Hyperactive schoolchildren, addiction, Tony Blair and others

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Hyperactive schoolchildren need specialist help, not expulsion





Hyperactive schoolchildren need specialist help, not expulsion

Sir: As a paediatrician, I was dismayed to read the recommendation at the annual conference of the National Association of Schoolmasters Union of Women Teachers that violent and disruptive children should be expelled (report, 30 March). Nowhere in the article was there any mention that a sizeable proportion of these children might have a medically treatable condition, attention deficit hyperactivity disorder (ADHD).

ADHD is a common childhood condition, with an estimated prevalence of about 5 per cent. These children typically have a high level of physical activity, short concentration span and a tendency to have quick reactions, acting impulsively on their emotions. Children with ADHD often present in some of the ways described in the article, shouting and hitting or throwing things around the classroom. Many of these children do not intend to get into trouble but the speed of their responses means that often they do not have time to think before they act. The children's lack of control over their behaviour may make modification using behavioural strategies (reward and punishment) ineffective. If untreated, the behaviour often continues, progressing to educational failure and delinquency. If the diagnosis of ADHD is considered and appropriate children are treated with stimulant medication, the improvement in behaviour may be dramatic.

Teachers can play a vital role in identifying children with possible ADHD in the early years at primary school. This may provide the opportunity to offer effective treatment before serious problems develop.

Dr ALISON POULTON
Penrith, New South Wales

New thinking to tackle addiction

Sir: Your article "There is a way to get addicts off drugs" (29 March) makes for sobering reading - there is a growing need for effective treatment of addiction, with all its social, psychological and medical complications.

However Deborah Orr ignores current medical evidence by preferring the old "social" view of addiction. By its very nature, addiction is a lifelong relapsing and remitting disorder - relapse rates are high following rehabilitation. There is scant evidence that simply increasing residential rehabilitation will be effective. Similarly, she is quite wrong to denigrate existing maintenance treatment of addiction as a service "which does not address the underlying psychological difficulties that often prompt drug abuse". At present it is our most effective treatment option.

Addiction itself is not a "failure of will", but a definable and measurable biological process which affects the brain, emotions and behaviour of the addicted person. These are processes related to exposure to drugs, and alter the biology of the brain permanently. Drs Laurence Reed, Patricia Conrod and others at the Institute of Psychiatry are exploring ways of using brain imaging and scanning to identify these changes, as this may well lead to completely novel treatments.

At present society is using systems based on outdated models of addiction and incarceration in the vain hope that by doing so it will solve a growing social problem. It is vital that in any treatment we take on board a new understanding of the neurological basis of addiction.

RICHARD HORNSBY

Dr LAURENCE JOHN REED
The Institute of Psychiatry
London SE5

Sir: While in wholehearted agreement with the thrust of Deborah Orr's article, I wonder why it is cast in a feminist light. In order to make the case for women-only treatment, she states that "in our prisons last year, 95 inmates committed suicide, 13 of them women". No suicide should be treated lightly, and any initiative to reduce their number should be considered seriously, but why the emphasis on the number 13? Are not the 82 non-women worthy of consideration? Imagine the fuss a liberal paper such as The Independent would make if the figures were the other way round.

D M PYATT
Preston, Lancashire

In defence of Blair

Sir: I was horrified by some of the letters on 30 March, under the heading "Tactical vote swaps will only help Blair". We have to stop this rubbish, as if Tony Blair is so bad that he needs to be removed at any cost, which would mean going back to the Conservative Party's under-funded society of privilege.

Under Tony Blair Labour has spread investment widely, to include funding for free nursery places and free level 2 education for adults. The minimum wage continues to rise, tax credits are available for those who need them, and child poverty will be halved by 2010 if current progress continues.

Then there's Africa: Labour didn't have to double the aid budget, and Tony Blair didn't have to set up the Africa commission. Although the Conservatives, in their own way, have come around to the idea of funding mainstream health and education adequately, they wouldn't match Labour elsewhere.

How can we get so high and mighty, directing indignation against Tony Blair when we risk losing so much that is good?

JAMES C BUCKLEY
Rotherham, South Yorkshire

Politics of fear

Sir: The four-letter f-word is already appearing in the election campaign. It affects the way we live our lives, our politicians manipulate it and the Archbishop of Canterbury says they should use it less: "fear".

Michael Howard says he wants yobs to fear the police. Respect the police and society, yes. Be confronted by the police and society, yes. Gain insight into what they are doing to people's lives, yes. Be punished appropriately for anti-social behaviour, yes. But promoting a culture of fear leads to more fear and more violence. Many of these youths spent their childhoods in fear of violent parents.

Leading us into the Iraq war showed us how people's fear can be whipped up and used to achieve a desired outcome. Using fear to win votes? No thanks.

Dr LESLEY MORRISON
Peebles, Scottish Borders

Callaghan's record

Sir: It is not true that James Callaghan's period as foreign secretary was typified by the "scandalous nepotism" of appointing his son-in-law to the Washington embassy, as Paul Barker maintains ("The working-class hero with a tragi-comic flaw", 28 March). Peter Jay was appointed by the hapless and hopeless David Owen some time later.

