Seeking straight A's, parents push for pills

Seeking straight A's, parents push for pills

http://www.msnbc.msn.com/id/14590058/

Pediatricians report increasing requests for 'academic doping'
By Victoria Clayton
MSNBC contributor

Updated: 10:16 a.m. CT Sept 7, 2006

A 15-year-old girl and her parents recently came in for a chat with Dr.
James Perrin, a Boston pediatrician, because they were concerned about
the girl's grades. Previously an A student, she was slipping to B's,
and the family was convinced attention deficit hyperactivity disorder
was at fault - and that a prescription for Ritalin would boost her
brainpower.

After examining the girl, Perrin determined she didn't have ADHD. The
parents, who had come in demanding a prescription, left empty-handed.

Perrin, a professor of pediatrics at Harvard Medical School and
spokesperson for the American Academy of Pediatrics, and other
physicians say this is an increasingly common scenario in doctors'
offices around the country, though there are no hard statistics on it.

Parents want their kids to excel in school, and they've heard about the
illegal use of stimulants such as Ritalin and Adderall for "academic
doping." Hoping to obtain the drugs legally, they pressure
pediatricians for them. Some even request the drugs after openly
admitting they don't believe their child has ADHD.

"I spoke with [some] colleagues the other day and they mentioned
three cases recently where parents blatantly asked for the medication
so that their children would perform better in school, yet there were
no other indications that the child had ADHD," says Dr. Nick Yates, a
pediatrician and director of medical ethics for Mercy Hospital in
Buffalo, N.Y.

"I'm very concerned that there's a fair amount - and we don't
know how much - [of ADHD drugs] being prescribed and used for
off-label purposes," says Yates.

Academic doping - using these stimulant prescriptions in an effort to
enhance focus, concentration and mental stamina - first started on
college campuses, especially Ivy League and exclusive, competitive
schools. Now, the problem is filtering down to secondary schools, Yates
says, and more parents are playing a role in obtaining prescription
ADHD medication for their teenagers.

Yates isn't entirely surprised that parents ask for it. He believes
that most families simply have a heartfelt - if shockingly
misdirected - desire for their children to do their best.

Parents can be overly eager to blame poor grades on a medical condition
rather than looking for other explanations, says Dr. Michael Rater,
medical director of the Adolescent and Residential Treatment Program at
McLean Hospital in Belmont, Mass. "It's usually that parents are
just trying to understand their children's struggles in a narrative
that makes sense to them," he says.

Yet some parents will do whatever it takes to keep opportunities from
slipping through a child's fingers - even outright lying to doctors
to get the drugs, says Rater.

And some pill-eager parents aren't just seeking to level the playing
field, they're trying to make their kids superstars, says Dr. Martin
Stein, a professor of clinical pediatrics at University of California,
San Diego.

"I see patients who come from privileged backgrounds and lower-level
economic backgrounds and there's a tremendous difference in parental
expectations," Stein says.

Privileged kids tend to have parents who will push them to be the
academic cream of the crop and when they aren't, they'll start
looking for reasons why, he says. "I tell them that honor roll, a
merit scholarship or acceptance in an Ivy League school is not the end
point. That would be poor medicine."

Safety issues

The concerns with academic doping aren't just ethical.

"The medications in general have a long safety record for people who
need them but when you use a drug for off-label purposes, there are
additional safety concerns," says Yates.

Although doctors generally agree that side effects from the medications
are minimal for most kids, there is an extensive, and sometimes
frightening, list of possibilities.

Commonly reported side effects include difficulty sleeping, loss of
appetite, irritability, stomachaches, headaches, blurry vision, nausea,
dizziness, drowsiness and tics and tremors. There have been concerns
that ADHD medication temporarily delays growth, and one study found
that up to 5 percent of children experience tactile hallucinations,
often involving a sensation that bugs or snakes are crawling on their
bodies. The FDA recently announced that certain ADHD drugs should
caution users about the risks of serious heart problems and psychotic
behavior.

A 2004 rat study conducted by the National Institutes of Health and
McLean Hospital/Harvard Medical School suggested that children who take
prescription drugs for ADHD but do not have the disorder may be at
higher risk for developing depressive symptoms in adulthood. The study
was particularly looking at the issue of misdiagnosis but it raises
obvious concerns for the future of young people who are electing to
take the medicine for no other reason than to do well in school.

In addition, Yates says that possible dependency issues, either
psychological or physical, could occur when the drugs are being
misused. It's widely acknowledged that some kids abuse the drugs to
get high. The pills are often crushed and snorted or even injected.

