Pubdate: Fri, 09 Mar 2001
Source: British Medical Journal (UK)
Copyright: 2001 by the British Medical Journal.
Contact:  http://www.bmj.com/

RITALIN NATION: RAPID-FIRE CULTURE AND THE TRANSFORMATION OF HUMAN 
CONSCIOUSNESS
Richard DeGrandpre W W Norton, UKP 9.95, pp 284 ISBN 0 393 32025 1

If children's behaviour becomes "out of hand" it is understandable that 
parents may seek a diagnosis to explain it away. There are several to hand. 
Ritalin Nation looks at one such diagnosisattention deficit disorder. 
Richard DeGrandpre proposes that US culture has medicalised child 
development and that attention deficit disorder is a child strategy for 
coping with the "go faster" ethos of modern life. In a medical model the 
disorder is a deviance from the norm, and the underlying biological changes 
require a biological treatmentmethylphenidate (Ritalin).

DeGrandpre, a psychologist, takes issue with the way in which attention 
deficit disorder is attributed to an underlying medical cause. Development, 
he argues, includes a continuous process of learning how to handle 
responsibility. Is attention deficit disorder being used as a medical 
solution to relieve parents of guilt, and children of responsibility for 
their actions?

Ritalin Nation discusses the issue of how much stimulation is good for a 
child. Intrusive parenting based on adults' parameters and timing, says De 
Grandpre, is overstimulation, and it is associated with biological changes 
in children such as a change in brain amines. The book's central thesis is 
that when adults dive into child rearing from 6 pm to 9 pm, work 
permitting, they put their children at risk of developing attention deficit 
disorder.

Although the book has some interesting data on the psychosocial aspects of 
the disorder, it fails to present a balanced biopsychosocial model of what 
is a complicated condition. As with schizophrenia nearly 30 years ago, the 
time has come for the World Health Organization to look at the different 
prevalence of attention deficit disorder in different countries. The 
diagnosis clearly has biological correlates and is also associated with 
child abuse and neglect.

The author's mission is to encourage Americans to slow down. The Sami in 
northern Norway say that time is always coming rather than going. Perhaps 
De Grandpre should persuade the United States to take on the Sami's view of 
time. But who knows whether this would protect children from attention 
deficit disorder?

Simon R Wilkinson, consultant in child and adolescent psychiatry.

Oslo, Norway
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