Further, though there has been some idle and unsubstantiated speculation, there is no evidence that Harold Wilson had experienced any signs of Alzheimer's when he resigned in 1976. I saw him on a couple of occasions shortly beforehand and he was as sharp as ever. It was certainly not, as Barker asserts, the cause of his resignation.

Barker says that Callaghan was the "keeper of the cloth cap". At the time, we all saw George Brown and Ray Gunter and, for a while, Frank Cousins, as sharing that role in the Cabinet.

Harold Macmillan was not "brought down" by people he trusted. He resigned because he believed, erroneously, that his prostate condition was more severe than it was.

PETER GRESHAM
London W14

Stamp of approval

Sir: J Samuel (letter, 31 March), should take a look at the history of commemorative stamps which shows that battles fought sixty years ago have indeed been remembered in the past by Royal Mail. Battle of Britain stamps were issued in 1965, Royal Air Force stamps in 1986 and D-day remembered in 1994. As recently as 2001 the Royal Naval Submarine Service was remembered. Last year Royal Mail went further back in history and issued Crimean War stamps and this October, stamps depicting the 200th anniversary of the Battle of Trafalgar will be on sale. Stamps should, quite rightly, focus on remembrance, but this needs to be balanced with all aspects of our history incorporating culture, past and current achievements and our social diversity.

RICHARD QUINLAN.
London SW9

Seal hunt in Canada

Sir: I refer to your article on the Canadian seal hunt and would like to draw your attention to some of the facts ("Canadian waters stained red by baby seal cull", 31 March).

The seal hunt is a sustainable activity based on sound conservation principles, with a herd in excess of five million animals - nearly triple what it was in the 1970s.

It has been illegal to hunt seal pups since 1989; only independent, fully-weaned animals are taken. Seals are not skinned alive; following death, the animals often undergo a series of nerve-reflex convulsions mistakenly interpreted by some as indicating that they are still alive.

The most recent Canadian Veterinary Medical Association Report indicates that Canada's seal-hunting methods are humane. What's more, the Royal Commission on Seals and Sealing found that the methods used in the seal hunt compare favourably to those used to hunt other wild animals.

The hunt is closely monitored and tightly regulated, and Canada's enforcement of sealing regulations is thorough and comprehensive.

MEL CAPPE
High Commissioner for Canada
London W1

Zimbabwe food aid

Sir: Jeremy Gordin and Daniel Howden are quite wrong to say that "the food aid that has poured into Zimbabwe from the World Food Programme in the last two years never seems to reach Mr Mugabe's opponents" ("Fear and loathing on the road to Harare", 16 March).

WFP's policy is to provide food to the most vulnerable. The vast majority of our operations in Zimbabwe are in the provinces of Matabeleland, Manicaland and Masvingo - the areas of the country worst affected by food insecurity. Most WFP beneficiaries are women and children, as well as people affected by the HIV/Aids pandemic.

Your article describes the situation in Victoria Falls. Had its authors contacted us, we could have taken them just down the road to Hwange district, where 21,000 primary school children and a further 1,500 pre-schoolers are supported by WFP.

KEVIN FARRELL
Country Director
The United Nations World Food Programme
Harare

US weapons report

Sir: You report that "A bipartisan US commission has delivered a devastating critique of the intelligence assessment of Iraq's pre-war weapons of mass destruction" (1 April).

Whatever we might think of the current US administration, we should admire a democratic system which is capable of independent and determined inquiries into government conduct, in a way which our own so clearly is not.

ALEX SWANSON
Milton Keynes

Extra helpings  

Sir: The UK taxpayers are such a generous bunch, they even pay to feed other people's children! Is it so outrageous to consider that parents might actually provide their children with a packed lunch to take to school and perhaps even a hot meal at home in the evenings?

P BODEL
Stow-on-the-Wold, Gloucestershire

Academic research

Sir: Your report (22 March) on the award of full university status to six university colleges implies that they offer "only teaching rather than research". To speak for my own establishment, we have been awarding research degrees under accreditation from a Russell Group university for at least ten years. The research strengths of Winchester staff are reflected in the national Research Assessment Exercise, where we have several groups recognised as conducting research of national and international excellence.

Professor PAUL LIGHT
University College Winchester

BBC and Jerry Springer

Sir: The BBC has always been a relentless opponent of self-appointed and unaccountable minority groups that seek to impose their moral views on the rest of us. In the wake of the Jerry Springer - the Opera affair, can we expect a searching, in-depth and critical investigation of the workings of TV producers and of the BBC's board of governors?

PAUL McGREGOR
Moreton, Merseyside

Paying for ski trips

Sir: My sister and I have just returned from a week's skiing holiday which we funded by doing a paper round. We would love to go back next year. If Charles and the boys would like to take over the paper round, we would be more than happy to do a couple of photo shoots.

KATE HUMPHREYS
Liverpool

Dr Johnson's birthplace

Sir: Samuel Johnson, of Lichfield, Staffordshire, a "Black Countryman" (The A - Z of Dr Johnson's Dictionary, 31 March)? I shudder to think what he would have said about this typically metropolitan geographical illiteracy.

GRAHAM DOWNIE
Studley, Warwickshire

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