More Than 10,000 Toddlers Get ADHD Medication Outside Guidelines

A new government study finds more than 10,000 toddlers in the United States are receiving medication for attention deficit hyperactivity disorder (ADHD) outside established guidelines. The report found children covered by Medicaid are most likely to receive drugs such as Ritalin or Adderall.

The American Academy of Pediatrics does not have guidelines for use of ADHD medications in children ages 3 and younger, because their safety and effectiveness in that age group has not been established, The New York Times reports.

“It’s absolutely shocking, and it shouldn’t be happening,” said Anita Zervigon-Hakes, a children’s mental health consultant to the Carter Center in Atlanta, where the data was presented last week by researchers from the Centers for Disease Control and Prevention. “People are just feeling around in the dark. We obviously don’t have our act together for little children.”

A California behavioral pediatrician, Dr. Lawrence H. Diller, told the newspaper, “People prescribing to 2-year-olds are just winging it. It is outside the standard of care, and they should be subject to malpractice if something goes wrong with a kid.”

Adderall is the only drug approved by the Food and Drug Administration for treating children below age 6 for ADHD. After some studies suggested use of Ritalin in preschool children with ADHD may be helpful, the American Academy of Pediatrics issued guidelines that authorize use of the drug in 4- and 5-year-olds, but only if formal training for parents and teachers to improve the child’s environment were not successful.

Several experts said hyperactivity and impulsivity are developmentally appropriate for toddlers, and more time is needed to see if they truly have ADHD.

A study published in 2012 found use of drugs for ADHD in children jumped 46 percent from 2002 to 2010. Ritalin was the top drug prescribed for teenagers, with more than four million prescriptions filled in 2010.