on Monday evening, the impression that I was left with, was that the content of the programme was not too bad after all. There were certain aspects of it that really irritated me - that stupid woman at the end - in particular. But all in all it was pretty objective. It had the 'for' camp, versus the 'against camp' in reasonably equal quantities, and everyone managed to get their views across.
We all knew what Prof. Peter Breggin was going to say as he is on an ignorant crusade, but it was very sad and worrying to see that we have our own UK 'Breggin' in the form of Prof. Steve Baldwin. I feel that it is very important that he is made aware of all the facts and evidence regarding ADHD and the use of medication before he continues with his misinformed remarks.
Simon Hensby for ADDers.org