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To the Editor:
In the span of less than a year, The New York Times has published several news and opinion articles about the use of stimulants to treat attention deficit hyperactivity disorder that are simultaneously intriguing, disturbing and confounding.
On the Op-Ed page, in January, L. Alan Sroufe ("Ritalin Gone Wrong") asserted that stimulants offer no lasting benefit because the causes of attention deficit disorder are better explained by environmental factors and experience. In August, Bronwen Hruska ("Raising the Ritalin Generation") wrote about being pressured to medicate her son, despite her misgivings.
In your news pages, in June, "Risky Rise of the Good-Grade Pill" documented the misuse of stimulants by upper-middle-class suburban youths in an effort to gain an academic edge. In October, "Attention Disorder or Not, Pills to Help in School" described physicians who treat children in low-income regions with stimulants to help them to perform better academically and behaviorally.
The contradictory images of stimulant medication conferring either no benefit or major benefit must be truly dizzying for the reader not familiar with the proper diagnosis and treatment of A.D.H.D.
But those of us who work in the pediatric mental health field see every day that stimulant medication properly used can help improve achievement and behavior in children and adolescents with bona fide A.D.H.D. Stimulant medication helps them curb impulsivity and sustain attention so they can function better in both social and academic contexts.
Medication is but one part of a program that should include education about the condition, psychotherapy, tutoring and, most important, coordination among all significant players in the child's life (family, school, doctors, academic tutors).
With all the challenges impinging on effective treatment of A.D.H.D., the task may seem next to impossible to accomplish, but despite these obstacles, we should not be dissuaded from finding creative ways to meet the needs of these children.
FRANCES C. SUTHERLAND
Bryn Mawr, Pa., Dec. 3, 2012
The writer is a psychologist who works with children and their families on attention deficit disorder and learning disabilities.
Editors' Note: We invite readers to respond by Thursday for the Sunday Dialogue. We plan to publish responses and Dr. Sutherland's rejoinder in the Sunday Review. E-mail: letters@nytimes.com
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