Searching out other explanations

While ADHD drugs aren't a quick fix for a lackluster report card, Stein
says that poor academic performance is cause for investigation -
sometimes for ADHD but also for a host of other problems. "If it was
brought to my attention that someone's grades were going down even to
B's I would start looking at the whole picture," he says.

Stein says there are a variety of learning disabilities and myriad
situations that are not medical but still may have an impact on a
child's academic performance.

"It could also be something situational like a divorce or a
relationship with another person this kid is having," he says. "It
could be that a parent has lost a job and there's financial stress in
the family."

Depression, anxiety and other mental disorders might also be at work.

"ADHD is only one of the possibilities, and I make a point to put
that at the end," says Stein.

Perrin says he's particularly skeptical when he's treated a patient
for many years and attention problems are only brought up once the
child reaches high school. The 15-year-old girl in question, for
example, had been his patient for more than a decade. He concluded that
she was just a normal teen experiencing the distractions - sports,
boys, friends - that teens experience.

He said that even if he had ultimately determined that the girl had
ADHD, medication would not have been a speedy remedy. "True ADHD is
not something that is dealt with quickly," he says.

Scrupulous doctors, Perrin says, will take numerous office visits and
much investigation before diagnosing the problem. And, if ADHD is
diagnosed, they will not just prescribe medication. They'll also
prescribe behavioral therapy (sometimes for the entire family) and
recommend fairly significant changes in the child's home and learning
environment.

Furthermore, doctors warn that if a kid doesn't have ADHD, the
benefit from taking the drugs is unpredictable and, despite the lore,
most likely extremely modest. Parents of unmotivated kids may be
particularly disappointed.

"One of the biggest problems in adolescent mental health is
motivation," says Rater. "And this medication doesn't effect
motivation. If a kid is not all that motivated, it's really not going
to help."

---
Victoria Clayton is a freelance writer based in California and
co-author of "Fearless Pregnancy: Wisdom and Reassurance from a Doctor,
a Midwife and a Mom," published by Fair Winds Press.

In article .com,
Fred Goodwin, CMA wrote:
Seeking straight A's, parents push for pills

http://www.msnbc.msn.com/id/14590058/

Pediatricians report increasing requests for 'academic doping'
By Victoria Clayton
MSNBC contributor

Updated: 10:16 a.m. CT Sept 7, 2006

A 15-year-old girl and her parents recently came in for a chat with Dr.
James Perrin, a Boston pediatrician, because they were concerned about
the girl's grades. Previously an A student, she was slipping to B's,
and the family was convinced attention deficit hyperactivity disorder
was at fault - and that a prescription for Ritalin would boost her
brainpower.

After examining the girl, Perrin determined she didn't have ADHD. The
parents, who had come in demanding a prescription, left empty-handed.

Perrin, a professor of pediatrics at Harvard Medical School and
spokesperson for the American Academy of Pediatrics, and other
physicians say this is an increasingly common scenario in doctors'
offices around the country, though there are no hard statistics on it.

Parents want their kids to excel in school, and they've heard about the
illegal use of stimulants such as Ritalin and Adderall for "academic
doping." Hoping to obtain the drugs legally, they pressure
pediatricians for them. Some even request the drugs after openly
admitting they don't believe their child has ADHD.

I suggest that grades be abolished, except for advisory
purposes. Also, it should be understood that getting a
high grade and learning the important material may well
be at odds with each other.

Furthermore, I see nothing wrong with signing up for a
course and then deciding it is not worth completing. I
see nothing wrong with collecting a lot of D's and F's;
the straight-A student tends to be weak and shallow in
the important things.
--
This address is for information only. I do not claim that these views
are those of the Statistics Department or of Purdue University.
Herman Rubin, Department of Statistics, Purdue University
Phone: (765)494-6054 FAX: (765)494-0558

Herman Rubin wrote:

Furthermore, I see nothing wrong with signing up for a
course and then deciding it is not worth completing. I
see nothing wrong with collecting a lot of D's and F's;
the straight-A student tends to be weak and shallow in
the important things.

Would such a student be accepted at, say, Purdue, to major in, say,
statistics?

In article . com,
Fred Goodwin, CMA wrote:
Herman Rubin wrote:

Furthermore, I see nothing wrong with signing up for a
course and then deciding it is not worth completing. I
see nothing wrong with collecting a lot of D's and F's;
the straight-A student tends to be weak and shallow in
the important things.

Would such a student be accepted at, say, Purdue, to major in, say,
statistics?

We do have statistics major, but I would not recommend
someone with ability to do so, unless it was a joint
major with mathematics.

The admissions department probably would look on such
a record with disfavor; however, if the SATs, in
particular the math one, were good, direct communication
to the department might get results.

