There has been explosion in the number of American children diagnosed with attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD) in the past few years -- and in the prescription of the amphetamine-like stimulant, Ritalin. Behavioral pediatrician Lawrence H. Diller expresses concern about the phenomenon, even as he continues to prescribe it.

Ritalin is given to children with a variety of symptoms -- from aggressiveness on the playground to day dreaming in class.

• The United States uses 90 percent of the world's supply of Ritalin, and use and production is up by 700 percent since 1991.

• About 75 percent of the drug goes to children.

• Nearly five million children and adults are diagnosed with ADD, and some experts say 10 percent of children have it.

• If all of those children took Ritalin, 1 in 6 boys ages 5 to 12 would use the drug.

Why is the drug being so widely used? Some parents are aware that having ADD can qualify as a disability, suggests Diller, allowing a child to have unlimited time to take the SAT, for instance. That "has changed ADD from a stigma to a potentially 'desired' diagnosis." And primary care providers like it, because it is cheaper to prescribe than other treatment alternatives, such as counseling.

Whether kids meet the criteria for a diagnosis of ADD, treatment with Ritalin doesn't address the larger issues families face, says Diller, such as the high pressure put on children, even in kindergarten, and households with two working parents, which requires more preschoolers to be put in day care.

Source: Lawrence H. Diller (author, "Running on Ritalin"), "Pills for Kids Sound Alarm Bell in Suburbs," USA Today, November 12, 1998.

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