Is Adderall the Best Solution for Our Nation's Failing Schools?

A doctor from Canton, Georgia, a city minutes from where I grew up, has taken a controversial stance on the prescription of the powerful ADHD drug Adderall. Dr. Michael Anderson has publically come forward to acknowledge prescribing the drug as an enhancement for children who have not been diagnosed with ADHD, but who attend low performing schools and need all the help they can get. In his mind, the prescription stimulant is a figurative band-aid to allow children who suffer academically a chance to succeed.

Dr Anderson remarks, “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.” This stark position might reflect the truth of the state of education in the US.

In 2010, director Davis Guggenheim (not related to the famous, rich ones) created a thoughtful documentary on the state of the American education system, Waiting for Superman. The film follows several elementary school children and their families as they navigate through failing schools, seeking out better opportunities in a system that often doesn’t have many good options. All the children in the film apply to public charter schools in their communities — schools with better teachers and better student results than ordinary public schools. The demand is staggering — one school received 727 applications for 25 spots – and admission is determined by lottery. Out of the five children in the film, one gains entrance to the charter school by “winning” the lottery. One other child is initially place on a waitlist, but is later admitted.

For the other children, their only option may be to return to the schools they tried to escape. And if that’s where they find themselves, in overcrowded schools with poor performing teachers and low academic expectations, is their best option for educational success a prescription stimulant? In the United States our per-child spending on education dwarfs other industrialized nations, but that money hasn’t translated into corresponding results. Our math and science levels fall well behind those of many other nations.

What’s intriguing about Dr. Anderson’s stance is he contends that ADHD is “made up” and “an excuse” used to fix the larger, more difficult problem of the public school system. It’s often significantly cheaper to medicate your child than it is to send them to private school. It’s also significantly easier to medicate your child than to invest time and money in private tutoring. When we look at the DSM criteria for diagnosing ADHD, it does appear somewhat nebulous.

Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is inappropriate for developmental level: Inattention
1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
2. Often has trouble keeping attention on tasks or play activities.
3. Often does not seem to listen when spoken to directly.
4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
5. Often has trouble organizing activities.
6. Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
8. Is often easily distracted.
9. Is often forgetful in daily activities. This is the list of diagnostic criteria for the inattention portion of the disorder, the “attention deficit.” There are additional criteria for the hyperactivity portion, for duration of symptoms, and for age of symptom emergence.

So is the disorder “made up”? Likely not entirely. There are surely some children who truly experience ADHD, but recent CDC statistics indicate that nearly 10% of parents reported that their child or children (aged 4-17) had ever been diagnosed with ADHD. Looking at the above criteria, it would be hard to find a child that doesn’t present with some or all of these symptoms at some point in their development. Lots of folks do not like schoolwork or homework; lots of children are easily distracted. The point is that ADHD, like all psychiatric disorders, exists throughout a spectrum. Medication may be necessary for those with the most severe symptoms, but for those with fewer or less severe symptoms, it may be the school, not their brain, that is the ultimate problem.

Research indicates that the poorest performing schools in our country, about 12% of all schools, produce about half of our country’s high-school dropouts. The educational reform community sometimes calls these schools “dropout factories." When you look at a US map of the poorest performing schools in the nation, my home state – the state where Dr. Anderson practices — is clearly one of the worst offenders. I was lucky enough to go to a charter school, one of the best public schools in Georgia, but how might my life have been completely different if I hadn’t? If I had, instead, attended one of the neighboring schools on this list of “dropout factories”? Would I have been prescribed Adderall to mitigate the inattention of my educators?

Dr. Anderson is voicing an opinion that many physicians may secretly harbor: that short-term medical solutions may be the best hope for students in struggling schools. The problem is that we don’t entirely know how powerful stimulants affect developing brains over time, and that there are always side effects. Quintn, one of the children that Dr. Anderson treated with Adderall, developed paranoid thoughts and hallucinations. He became suicidal, spent a week in a psychiatric hospital, and now takes Risperdal, an antipsychotic medication. Quintn is eleven-years-old.

When we spend more than anyone else on education, yet perform significantly worse, it’s the school system that is broken. When the best option is becoming the application of far-reaching diagnostic criteria to children so that we can call them diseased and dole out some prescription stimulants, we need to realize that there is something fundamentally wrong with public education. Maybe there’s no quick fix for this one, no pills to swallow every morning, but it’s rapidly becoming apparent that it’s our schools that are sick, not our country’s children.

Follow Kelly Bourdet on Twitter: @kellybourdet"