Many high schools will not reveal grades or GPAs or
class ranks to universities, including most of the
good ones in Indiana. In that case, the admissions
department, of whatever school, would not know about
those poor grades.

What we really need for university admission, and even
for high school graduation, is a comprehensive examination
of sufficient length, with no multiple choice questions,
and examining understanding.


--
This address is for information only. I do not claim that these views
are those of the Statistics Department or of Purdue University.
Herman Rubin, Department of Statistics, Purdue University
Phone: (765)494-6054 FAX: (765)494-0558

Herman Rubin wrote:
In article . com,
Fred Goodwin, CMA wrote:
Herman Rubin wrote:


What we really need for university admission, and even
for high school graduation, is a comprehensive examination
of sufficient length, with no multiple choice questions,
and examining understanding.

What is sufficient length? A 3-hour exam in each of English,
Foreign Language, Math, History, Government, Biology, Chemistry,
Physics, Art, Music, Phys Ed etc. etc?
You would also need exams for many *different* foreign languages...
Most states have a Phys Ed requirement for graduation.

Where are Universities going to get the money to pay for people
(or even find enough people) to grade these exams? Ditto for
high schools?

What consitutes a "comprehensive" exam? Not all students study
all material to the same depth. Would you expect that someone planning
to be a music major study math, chemistry and physics to the same
extent as a potential physics major? Or vice versa? You would have
to have *many* different exams depending on the type of program
followed
in high school. This would be prohibitive to administer.

The alternative "one size fits all" comprehensive exam would either
set
the bar too low, or not properly separate the students applying to
Princeton
from the students applying to Podunk University. Or do you propose a
separate exam for each college? Now we are REALLY talking about
"expensive"!!

"Pubkeybreaker" wrote in message
oups.com...

Herman Rubin wrote:
In article . com,
Fred Goodwin, CMA wrote:
Herman Rubin wrote:


What we really need for university admission, and even
for high school graduation, is a comprehensive examination
of sufficient length, with no multiple choice questions,
and examining understanding.

What is sufficient length? A 3-hour exam in each of English,
Foreign Language, Math, History, Government, Biology, Chemistry,
Physics, Art, Music, Phys Ed etc. etc?
You would also need exams for many *different* foreign languages...
Most states have a Phys Ed requirement for graduation.

Where are Universities going to get the money to pay for people
(or even find enough people) to grade these exams? Ditto for
high schools?

What consitutes a "comprehensive" exam? Not all students study
all material to the same depth. Would you expect that someone planning
to be a music major study math, chemistry and physics to the same
extent as a potential physics major? Or vice versa? You would have
to have *many* different exams depending on the type of program
followed
in high school. This would be prohibitive to administer.

The alternative "one size fits all" comprehensive exam would either
set
the bar too low, or not properly separate the students applying to
Princeton
from the students applying to Podunk University. Or do you propose a
separate exam for each college? Now we are REALLY talking about
"expensive"!!

Well, this is what schools of music do, both at the baccalaureate and
post-baccalaureate levels. You do an audition/interview and take tests in
theory and literature (and, depending on the major, a scholarly writing
sample), which determine not only your admission but your placement. Most
good music schools do not accept the Music AP exams or the GRE as valid for
people majoring in the field and prefer to do their own testing, and even
the SAT/ACT is very secondary to the student's interview when it comes to
getting accepted to the school of music, although it may come into play in
getting into the college or university hosting the program. The real expense
comes to the parents and the student, who have to travel to do these
placement interviews/auditions on site instead of just sending in an
application.

I strongly suspect that an oral exam/discussion given 1-1 would have much
the same benefit a music audition/interview does, if schools decided to do
it that way.

In article .com,
Pubkeybreaker wrote:

Herman Rubin wrote:
In article . com,
Fred Goodwin, CMA wrote:
Herman Rubin wrote:


What we really need for university admission, and even
for high school graduation, is a comprehensive examination
of sufficient length, with no multiple choice questions,
and examining understanding.

What is sufficient length? A 3-hour exam in each of English,
Foreign Language, Math, History, Government, Biology, Chemistry,
Physics, Art, Music, Phys Ed etc. etc?
You would also need exams for many *different* foreign languages...
Most states have a Phys Ed requirement for graduation.

Three hours is unlikely to be long enough. And Phys Ed is
essentially an attendance and participation requirement,
with essentially no subject matter.

Where are Universities going to get the money to pay for people
(or even find enough people) to grade these exams? Ditto for
high schools?

Britain seems to be able to find enough for their sixth
form exams.

