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   Inside Out - East: Monday February 7, 2005

LIFE AFTER RITALIN

Ritalin tablets
Ritalin may not be the panacea expected for all with ADHD

With Ritalin and similar brand medication prescribed to over 300,000 children in the UK in 2004 alone, Inside Out meets one teenager to discover what life is like after treatment.

Ritalin is a drug prescribed to treat attention deficit hyperactivity disorder, or ADHD, as it is commonly known.

ADHD is a complex problem - there are many different types and the condition may include language and learning problems and is often mistaken for bad behaviour.

There is no single definitive test to confirm a diagnosis of ADHD, so diagnosis rests on a doctor's interpretation of symptoms.

In 1997 the BBC made a documentary about children with ADHD. Dale Roberts was one of those children and was prescribed Ritalin.

Miracle cure?

Now Dale is 17, he and his mum Roxine have mixed feelings about Ritalin.

Dale Roberts in 1997
Dale's unruly behaviour was captured by a documentary team in 1997

"I couldn't eat on it, couldn't sleep, I was just having a bad life really. It didn't agree with me," says Dale.

"On the other hand, it did help me in the classroom."

Roxine believes medication was not the answer to Dale's problems.

"Parents are happy at the time because they've got a diagnosis," says Roxine.

"They think 'this tablet is going to do it for me - problem solved'. It's far from that."

With or without

The Facts

It's difficult to draw the line between an active but normal child, and one with mild ADHD.

One of the best guides is when a particular behaviour is becoming a persistent problem. The core behaviours to look out for are:

Inattentiveness: gets bored easily, goes from task to task without finishing anything, poor short -term memory

Impulsiveness: acts without thinking, frequent accidents, has a short fuse

Hyperactivity: restless, fidgety, rarely sits still for long

Other typical behaviours:
Insatiability
Social clumsiness
Physical clumsiness
Disorganisation
Enormous fluctuations in performance and mood
Extreme sensitivity and poor self-esteem

Source: BBC Health

Ritalin may not have agreed with Dale, but stopping the treatment is not without its problems too.

Ritalin prescribed for children with ADHD is withdrawn when they leave school. Left un-checked, their previous anti-social behaviour often returns.

Many end up in trouble with the police and Dale now has a criminal record for rowdy behaviour.

Roxine fears this may have serious consequences for Dale's future.

"All he wants to do now is be like any normal lad of his age, but he can't get a job because of the things that have happened in the past."

Barry Turner, a lecturer in Medical Ethics at Lincoln University, also has concerns about treating ADHD with drugs.

"There are undoubtedly large numbers of unruly and disruptive children - that's a child's job.

"The medicalising of the problem is the issue - whether these children have a condition that requires medication - I don't believe they do."

Barry Turner believes that children with ADHD get into trouble more frequently regardless of treatment.

Sources of help and support

The AD/HD Family Support Group UK
1a High Street, Dilton Marsh, Westbury, Wiltshire BA13 4DL
Tel: 01793 813694


The Hyperactive Children's Support Group
71 Whyke Lane, Chichester, West Sussex PO19 2LD
Tel: 01903 725 182 (Monday to Friday, 10am to 1pm)
Website: www.hacsg.org.uk


The National Attention Disorder Information and Support Service
PO Box 340, Edgware, Middlesex HA8 9HL
Tel: 020 8906 9068
Website: www.addiss.co.uk


DC Educational Services
A charity specialising in ADHD and other behavioural issues in children.
Tel: 020 7834 0033
Website: www.dcedservices.com


ADDNet
Tel: 020 8905 2013
Website: www.btinternet.com

"There's no evidence whatsoever that the treating of these children ameliorates this.

"At some stage they get into trouble more than others do."

Those in favour

Despite Roxine's doubts, Dr Julian Parker, the psychiatrist who first diagnosed Dale, still believes Ritalin is the correct treatment for ADHD.

"It certainly is a wonder drug for a small proportion of the children we see.

"For the majority it makes a significant impact, relieving the symptoms of impulsiveness.

"Seventy to eighty percent of parents say they're impressed and relieved at the effects Ritalin has had on their children."

A large study conducted in 2002 by the Professor of Psychiatry at the Harvard Medical School, looked at the treatment of more than 500 children diagnosed with ADHD.

The study found that those children given medication rather than intensive behavioural treatment alone showed significantly more improvement.

However, not every child does well on stimulants.

Putting the past behind him

With the help of his mum, Dale has battled to control his behaviour without drugs.

Dale Roberts
Dale is distressed by the footage of his behaviour as a child

Watching the documentary footage of his behaviour as a child is deeply distressing for Dale.

"As soon as I calmed down I saw what it did to my Mum, that's why I got my act together and I'm here now," he explains.

But combating his unruly behaviour is not the only obstacle Dale must overcome.

"He's still got a battle on his hands to prove to people he is not just the youngster people remember him as," says Roxine.

