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Pediatrics: Those Mean Little Kids
Friday, Oct. 18, 1968

Mother complains: "I don't know what's the matter—I just can't handle
him. He won't do anything I tell him. He won't sit still for a minute,
he smashes things, he's mean to his brothers and sisters, and when he
wants something and I don't give it to him right away, he throws a
temper tantrum." If Mother seeks medical help, the doctor is soon
exasperated as the little monster upsets ashtrays, spins the examining
stool, snaps the tongue depressors, and tries to grab the guppies in
the fish tank. At such moments, says California's Dr. Daniel M.
Martin, "it behooves the doctor to suppress that 'urge to kill' look
in his eyes."

There are hundreds of thousands, possibly millions of such boys and
girls in the U.S., and little is being done for them. There are not
enough pediatric psychiatrists to treat them all, and most of them get
no farther than the family doctor's office. Dr. Martin, a family
physician, told the American Academy of General Practice what he has
found works best: a daily dose of three or four tablets of
methylphenidate, trade-named Ritalin by the Ciba Pharmaceutical Co.

Children with this disorder are distinguished from ordinary bratty
youngsters, who may have one or two of the symptoms, by the fact that
their behavior is disturbed in five or six different aspects. There is
no single, simple explanation for what ails them, or even a generally
accepted medical label for it. Martin elects to call it the
hyperkinetic (excessively mobile) syndrome.

Victims, he says, have been described as brain-injured or brain-
damaged, or as having an organic brain defect resulting in
unsocialized, aggressive behavior. It is likely, most psychiatrists
agree, that these children have suffered (perhaps in the womb or at
birth) a minute brain abnormality that impairs their social behavior.
But they are not mentally retarded; their intelligence is usually
average or above.

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