Tuesday, April 21, 2009

Guest Blog: Do You Have the Right Stuff?

My favorite parent advocate, Louise Woo, shares a new concern about the fate of our kids. Louise, please tell us what's on your mind ...

Thank you, John.

The world of high-anxiety, achievement-oriented American parents is abuzz this week about Margaret Talbot's grimly-reported New Yorker article, "Brain Gain: The Underground World of 'Neuroenhancing' Drugs."

(For those of you who haven't read the article yet, here it is: http://www.newyorker.com/reporting/2009/04/27/090427fa_fact_talbot?currentPage=all )

The initial premise of the article wasn't particularly shocking. Most parents already know that teenagers and college kids have been abusing ADHD stimulant medications for over a decade now.

What was sobering was Talbot's revelation about the growing number of studies showing that prescription stimulants do indeed provide measurable improvement in cognitive abilities for people who do not have ADHD. That, and reports of drug manufacturers like Cephalon (makers of Provigil) who have already been reprimanded for efforts to subtly market the drug for "neuroenhancement" purposes.

Why should this bother me? Isn't it a good thing that relatively safe prescription drugs can help people be smarter and more productive?

On the face of it, it's hard to oppose it as a bad thing. Certainly many bright, highly-productive researchers think it's just fine as evidenced by a 2008 survey of readers of the scientific journal Nature, where the majority of respondents said healthy adults should be allowed to take medications for cognitive improvement.

But in our household, we face an ironic dilemma. Both of my sons are diagnosed with ADHD and mood disorders. And while the mood disorders (bipolar and depression) have been successfully stabilized with medication, neither teenager can take standard ADHD medications.

We've done a trial of every common ADHD medication in the book: Ritalin, Concerta, Adderall, Strattera. These medications make my son with bipolar disorder go manic and the one with depression irritable and nasty. So their ADHD must be left untreated, which puts them at a distinct disadvantage in a highly-competitive, above-average school district where ALL kids are expected to perform at peak ability from middle school onwards.

I have a sickening feeling in my stomach as tide surges forward. Clearly if scientists and doctors think it's OK and the research supports it, most high school and college students will be taking "neuroenhancement" drugs in the near future.

And where does that leave kids who can't take these drugs? Or the kids whose families don't have health insurance? Or the kids from uneducated families in less-competitive (i.e. poor) public schools? I don't know. It threatens to create a Cognitive Abilities Gap, where the bright get brighter and everyone else just has to drink more coffee.

Here in California, where the public schools are already slaves to the No Child Left Behind law and the curriculum is skewed to have children focus on annual statewide standardized tests, things will get ugly.

Teachers are already under tremendous and unrealistic pressure to improve their class's test scores every year. For high-scoring schools, this is a bizarre challenge. How much better can the scores get?

Can the scores be improved if more kids are on "neuroenhancement" drugs? Maybe. Will there be (more) pressure placed on parents to "do something" about their "only average" kids? Probably.

Will parents, rich and poor alike, become alarmed by this? Absolutely. But how do you fight the incoming tide?

In the past 20 years, we have already been swept out to sea by the tide of Higher Achievement. It is standard practice -- NOT a luxury -- in "good" school districts that we hire after school tutors for our elementary school kids and put our teenagers in private SAT prep courses.

Teenagers are encouraged to take Honors and Advanced Placement courses in high school, discouraged from having jobs (because it takes time that could be used for academic work) and assigned hours of homework -- even over school vacations.

And for what? To make the grade so they can be accepted by colleges which don't have enough seats for every qualified applicant anyway?

I don't know where the end of this will be, but I certainly don't like where I see things going.

Every year the competition gets stiffer for good grades, good colleges and finally good jobs. As Talbot noted in The New Yorker article, even middle-aged workers are feeling the pressure to take these drugs to keep-up with younger colleagues.

Will this ultimately change the meaning of the question: Does he or she have "the right stuff?" Yesterday, having the "right stuff" meant having intelligence, perseverance and bravery.

Tomorrow, it seems, it will just mean having a prescription for Adderall.

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