By Debra Edwards
debra@caymannetnews.com

Mirroring trends in the US, more of Cayman’s children are being diagnosed with one of two attention deficit disorders and being treated with the popular drug Ritalin.

But the increase in the number of those children suffering from attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) may be due more to better screening techniques, explained one local doctor.

“I am not sure that more children have ADD or ADHD than in the past, but I believe the difference is that a lot of children were missed in the past, whereas many are now able to be properly diagnosed and treated,” said Dr Virginia Hobday, a general practitioner.

“I think it is similar to autism, it’s not that autism is new, but many children were just not diagnosed in the past,” she added.

Ritalin is a mild central nervous system stimulant that affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control. Available in several strengths, it comes in a tablet form that is generally taken two or three times a day.

Some of the more common side effects of the medication include loss of appetite, nausea, insomnia and nervousness.

According to psychiatrist Dr Marc Lockhart, to form a clear diagnosis of ADD and ADHD, it is necessary to analyse three major areas - hyperactivity, inattention and impulsivity.

Though the use of Ritalin has sparked some controversy, Dr Lockhart supports the medication. “Overall, I would say that Ritalin is safe when you weigh all the risks versus the benefits when it is used in a right diagnosis,” he explained.

Brent Holt, Head of Student Services and Educational Psychologist, at the Department of Educational Services, said, “It is a controlled substance so I have to emphasize the need for other issues to be ruled out, and that it should only be administered after being prescribed by a medical professional.”

He added:

“The good thing about Ritalin, however, is that it is water-based, so if it is working, the results in the child’s behaviour will be seen pretty quickly. And if it doesn’t work, it will also leave the system just as quickly.”

The website, Drugs.com, recommends that it should be taken as an integral part of a total treatment program that includes psychological, educational and social measures, with which Mr Holt agreed. “It is not a magic pill and many factors need to be taken into consideration when giving it to a child,” he explained.

Dr Lockhart pointed out that a list factors should first be considered before prescribing the medication. “There is a process that goes into prescribing a medicine like this. Their parents should first to take the child to a psychologist to rule out other problems. Then come to see a psychiatrist, paediatrician or general practitioner on the recommendation of the psychologist and input from their teacher.”

A local teacher, who requested anonymity, has found that Ritalin has benefited some of her students. “Although I don’t advocate it, I have found Ritalin to help many of my students who have serious behavioural problems, who just can’t pay attention in class, disrupt the lessons and are sometimes a danger to themselves and sometimes others,” she said.

“It makes those who have a problem focus much more in the class, but I think it should only be used when all else fails.”

Alternatives to Ritalin are available for those diagnosed with either ADD or ADHD, the most popular including other brand-name pharmaceuticals such as Adderall and Strattera, along with Omega-3 and herbal treatments. Other options include putting the child in a more restrictive class setting to enable a proper diagnosis, or placing him or her on a special diet.

“I would never discourage the parent who would want to try the diet for their child,” Mr Holt said. “However, I would be cautious because I find that if there is a change in behaviour because of this diet, it is not necessarily a situation where the child has ADHD in the first place, but rather had an allergy to what they were eating before.”

But Dr Lockhart has found that “the change in behaviour due to a diet in my experience has not been that substantial”.

Experts agree, however, that parents should not attempt to diagnose and medicate the condition on their own.

Ritalin is also used for adults with ADD and ADHD as well as to treat the sleeping disorder narcolepsy.