Over Use of Antipsychotics for Treating ADD in Low Income Children

December 12, 2009 by Geoff Nixon

ADHD Drug Abuse?

Today’s NY Times article  entitled “Poor Children Likelier to Get Antipsychotics” notes that over 4% of children on Medicaid use antipsychotic drugs for ADHD, bipolar and other disorders, versus 1% for children on private insurance.

The article talks about the pressures that poverty puts on younger children and the fact that drugs are covered by Medicaid whereas other interventions are not.

There was an important omission however.  A major reason for this gap is the prevalence of learning issues in these communities.

The Importance Of Stimulation In Early Life

Many disorders where the symptoms are treated with anti-psychotic drugs have at their root cause an underlying learning problem.  This is what the article fails to mention.  It is well understood in our circles — cognitive learning , that is —  that children in poor families suffer from a disadvantage in developing learning skills needed to avoid learning frustration.

In the first 48 months of life children in poorer families hear less than half as many words as in middle class families.  That’s what the chart shows — the top line is middle class children who hear 50 million plus words in their first four years.   The bottom line on the chart is children in poor families who hear <25 million words.

 This means the lower income kids receive far less brain stimulation and so are likely to start school far less prepared, certainly with less developed language skills — listening and speaking.  This directly impacts their ability to keep up with the teacher in class (auditory processing difficulties) and later on it undermines reading fluency and comprehension skills.

If a child struggles at school, avoidance behavior is a self-defense against expected failure and disappointing teachers and parents.  If processing language is strained, staying engaged when the teacher is talking is an exhausting task that cannot be maintained for long periods.  These frustrations show themselves in inattentiveness attention deficit disorder (ADHD) or erratic behavior (bipolar) and on and on.

It is no coincidence that studies suggest 60-85% of prisoners have learning issues — frustration shows itself in many ways.

Cognitive Research Is Providing Answers

This stimulation deficit is one reason the cognitive software, Fast ForWord, is spreading like wildfire through schools in poorer areas.   This natural remedy for ADD, now in 3,700 schools (and a few prison systems) uses sound and memory exercises to stimulate under-stimulated auditory systems.  It is giving kids the equivalent of the 25 million words they missed out on, transforming them into more capable learners.  As programs  like  Fast ForWord build traction in these areas, the number of children requiring medication should start falling.

That is one of the great hopes for all the advances we are now seeing in brain research.  Gemm Learning is a private provider of Fast ForWord for children who do not have access to Fast ForWord at their school.