by Paula Trubisky, Public Policy Office

More research is needed on the long- and short-term effects of medication, psychological interventions, and combination therapy on children, particularly preschoolers, APA Board Member Ronald F. Levant told the Clinton administration at a briefing on March 20, 2000. The White House meeting, aimed to ensure that children with emotional and behavioral conditions are properly diagnosed and treated, responded to recent reports about dramatic increases in the use of psychotropic medications.

"We need better information about appropriate diagnoses for young children," Levant said during a discussion with First Lady Hillary Rodham Clinton, Secretary of Health and Human Services Donna Shalala, Surgeon General David Satcher, National Institute of Mental Health Director Steven Hyman, FDA Commissioner Jane Henney, and Assistant Secretary of Education Judith Hueman. Fourteen other major mental health, health care, educational, and consumer leaders also participated in the discussion. Levant underscored the need to better understand the parameters of normal development in order to properly diagnose young children?s behavior as abnormal.

The Clinton administration called the meeting in response to the study in the February 23, 2000, issue of the Journal of the American Medical Association, which found that the amount of psychotropic medications prescribed for preschoolers, including Ritalin and Prozac, increased dramatically from 1991 to 1995.

During the meeting, the White House outlined its plan to ensure better diagnosis, treatment, and management of children with emotional and behavioral conditions. Federal actions include:

• Funding a $5 million 5-year study by the National Institute of Mental Health to investigate safety and effectiveness of Ritalin use, behavioral therapy, or some combination of the two in preschoolers;
• Creating a process to improve pediatric labeling information for psychotropic drugs used in young children;
• Sponsoring a national conference this fall on the diagnosis and treatment of children with behavioral and mental disorders;
• Disseminating better information to parents about what is currently known.

"There appeared to be consensus at the meeting that proper diagnosis by qualified professionals is essential," said Levant. During the discussion, Levant also described the problem of access to health professionals with specific training in mental health diagnosis and treatment, aggravated by a cost-conscious managed care context.

Back to Top^