VOICES brings the perspectives and experiences of children into international debates around rising child psychiatric diagnoses and the increasing use of drugs in child psychiatry. These voices contribute to an empirical evidence base that helps to inform ethical debate, clinical judgment, and national policy. VOICES is a Wellcome Trust funded research project led by Professor Ilina Singh at Kings College London.
Attention Deficit/Hyperactivity Disorder (ADHD) is the most common child psychiatric disorder in the world. Estimates of ADHD prevalence amongst school-age children vary within and across world regions. Estimates also vary according to how prevalence rates are measured. According to one study, Europe and North America have lower prevalence of ADHD (5% - 6%); and Africa and South America have higher prevalence (8.5% - 12%). Approximately 75% of children diagnosed with ADHD are boys.
Methylphenidate, marketed under different names including Ritalin or Concerta, is the most common form of treatment for ADHD. Methylphenidate consumption is increasing rapidly and significantly in most countries around the world. The United States consumes more methylphenidate than all other countries combined. In 2005, the US consumed 80% of the world's methylphenidate.
Rising consumption of stimulant drugs has motivated considerable public and ethical debate. Ethical concerns have focused on the implications of stimulant drug use for key dimensions of children's moral identity. These dimensions include children's conceptions of...
* Personal authenticity (who am I? how am I different from others? can I be myself?)
* Autonomy and agency (what can I do? what can I affect? what can I create? what can I become? what can I decide?)
* Children's moral self-evaluations (am I a good person? what do others think of me?)
The VOICES study set out to understand how children think, feel and live these dimensions of moral identity and moral experience. A primary aim of the study was to understand whether children's perspectives and experiences support claims about the potential harms of stimulant medication. Between 2008 and 2010 we interviewed over 150 children, ages 9-14, in the US and the UK. Three groups of children were interviewed: children who were taking stimulants for a diagnosis of ADHD; children who have a diagnosis of ADHD but were unmedicated; and children without a psychiatric diagnosis. We are now in the process of writing up the findings from the VOICES study and giving talks to academics, health professionals, educators and lay people about our discoveries.
Wellcome Trust Grant # 080209