High Stakes Standardized Tests Help Fuel Drug Company Profits

Don't you just love how the entire education industrial complex is intertwined with  corporations like pharmaceutical companies?  Just think of all the stress, physical ailments and behavioral problems that will result from the continuous test and punish, value added, and merit pay for high test scores education deform can yield. Even the rich kids of the 1% find drugs can help them compete and perform better in high pressure environments.

In a society that values competition over collaboration, privilege over justice and test scores over children's health and well being, what do you expect?

A class in Tae-Kwon-Do or music, or art, or dance, or drama would probably help these kids improve their learning abilities and overall health and emotional well being. However, what would happen to the pharmaceutical company's profits if all those ADHD kids were suddenly actually doing well and didn't need drugs to get through life in the U.S.A.'s version of education reform in 2013?

Until Citizens United is overturned and our elected representatives begin to focus on the best interests of the children, our nation's future will be bleak. These stories about corporate abuse will proliferate, but not on the corporate owned evening news stations on television but online where journalists are still free to report. 

As 2014 begins, watch out for the upcoming battle over net neutrality as the crescendo of voices speaking truth to power is scrutinized more closely by the powers that be and the monied interests.  The only thing that counts these days in this for profit education universe, at the expense of the 99 percent, is how much money Governors like Chris Christie can funnel to his friend's pockets. In fact, Governor Chris Christie's high school buddy caused a major traffic jam on the first day of school as retribution for the Mayor of Fort Lee's refusal to back Christie in the gubernatorial election.  Let's see. How many value added points should we deduct from those schools where the children lost the first day of school as they sat on school buses in traffic for two to three hours?

Luckily, we still have freedom of speech and access to the Internet where most of us educated and curious people get our information. So, sit back and enjoy some real journalism, from real reporters in real media about ADHD drugs and their overuse and abuse for boys and girls who just don't know how to sit for 7 or 8 hours in school at desks filling in bubbles or staring at a computer screen.

As Bill Gates and David Coleman altruistically prepare this generation for sitting at the computer 10-12 hours a day to collect all that data on how their peers, teachers and schools are doing, overprescribing ADHD drugs is a good education strategy for raising test scores.

Merry Christmas. 

From Democracy Now!

But a new report in The New York Times questions whether these staggering figures reflect a medical reality, or an over-medicated craze that has earned billions in profits for the pharmaceutical companies involved. Sales for ADHD drugs like Adderall and Concerta topped $9 billion in the United States last year, a more than 500 percent jump from a decade before. The radical spike in diagnoses has coincided with a 20-year marketing effort to promote stimulant prescriptions for children struggling in school, as well as for adults seeking to take control of their lives. The marketing effort has relied on studies and testimonials from a select group of doctors who have received massive speaking fees and funding grants from major pharmaceutical companies.

Democracy Now! is joined by four guests: Alan Schwarz, an award-winning reporter who wrote the New York Times piece, "The Selling of Attention Deficit Disorder"; Jamison Monroe, a former teenage Adderall addict who now runs Newport Academy, a treatment center for teens suffering from substance abuse and mental health issues; Dr. Gabor Maté, a physician and bestselling author of four books, includingScattered: How Attention Deficit Disorder Originates and What You Can Do About It; and John Edwards, the father of a college student who committed suicide after he was prescribed Adderall and antidepressant medications at the Harvard University Health Services clinic.

The Greed of Big Pharma + Total Compliance Reformer Schools = More Child Doping

From Alternet, a clip from an excerpt of this book:

Prices of ADHD meds at the middle dose for ninety pills on Drugstore.com in 2011 were Concerta, $540; Vyvanse, $532; Intuniv, $500; Adderall, $278; and Ritalin, $191. The price of the most common antidepressants, like Prozac, Celexa, Lexapro, Zoloft, Cymbalta, and Wellbutrin, for ninety pills, was around $380. Two of the drugs prescribed to Rebecca Riley by Dr. Kifuji happen to be quite pricey. Drugstore.com rates in 2011 for 180 500 mg tablets of Seroquel were $1,048 and for Depakote, $708.

