Ritalin Nation: Rapid-Fire Culture and the Transformation of Human Consciousness

British Medical Journal, March 10, 2001 by Simon R Wilkinson

Ritalin Nation: Rapid-Fire Culture and the Transformation of Human Consciousness Richard DeGrandpre WW Norton, 9.95 [pounds sterling], pp 284 ISBN 0 393 32025 1

Rating: *

If children's behaviour becomes "out of hand" it is understandable that parents may seek a diagnosis to explain it away. There are several to hand. Ritalin Nation looks at one such diagnosis--attention deficit disorder. Richard DeGrandpre proposes that US culture has medicalised child development and that attention deficit disorder is a child strategy for coping with the "go faster" ethos of modern life. In a medical model the disorder is a deviance from the norm, and the underlying biological changes require a biological treatment--methylphenidate (Ritalin).

DeGrandpre, a psychologist, takes issue with the way in which attention deficit disorder is attributed to an underlying medical cause. Development, he argues, includes a continuous process of learning how to handle responsibility. Is attention deficit disorder being used as a medical solution to relieve parents of guilt, and children of responsibility for their actions?

Ritalin Nation discusses the issue of how much stimulation is good for a child. Intrusive parenting based on adults' parameters and timing, says De Grandpre, is over-stimulation, and it is associated with biological changes in children such as a change in brain amines. The book's central thesis is that when adults dive into child rearing from 6 pm to 9 pm, work permitting, they put their children at risk of developing attention deficit disorder.

Although the book has some interesting data on the psychosocial aspects of the disorder, it fails to present a balanced biopsychosocial model of what is a complicated condition. As with schizophrenia nearly 30 years ago, the time has come for the World Health Organization to look at the different prevalence of attention deficit disorder in different countries. The diagnosis clearly has biological correlates and is also associated with child abuse and neglect.

The author's mission is to encourage Americans to slow down. The Sami in northern Norway say that time is always coming rather than going. Perhaps De Grandpre should persuade the United States to take on the Sami's view of time. But who knows whether this would protect children from attention deficit disorder?

Reviews are rated on a 4 star scale (4=excellent)

Simon R Wilkinson consultant in child and adolescent psychiatry, Oslo, Norway