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Ritalin is not right for every child

Attention deficit hyperactivity disorder: long words for bad behaviour or the description of a complex neurological condition, cured by a mood-changing drug? Wendy Wallace reports. Lorraine Crook has three children and has had difficulties with her middle child, Adam, now almost seven. She tried Ritalin under the supervision of Dr Kewley, but was not happy with the results.

"Adam was a very angry and aggressive toddler. He'd just charge around all the time and you couldn't communicate with him at all. He wasn't speaking. He was tested for autism but it was negative.

"We went to see Dr Kewley when he was four, and he asked questions about his education. He couldn't settle to anything and his concentration was very poor. When Dr Kewley said he thought he had ADHD, I'd never heard of it. He explained that it was a chemical disorder of the brain, and suggested Ritalin.

"I didn't give it much thought. I was quite desperate at the time, and I thought 'fine. This is what the doctor has given me'. He was on a half or a quarter of a tablet, I think, twice a day.

"The first day it made him sleepy, and he seemed a bit groggy. Over the next few days, he got more and more lethargic. I couldn't get him to eat and he didn't have the will to play on his own. He just sat and wet himself.

"I telephoned Dr Kewley after three or four days and said how distressed I was, and that I was going to stop it. He seemed to think it would settle down, but I wasn't prepared to let it go on.

"In the end we decided to try and cope with it at home, and with the school. We tried completely ignoring any bad behaviour, and praising him for little things like not smearing toothpaste over the mirror, or taking his plate out to the kitchen after dinner. He started to come round a bit. Now he's in a school for children with moderate learning difficulties. I don't think he is ADHD.

"He was slow right from a baby. He never sat up until he was nearly a year. He's still an immature little boy but his speech has come on, you can reason with him, you can play with him. I think really he just needed more time to come forward. Maybe a certain amount of the aggression was due to frustration - not being able to communicate, or to talk, he just ended up being constantly angry. I think that Ritalin is not right for every child, and that every other avenue should be exhausted first and they should be allowed to mature a little bit first. That's worked wonders for us."

Dr Kewley says treatment with Ritalin needs time for fine-tuning. "very often one does have these transient side-effects in the first week, but with adjustment you get it right." He recognises that misdiagnosis is possible, "but I don't think we get it wrong very often."

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