Doing Life Together

Doing Life Together

Should You Ditch the ADHD Medication for Your Child?

childYears ago, I began treating children with attention and behavioral problems with parent training. Yes, it was time consuming. Parents had to attend classes, track their child’s behavior and apply various parenting skills to the problems they saw. Then I would go in to the child’s classroom and train the teacher in the same methods so that we all were consistent and building skills in both the adults and children. Again, time consuming but seemed to have a good result.

Then medications for children became popular. Teachers were busy with classrooms too large, few helpers, too much paperwork and families who were not involved. Medicating children with ADHD seemed to help everyone immediately , but the question always was, was it good for the child and would the help last?

Families with an ADHD child often have concerns when a medication is recommended to treat symptoms. Parents typically do not want to medicate children unless they feel it is absolutely necessary and the benefits outweigh the costs. Since so many children are put on ADHD medications (2.7. million in the US according to the CDC; 2007) in order to help them in school, we have to question this practice given the recent findings. Perhaps parental reluctance to use medications on their young children now has more validity. This latest study may help parents decide what to do when it comes to medicating a child in order to improve school success.

Nearly 4000 students were followed in Quebec, Canada over an 11- year period.  The result of this longitudinal study was that boys who took the ADHD drugs actually performed WORSE in school than those who did not drugs and yet had similar symptoms! In terms of the girls, the National Bureau of Economic Research, discovered that those taking ADHD drugs had more emotional problems. So for both genders in terms of long term school performance, not good results.

But the picture isn’t clear. It seems that ADHD drugs do help kids sit still, pay attention and complete more problems and tasks with accuracy. However,  in the long run, the benefits of the medication do not seem to translate in the classroom, especially when we look at academic achievement measures. One thought is that maybe the improved concentration of the child isn’t directed at the academic tasks required for long term success. We just do’t know.

So what does all this mean? 

It means that medication alone is not going to enhance academic performance in the long run. Maybe drugs help kids focus on the immediate, but drugs do not teach skills, organization and prioritizing needed for academic success.

And since the medications also seem to backfire when it comes to studying and improving concentration, parents need to wonder if using the medications is a good idea, especially if the goal of using the medications is to improve academic success.

This study certainly casts doubt on the effectiveness of stimulant medication for children and  further highlights the safety issues involved.

Another option is to go back to those parent training classes and apply the cognitive and behavioral interventions that have no side effects. These interventions take longer and require more parental involvement, but it might be worth the investment in the long run. And remember parents, many, many creative types did not do well in school, but did well in life! Academic success isn’t always an indicator of life success.

 

 

  • http://AddaURLtothiscomment Laura Leikona

    Thank you Dr. Mintle! Appreciate the info.
    Laura

  • Linda Mintle

    These are great questions and more than a short article can address. The medications do help with focus and concentration but don’t seem to translate into academic success. REsearchers think the meds don’t teach you what to focus on so the focus may be away from the academic skills.

    Here is one link on preschoolers: http://www.jaacap.com/article/S0890-8567(12)00993-8/abstract
    The link to the Wall Street Journal article http://online.wsj.com/article/SB10001424127887323368704578593660384362292.html?mod=wsj_share_tweet
    The link to the white paper http://www.nber.org/papers/w19105

    There are many children who can’t tolerate the drugs so we have always had a behavioral component. I sometimes use an ADHD coach who can help kids organize, set goals and work on accommodation systems until they find effective ways to manage their academic issues. Smaller classes, more teacher involvement, flexibility in learning styles in the classroom help as well. Parent training involves setting short goals, using contingency management, and more. It’s really a matter of working with each individual child, making sure there are no other academic issues like learning disabilities, working with their interest areas and in a style that is more kinetic and hands on. The traditional classroom suits auditory learners which most of these kids are not. I usually see the entire family to get a picture of strengths and goals. It is usually a lot of trial and error until we find something that seems to work. But the ADHD coaching has been a really great thing for many of the kids.

  • http://AddaURLtothiscomment Laura Leikona

    Hi Dr. Mintle,
    I enjoy your posts and have a few questions about this as a parent of a child who was once diagnosed with ADHD at age 5, but now has “lost” her diagnosis since we independently had her tested for food sensitivities and changed her diet, then held her back a year in school.

    She is 7 now and I still see attention and focus issues in her school work, however, the teacher does not. Unfortunately, she is very frustrated because she is very intelligent, but has problems with writing and reading, and sometimes with finding the right words. She often makes up her own words, because she forgets the correct word. She is saying things like, “I am bad at reading,” and doesn’t believe she is smart, even though she is. She is so smart that she realizes that her school performance is not on par with her intelligence, which frustrates her.

    Could you please provide cites or links to the studies you mentioned? I would love to read them in more detail.

    Also, I wonder what types of things you taught the parents/teachers to do. I have read dozens of books on this subject and taken my daughter to many doctors, therapists, and specialists trying to help her. They all say variations of the same things that we already do. I just wonder what you are doing differently to help children with ADHD. Have you written a book or any articles on the subject that you could refer me to?

    We tried medication btw, and she had severe side effects. She begged for months to have the medication again, bc she said that was the first time she could concentrate. We found out later that almost all medications use cornstarch as a carrier, and she is very sensitive to corn.
    Thank you,
    Laura

  • http://blog.dc4k.org Linda Ranson Jacobs

    I have read that study also and am glad to see it is out. When I ran a therapeutic child care we worked with our kids and with our parents. In the summer months many ADHD kids would go off their meds – that was the popular thing at the time. We loved it because we saw a different kid during those months. Rarely did we have behavior problems because of the way we worked with them. We saw such creativity and personal interactive skills develop. We saw determination in our committee work. We had a barnyard and animals and we saw unbelievable tenderness toward the animals and they had to work on their organizational skills and set goals or the animals would suffer.

    Some of our hardest working kids on our landscape committee were our ADHD kids. They would study and research what would work best on the 3 acres of grounds and then follow through. All of this and no meds.

    Thanks for sharing this info Linda Mintle. Love your work

    Linda Ranson Jacobs
    blog.dc4k.org

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