Flicking through the papers this morning, I was relieved to note that Supernanny returns to our screens tonight for the start of a new series. Jo Frost is just in the nick of time!
New NICE guidelines (covering England, Wales & N Ireland) state that attention-deficit hyperactivity disorder (ADHD) should be diagnosed in secondary care, and drugs such as Ritalin used ‘only as a last resort' and not given to the under-fives at all.
NICE recommends that drugs should be limited to children over five with severe ADHD (when other interventions haven't worked) and must be used alongside psychological therapy and support.
‘Support' includes parent training and education programmes, to be offered as a first-line treatment for hyperactivity, both for pre-school and school-age children, teaching parents how to create a structured home environment, encourage attentiveness and concentration and manage misbehaviour.
This sounds eminently sensible, particularly given the controversy surrounding the use of the ‘chemical cosh'. Googling ‘Ritalin' brings up stories questioning its efficacy, safety and long-term use, though it also highlights successes in children with genuine ADHD - a condition not to be confused with simple ‘bad behaviour'.
The aim is not to deny drugs to children with severe ADHD but to reduce the over-reliance on medication, points out Dr Tim Kendall, a consultant psychiatrist from Sheffield who is joint director of the National Collaborating Centre for Mental Health and helped draw up the guidelines. Numbers of prescriptions have apparently soared, almost tripling between 1993 and 2003.
However, whether there will be sufficient access to appropriate parent training and education programmes is highly questionable. Such resources must be tailored to the specific needs of ADHD patients, according to experts such as Andrea Bilbow, chief executive of the ADHD charity ADDISS. She warns that the courses mentioned by NICE are suitable for children with conduct disorder but not for those with hyperactivity.
The worry for health professionals is that they will be guided away from prescribing drugs to hyperactive children, but left without access to adequate alternatives.
If this is the case, we may find parents joining the hosts of unpaid carers unable to hold down jobs or look after their own physical or mental health needs, while Jo Frost and her many clones become permanent additions to our programming schedules.