July 2, 2005
New law: Schools can't force meds on kids

(source)

Rob Hotakainen and Melissa Lee Star Tribune Washington Bureau Correspondents

WASHINGTON, D.C. -- As a first-grader, Garrett Nash blurted out answers before his teacher called on him. He tickled a student sitting next to him and sometimes bolted out of lines. One cold day, he left school without his winter coat.

Michelle Nash of Blaine thought her son's behavior was typical for a child adjusting to a full day of classes, but school officials suspected he had a hyperactivity disorder. They recommended giving him Ritalin, a stimulant used to treat children with that problem. She refused.

"I just said I'm not going to do it," said Nash, 40. "And their response was, 'You know, it's against the law for you to deny a child medication.' "

That's no longer the case.

As of Friday, schools no longer have the upper hand in deciding whether children should be given Ritalin or other controlled substances. A new federal law tilts that power to parents, barring states and schools from keeping students out of class in cases when parents disagree with a recommendation to medicate a child.

The law is provoking an emotional debate over the proper role of teachers and other school employees in trying to help children they believe are troubled. And it is taking effect amid growing concern over the exploding use of Ritalin, the brand name for methylphenidate. Production of that drug has nearly doubled in the United States since 2000, according to the Drug Enforcement Administration.

Medical professionals come down on both sides of the issue.

Lance Clawson, a child psychiatrist from Cabin John, Md., said the new law could make teachers fearful of communicating legitimate concerns to parents. Because teachers see so many children every day, they are best-equipped to identify abnormal behavior, he said.

"If you tie the hands of the schools, they lose the right to advocate for the child," Clawson said.

But Karen Effrem, a former pediatrician who lives in Plymouth and who testified before Congress on the issue two years ago, said that children are often incorrectly diagnosed. Sometimes, she said, the problem is simply that they are watching too much television, eating a poor diet or are bored. She said the legislation does nothing to keep teachers from speaking out.

"What it does is prevent teachers from becoming physicians," she said, adding that "there's a lot of overuse and forced use of medications going on."

Incentive to comply

Schools will have plenty of incentive to comply with the new law: Congress is threatening to block federal aid to schools that try to force medication on students against the wishes of their parents. Congress also is already considering expanding the law. A bill sponsored by Rep. John Kline, R-Minn., a member of the House Education Committee, would extend the Child Medication Safety Act to include psychotropic drugs such as Prozac, Paxil and Zoloft.

"Except for a contagious disease sort of situation, you shouldn't be required to provide any medication to your kid as a condition of going to school," said Kline, who has lined up 20 cosponsors for his bill, including Minnesota Republican Reps. Gil Gutknecht and Mark Kennedy and Ohio Rep. John Boehner, the chairman of the House education committee.

Minnesota's picture

Reaction in Minnesota is divided.

In 2001, the Legislature passed its own Ritalin Relief Act, sponsored by state Rep. Barb Sykora, R-Excelsior. The little-noticed law states that schools cannot require parents to submit their children to special education testing and that Ritalin can be prescribed to children only after doctors, parents and school professionals explore other strategies. Sykora said she introduced the bill because parents were feeling pressured to put their children on Ritalin.

"Drugs can be devastating to kids," she said. But state Rep. Mindy Greiling, DFL-Roseville, called the state and federal laws "unnecessary and redundant" and said they are part of a national anti-psychiatry movement that could prove dangerous to children with real problems.

Greiling, the leading DFLer on the House's Education Finance Committee, said parents "aren't leaping to get their kids on medication," adding: "There's already plenty of roadblocks to kids getting help without having the government make it out to be a really bad thing. It's chilling, this legislation."

According to the most recent federal statistics, Minnesota ranks 22nd among states in Ritalin consumption in 2004, and per-capita consumption has actually declined in the past seven years. But critics say the use of the drug is still far too prevalent.

"The schools still can find roundabout ways of getting kids on Ritalin," Nash said. She doesn't believe her son has a hyperactivity disorder and said schools are too quick to recommend Ritalin for any child who fidgets or might have trouble finishing a task: "There's so many stages in a child's development. How do you determine what's [a disorder] and what isn't?"

One boy's case

Garrett, now 11, attended first grade at Kenneth Hall Elementary School in Spring Lake Park. His mother said school officials told her that Garrett was "being impatient" in the first few weeks of school, being silly in class and acting as though he wanted to be the center of attention. Sometimes he forgot his papers or gloves. She said she agreed to allow tests of her son because she felt pressured.

After the tests, Nash said she was told her son was normal and that he was performing well academically. But she said school officials insisted that the boy meet with a specialist in hyperactivity in an attempt to get him to take Ritalin. She said that even her pediatrician disagreed with the school's recommendation.

Nash complained to school system officials, who investigated the case. Spring Lake Park Superintendent Don Helmstetter wrote a letter to Nash, saying that school officials had "taken steps to ensure that such a process will not happen to any other parents." At Nash's request, school officials agreed to destroy any paperwork and to delete any information on computer hard drives that Nash and her husband deemed "inappropriate and invalid."

In an interview, Helmstetter declined to comment on specifics of the case. But he said he would never approve of the practice of school officials recommending prescription drugs, adding that both Nash and school personnel felt "very misunderstood."

"Clearly there were breakdowns in communication, whether intentional or otherwise," Helmstetter said, adding that he supports the efforts by Congress.

So does Nash, who has decided to teach all three of her children at home.

"The school was very intimidating," she said. "From the beginning, the school made me feel they were more powerful and knowledgeable than me. ... This can happen to anyone."

The writers are at rhotakainen@mcclatchydc.com and mlee@mcclatchydc.com.