See also ...

On the rest of Inside Out
Banished to boot camp

On bbc.co.uk
ADHD

On the rest of the web
The National Attention Deficit Disorder Information and Support Service
CHADD - Children and Adults with Attention Deficit/Hyperactivity Disorder

The BBC is not responsible for the content of external websites

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Readers' Comments

We are not adding any new comments to this page but you can still read some of the comments previously submitted by readers.

Sarah Willmott
My son is 6 years old and has been taking ritalin for a year now for adhd. He has really improved in his behaviour at home and school since starting on ritalin and is now in the top 5 for literacy and is getting early literacy support at school due to this. I would not consider taking my son off ritalin at the moment as it is making a big difference in his daily life and helping him in all the best ways. He still has the odd temper tantrum but they are not as bad as they have been. My son also suffers from dyspraxia and is also getting support for this at school. My son is under Dr Julian Parker at Ivry house and he is always prepared to answer any concerns I have regarding my sons condition.

I A Jones
My son Ian has been diagnosed with Dyslexia and ADHD. He was give Ritalin around the age of 12 but he never realy took to it he would take it one day and not another, he left school with no qualifications and basicly went down hill from there. He is now 20years of age and is in a young offenders institute, where 60% of individuals with this nurelogical complaint are. I feel sad and angry that the Government will not put more money into helping these suffers. WHY?

Worried Dad
My daughter was diagnosed as an ADHD child, given drugs to combat this. I myself feel she does not need this she just needs a kind loving family to be there for her and a good set of rules to abide by. The drugs didn't make any difference at school and I beleive she is what she is and no need to look into who to blame. Its easy for doctors to give out these drugs but whats going to happen in the future. I felt sorry for Dale and his Mum and hope and pray that he can get a job soon so he can channel his energy into something usefull. Fingers crossed for you dale...

N Lockwood
My son has been diagnosed with ADHD, it took quite a few years before we saw a doctor, then it seemed that the doctor was only intrested in giving my son 'Ritalin', at present Myself and my wife do not wish to agree to that as we have read alot of disturbing articles concerning 'Ritalin'. We are at present giving my son 'Haliborange Omega-3 Fish oil', he is also getting help from an outreach worker that comes into the school. At present he is a different person when he has the above medicine, of which is really nice to see. I beleive that his ADHD was caused when he was born as he had the cord around his neck choking him, also when they brought him around he had a fit,(at present he has not had any more). I just wish that the doctors would take more time before they say that they would like to put your child on Ritalin.

Parents
Our son is six next month. Next month he starts medication. Perhaps next month he can start to learn. He is clever. Does he have a future? I really don't know. We know from our own reading that he has a genetic condition not one caused by bad parenting or moving house at a critical age or any thing else. He is emotionally and physically draining and we would not have coped with out friends who have stood by us. Watching Dale last night caused my husnband and myself great concern. What is the point of calming our boy down and getting him through GCSE's in ten years if his medication is going to be taken away from him. IF he still needs it at 16 he could need it for life. We face a very uncertain future. We understand the old film of Dale completely, we live with this daily although I do suspect he played up for the camera, what child does not. We also saw our son on the Horizon program last week. Kicking walking of being difficult. As families we and our children need help and support there seems to be very little although we do have a great support group in Milton Keynes. All children are different so there can be no wonder drug for all. Perhaps in a few years our son will be 'normal'. Perhaps not. Whatever he will still be our son.

George Moore
It is worrying when you feel your children are being treated like guinea pigs. There are so many views on ADHD, but no one can state with any confidence what causes it. My wife is convinced it was the MMR jab. Give a child with ADHD an audience and they will perform. Give them a camera crew and they will perform even better. I feel our son, aged 13, is out of control, he even admits it himself. I want to be told what we can do, or what services ( or financial assistance ) are available to us in order to help him live as normal a life as possible. There is so much negativity towards children with ADHD. It has got to the stage when we dont know what is best for him. He has just undergone trials of the new drug Atamoxetine, thinking it might help him, but we have had to take him off it as it was making him ill. We accept his behaviour at school may get him excluded and have no idea what we will do if that happens. I feel very concerned for his future.

teresa chaplin
i have two sons who have been diagnosed with a.d.h.d and who have both taken ritalin. The younger son is now taking concerta which is one slow releasing tablet per day which takes away the stigma associated with his friends. Since being on the medication it has helped him tremendously at school, this year acheiving his first year for 5 years with out being excluded.M y older son is no longer on medication which has subsequently resulted in him attending court several times the last time the case was stopped with his a.d.h.d used as mitigating circumstances. Most of these children also have varing learning difficulties too which the medication and selfdiscipline together helps the child. However much research is done on ritalin or other similar medication is irrelevant as until you have lived with a child that has the condition you cannot understand how much affect it has on their lives. It is an intrusive medication but one that my son would be unable to survive society without.