What consitutes a "comprehensive" exam? Not all students study
all material to the same depth. Would you expect that someone planning
to be a music major study math, chemistry and physics to the same
extent as a potential physics major? Or vice versa? You would have
to have *many* different exams depending on the type of program
followed
in high school. This would be prohibitive to administer.

It is not "depth" but understanding which needs to be tested.
Someone who understands can use it, even if the manipulations
turn out to be difficult. The universal math requirement for
graduation should be the understanding of the numbers up to
the real numbers, formulation of word problems, and understanding
of what proofs are. For those who will be doing mathematics,
some facility in solving problems and producing proofs is needed.
These are weaker than the English requirements, of which reading
and writing fiction is a major part.

The alternative "one size fits all" comprehensive exam would either
set
the bar too low, or not properly separate the students applying to
Princeton
from the students applying to Podunk University. Or do you propose a
separate exam for each college? Now we are REALLY talking about
"expensive"!!

Not really. One examines in the subjects submitted. Each
university would use its evaluations of the results, just
as they do now for the other evidence submitted.

And if Podunk offers a course which Princeton offers, it
should be equivalent. Only absolute grades are meaningful.

--
This address is for information only. I do not claim that these views
are those of the Statistics Department or of Purdue University.
Herman Rubin, Department of Statistics, Purdue University
Phone: (765)494-6054 FAX: (765)494-0558

Herman Rubin wrote:

Furthermore, I see nothing wrong with signing up for a
course and then deciding it is not worth completing. I
see nothing wrong with collecting a lot of D's and F's;
the straight-A student tends to be weak and shallow in
the important things.

Interesting, and if such a student were to attend college and have that
same attitude about his/her school work and then earn a bunch of D's or
F's, don't you think it is a safe assumption that the student will be
placed on academic probation or suspension? So, there are consequences
to being a slackard.

Many high schools will not reveal grades or GPAs or
class ranks to universities, including most of the
good ones in Indiana. In that case, the admissions
department, of whatever school, would not know about
those poor grades.


I work in the admissions office at a large public university and I can
tell you, the high school students who apply at our university are
required to provide high school transcripts with their applications.
These transcripts *do* reveal grades and GPAs. Many provide class
rank. We probably only receive one or two transcripts a year from high
schools that do not grade their students. However, they will provide a
course description of each course that they student took and then a
notation beside it that says "if the student were to receive a grade in
this course, he/she would have earned an 'A'or 'B' or whatever." So
I'm doubtful that there are really that many students who don't have
grades or gpa's recorded on their transcripts. Even the homeschooled
kids have grades recorded on their transcripts. Of course, they're all
A's. ;-)

lisa



What we really need for university admission, and even
for high school graduation, is a comprehensive examination
of sufficient length, with no multiple choice questions,
and examining understanding.


--
This address is for information only. I do not claim that these views
are those of the Statistics Department or of Purdue University.
Herman Rubin, Department of Statistics, Purdue University
Phone: (765)494-6054 FAX: (765)494-0558

karlisa wrote:
snipped
Even the homeschooled
kids have grades recorded on their transcripts. Of course, they're all
A's. ;-)



Interesting. I know a lot of homeschooled kids, including mine, who
*don't* have all A's. :-)

AAMOF, my two youngest both got B's and C's in their biology and
chemistry courses, because they didn't study enough. YD go a B in
biology and a C in chemistry; and YS got a B in chemistry and a C in
biology. Neither of them is earning an A in their required budgeting
and finances course, either.

Kitten

karlisa wrote:
Herman Rubin wrote:

Furthermore, I see nothing wrong with signing up for a
course and then deciding it is not worth completing. I
see nothing wrong with collecting a lot of D's and F's;
the straight-A student tends to be weak and shallow in
the important things.

Interesting, and if such a student were to attend college and have that
same attitude about his/her school work and then earn a bunch of D's or
F's, don't you think it is a safe assumption that the student will be
placed on academic probation or suspension? So, there are consequences
to being a slackard.

It depends though, doesn't it? One option for the students is to only
start classes of they think they can get an A on it (ie deliberately
*not* stretching themselves). Another is to start several more classes,
and drop the worst subjects or the subjects they dislike after they
have tried it. So they might end up with 2 As, 5 Bs, 2 Ds and an F,
but they are more rounded then the student who started 4 subjects
and got As in them.

I work in the admissions office at a large public university and I can
tell you, the high school students who apply at our university are
required to provide high school transcripts with their applications.
These transcripts *do* reveal grades and GPAs. Many provide class

GPA is "grade point average", right? So there is a risk for a student
who takes an extra subject if they might do badly in it? They might
be better off taking only familiar subjects they feel confident
about doing well in.

[snip]

Note, I haven't been through the US education system.

--
Penny Gaines
UK mum to three