Education Task Force Co-Chairs:

                                                                                                                                                Leslie Jackson, AOTA, 301-652-2682

                                                                                                                                                Paul Marchand, The Arc, 202-783-2229

                                                                                                                                                Katy Beh Neas, ES, 202-347-3066

                                                                                                                                                Steve Spector, CHADD, 301-306-7070

                                                                                                                                               Jane West, HECSE/TED, 202-289-3903

The Child Medication Safety Act, S. 1390

The Consortium for Citizens with Disabilities (CCD) opposes the Child Medication Safety Act, S. 1390, because it burdens local education systems with an unnecessary federal requirement that could create barriers to learning for children with disabilities, particularly children with serious emotional disorders. S. 1390 specifies that schools that do not implement state-developed policies and procedures to prevent school personnel from requiring that a child be placed on a controlled substance as a condition of attending school can lose their federal education funding. CCD is concerned that despite S. 1390’s language protecting specific communication between parents and school personnel, if enacted into law, this enforcement provision threatening a loss of school funds may cause school administrators to become overly cautious and discourage teachers from aiding parents in the identification of children with serious emotional disorders. This could include communicating classroom observations about a student’s learning difficulties or behavior to parents or other treating professionals.

Although there have been highly publicized and isolated instances where school personnel have inappropriately pressured parents to place their children on medications, there is no data to suggest that coercion of parents regularly occurs or that this is a pervasive national problem. In schools where it has occurred, the situation has been handled at the local level by school boards, which have resolved the issue without state or federal intervention. CCD would support a study by the General Accounting Office (GAO) to determine the prevalence of parent coercion by school personnel.

Medication assessment and prescription is the exclusive role of a qualified medical professional, not school personnel. The decision to include medication, as part of the treatment plan for a child’s emotional or behavioral disorder should be a decision agreed upon by parents and caregivers in close consultation with a qualified and trusted medical professional. A key concern with S. 1390 is that it discriminates against child and adolescent mental disorders by singling out for study definitions and prescription rates of psychotropic medications, as opposed to other prescription medications. This language is contrary to the science on children’s mental disorders. The American Medical Association (AMA), the American Psychiatric Association (APA), the American Academy of Child and Adolescent Psychiatry (AACAP), the American Academy of Pediatrics (AAP), the National Institutes of Health (NIH), and the U.S. Surgeon General all recognize the safety and efficacy of psychotropic medication as a treatment for certain children’s mental disorders, including attention-deficit hyperactivity disorder (ADHD).

The information that school personnel provide to physicians and other health professionals about a child’s behavior in the classroom is critical to an accurate diagnosis of a child’s serious emotional disorder, learning disability or other disability. Because children spend the majority of the day in the classroom, teachers and school health professionals are often the first to notice learning, functioning and behavioral problems that should be communicated to parents and caregivers. Writing in Emotional and Behavioral Disorders in Youth, Fall 2002, Peter Jensen, M.D., one of the authors of a 1999 National Institutes of Mental Health (NIMH) study on ADHD, identifies one of the key problems leading to inadequate assessments, treatment and prescribing practices as a “failure to include teacher-based information as a necessary component of the diagnostic evaluation.” He goes on to suggest that better training and education of medical providers and parents is necessary to prevent an over-reliance on medication, in those communities where it does occur.

Collaboration and open communication with school personnel is essential to ensuring that a child receives an accurate diagnosis and comprehensive Individualized Education Plan (IEP) that meets their needs to succeed academically. CCD is extremely concerned that S. 1390 could discourage the identification of children with disabilities, violating the principle of leaving no child behind. The consequences of untreated mental disorders in children and adolescents are severe and life-long. Children and adolescents with untreated mental disorders are at high risk for school failure, delinquency, substance abuse and entrance into the juvenile justice system. In 2000, the Coalition for Juvenile Justice reported that 50-75% of juvenile offenders have one or more diagnosable mental disorders.

CCD opposes S. 1390 because it discriminates against mental disabilities. We remain concerned that S. 1390’s requirement for states to develop policies on this issue for schools may create confusion and discourage open communication between parents and school personnel about a child’s learning difficulties. The isolated nature of the problem does not warrant a federal compliance mandate on every school district. We support legislation and policies that promote early identification and interventions for children with emotional and behavioral disorders, not policies that would threaten that process. This goal is supported by the President’s New Freedom Commission on Mental Health, which in its final report, Achieving the Promise: Transforming Mental Health Care in America, recommended that schools play a larger role in the delivery of mental health services for children.