The Effects of Stimulant Medication on Children with "ADHD"
Most prents hear the word "ADD or "ADHD" used to describe their child at school and go to their child's doctor with a question, "Is my child ADD?" Some pediatricians will use a self-report questionnaire or will ask parents a few questions before determining whether the child has Attention-Deficit Hyperactivity Disorder. The next course of action usually is putting the child on stimulant medication.
While research studies have shown that stimulants produce significant reduction in ADHD symptoms and a temporary improvement in academic performance, the long-term positive impact of stimulants on academic outcomes is unclear. This is a very important issue to consider as children with ADHD often have problems with academic achievement. Recent research studies have shown that stimulant medication: 1) May bring about improved academic achievement for those children who have inattention problems; (2) Do not necessarily bring about changes for those who have issues related to hyperactivity and impulsivity; (3) Produce academic gains that are only small to moderate in magnitude, and not long-term in nature; (4) May reduce academic achievement over time in those children who did not show significant benefits to treatment because of the lack of other appropriate interventions.
Parents need to be aware that inadequate assessment may lead to misdiagnosis or overdiagnosis. This may lead to your child either being put on the wrong medication that may have negative effects or put on the "right" medication that may not be sufficient for your child to succeed in school and beyond. It is important to have your child assessed using a psychoeducational battery, which will include several measures that tap into your child's strengths and weaknesses and describes how your child learns.
Individualized assessments will identify the actual difficulties that your child is facing that may not be addressed simply by medication. For example, your child may have a learning disability that may appear to look like ADHD in the classroom. The child may not benefit from stimulant medication but will likely benefit from specialized instruction, academic supports, and self-management techniques at home and at school to deal with the issue.
Research has repeatedly shown that the combination of medication and specific forms of psychotherapy has far better outcomes than medication alone. Medication may decrease common ADHD symptoms like inattention and hyperactivity. However, it does not necessarily change behavior. For example, a child on medication may be less inclined to beat someone up because he is less impulsive but will not automatically know what to do instead. Behavioral therapy for ADHD helps the child fill up those gaps and teach him/her positive alternative behaviors.
Behavioral therapy will also assist a parent in learning how to interact positively with their child. Studies show that the average ADHD child has one to two negative interactions per minute with parents, peers, and teachers. Early intervention can help avoid such problems. Behavior therapy may include parent training, children training, and sometimes, teacher training. While the effects of medication may show up soon, behavioral improvements due to therapy may not be apparent for weeks or months. Do not give up!
Bottom line: Make sure your child receives a thorough standardized diagnostic evaluation before you ask your doctor for a stimulant medication. Be open to non-medication interventions. We also encourage you to participate in behavioral therapy to allow your child to learn skills that he/she will be able to use for a long time even after the effects of medication no longer prevail. If your child can learn self-management skills, he or she will be successful in whatever they do.