Yale, New York University and University of Wisconsin Madison study: More ADHD medication given during school term to lower status children

16 Oct

Carolyne Gregoire reported in the Huffington Post article, American Teens Are Even More Stressed Than Adults:

Last year, the American Psychological Association’s Stress in America survey found that Millennials, aged 18-33, were the country’s most-stressed generation. Now, the title belongs to an even younger demographic: American teenagers.
Even before the pressures of work and adulthood set in, for most young Americans, stress has already become a fact of daily life. And this sets the stage early for unhealthy behaviors and lifestyle choices that may increase the risk of developing stress-related health problems down the road.
American teenagers are now the most stressed-out age group in the U.S., according to APA’s 2013 Stress In America survey. While adults rate their stress at a 5.1 on a 10-point scale, teens rate their stress levels at 5.8…… http://www.huffingtonpost.com/2014/02/11/american-teens-are-even-m_n_4768204.html?utm_hp_ref=email_share

Quite often stress and depression in children is treated with medication.

Science Tech Daily reported in the article, Study Finds Stimulant Use Increases by 30% During the School Year:

New research from Yale, NYU and the University of Wisconsin-Madison shows that students are 30% more likely to take a stimulant medication during the school year than they are to take one during the summer.
The authors found that school-year increases in stimulant use are largest for children from socioeconomically advantaged families. Because many children use stimulants only during the school year and take a “drug holiday” in the summer, the authors conclude that these children are using stimulants to manage their schools’ academic demands.
Stimulant medications, which improve concentration and help manage other symptoms associated with attention-deficit hyperactivity disorder (ADHD), are the most widely used class of medications among adolescents. Childrens’ use of these medications in the United States has increased dramatically in the last two decades, from approximately 2.4% of children in 1996 to 6% of children at present…. http://scitechdaily.com/study-finds-stimulant-use-increases-30-school-year/

Citation:

Medical Adaptation to Academic Pressure
Schooling, Stimulant Use, and Socioeconomic Status
1. Marissa D. Kinga
2. Jennifer Jenningsb
3. Jason M. Fletcherc
1. aYale School of Management
2. bNew York University
3. cUniversity of Wisconsin-Madison
1. Marissa King, Yale School of Management, 165 Whitney Avenue, New Haven, CT 06511 E-mail: marissa.king@yale.edu
Abstract
Despite the rise of medical interventions to address behavioral issues in childhood, the social determinants of their use remain poorly understood. By analyzing a dataset that includes the majority of prescriptions written for stimulants in the United States, we find a substantial effect of schooling on stimulant use. In middle and high school, adolescents are roughly 30 percent more likely to have a stimulant prescription filled during the school year than during the summer. Socioeconomically advantaged children are more likely than their less advantaged peers to selectively use stimulants only during the academic year. These differences persist when we compare higher and lower socioeconomic status children seeing the same doctors. We link these responses to academic pressure by exploiting variation between states in educational accountability system stringency. We find the largest differences in school year versus summer stimulant use in states with more accountability pressure. School-based selective stimulant use is most common among economically advantaged children living in states with strict accountability policies. Our study uncovers a new pathway through which medical interventions may act as a resource for higher socioeconomic status families to transmit educational advantages to their children, either intentionally or unwittingly.

Here is the synopsis from Yale Insights:

Medicate to Educate: Study Finds Stimulant Use Increases by 30% During the School Year
Marissa D. King — October 2014
Children are 30% more likely to take a stimulant medication during the school year than they are to take one during the summer, according to a new study published in the American Sociological Review. The authors found that school-year increases in stimulant use are largest for children from socioeconomically advantaged families. Because many children use stimulants only during the school year and take a “drug holiday” in the summer, the authors conclude that these children are using stimulants to manage their schools’ academic demands.
Stimulant medications, which improve concentration and help manage other symptoms associated with attention-deficit hyperactivity disorder (ADHD), are the most widely used class of medications among adolescents. Childrens’ use of these medications in the United States has increased dramatically in the last two decades, from approximately 2.4% of children in 1996 to 6% of children at present.
Larger school-year increases in stimulant use were found in states with higher levels of accountability pressure, suggesting that education policies impact stimulant use. Children from families who are not poor and live in states with more strict standardized-testing and school-accountability environments are much more likely to use stimulants only during the school year compared to their less economically advantaged peers in states with less stringent accountability environments.
“Many parents are faced with a tough decision: Do they medicate their kids to help them manage in an increasingly demanding school environment?” said Marissa King, assistant professor of organizational behavior at the Yale School of Management and lead author of the study. “Rather than trying to make kids conform to the school system by taking stimulants, we need to take a closer look at what is happening in schools.”
To examine the effect of schooling on stimulant use, King and her colleagues analyzed a data set including the majority of prescriptions written for stimulants in the United States during the 2007-2008 academic year. They linked the patterns of stimulant use during the school year to academic pressure by analyzing state rankings of school-accountability policies published by Education Week. Differences in school year and summer use could not be explained by avoidance of medication side effects, medication cost, or type of ADHD.
The researchers also examined the influence of doctors on school-based stimulant use to determine whether the socioeconomic differences they observe occur because more- and less-advantaged children see different doctors. Even when children from more- and less-advantaged backgrounds were treated by the same doctor, children from more-advantaged backgrounds were more likely to use stimulants only during the school year. This suggests that socioeconomic differences in school-based stimulant use are driven by parents, not doctors. “Socioeconomically advantaged families are more likely to trust their own judgment about medication decisions rather than defer to their doctors,” said King.
The researchers say that the study suggests that medical interventions like stimulant use may be a new pathway through which more advantaged parents translate their economic advantages into educational advantages for their children, either intentionally or unwittingly.
“Medical Adaptation to Academic Pressure: Schooling, Stimulant Use, and Socioeconomic Status,” by Marissa King (Yale School of Management), Jennifer Jennings (New York University), and Jason Fletcher (University of Wisconsin-Madison), is published in the American Sociological Review.
http://insights.som.yale.edu/insights/medicate-educate-study-finds-stimulant-use-increases-30-during-school-year

