New Laws Leave Ritalin Decisions To Parents and Doctors
Two states have enacted what are thought to be the nation's first laws to clarify that parents, not school districts, will have the final say on whether their children take drugs to control behavior.
The laws in Connecticut and Minnesota, which went into effect last month, give parents the right to decide against giving their children stimulants such as Ritalin, without fear of losing custody of the children under the states' educational-neglect laws. Ritalin, the brand name for methylphenidate, is used to treat attention deficit hyperactivity disorder.
Many teachers have become adept at spotting signs of ADHD in a child. Students with the condition may have difficulty concentrating, be unusually fidgety while seated, get up to walk around the room, or interrupt class with comments at inappropriate times.
Educators have increasingly found themselves on the front lines of referring children for diagnosis and treatment of the disorder. In that role, teachers have been embroiled in controversies about such treatment, especially whether students should take medication.
The Connecticut measure, which was approved unanimously by the legislature on June 28, explicitly prohibits school personnel from even recommending to parents that their children take Ritalin or other psychotropic drugs. The Minnesota law does not impose any such gag order.
A spokesman for a Connecticut school group argues that the law is unnecessary and won't change how most staff members handle the identification of children with special needs because of ADHD.
"The law doesn't appear to be anything that would be in conflict with normal operating procedures within a school," said Thomas Galvin of the Connecticut Association of Schools, an umbrella group for school personnel. "These drugs should be recommended by a physician in the first place."
It is permissible for school employees in Connecticut to suggest to parents that their children be evaluated by a doctor, but the new law makes clear that the first mention of drug treatment must come from a medical professional or a parent, not the school, state officials said.
Signaling a Trend?
A national expert on health legislation said the two new laws go further than any other state laws dealing with the issue of drugs such as Ritalin, and could signal the start of a trend toward legislative attempts to clarify educators' role in helping children with ADHD get treatment.
"There are several states looking into the issue of Ritalin use," said Tracy Delaney, a health-policy specialist with the National Conference of State Legislatures, based in Denver. "As more information is gained, I would expect we are going to see more detailed legislation. Whether states will take the Connecticut approach, we don't know."
Both Connecticut's and Minnesota's laws say that refusing to give a child Ritalin does not constitute "educational neglect," an offense that could warrant the state's removal of a child from his parents' care. Educational-neglect laws were originally intended to provide recourse for schools against parents who didn't send their children to school.
The state lawmakers behind the new laws said legislation was needed because, they believe, educators are contributing to the growing number of students on medication such as Ritalin.
Minnesota Rep. Barb Sykora, a Republican, said the idea for the bill came to her after parents complained that they had felt forced by schools to begin drug treatment for their children.
"I heard from parents who said teachers were pushing them to put their child on Ritalin by saying, 'Hey, your kid is a problem. You need to take him to the doctor and get some Ritalin,' " said Ms. Sykora.
"Kids are given the diagnosis with no real physical work-up," she contended. "If a school was threatening to sue you for educational neglect and get your child taken away from you, I bet you'd do what they wanted."
Connecticut Rep. Lenny Winkler, also a Republican, said she introduced her state's measure because teachers are held in high esteem by parents and thus their opinions about a student's health are taken seriously. That could lead to more drug use by students, she said.
One national advocate for people with ADHD says the laws are a positive development for parents and teachers trying to navigate children through diagnosis and treatment.
"People should act within their professional scope of practice," said Clarke Ross, the chief executive officer of Children and Adults with Attention Deficit/Hyperactivity Disorder, an advocacy group based in Landover, Md.
"Only those who can prescribe the drugs should recommend them. I'm sure it exists where schools force the parents to make their children take drugs. But I'm sure that's not typical of school personnel."
Teachers Not To Blame
A spokesman for the National Education Association said teachers are not to blame for the increase in Ritalin use.
"I think it's great that they have the law," Jerald Newberry, the director of the NEA health-information network, said of Connecticut. "But I was a teacher and I have never seen an incident where in any way a teacher tells parents that they have to use Ritalin. I think it is a silly argument."
In Connecticut, local school boards will be responsible for coming up with penalties for teachers who violate the new law, state officials said.
Between 1990 and 1997, the production of Ritalin increased 650 percent, according to the U.S. Drug Enforcement Administration. In a DEA ranking of pharmaceutical drugs most likely to be stolen, Ritalin falls within the top 10. ("Thefts of Drugs Prompt Schools To Tighten Up," March 28, 2001.)
Last year, the Texas board of education passed a measure recommending that schools consider alternative, nonmedical solutions to behavior problems in the classroom. The Colorado board of education took a similar step.
The Texas measure urged schools to use "proven academic solutions" for dealing with students deemed hyperactive.
The Minnesota law calls for a $50,000 study on how many children in the state use Ritalin and similar medications, and for what reasons. The study will be finished in February, Rep. Sykora said.
The measure also requires Minnesota's teacher-training programs, within a year, to begin offering lessons on alternatives to drugs for dealing with children who are hyperactive.
Vol. 20, Issue 43, Page 31