"I CAN'T TELL YOU how many letters I've received from parents asking that their children be classified with a learning disability," sighs a high school guidance counselor from an affluent New Jersey community. The disability: short attention span. The payoff: an edge in school admission and professional licensing.
No longer something to be embarrassed about, some learning disabilities have become positively chic. Credit the Americans with Disabilities Act, passed in 1990 by Congress and signed into law by George Bush. Under ADA, getting classified as a "victim" of attention deficit disorder carries many advantages, which is why some parents eagerly embrace the diagnosis.
What is this disease that supposedly afflicts 2.5 million young Americans?
ADD - An Agreeable Afflication
by Dyan Machan
Some help groups describe it--somewhat hazily--as an inability to focus, follow instructions and play calmly. If the kid is fidgety, he's a candidate for ADD diagnosis. Since boys tend to be more fidgety than girls, most victims of ADD are male. Even though there is scant biological evidence to support the disorder, ADD-diagnosed children are almost always fed Ritalin, a prescription amphetamine that can produce a powerful euphoric rush. How can an amphetamine, commonly known as speed because it speeds up the heart rate, slow down a hyperactive child? It's complicated, but it works. Across America, it's no longer uncommon to see lines of high school students waiting at their school nurse's office for their daily dose of Ritalin. And, if the child is enterprising, he or she can pocket a few dollars selling the pills on the playground.
But that's only petty cash. The bankable perks come when it's time for college. With a note from a doctor and some documentation from the high school, the teen can qualify for an extended or untimed Scholastic Assessment Test in a private, distraction-free room. The nonprofit Educational Testing Service, which oversees the sat and many other admission and licensing tests, administered 35,000 of these nonstandard exams out of the 2 million tests it gave out this year. That's just about double the number four years ago. The pressures of a timed test are, of course, a key part of the challenge. One wealthy New York City mother boasts that her son's ADD diagnosis added 100 points to his combined verbal and mathematical sat score.
When a college receives untimed scores, they are only marked "nonstandard administration." The testing service does not indicate what was nonstandard--whether the test was in Braille, large print or untimed; under the Americans with Disabilities Act that may be illegal. Fearful of losing federal funding or getting sued, the colleges sometimes ignore the designation altogether. Yale and Harvard treat them like any other. "We have no particular theory about them," equivocates Harvard's director of admissions, Marlyn Lewis. "We are obligated to make reasonable accommodations." One Ivy League admissions officer is more blunt (though not blunt enough to speak other than anonymously): "I'm glad Forbes is going after this. ADD has become an enormous and growing business. It's also a rich kid's business and an enormous class issue." Children diagnosed with attention deficit disorder are almost always fed Ritalin, a prescription amphetamine that can produce a powerful euphoric rush.
Rich kids? The Ritalin runs $40 a month, and getting a doctor's certification is an expensive process. The Cedar Hill Learning Center in Wyckoff, N.J. charges $250 for a neuropsychiatric evaluation. "We have a lot of parents trying to get untimed tests," the receptionist says candidly. "Who wouldn't?"
No surprise, aspiring lawyers have discovered this loophole. In the 1995-96 school year there were 160 ADD-accommodated law school admission tests given, 16 times the number given five years ago. Intrigued by the outcome of the tests, the Law School Admission Council conducted a study and found that while the scores from its nonstandard tests were about the same as those taken under normal circumstances, they yielded a subpar set of students. While all accommodated students tended to do worse than predicted by their LSAT scores during their first year, the only year for which statistics exist, those with learning disabilities did measurably worse than those with hearing and vision impairments. The problem for the admissions director, says James Vaseleck, a lawyer at the admissions council: "We don't know what the scores mean. And when we challenge them, we get sued." The council has had to face two lawsuits so far.
"Sure we're skeptical," worries John FitzRandolph, dean at Whittier Law School in Los Angeles, "but we don't like to be taken to court all the time." An ADD student recently sued Whittier because it was willing to give the student only 20 extra minutes per hour-long exam instead of an additional hour. For fear of protracted legal expenses, the school settled the case. Whittier also no longer has pop quizzes: ADD students require separate rooms and extra time.
Ironically, those who abuse the rules hurt those who have real problems. "I have several dyslexic students who don't want special treatment," FitzRandolph says. That's not surprising. Those who have overcome well-documented learning disabilities are too proud of the accomplishment to want to draw attention to themselves. So those who genuinely need the help won't take it, while those who don't, benefit, creating an even greater disparity in grades.
"I'm quite convinced little boys are getting put on [Ritalin] because they're little boys. There are some reasons for using it, but usage in the U.S. is way above clinical necessity."
The malady has also infected medical schools. Last year there were 645 nonstandard Medical College Admission Tests, more than five times the number of such tests five years before. The majority--seven out of ten--were victims of attention deficit disorder or learning disabilities. "It's not a variable held against them," says Mark Notestine, admissions director for Ohio State's medical school. "We just make sure we can reasonably accommodate them. If they take an untimed MCAT, we'll try to do the same." Does this doctor get extra time when a patient is wheeled into the emergency room? No, but the Americans with Disabilities Act is served.
Interestingly, in Europe, where laws give scant comfort to alleged victims of the "disease," the ADD diagnosis is only a tenth as common as it is here. In Japan the disorder has barely been noted. But in the U.S. the diagnosis is promoted by dozens of self-help books and by 650 chapters of the ADD support group, Children & Adults with Attention Deficit Disorder. No surprise that Ciba-Geigy, the manufacturer of Ritalin, has given money to the group. Purchases of Ritalin and its generic counterpart increased 36% last year, to $373 million.
Is all this really needed? You supposedly have an ADD child if he fidgets, interrupts, intrudes into other children's games, has difficulty following instructions, shifts from one uncompleted activity to another or has difficulty playing quietly. But doesn't this describe many a normal, if undisciplined, kid? "There are some reasons for using [Ritalin] with some kids," says Anne Moir, a genetics Ph.D. and independent TV producer in Wiltshire, England. "But usage in the U.S. is way above clinical necessity. I'm quite convinced little boys are getting put on it because they're little boys." You want victims, we'll find you victims. But what else would you expect in a society where no one is held responsible for his own behavior and where every pathology is supposedly fixable with a government mandate?
U.S. relaxes with Ritalin So extraordinary has the divergence now become between U.S. and world consumption of the mood-altering drug methylphenidate (popular brand, Ritalin), that the Vienna-based International Narcotics Control Board has asked American authorities to monitor whether it is being properly prescribed. The U.N. agency also invited them to look into whether parents' groups are undermining a treaty that prohibits advertising of dangerous drugs. The U.N.'s concerns about excessive drug use in the U.S. are well founded. Indications are that finding ADD victims is a profitable deal for a lot of people--including the victims.
Even more extraordinary--and significantly underreported, perhaps because of the absence of a male liberation movement--is the extent to which medication with Ritalin is given to boys. Among children under 16, boys account for 80% of consumption.
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