christina
we took our child off ritalin after 6 months because he lost a lot of weight, had facial tics and seemed frighteningly subdued even on the lowest dose, although there were academic improvements. It seemed to be another 6 months before his body normalised and during this time he was quite strange, very very hyperactive, organisation & social skills became appalling. We started him on a daily regime of co-ordination & balance excersises which channelled his phenomenal energy, with many references to left and right etc. Also we tutored him heavily with the 3 Rs, we never spent longer than a few minutes on each subject before boredom set in and gave him quizzes & educational games weighted heavily in his favour -we gave him instant rewards for his hard work including small toys, sweets and money daily. He was given daily social education (social rules, games, sharing etc) and we invited many children for tea, he was instantly rewarded if he followed the social rules laid out. He is now doing very well at school and has many friends. This regime was not easy and his life was hellish at the time but now he is settled, calm and happy. I believe my most effective disciplining tool was never ever to critise him but simply to insist that this was the rule (it was not easy!) He also had praise by the bucketload for the smallest acheivement & for any show of manners. This daily regime took around a year to be effective, no one thing we tried to teach him corrected overnight it took many many months of frustration. I also believe he was quite mild compared to others and we have been extremely lucky.

marion ross
I agree with the mother on her comments about the fact that once the diagnonis is made then you seem to be on your own. My 17 year old son has the opposite affect from Dale. He has had many, many problems and instead of weight loss, he has comfort eaten for so long, that he is now overweight. Socially he does not have many friends. He is only one of four children, of whom two others have ADHD. All three are on Ritalin but he will not take it anymore. He says that he wants to be "normal" and taking medication every day is not allowing him to be himself. My daughter is 15 and if she weighs 5 stone then I would consider myself lucky, Her knickname at school is "anorexic legs". People constantly ask her if she is anorexic. Tears, I don't think I can have many left.

Anonymous
my daughter has been diagnosed ADHD & dyslexia. She is now 9 years old and we think that Ritalin has helped her to concentrate and improved on her school work. we only give her the medication for school, but there is the odd occassion that she may recieve the medication, eg: swimming lessons for co ordination. We attend monthly meetings at the ADHD HQ in Kettering with other parents where we discuss problems that we have had at home, school and holidays etc, where we pick up tips, and watch videos about child behaviour for example as easy as 123.

Matt Donaldson
My nephew has been diagnosed with ADHD for a number of years now and is the same age as Dale. He has just been released from Feltham Young offenders institute and is now trying to get his life back on track. However with no education this is going to be a problem even getting into the Army is going to be a struggle. I can't help thinking though, that as society and schooling is getting softer and more politically correct, there is more and more cases of a relatively new condition. Is it a case of there is no condition, or are more and more youngsters getting diagnosed with a problem that they shouldn't be, leaving them on drugs they don't need, when a clip around the ear would do.

helen mansfield
the article was very interesting and its good to see Dale has improved without drugs. This is what i would like for my son, he is 9 this year he got the diagnosis last july but id always known he had problems hes always been different to other boys. My son is on strattera for his (ADHD) which is a slow release tablet he cannot have ritalin because he has a heart murmour which is one of the side effects of ritalin i would like alot more help than i am getting but that will come with time.

russell adams
to dale and roxine. well done lad your mum must be very proud of you and you should be of yourself. my son is autistic and like you said its not seen on the outside, everything looks very normal so people think he is just a naughty little boy. i pray with my heart that he shows the courage you have shown dale. keep going, the past is behind you the future is yet to be discovered. believe in yourself and believe in your mum. all the best for the future

Name Withheld
While i agree with dale's mum, i also agree with dale too.The problem with ADHD is it's so difficult to correctly diagnose.. these children and their parents on the whole are desperate for normality.. and ritalin may not be the answer. With the increasing knowledge of the use of ritalin comes misdiagnoses. All too often it's easy to give this medication and assume that a badly behaved child, or an inatentive one has ADHD, certainly more research needs to be done, not only on the medication, but the condition in general, only then will it go to help the children and their parents that need it!

eddy van-bishop
i am 13 and have been kicked out of school 3 times and i have told by ivry house in ipswich suffolk i have adhd and i was on 70mgs of conserter XL and i am now on the new antidepresion and i think it is good how ppl are now learning about adhd and trying to understand it

S Cooke
My son was diagnosed has having ADD at age 9. He was under performing at school, had no close friends & 'difficult' at home. When prescribed Ritalin he came top in all his exams & was much calmer at home. However there was a niggling doubt over the treatment. At 11 he changed schools & I took him off the Ritalin. By 14 he was a changed person At 18 he got AAB at A level and was a model pupil at school. He is now at university & has a group of friends - and is happy. I question the original diagnosis. If more time had been taken to get to know my son, his background, his school etc instead of using a standard diagnosis tool it would have been found he hadn't got ADD



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