Of all the psychiatric diagnoses du jour, the most fashionable for children and teens has been attention deficit disorder (ADD) as well as its sibling, attention deficit hyperactivity disorder (ADHD). A recent New York Times op-ed by Bronwen Hruska, titled "Raising the Ritalin Generation," revealed that, as of 2010, 8.4 percent or 5.2 million children in this country between the ages of 3 and 17 had received a diagnosis of ADHD, according to the National Health Survey.
These disorders would not be so fashionable, however, if parents were fully aware of the perilous nature of the medications prescribed to their kids.
Hruska's fine debut novel, Accelerated, offers a cautionary tale not only of the pharmaceutical-industrial complex but also of the high-pressured, high-powered world of privilege in Manhattan's elite private schools. As its subject matter and title suggest, the novel moves at a propulsive pace. Even its hilarious, opening "bad sex" scene takes place in umm... accelerated fashion.
A scathing social satire, the first half of the book presents a portrait of Manhattan not unlike that of Bonfire of the Vanities, only set 25 years later. It is as if the Master of the Universe, Sherman McCoy, has given up bond trading and is now living in a two-bedroom apartment as an art designer for a supermarket tabloid magazine. The Social X-Rays are still malnourished except that they have added silicone to their chests. And the kids are ingesting scary doses of Ritalin or the equivalent medication, called Metattent Junior in the book.
Except the kids are not high school students at Stuyvesant, which recently had a cheating scandal. The kids are third graders at the fictitious Bradley, considered the toniest of all Manhattan private schools, with six Supreme Court justices as alumni.
And the kids are not taking the medication on their own, as high school and college kids often do to boost their attention level for final exams.
No, the kids are taking the medication at the behest of the school and its ethically challenged headmaster, psychologists and nurses who want them to get the highest SAT scores so that Bradley can maintain its perch as arguably the best prep school in the country.
As one can imagine, the satirical edge of the book turns sharper in the second half, as the book evolves into somewhat of a legal thriller and Bradley becomes the school from hell. In a nod to The Firm from John Grisham's novel of that name, it might be said of Bradley that it is the school that once you get in, it's hard to get out.
Earlier this week, I met with Hruska, a statuesque brunette who bears a resemblance to the actress Jennifer Connelly, outside of Diesel Bookstore in Brentwood, Calif., a zip code as affluent as the Upper East Side of Manhattan where the Masters of the Universe congregate.
Dressed elegantly in a black dress with a silver pendant in the shape of a circle draped around her neck, Hruska said that the over-diagnosis and over-medication of children is "not a New York problem, not an East Coast problem, not a private school problem."
Hruska, who speaks in a calm, measured manner, pointed out that these problems exist everywhere in this country, a point driven home by a recent article in the New York Times by Alan Schwarz. Schwarz's front-page piece noted that low-income kids at less prestigious schools in places like Canton, Ga., may be particularly vulnerable to prescriptions for Ritalin and Adderall, another stimulant, because Medicaid typically covers prescriptions for these medications. In some cases, this can be the most economic means of treating what may or may not be ADD or ADHD, since the parents of these kids often cannot afford to pay for tutoring or counseling.
Hruska, who sat at a picnic table in the Brentwood Country Mart and sipped occasionally from a pressed juice bottle that contained water, described how her son, Will, took psychotropic medication for a year or so, starting in the third grade. When he was in the fifth grade, he watched an episode of MTV's "The Real World," which showed kids snorting ground-up Adderall. After that, he refused to take his medication, which was no longer helping him anyway.
Thankfully, Will is thriving now in school, even reading for pleasure outside the classroom. He is also a strapping six-foot-three teen, whose growth has not been stunted by the meds, as can be the case with some children who are put on stimulants.
I asked Hruska, whose day job is publisher of Soho Press, what she thinks of President Obama's "Race to the Top" program, a system that in my view relies too much on standardized testing as a basis for evaluating children and teachers. She said that she has always had a "problem with teaching to the test" and added that while standardized testing was "an attempt long ago to even out the playing field," it may no longer be as helpful as it once was.
Though Hruska has never been a schoolteacher, she has "vapor blue" eyes like that of Jess, the third-grade teacher and lover of protagonist, Sean Benning, in Accelerated. When asked if she served as a model for Jess, Hruska chuckled and said, No. In fact, she had a difficult time "getting into the head" of Jess and found that writing from the point of view of Sean, a parent with a child on medication, was "very familiar" to her.
My wife, Barbara, who taught public school kindergarten and 2nd grade for 26 years, had a smart approach for handling rambunctious boys. She placed them in the front row on the second day of class. She also let them play kickball during school hours, which allowed them to burn off their extra energy. She almost never had a problem with those boys after the first day of school. Needless to say, not one of those boys was ever medicated.
Perhaps, Bill Clinton, who makes a cameo in Accelerated as "the bastard" who flirts and dances with Jess at a soiree, says it best in the book, "Good teachers are the key to the future."