This increase shows once again how strongly the environment influences whether a child becomes fidgety to the point of needing treatment. Another factor is date of birth. Children who happened to be born just before the deadline for school enrollment, making them the youngest entering first grade, have a significantly increased likelihood of being diagnosed with ADHD. Doctors often interpret the age-related immaturity as a mental disorder, which is in fact a misdiagnosis.
Manufacturers of ADHD medications, on the other hand, portray the condition as a congenital disorder of brain metabolism, thus exonerating families. “It is important for parents of children with ADHD to know that ADHD is not caused by parenting mistakes. Rather, it is assumed that the disorder develops essentially due to a hereditary predisposition,” states an ADHD portal operated by Medice Arzneimittel Pütter, a German pharmaceuticals company. The company sells pills that contain methylphenidate, which helps ADHD children to calm down and be more attentive.
In addition to informing the public about ADHD, Medice also recruits doctors from universities and research institutions willing to work for the company – in exchange for compensation, of course. Such “opinion leaders” have long been part of marketing pharmaceuticals. Doctors who are critical of the practice accuse colleagues who are taking the money of being corporate shills.
Members of the European ADHD Guidelines Group have issued an appeal calling for children with attention deficit disorder to be given medication even in cases when coronavirus containment measures have prevented them from undergoing the normal medical examinations. Of the 25 people named in the appeal, eight have a financial affiliation with Medice.
Thirty years ago, methylphenidate was only very rarely prescribed in Germany. Between 1993 and 2013, consumption increased 50-fold and has since stagnated at a high level. Exact numbers are rarely collected, but a study by public health insurer Barmer GEK found that 6.5 percent of boys aged nine to 11 and 2 percent of girls received an ADHD medication in 2011.
The medication is often given because a child appears to be too unfocused in class. That was the case with an 11-year-old boy who came to Meinhart’s practice on a recent Thursday. The family asked that the name of the boy not be included in the article. His mother says she and her husband would have been fine with their child not going to a college-prep school, but their son had insisted on it.
The boy was prescribed methylphenidate at the end of 2019, before the pandemic struck. He improved his grades in the middle of the lockdown and managed to get them up to the level he needed to get into a college-prep school. But neither his classmates nor teacher know that he continues to take medication. “We don’t tell people about it,” his mother says. “I don’t want to have to justify myself.”
For Lukas, the pandemic was the decisive factor. Psychotherapist Meinhart also treated him each week during the first wave of the pandemic as he sought to make sense of the child’s worries and boost his self-confidence. But Lukas’ suffering worsened from the tense situation at home and Meinhart suggested to the parents that they allow him to receive a prescription.