

Karen Effrem, MDKaren R. Effrem, MD
EdWatch Board of Directors
Alliance for Human Research Protection Board of Directors
ICSPP Board of Directors






The Minnesota Roadmap clearly states what that plan is for young children.  It proposes to, “…integrate early childhood screening systems to assure that all children ages birth to five are screened early and continuously for the presence of health, socioemotional or developmental needs” and then to implement, among other things, “mental health services and early care and education.”



•    Not a single peer reviewed study exists to support the theory of a neurotransmitter (chemical) imbalance as the cause of mental illness or the means of treatment.

•    There are no structural, functional, or laboratory tests or chemical markers that can consistently identify any of the mental illnesses.

•    Experts like the US Surgeon General, the World Health Organization, the chief of child psychiatry at the National Institutes of Mental Health, psychiatric textbook authors, and the authors of psychiatry’s Diagnostic and Statistical manual, considered the gold standard of psychiatric diagnosis, call these criteria “subjective,” “impressionistic” and “social constructions.”

•    These same experts also state that it is very difficult to accurately diagnose children due to rapid developmental changes.

•    The screening instruments are based on these highly subjective diagnostic criteria and are not at all like medical screening tests, such as for hearing or vision.

•    In fact, the technical data for the Ages and Stages questionnaire being promoted for this legislation admits that its overall positive predictive value is only 27%.  That means that for every 27 children that are supposedly correctly identified by the admittedly subjective DSM or other impressionistic screening instruments, 73 are falsely told that something is wrong with them and referred for further evaluation.  That is three times the rate of false positives to putative true positives and worse than a coin flip. Any other screening procedure with that large a false positive rate would be eliminated from consideration with hysterical laughter.

•    A movement already exists within organized psychiatry to label and drug people mentally ill based on highly controversial political and religious criteria, such as “intolerance.”



•    Dr. David Willis, medical director of the Northwest Early Childhood Center said, “Psychopharmacology is on the horizon as preventive therapy for children with genetic susceptibility to mental health problems.”

•    Rates of psychotropic drug use in children, often in unapproved, unstudied multi-drug cocktails, as young as age two, have already skyrocketed and will only increase with widespread mental health screening. Psychiatric drugging coerced by schools has resulted in several deaths and has prompted at least 7 states and the US House of Representatives to pass legislation against it.

•    No psychiatric drug has been found to be effective in the long term for treating ADHD or depression in children.

•    Every class of psychotropic drug is either under the FDA’s most stringent black box warning short of a ban for serious or fatal side effects or is being so considered.  These side effects include suicide, violence, psychosis, diabetes, and cardiac sudden death. There are no studies available of long–term safety or effectiveness or the effects on the brains and bodies of growing children.

•    Government and pharmaceutical industry promoted drug regimens are rapidly depleting Medicaid budgets.

•    Even if psychosocial or educational programs were used instead of medications, Dr. Benedetto Vitiello, head of child psychiatry at NIMH said in 2002, “Little research has been conducted to study the effectiveness of psychosocial interventions in young children, and the long-term risk-benefit ratio of psychosocial and pharmacologic treatments is basically unknown.”

•     In November of 2005, researchers at the University of California and Stanford released a study stating:

“Attendance in preschool centers, even for short periods of time each week, hinders the rate at which young children develop social skills and display the motivation to engage classroom tasks, as reported by their kindergarten teachers…Our findings are consistent with the negative effect of non-parental care on the single dimension of social development first detected by the NICHD research team [in 2002]”

This data is suggesting that not only is there no scientific justification for psychosocial interventions including preschool education, but that these interventions may be causing some of the very problems that supposedly justify screening and that they are purported to treat .

In summary, universal mental health screening and treatment for preschool aged children is far beyond the proper role of government, lacks scientific and medical justification and will have dangerous effects on our youngest citizens.   The premier dictum of medicine is “First, do no harm.” Both the psychiatric profession and policymakers would do well to heed that advice.