I am usually a quiet observer on this list and let many controversial posts
go by without commenting but I feel that I cannot remain silent now.



I am not a physician. I do not prescribe Ritalin or any other medication.
However, I have many years of experience working with children and parents
with ADHD. The decision to medicate a child is a very difficult one. It is
also a very personal decision, that each family makes after doing research
and getting advice from professionals they trust. The decision to medicate a
pre-schooler is even more difficult.



In the medical community in Israel, there is a strong hesitation to medicate
a child under age 6 with Ritalin. BUT when it is recommended it is because
the child’s attention deficit disorder is affecting so many areas of his
life and his ability to function and learn. It is not used to control
difficult but “typical preschool behavior”.



I personally have seen several preschoolers who were unable to socialize,
learn or gain essential preschool skills, some learning in regular education
and some in special education settings. Once on appropriate medication,
these children were able to finally begin to learn, make friends and enjoy
preschool.



I am not advocating medicating preschoolers. I am advocating supporting the
parents who have made this difficult decision because it is what their child
needs.



Ziva Schapiro, OTR

Director

Mercaz Rakefet Child Development Center

Zeelim 6, Ramat Bet Shemesh A

phone- 02-992-0947

fax- 02-992-0948

www.mercazrakefet.co.il



Mercaz Rakefet is now a non-profit organization dedicated to providing
quality child development services to all children in the Bet Shemesh and
greater Jerusalem area, regardless of their ability to pay.

_____

From: ADD_ADHD_LD@yahoogroups.com [mailto:ADD_ADHD_LD@yahoogroups.com] On
Behalf Of Nachum
Sent: Tuesday, November 14, 2006 1:21 AM
To: ADD_ADHD_LD@yahoogroups.com
Subject: [ADD_ADHD_LD] Popular ADHD drug Ritalin safe and effective for
pre-schoolers



If you have seen this headline recently(as I have) please read the
following article from the HSINewsletter
Nachum

What are the symptoms of being a preschooler? Parents need to be on
the alert for these six warning signs that their child is being
childlike:
A tendency to color outside the lines
A desire to sing favorite songs over and over and over again
Refusal to mask grumpiness after naps
Sometimes "unable" to hear parents speaking
Organizationally challenged
No hesitation to pout, cry, or scream in public places
If you notice any of these symptoms (sometimes all within the same
hour) then you have a typical preschooler. But don't worry. All these
symptoms can be easily smoothed over, creating a sort of
permanent "time out"...as long as you're okay with giving your three-
year-old a powerful prescription drug.

--------------------------------------------
Don't make me stop this car
--------------------------------------------

I don't know what's more disturbing; the fact that Columbia
University recently conducted a Ritalin study on 300 children aged
three to five, or the fact that so many parents were willing to allow
their preschoolers to be medicated.

Ritalin, of course, is the attention-deficit/hyperactivity disorder
(ADHD) drug that's been approved by the FDA for use in children age
six and above.

But why wait until a child is six? Ask any parent: Ages three through
five are often just as challenging as the terrible twos. So, gee,
wouldn't it be nice to just pop a pill in your little tyke and undo
all the tantrums, crying jags, and incessant demands?

Half of the kids in the Columbia study were given low doses of
Ritalin and half received a placebo. In the November 2006 issue of
the Journal of the American Academy of Child and Adolescent
Psychiatry, the authors write that Ritalin "produced significant
reductions on ADHD symptom scales in preschoolers compared to
placebo."

Such as it is, that's the good news.

--------------------------------------------
Safety net
--------------------------------------------

Now for the bad news, which is all about adverse events (AE). The
study authors note: "Thirty percent of parents spontaneously reported
moderate to severe AEs in all study phases after baseline. These
included emotional outbursts, difficulty falling asleep, repetitive
behaviors/thoughts, appetite decrease, and irritability."

Arguably, the most unsettling item on this list is "difficulty
falling asleep." Have you ever known a three-year-old with insomnia?

But here's the kicker. Some media outlets actually portrayed the
results as safe! Here are headlines from two different sources:

"Ritalin Safe for Hyperactive Preschoolers"

"Popular ADHD drug Ritalin safe and effective for pre-schoolers"

What are they thinking? Nearly ONE THIRD of the medicated kids had
adverse events. How can anyone interpret that as safe?

Eleven percent of the children in the medication group were pulled
out of the study because of unfavorable side effects. I wonder...if
we checked with the parents of those kids, do you suppose they would
describe this drug as safe for a three-year-old?





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