Ritalin on Trial

While some Houston parents fight what they charge is "a river of Ritalin" running through the schools, one father has gone to court to try to prove that, for his son, Ritalin use is Ritalin abuse.

The fight over the Ritalin use was one of the factors that, in November 1994, led a court to end Steven Keene and Patricia Radloff's joint custody arrangement. The court ruled that Keene's refusal to administer Ritalin to his son constituted a threat to the boy's health and safety, and gave sole custody to the child's mother.

A series of court appearances, charges and countercharges followed, but last September Steven Keene finally got his chance to put Ritalin on trial. Getting there had not been easy; Keene estimates he had spent close to $60,000 on his custody battle over the previous year and a half. His printing and graphic arts business had entered bankruptcy proceedings for an unpaid sales tax bill. His ex-wife had sued him for failure to pay child support, and he had been jailed twice for contempt of court.

Early on, Keene, an articulate and persistent man, tried to cut costs by acting as his own attorney, but by the time he entered Judge Linda Motheral's courtroom, he had hired attorney Shawn Casey to represent him.

Proponents of the ADHD diagnosis believe that the disorder is hereditary. If it is, and if his son actually has ADHD, then Keene doesn't seem to be the source. He is one focused individual. The 36-year-old grew up on Long Island and attended both public and private schools, finally dropping out of high school from boredom, he says. It was only when he got into college that he felt academically challenged. He thinks something similar may be happening to his son. The child's misbehavior may stem from his intelligence, Keene believes, not from a mental disorder. He points out that the diagnostic manual for mental disorders reminds physicians that "inattention in the classroom may also occur when children with high intelligence are placed in academically understimulated environments."

In private school, says Keene, where his son got a lot of individual attention, the child made all A's but had N's in conduct, for "needs improvement." In public school under Ritalin, Keene adds, his son's conduct has become satisfactory, but his grades are high C's and low B's.

And that points to Keene's central accusation: that Ritalin is a drug prescribed to make life easier for the teachers and parents, not for the child. Not for his child, anyway.

Shortly after his son started taking Ritalin, Keene remembered that a couple of months earlier he had tuned in to a Rush Limbaugh program that featured a psychiatrist who criticized the use of Ritalin for treating children. Keene called Limbaugh's producers, and within an hour he had a fax with the psychiatrist's name, Peter R. Breggin. A Harvard-trained doctor and consultant to the National Institute of Mental Health, Breggin was widely critical of his profession in a book titled Toxic Psychiatry. Breggin has called for the abandonment of the diagnoses of ADD and hyperactivity and the end to what he considers the mass medication of children.

Breggin put Keene in touch with San Diego physician Fred Baughman, who would become Keene's expert witness in his attempt to debunk ADHD and Ritalin. Baughman spent a day on the stand in Judge Linda Motheral's family law court. Baughman, who recently retired after 35 years as a child neurologist, has been relentless in his questioning of the ADHD diagnosis. He disputes that there is any organic symptom of the disease, and has challenged the medical establishment to show one. On that issue, he knows himself to be on safe ground, for although the popular literature and many scientists theorize that some sort of chemical imbalance in the brain causes ADHD, no one has pinpointed a specific cause of the disorder. Baughman contends that ADHD is not a disease or even a disorder. Instead, he says, it's a list of symptoms that are subjectively evaluated by doctors, teachers and parents.

Patricia Radloff's attorney didn't bother to put on an expert witness to rebut Baughman. That may have been a good tactic. After all, giving a child Ritalin therapy isn't exactly exotic these days, and Baughman's views are known to be in the medical minority.

At the end of the custody hearing, Motheral told the parties that while she could make a ruling quickly, she thought it might be better if young Steven were evaluated by an independent team of medical and psychological experts. Both sides agreed to the judge's request for a medical evaluation, but the process of picking a team of physicians has been slow. Keene wants to make certain that someone on the panel has a healthy skepticism about diagnosing ADHD. Still, he believes -- or perhaps hopes -- that Motheral asked for the evaluation because she takes his son's complaints about Ritalin's side effects seriously.

But Keene wonders how objective such an evaluation will be if his son is still on Ritalin while he's being evaluated. And he doesn't understand why other adults can't discipline his son the way he does: with a pointed finger and a sharp voice. Keene says that during weekend visits, once his son has come down from the drug, he manages himself well. Keene still can't shake what seems to him an essential unfairness in forcing his son to take a drug for something that is not life-threatening.

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