Psychotropic Medications vs Alternative Treatments for Children

When working in the field of School Psychology, I worked with numerous families that chose to medicate their young children.  There is ample documentation of the benefits of early intervention, and effective pharmaceutical intervention can help young children perform better in school, build self-esteem, and have more positive peer interactions.  I would never consider myself anti-methylphenidate person overall.  However, my concerns about giving young children psychotropic medications largely stem from a young child’s inability to effectively communicate with practitioners or other adults.  As with any type of treatment plan of an ongoing disorder, the treatment plan should be tailored to fit each individual child.

Concerns about psychotropic medications

Most adolescents or adults can adequately verbalize how treatments are working and what is bothersome.  Primarily, adolescents and adults have a better baseline as to what is normal and what is not.  They can accurately convey the difference between routine stomach upset and stomach upset that requires emergency medical treatment, such as experiencing symptoms associated with a bleeding stomach ulcer.  However, children in the early childhood stages of development (approximately those younger than age 8) often lack the frame of reference needed to verbalize concerns.  Instead, adults in different settings must watch them and look for any potential warning signs of medical concern or signs of pharmaceutical success.

Concerns about alternative medicines and treatments

Many alternative medicines and treatments have little evidence to support their efficacy.  However, most psychotropic pharmaceuticals have not been studied on people under the age of 18 by the FDA.  They are legally prescribed for children under the age of 18 for off-label uses.

I am under the conviction that if any treatment is working, it should not be altered.  There are many different reasons why various alternative medicines and treatments may improve a child’s behavior or ability to focus.  One reason that a child might improve after being dragged by his parent to acupuncture sessions is that he dislikes acupuncture and knows that the sessions will be discontinued after improvement is seen.  Conversely, he might improve due to the acupuncture itself.  In the end, what matters is that the child did improve.

Documented calming effects of certain diets and herbal remedies

Old wives’ tales have been given more credence by recent research.  For example, chicken soup does have properties that help to cure colds.  And, warm milk will help people of all ages sleep.  There has been recent controversy that there is not enough evidence to support gluten-free and casein-free diets in children with Autism.  Conversely, there has not been ample documentation that gluten-free and casein-free diets are damaging to children.  In addition, many parents can come up with simple ways to make sure their child does not feel left out at a birthday party by brining special cupcakes that fit their child’s dietary needs.

Alternative medicines including Chinese herbal teas and raw herbs can have calming effects to assist in treating behavioral problems or treat symptoms associated with anxiety, such as upset stomach.  In addition, children will often like the taste of a certain type of tea or herbal remedy mixed into a smoothie.  Drinking herbal teas or infused smoothies will not typically make a young child feel “weird” or that something is wrong with him.  Most young children know that medicine is used to treat disease.  However, most young children conceptualize tea or smoothies as tasty drinks.

When psychotropic medications are strongly recommended

Unless there is outstanding documentation that suggests a young child requires psychotropic medication to treat a severe mental illness (e.g. outstanding and developmentally inappropriate behaviors such as extreme violence towards others or self along with a family history of severe mental illness), psychotropic medications should be given to young children with caution.  It is highly important that parents work with a reputable child psychiatrist rather than a family physician when giving children psychotropic medications.  A child psychiatrist is more likely to know what medicinal courses of action are best to take, what normal reactions to medications are, and when to be concerned.

The bottom line

Who cares why any treatment works as long as it works?  Finding an effective solution to treating childhood mental illness or behavior problems is rarely simple and requires continual collaboration with physicians, medical professionals, alternative medicine providers, and school staff.  Often, alternative treatments without a solid evidence base work.  It is of paramount importance to always listen to children carefully as well as collaborate with the people who spend the most time around children, such as teachers and caretakers.  Find something that works, and stick with it.