 

Among drug reps, it is common knowledge that kids are a lucrative market. At the urging of doctors, parents, and teachers, kids are required to buck up and take their meds. In the words of Gwen Olsen, who worked for fifteen years as a drug rep with such pharmaceuticalindustry mainstays as Johnson & Johnson and Bristol-Myers Squibb: “Children are known to be compliant patients and that makes them a highly desirable market for drugs, especially when it pertains to largeprofit-margin psychiatric drugs, which can be wrought with noncompliance because of their horrendous side-effect profiles.” Most large-profit-margin psychiatric drugs are approved by the FDA strictly for use with adults, not kids. However, doctors are allowed to use their discretion and prescribe them to kids for “offlabel” purposes. Doctors can use their medical instincts to determine whether a drug approved for adults might also ease the suffering of kids. But there is no scientific backing for such use. The studies haven’t been conducted. The FDA approval hasn’t been obtained. Off-label prescribing relies on doctors’ instincts alone. While drug manufacturers and their marketing staff are bound by law not to influence doctors’ off-label prescribing habits, it’s not the law that’s foremost on the minds of drug reps fanning out to doctors’ offices all over the country.

 

It’s upping sales. The right to use adult meds with kids for off-label purposes has left many physicians easy prey to drug reps and pharmaceutical companies’ marketing ploys. A glaring example of this was uncovered in the largest health-care fraud case ever handled by the US Department of Justice, in 2009.  Pfizer agreed to a $2.3 billion settlement for promoting off-label use of a variety of drugs, one of which was the antipsychotic medication Geodon. One of Pfizer’s illegal actions was paying 250 child psychiatrists to promote its off-label use with teens. Dr. Neil Kaye, for example, was paid $4,000 a day in speaker’s fees to give speeches to other physicians with titles like, “the off-label use of Geodon in Adolescents.” Geodon happens to be a highly expensive and highly profitable drug. At Drugstore.com in 2011, it cost $1,400 for 180 40 mg capsules. It currently nets Pfizer $1 billion a year.

Autism, ADHD, Adaptation and Randomization

I.

Some time ago I wrote a piece noting how it seems autism is becoming a useful "disorder" to have.  (I used the quotes for a reason which I hope becomes clear.)  The post, "Autism: the next 'specialty' credential," tried to create a kind of choral effect between an essay by Adam Philips on the cultural definitions (always changing) of "mental illness," and a Wired article detailing the hiring practices of an "entrepreneur" (someone with money, or access to money, who can create little bubbles of reality in which to try out new definitions), Thorkil Sonne; he finds the "autistic human capital" uniquely wired to work in the IT field.  "In Sonne's native Denmark, as elsewhere, autistics are typically considered unemployable. But Sonne worked in IT, a field more suited to people with autism and related conditions like Asperger's syndrome. 'As a general view, they have excellent memory and strong attention to detail. They are persistent and good at following structures and routines,' he says. In other words, they're born software engineers." ( Thorkil Sonne: Recruit Autistics in Wired, 9/09)

II.

...I have been able to come to no other than the unsettling conclusion that the meaning of an utterance is the response to that utterance and that the connection between the two is entirely conventional.  That is, meaning is not immanent in utterance.  If that is the case, as I believe it to be, it follows that any utterance is theoretically capable of eliciting all possible responses, and that all utterances are theoretically capable of eliciting but one single response....Two kinds of what we call insanity can be understood from this point of view, the one characterized by an increasing randomness and unpredictability of response, the other by an increasing limitation of response, sometimes to the point that any utterance elicits one of only an increasingly smaller family of responses, or even but one response...Thus, to humans the world consists--except for reflex responses not fed through the brain--of signs, to each of which all possible responses are theoretically possible....(Peckham, Morse, "Humanism, Politics, and Government in the Nineteenth Century.")

III.

Recently, at the WaPo "Answer Sheet," there was a piece regarding children diagnosed with ADHD in public schools.  Here is the set-up to the personal narrative that followed.

There’s a group of students struggling through school rd to navigate that gets little attention in the media or in the debate about how to fix schools: Children with ADHD. 

ADHD, or Attention Deficit Hyperactivity Disorder, is a brain condition that makes it especially hard for children to focus and concentrate in school and has a number of other symptoms. It is too often misunderstood by teachers, parents and even the students themselves. According to the Centers for Disease Control, about 9.5% or 5.4 million children 4-17 years of age, had been diagnosed with ADHD, as of 2007. Many others who have the disorder haven’t had the benefit of a diagnosis. 

Here is a powerful post by David Bernstein, a nonprofit executive who lives in Gaithersburg, Md., writing about the difficulties that his two sons, ages 7 and 15, have confronted in school as a result of ADHD.

I normally like "The Answer Sheet," and it seems a column devoted to defending the schools as the proper locus of our social commons, but this piece set my spider-sense tingling.  And it reminded me of the piece on Thorkil Sonne.

