Apr. 2. The clinic specializes in treating children suspected of suffering from psychiatric disorders
By Lee Yu-jin and Yang Sun-ah, staff reporters and Kim Yang-joong, medical correspondent
“Teachers told me that my child has a reading disability. It’s nothing serious, but I wanted to check just to be sure.”
A mother said this to a Hankyoreh reporter at A Learning Clinic in the Daechi neighborhood of the Gangnam district of Seoul on Apr. 2. She was anxiously awaiting the results of the tests done on her 10-year-old son, who was watching her vacantly.
The same six-story building, which overlooks Daechi Station, is also the location of B Learning Clinic. In B Learning Clinic, there is also a line of mothers and children who have come in for treatment. While both of these businesses call themselves “learning clinics,” they are in fact psychiatric hospitals for children specializing in attention deficit hyperactivity disorder (ADHD).
At the beginning of the school year, various juvenile psychiatric hospitals are filled with women and their children from the afternoon until late at night. A large number of the mothers who take their children to psychiatrists at the beginning of the school year suspect that their children might have ADHD. At the parent-teacher conferences that typically take place between the end of March and early April, teachers often tell parents whose children are distracted or unable to focus in class that they should seek professional help. Feeling anxious about the teacher’s remarks, most parents feel they have little choice but to see a psychiatrist.
Significant increase in the number of kids being treated for ADHD
Nowadays, more children who are suspected of having ADHD see psychiatrists than in the past, and the number of children being diagnosed with ADHD has increased considerably. According to statistics collected by the Health Insurance Review and Assessment Service, 56,957 children and teenagers had doctor’s appointments because of ADHD in 2011. This number has been increasing steadily following a major jump from 16,266 in 2002 to 48,095 in 2007.
As the number of people diagnosed with ADHD and the number of children taking ADHD medication increases, some are arguing that doctors are diagnosing ADHD excessively. This criticism is caused by doctors who prescribe ADHD medicine even in cases where the child is exhibiting only minor symptoms, as well as cases in which patients taking ADHD medication suffer from various side effects that no one had properly warned them of.
This is what happened in the case of 40-year-old “Lee Jeong-mi” (not her real name). Lee’s son, who suffered from a developmental disability, had been receiving play therapy and language therapy at a psychiatric hospital from an early age. Shortly before her son entered elementary school, his therapist and his pediatric psychiatrist said that he had symptoms of ADHD and suggested that he would need to take ADHD medication if he was going to attend school.
Lee expected that her son’s IQ would go up if he took the medicine. Starting in the fall of that year, when her son was six years old, until this year, when he turned eight, Lee had her son take the medication. “After he started taking the medicine, he didn’t eat as much, his face got very stiff, and he started to just burst into tears quite often,” Lee recalled.
Two weeks ago, she finally stopped giving him the medication. Now, her son’s appetite has returned, and he even eats snacks. His face is much brighter as well. “I just wanted my son to adjust to school more easily. I regret that this made me give him medication that he didn’t really need,” Lee said.
In addition to symptoms such as these, there are also many children who experience stunted growth, insomnia, and frequent seizures. Additionally, there are cases of children for whom the medication has little effect.Controversy caused by over-diagnosis and excessive medication
Pediatric psychiatrists have a variety of opinions about the over-diagnosis controversy.
“A debate is raging around the world concerning the over-diagnosis and over-treatment of ADHD, and South Korea is no exception,” said a professor at a university hospital, who asked that his name not be disclosed. “This has been caused both by parents who just want their child to sit down and study all day and get better grades and doctors who try to satisfy their wishes.”
On the other hand, there are also those who suggest that there are actually many children who are not able to get the treatment that they need because of the fact that many Koreans are afraid to receive psychiatric treatment.
“The percentage of children with ADHD is almost identical in countries around the world: between 4-7% of all children. People say that the number of cases has increased recently, but Korea falls far short of those figures,” said Kim Seong-gu, a professor of pediatric and juvenile psychology at Hallym University College of Medicine. “People used to hide ADHD, but now, as more people become aware of the condition, they have started getting treatment.”
“In the US, the controversy over excessive ADHD treatment was triggered by the fact that ADHD is frequently diagnosed in neighborhood clinics and that many people take the medication. In Korea, however, since most people go to psychiatric hospitals, over-diagnosis is not a widespread phenomenon,” said Kim.
Setting aside the controversy about over-diagnosis, there are also those who think that ADHD should be approached not so much through medication-centered treatment at hospitals but rather that schools, teachers, and parents should work to effect change in every aspect of children’s lives. Medication as a last resort and the need for a change in school culture
“Medication can be used as a last resort when it is determined that there are no other alternatives after the age of nine, when self-regulatory hormones stop being produced,” said Seok In-su, head of the Green Tree Children’s Psychology Research Institute. “But even then, the decision should be made carefully, since there is research showing that medication can inhibit growth and development and can damage the immune system.”
“You have to look at ADHD in terms of life as a whole, including how children communicate with their teachers, family, and peers,” said Park Gyeong-hyeon, head of the Fount Education and Welfare Research Center. “Psychiatric treatment is important, but it should not be relied upon exclusively. Children who have severe ADHD symptoms need improvement in a variety of areas, including family issues, physical health, home environment, and peer relationships.”
There are also many who argue that children will only become healthier when change comes to schools, at which the sole emphasis is placed on studying.
“It seems like there are more children now than in the past who experience emotional difficulties in the excessively competitive atmosphere at school,” said a teacher at an alternative school in Seoul surnamed Song, 36. “Just look at the children who are told at ordinary schools that they need psychiatric treatment but then are able to successfully adjust at alternative schools.”
“It isn’t enough to send children to private academies and give them extra tutoring,” said Kang Yong, director of the Korea Psychological Counseling Center. “You have to deal with these problems by getting kids to exercise or going traveling with them,” he suggested.
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