Paul Tough wrote a very thoughtful New York Times piece about the importance of failure in developing character, not characters.
In What If the Secret to Success Is Failure? Tough writes:
Dominic Randolph can seem a little out of place at Riverdale Country School — which is odd, because he’s the headmaster. Riverdale is one of New York City’s most prestigious private schools, with a 104-year-old campus that looks down grandly on Van Cortlandt Park from the top of a steep hill in the richest part of the Bronx. On the discussion boards of UrbanBaby.com, worked-up moms from the Upper East Side argue over whether Riverdale sends enough seniors to Harvard, Yale and Princeton to be considered truly “TT” (top-tier, in UrbanBabyese), or whether it is more accurately labeled “2T” (second-tier), but it is, certainly, part of the city’s private-school elite, a place members of the establishment send their kids to learn to be members of the establishment. Tuition starts at $38,500 a year, and that’s for prekindergarten.
Randolph, by contrast, comes across as an iconoclast, a disrupter, even a bit of an eccentric. He dresses for work every day in a black suit with a narrow tie, and the outfit, plus his cool demeanor and sweep of graying hair, makes you wonder, when you first meet him, if he might have played sax in a ska band in the ’80s. (The English accent helps.) He is a big thinker, always chasing new ideas, and a conversation with him can feel like a one-man TED conference, dotted with references to the latest work by behavioral psychologists and management gurus and design theorists. When he became headmaster in 2007, he swapped offices with his secretary, giving her the reclusive inner sanctum where previous headmasters sat and remodeling the small outer reception area into his own open-concept work space, its walls covered with whiteboard paint on which he sketches ideas and slogans. One day when I visited, one wall was bare except for a white sheet of paper. On it was printed a single black question mark.
For the headmaster of an intensely competitive school, Randolph, who is 49, is surprisingly skeptical about many of the basic elements of a contemporary high-stakes American education. He did away with Advanced Placement classes in the high school soon after he arrived at Riverdale; he encourages his teachers to limit the homework they assign; and he says that the standardized tests that Riverdale and other private schools require for admission to kindergarten and to middle school are “a patently unfair system” because they evaluate students almost entirely by I.Q. “This push on tests,” he told me, “is missing out on some serious parts of what it means to be a successful human.”
The most critical missing piece, Randolph explained as we sat in his office last fall, is character — those essential traits of mind and habit that were drilled into him at boarding school in England and that also have deep roots in American history. “Whether it’s the pioneer in the Conestoga wagon or someone coming here in the 1920s from southern Italy, there was this idea in America that if you worked hard and you showed real grit, that you could be successful,” he said. “Strangely, we’ve now forgotten that. People who have an easy time of things, who get 800s on their SAT’s, I worry that those people get feedback that everything they’re doing is great. And I think as a result, we are actually setting them up for long-term failure. When that person suddenly has to face up to a difficult moment, then I think they’re screwed, to be honest. I don’t think they’ve grown the capacities to be able to handle that….” http://www.nytimes.com/2011/09/18/magazine/what-if-the-secret-to-success-is-failure.html?emc=eta1&_r=0
Because of high stakes testing, it appears that poorer children are being given medication because of educational policy issues like having a school or district appear to succeed in a testing environment, rather than the particular need of the child.

Related:

Schools have to deal with depressed and troubled children https://drwilda.wordpress.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

School psychologists are needed to treat troubled children https://drwilda.wordpress.com/2012/02/27/school-psychologists-are-needed-to-treat-troubled-children/

Battling teen addiction: ‘Recovery high schools https://drwilda.wordpress.com/2012/07/08/battling-teen-addiction-recovery-high-schools/

Resources:
Psych Central’s Depression In Young Children http://psychcentral.com/news/2010/05/20/depression-in-young-children/13970.html

WebMD’s Depression In Children http://www.webmd.com/depression/guide/depression-children

Healthline’s Is Your Child Depressed? http://www.healthline.com/hlvideo-5min/how-to-help-your-child-through-depression-517095449

Medicine.Net’s Depression In Children http://www.medicinenet.com/depression_in_children/article.htm

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