Greg Selkoe, the 36-year-old CEO of Karmaloop, a growing hipster media company with revenue of more than $130 Million a year, stated in a recent interview in Inc.: “I was diagnosed with ADHD in elementary school and actually got kicked out of several schools before landing in one for kids with learning issues. What made me not do well in school has actually been very beneficial in business, because I can focus on something very intensely for a short while and then move on to the next thing.”

What is the goal of "marketing" the benefit of "disorder?"

Yet today’s schools insist that we prescribe our kids drugs to rid them of their hyper-focus.

 There is a concerted effort to redefine a social "error" into a "creativity" and benefit.

IV.

Social management may thus be more precisely defined as the limitation and channeling of semantic response to verbal and nonverbal signs and sign-constellations, or, in one aspect fo language, the syntactical, sign structures.  Against such channeling two forces are at work.  The brain, such is its construction, constantly produces random variations of response--or at least at present (1973) the process is best understood as a random process, the nonrandom being obedience to the conventions and practices of a situation.  Second, as situations change by the introduction of novel factors, semantic response becomes inappropriate.  By this I mean that both these factors introduce incoherence into families of semantic response--a social role, for example.  For interaction to continue, such incoherences need to be resolved...(Ibid.)

V.

In a classroom, the inclusion students are often ignored.  What I mean is that the strategy employed is that of ignoring the "minor" distractions of a child who cannot seem to sit with a "normal" attention or focus.  Constant movement, if small and contained, can be ignored; a kind of running commentary, if quiet, can be ignored; even getting out of the seat and simply moving to another place in the room can be ignored.  Other things cannot.  Loud outbursts of any kind, which means any of the above taken "up a notch," cannot be ignored.  And all attention moves towards the student.  At that moment, what can be taught and/or what can be learned?  What behaviors are instructed?

VI.

There is no doubt that schools are failures of flexibility.  They are easily the most recalcitrant institution we have.  The law changes exponentially more often than our schools.  What is at question though is the way the schools are losing their public mandate; rather, the way the public mandate of a place of commonness, and ostensibly "equalizing" institution, is being made "unpublic" and so "uncommon."

VII.

"Yet today’s schools insist that we prescribe our kids drugs to rid them of their hyper-focus."

I just wanted to note the figuration here of "schools" as agents as I will return to this again when I post about the homeschooling essay by Paul Elie in The Atlantic.

Schools are institutions managed by the state, and currently the state is under aggressive management by self-interested politicians with economic ties to privatization companies.  

Schools are not entities to blame.  They are "policed" (we might see this as "policy-ed") by the very people who are elected to protect our public interests.  People are to blame.  Senators and representatives are to blame.  School Boards are to blame.  Superintendents are to blame.  These are the institutional handmaidens of self-interested power.

VIII.

I'm a guy who would easily ascribe much of our "new brains" to the configuration of our social "entertainments" but also our "change-oriented" lifestyles.  Constant imagery, constant change, constant stimulus.  Why not see this as a kind of adaptation instead of a disorder?  Perhaps this kind of brain is simply not constraining its randomness.  That's probably a worthy adaptive strategy.  Should we try to squelch this?  Or should we find ways to nurture it?  Should we encourage all brains to "randomize?"

"Science" as it theorizes (blindly guesses) is a kind of randomization engine in itself.  The Wikipedia entry on ADHD makes it very clear that all of the data is speculative, to put it kindly.  Here is my favorite part:

See also: Hunter vs. farmer hypothesis

As ADHD is more common than 1 percent of the population, researchers have proposed that due to the high prevalence of ADHD that natural selection has favoured ADHD possibly because the individual traits may be beneficial on their own, and only become dysfunctional when these traits combine to form ADHD.  The high prevalence of ADHD may in part be because women in general are more attracted to males who are risk takers, thereby promoting ADHD in the gene pool.

Sure, why not?  But that's unhelpful to say the least and bases unprovable nonsense on unprovable nonsense.

A behavior is "dysfunctional" when it is not conventionally appropriate.  That in no way precludes it from being highly beneficial.  

"Social management" lacks the flexibility to see dysfunction from a functional perspective.  Perhaps this is exactly the benefit that Thorkil Sonne and George Selkoe proposes.  Even if their perspectives are manipulative for profit, they are at least creating another possibility, an outlet for randomness, an appropriateness.

IX.

