Childhood is not what it used to be

The rise of Ritalin has moreto do with shifting social values than  advances in neuropharmacology, argues David Concar

UNRULY children behave properly within  minutes of swallowing it. Books, lawsuits  and websites have been mobilised in  honour or horror of  its name. But Ritalin  is more than just a noisily debated  treatment for young hyperactive brains.  Increasingly, it is being held aloft as a grim  warning of where the new biomedical  sciences are leading us.

Take the latest call for a tighter rein on  such research. In Our Posthuman Future,  Francis Fukuyama rates the galloping  pace of neuropharmacology and the  brain sciences as even more threatening  to human dignity and freedom than the  prospect of designer babies. "Virtually  everything that the popular imagination  envisions genetic engineering  accomplishing is much more likely to be  accomplished sooner through  neuropharmacology," he writes. And for a  taste of the kind of "mind engineering"  that might flow from this, he suggests we  look at the impact of Ritalin.

Clearly there are worries with this pill  and its long-term effects on the brain.  What Ritalin has neverbeen, however, is a  high-tech product of the new biomedical  sciences. The suggestion that it is  overlooks its true history and the real  lessons it holds.

Chemists first synthesised Ritalin, or  methylphenidate, in Switzerland in igq~,  and the first clinical trials using it to treat  hyperactivity ran some four decades ago.  Far from being a precise clinical tool, it  interferes messily with the brain's  chemistry. It is the product of old­fashioned suck-it-and-see science. To this  day, nobody is exactly sure how it works.

So how did it get to be the pin-up pill  for a scary new age of revolutionary  neuroscience? Like Monty Python's  hapless Brian, this run-of-the-mill  amphetamine acquired its reputation  only because it caught the eye of an  expectant crowd. Demand for Ritalin took  off in the early i99os, a time of much  breathless talk about neuroscience.

Scientists were starting to expose the  genetic and biochemical roots of human  personality, supposedly turning the mind  into a machine ripe for fixing. Yet real  examples of high-tech mind engineering  were scarce, so when commentators  needed evidence of the revolution they  held up Ritalin, endowing it with a more  sophisticated image than it deserved.

But what triggered the soaring  demand? As psychiatrist David Healy  points out in The Creation of  Psychopharmacology: "The psychiatric  treatment of young childrenwith drugs  had until the i99os been all but  taboo...mass treatment on the scale that  developed by the mid-rggos indicates a  profound cultural shift:' The rebranding  of hyperactive behaviour as ADHD  (attention deficit hyperactivity disorder)  in the ig8os helped create that shift, as  did a huge marketing effort by Ritalin's  manufacturer. But neither could have  succeeded if doctors and patients weren't  themselves becoming more open to  viewing problem behaviour as an  abnormality serious enough to be fixed  through drugs.

The roots of this change have been  widely debated. One favourite suggestion  is that harried parents and teachers prefer  to blame brain chemistry rather than bad  parenting or teaching for their charges'  troublesome behaviour. But there are  other, less obvious factors. One is the  development of psychological rating  scales for measuring mood, behaviour  and personality. Healy argues that just as  the spread ofbathroom scales in the  ig6os laid the ground for anorexia  nervosa, so the arrival of psychological  checklists did the same for conditions  such as ADHD. Without them, drugs  manufacturers would struggle to design  trials, and to identify children who  deviate sufficiently from behavioural  norms to require treatment.

But merely measuring and naming a  behavioural deviation cannot spark a giant epidemic. What else was going on? It  is probably true that before Ritalin took  off, a lot of damaging hyperactivity was  overlooked. It might even be true that  hyperactive behaviour is increasing. But  no psycho-medical condition spreads as  fast as prescriptions for Ritalin have in the  past decade. If hyperactivity is now  diagnosed so often it is because it matters  more to parents and teachers than it did.

Which isn't surprising.In today's  super-competitive and super-protective  world, childhood is not what it was. The  idea has quietly taken hold that we're all  prisoners of our early years. Children's  behaviour, what they learn and when they  learn it have taken on unprecedented  significance. What was once a fluid time  of discovery has been reinvented by  cognitive psychologists as a succession of  neuralphasesforlearninglanguage,  social skills, number concepts and the  rest. Grab these chances and your child  prospers; miss them and supple synapses  might ossify. Poisoning young minds  with bad experiences is seen as a sure-fire  recipe for a blighted life. Childhood has  become something that has to be normal  and got right-even if, paradoxically, that  means using psychiatric drugs.

Drugs and technologies are not simply  dumped into our laps by scheming  scientists. They emerge because of a  complex web of forces. If we want to  control their impact, we ignore this web  at our peril.

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