Connecticut Ritalin law targets schools, not docs

By Karen Pallarito

NEW YORK, Jul 25 (Reuters Health) - To reduce the inappropriate medication of children with behavioral problems, a new Connecticut law takes aim at the schoolhouse.

The measure allows school medical staff to recommend that a child see a medical practitioner and with parents' consent, teachers may consult with a child's doctor. But it specifically forbids teachers, school psychologists and other school officials from recommending that a child be prescribed a psychotropic drug.

Connecticut is the first state in the nation to pass a law targeting the alleged practice by some school personnel of suggesting that an unruly student take methylphenidate, which is most commonly known as Ritalin.

"If the diagnosis is made and it's an appropriate diagnosis that Ritalin be used, that's fine," said Rep. Lenny Winkler, lead sponsor of the measure. "But I have also heard of many families approached by the school system that their child cannot attend school if they're not put on Ritalin," she told Reuters Health.

Winkler, a Republican legislator who also works as an emergency room nurse, has seen "more and more children on Ritalin, Prozac, Zoloft, Haldol, Thorazine...which has really taken me aback completely."

The problem is nationwide, she added, and many professionals agree.

"Right now, parents and teachers are putting a lot of pressure on professionals to throw some Ritalin at kids," Dr. Janice Hutchinson, a Washington, DC-based pediatrician and child psychiatrist, told Reuters Health. "I understand the frustrations that parents and teachers have with a child that cannot attend, that cannot listen...but these kids need more than [a] kind of an armchair diagnosis of ADHD (attention-deficit/hyperactivity disorder) plus Ritalin for treatment," she said.

Hutchinson said the Connecticut law is fair because it means a child "is going to have a thorough evaluation by the appropriate professional."

The National Education Association does not take a position on the issue, but Kevin Dwyer, past president of the National Association of School Psychologists, told Reuters Health that the law seems "somewhat redundant" since only physicians are licensed to prescribe a medication.

"I don't perceive it as a necessary law," he said. It should be the responsibility of school psychologists and principals to say what teachers should and should not do, he added.

Dwyer, who currently serves as senior adviser for prevention and children's mental health with National Mental Health Association in Alexandria, Virginia, agrees that it is not only improper for teachers to recommend that children take Ritalin, it is potentially detrimental.

Indeed, professionals agree that without a proper diagnosis, it is impossible to tell whether a child who is acting out in class is suffering from attention-deficit/hyperactivity disorder or some other medical, psychological or social problem.

Having served as a member of a board of education, Winkler insists that she holds educators in the highest regard. Despite what critics contend, she still believes the law is a necessary one. Since the law's enactment in June, Winkler has received calls from legislators in several states interested in passing a similar ban.

Physicians should not be prescribing drugs without a thorough diagnosis, but teachers should not be setting the stage by telling the parent "that Johnny has a problem and Johnny needs to be put on Ritalin," she said.

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