For aeons Satan and the other heavenly beings had been thronged in serried hierarchical order around the Heavenly Throne, worshipping the Divine Being.  One fine day, however, Satan said to himself, "Really, there must be something else to do."  What happened can be put, I think, quite simply.  he had been engaged in a socioculturally validated pattern of behavior--a pattern validated, moreover, by the highest possible authority; a pattern, worse still, which he had been created to perform.  His sin was simply that he innovated and performed an alternative pattern of behavior.  (Peckham, "Rebellion and Deviance.")

New Cure for ADHD: Recess

From HuffPo:

On April 15, the Centers for Disease Control and Prevention held a media conference at the National Press Club in Washington, D.C., to announce the release of a new report on school-based physical activity and its association with academic performance.

The report -- a review of 50 studies published in 43 articles -- reached a conclusion that is no great surprise to those of us who know kids well (I have five), and work to promote their health (both physical, and intellectual). Physical activity is good for body and brain, alike. As often seems to be the case, modern analytic methods and systematic review of evidence landed us right in the middle of Grandma's common sense counsel: sound mind, sound body.

The fundamental findings of CDC's 129-page report were that diverse interventions for kids of various ages produced a net improvement in academic performance more often than not. Over 50 percent of the studies analyzed improved some measure of cognition or academics. An additional 48 percent of the interventions contributed to fitness and health without compromising academics.

The benefits of physical activity probably need no introduction. Being active, in combination with eating well, is both the first, and only truly reliable, line of defense against the clear and omnipresent danger of childhood obesity. Even when physical activity is not preventing overweight, it is promoting vitality and helping to prevent disease. Independent of weight control, exercise can help keep diabetes at bay.

But while fitness, vitality, the avoidance of disease and the pleasures and glories of athletics might make a totally persuasive argument for routine exercise, the benefits don't stop there. The mind and body are genuinely connected, and the soundness of one redounds to the other.

Just consider that rates of behavioral disorders in childhood -- attention deficit disorder in particular -- are at an all-time, unprecedented high. How do we account for that? Certainly, there has been no radical shift in the genes that oversee the construction of children in the last generation. Children are much the same as they ever were. Their typical day is as it never was before.

Children used to play outside. They used to have physical education and recess during the school day. More and more, we take naturally rambunctious children, send them to schools from which recess and Phys Ed have been all but banished, bolt them to chairs all day long, and then watch them grow into adults we can't get off couches with crowbars! And, alas, along the way we medicate more and more of them for attention disorders. Could it be that WE are the ones who have not been paying sufficient attention to the natural, healthy restlessness of children?

Some years ago, when my son, Gabriel, was five, he joined the rest of my family in attending an evening talk I gave at Dartmouth. Whereas my daughters, all older than Gabe, were able to sit attentively as my talk began, Gabe was fidgeting out of his seat and tormenting his poor mother within minutes.

The story that ensued -- one I have told many times -- is that I interrupted my talk to intervene on my wife's behalf. I asked Gabe to run a lap around the large auditorium in which I was speaking. He did, completed it, then popped up from his seat and took off for another. As he came around at the end of lap two and kept on going, three other kids took off after him. When the four of them came around and kept going, several dozen children joined in!

As the ruckus played out, I noted to my audience that what we were observing was more important than anything I might be saying. I presumed all of the kids running laps around us were healthy. My son, certainly, was healthy -- although, lord knows, if you were cooped up with him at that age for any length of time you'd be tempted to medicate either him or yourself! But he was, and is, healthy. Rambunctiousness in children is normal.

And it should be treated with recess, not Ritalin! Gabriel had shown me how.

The result of Gabe's fidgety disruption was a program called ABC for Fitness (Activity Bursts in the Classroom), ultimately crafted not only by my research staff, but by experts in physical education, notably Marvin Christley with the New Haven, CT, Public Schools, and experts in education from the CT Department of Education. The program, available to all for free at http://www.davidkatzmd.com/abcforfitness.aspx, not only allows for intermittent bursts of activity throughout the day whenever kids 'need' one, but matches aerobic routines to grade level and subject matter. Teaching time actually goes up!

The program has rapidly spread to thousands of schools, because it's so easy, costs nothing, and works so well. We've analyzed the results in over 1,000 children and found not only improvements in fitness, but stable academic performance, and significant declines in medication use for both asthma, and ADHD. This report has been accepted for publication, and will be out soon.

The traditional three 'R's -- reading, writing, and 'rithmetic- remain as important as ever. Our own work, CDC's review of 50 studies, and every parent's experience with children indicate there is a strong case to add back a fourth that contributes its own benefits, while supporting the time-honored three. It is variations on the theme of recess- not Ritalin!