Parents Charged with Killing 4-Yr-Old by Overmedicating for ADHD

By Carol Johnson

All of the people around little Rebecca Riley noticed for months that she was weak, listless, and lethargic. All of the people who were supposed to be looking out for Rebecca—teachers, the preschool principal, neighbors, the school nurse, and social workers—suspected there was something wrong with the girl but never took their suspicions a step further to seek help for her. And on December 13, Rebecca died of an overdose of prescription drugs given to her by her parents.

Rebecca’s parents, Michael Riley, 34, and Carolyn Riley, 32, have been arrested and charged with murder for drugging their daughter to death. The Rileys told police that Rebecca had been diagnosed with ADHD when she was just 2½ years old, and Rebecca’s psychiatrist had prescribed the same medications for her that had been prescribed for Rebecca’s older sister and brother several years earlier, when the same psychiatrist had also diagnosed them with ADHD.

The psychiatrist, Dr. Kayoko Kifuji, gave the Rileys prescriptions for Clonidine, a blood pressure medication also used for ADHD, and Depakote, an anti-seizure mood-stabilizing drug. Both medications are FDA-approved for use in adults only, but doctors can legally prescribe them for children. Kifuji vehemently denies having any responsibility for Rebecca’s death, although her license has been suspended while the state medical board investigates her treatment. Kifuji told police that her diagnoses of ADHD and bipolar disorder were based on the family medical history that Carolyn Riley had told her. She said that Carolyn had described Rebecca’s behavior, but Kifuji herself had only briefly observed "symptoms" of ADHD during office visits.

Kifuji told investigators that when Carolyn Riley told her in October 2005 that she had increased Rebecca’s nighttime dose of Clonidine, she warned Carolyn that the higher dose could kill the little girl. But Carolyn disputed Kifuji's claim, saying that the psychiatrist had told her she could give Rebecca and her sister extra Clonidine at night to help them sleep.

In interviews with police, a school nurse said that Rebecca had been so weak in the final months of her life that she seemed like "a floppy doll." The principal at Rebecca’s preschool, Johnson Early Childhood Center in Weymouth, about 20 miles south of Boston, had helped the little girl off the bus because she was shaking so badly. Teachers and staffers at the school said that they called Rebecca’s mother on numerous occasions to say that Rebecca was acting "out of it," but Carolyn Riley told them that her daughter was just tired because she hadn’t been sleeping well. Pharmacists called Kifuji twice to complain that Carolyn Riley had requested more and more Clonidine, even though Rebecca’s prescription wasn’t due for a refill. A neighbor of the Rileys said that all of the children "didn’t look right" and seemed "like little robots."

Rebecca’s uncle, James McGonnell, and his girlfriend, Kelly Williams, who lived in the same house, told police that the Rileys would put their children to bed as early as 5:00 p.m., and that Rebecca often slept through the day, only getting up to eat. McGonnell said that Michael Riley would tell Carolyn to give the kids pills when they were "acting up." Relatives told police that the Rileys called Clonidine the "happy medicine" and the "sleep medicine."

According to McGonnell, in the last few days of her life, Rebecca wandered around the house disoriented and sick. But Carolyn told investigators that they weren’t worried about her, and that "it was just a cold." Williams told investigators that the night before Rebecca died, she seemed "out of it" and was pale and sniffling. At one point she knocked weakly on the door of her parents’ bedroom and called softly for her mommy, Williams said, but Michael Riley opened the door just a crack and yelled at Rebecca to go back to her room.

McGonnell told police that later that night he heard Rebecca gurgling as though she had something stuck in her throat. He wiped vomit from his niece’s face, then went to her parent’s room, kicked in the door, and shouted at them to take Rebecca to the emergency room because she was really sick. But instead, Carolyn Riley told police, she gave Rebecca another half tablet of Clonidine.

On December 13, Rebecca was found dead lying on top of a pile of clothes and magazines on the floor in her parents’ bedroom, wearing only a pink pull-up diaper and clutching a stuffed bear. The medical examiner said that the little girl had died a painful death, with the overdose of Clonidine causing her organs to shut down slowly and her lungs to fill with fluid.

John Darrell, Michael’s lawyer, and Michael Bourbeau, Carolyn’s lawyer, say that the Rileys are unsophisticated people who did not ask questions or do research before giving their children medication prescribed by the doctor. Both of the Rileys were unemployed, collecting welfare and disability benefits, and they lived in subsidized government housing. In addition to the murder charges, Michael Riley is also awaiting trial on charges of molesting a stepdaughter two years ago. He claims to suffer from a rage disorder and bipolar disorder. Carolyn told police that she suffers from depression and anxiety.

According to the Centers for Disease Control and Prevention, about 7% of elementary school-age children—approximately 1.6 million children ages 6 to 11—have been diagnosed with ADHD. A study published last year by researchers at Vanderbilt Children’s Hospital in Nashville, Tennessee, disclosed that the annual number of children in the United States that are prescribed anti-psychotic drugs jumped fivefold between 1995 and 2002 to an estimated 2.5 million children.