The Journal of the American Medical Association has released a report showing "psychotropic medications prescribed for preschoolers increased dramatically between 1991 and 1995," causing a revival in the debate over a "medical condition" some are saying is not a behavioral disorder requiring medication, but rather the result of bad parenting.

JAMA's report, issued last week, said the number of 2- to 4-year-olds on psychiatric drugs including Ritalin and anti-depressants like Prozac soared 50 percent in the early '90s.

Experts said they are troubled by the findings, because the effects of such drugs in children so young are largely unknown. Many doctors worry such powerful drugs could be dangerous for children's development.

Dr. Joseph T. Coyle of Harvard Medical School's psychiatry department said the study reveals a troubling trend, "given that there is no empirical evidence to support psychotropic drug treatment in very young children and that there are valid concerns that such treatment could have deleterious effects on the developing brain."

Dr. Grad Flick "These disturbing prescription practices suggest a growing crisis in mental health services to children and demand more thorough investigation," Coyle wrote in an editorial accompanying the study.

The report's authors reviewed Medicaid prescription records from 1991, 1993 and 1995 for preschoolers from a Midwestern state and a mid-Atlantic state, as well as for those in an HMO in the Northwest. The states were not identified.

Use of stimulants, anti-depressants, anti-psychotics and clonidine -- a drug used in adults to treat high blood pressure and increasingly for insomnia in hyperactive children -- were examined.

Substantial increases were seen in every age and drug category examined except anti-psychotics, though in some cases the actual number of prescriptions was quite small.

The number of children getting any of the drugs totaled about 100,000 in 1991, and jumped 50 percent to 150,000 in 1995. That year, 60 percent of the youngsters on drugs were age 4, 30 percent were 3 and 10 percent were 2-year-olds.

The use of clonidine skyrocketed in all three groups. Although the numbers were small, the researchers said the clonidine increases were particularly remarkable because its use for attention disorders is "new and largely uncharted." They noted that slowed heartbeat and fainting have been reported in children who use clonidine with other medications for attention disorders.

Michelle Barker, mother of an ADHD-diagnosed child whose doctor prescribed Ritalin to modify her son's behavior, has anecdotal evidence suggesting -- as the researchers do -- the number of youngsters on psychiatric drugs is still rising. Through her involvement in Internet support groups for parents of children with behavior problems, Barker said she is hearing of more and more 3- and 4-year-olds being put on drugs like Prozac.

"It's become a quick fix," said Barker, 39, of Hot Springs, Ark. Although the study did not examine reasons for the increases, Julie Magno Zito, the lead author and an assistant professor of pharmacy and medicine at the University of Maryland, suggested a few possibilities.

With an increasing number of children attending daycare, parents may feel pressured "to have their children conform in their behavior," Zito said. She also said there is a much greater acceptance in the 1990s of psychoactive drugs. Dr. Peter Breggin says "attention deficit disorder" is a sham

Dr. David Fassler, chairman of the American Psychiatric Association's council on adolescents and their families, said the medications studied "can be extremely helpful for some children, even quite young children." But they should be prescribed only after a comprehensive evaluation and in conjunction with other therapy, he said.

However, because their effects on younger children and their development aren't known, Fassler said, the Food and Drug Administration has recently instructed pharmaceutical companies to study the connection.

Their use is increasing in part because doctors are getting better at diagnosing behavior disorders at an early age, Fassler said. One of the more commonly known behavior disorders is Attention Deficit Disorder, with or without hyperactivity -- known as ADD/ADHD.

Grad L. Flick, who earned his Ph.D. in clinical psychology, has over 25 years' experience in both research and clinical practice with children who have ADD, learning disabilities, and behavior disorders. He and his wife, also a doctor and social worker, raised a child of their own with ADHD.

In defining ADD, Flick said, "Recent research suggests that ADD is a physiological disorder characterized by some structural or chemically-based neurotransmitter problem in the nervous system. It appears to be inherited, although ADD-like behavior can also be acquired through brain injury, exposure to toxins, or high fever."

Dr. Flick's website lists symptoms of the condition, which he says is diagnosed by observing the child in question:

Often fails to give close attention to details or makes careless mistakes
Often does not seem to listen when spoken to directly
Often does not follow through instructions and fails to finish tasks (not due to oppositional behavior or failure to understand)
Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort, such as schoolwork
Is often easily distracted by extraneous stimuli
Is often forgetful in daily activities
Often fidgets with hands and feet or squirms in seat
Often leaves seat in classroom or in other situations in which remaining seated is expected
Is often "on the go" or acts as if "driven by a motor"
Often talks excessively
Often has difficulty awaiting turn

If symptoms have "persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level," then the child is a possible ADD case.

But not all doctors believe ADD "symptoms" warrant drug use, or even a disorder diagnosis.

Dr. Peter Breggin, a veteran psychiatrist, author and founder of the Center for the Study of Psychiatry and Psychology, told WorldNetDaily the "disorder" of ADD is a sham.

"ADHD is a false diagnosis to encourage the prescription of drugs," he said. "It is simply a list of behaviors with no scientific basis."

Breggin said by pumping drugs into a child's system, the "brain is growing in an environment of toxic drugs."

"Psychiatry and the drug companies have convinced the public that the problems children have are biological and genetic, and this has opened the road to medicating soon after birth," said Breggin. "Soon they'll be giving drugs to pregnant women if the baby's overactive in the womb."

He also noted there is currently no technology for measuring chemicals in the brain, so claims such as Flick's that ADD is a "structural or chemically-based neurotransmitter problem in the nervous system" are merely speculation. The Maryland doctor believes the "cure" to ADD is not in drugs, but in parenting.

"We're a quick-fix society," Breggin explained. "Parents don't have the time or the motivation to properly raise our children. The attention deficit is in us, not our children."

Breggin's latest book, "Reclaiming Our Children: A healing plan for a nation in crisis," outlines parenting skills he believes are the answer to so-called behavioral disorders...