Effects of ADHD Medication in School Children

According to Brock, Jimmerson and Hansen (2009) when walking into a classroom of 25 students, 2 of those students will have been diagnosed with a disorder that effects approximately 4.4 million children between the age of 4 - 17 in the United States. This disorder is ADHD and is characterized by a child's "distractibility, hyperactivity, impulsive behaviors, and the inability to remain focused on tasks or activities" as said by Ford-Martin (2001). Attention deficit/hyperactivity disorder or ADHD is the current psychiatric term for children showing drastic problems with inattention, hyperactivity and impulsivity. (American Psychiatric Association [DSM-IV],1994) It can also be characterized by three major and five minor conditions according to Barkley (2000) the three major conditions are: impaired response inhibition, excessive task-irrelevant activity and poor sustained attention. The five minor conditions are: poor working memory, delayed development of the mind's voice, difficulties with regulating emotions, Diminished problem solving and variability in their task or work performance.

There is no single cause for ADHD, although there are several possible causes. According to DuPaul and Stoner (2003) hereditary influences and neurobiological disorders have received the most attention, but environmental toxins could be another possible cause as well. DuPaul and Stoner (2003) state that, "Perhaps as the use of advanced assessment technologies, particularly in the realm of molecular genetics, becomes more widespread, clinically useful information about the etiology of ADHD will be forthcoming."(p.15, 16) There is no single cause for ADHD, therefore there is no single treatment. Therapy must be used alongside medication to be effective.

The (DSM-IV)1994 diagnoses the disorder as children exhibit a minimum of 6 signs of abnormal inattention, hyperactivity, impulsivity or combined signs. Diagnosing children with ADHD should to be left up to the professionals, since there are many conditions that may mimic the disorder. Although as stated by Sinha (2003) there are no formal guidelines for evaluating a patient self diagnosing can lead to unnecessary treatments. Anxiety disorders, mood disorders, and sleep disorders are examples of conditions that may or may not be a determining factor to diagnosing a child with ADHD. DuPaul and Stoner (2003) are correct in saying that school professionals should also understand the diagnosing procedures as behavior control and attention problems are two main reasons for school referrals. School professionals also have the ability of notifying parents of possible problems the child may be having.

After a child has been properly diagnosed with ADHD a type of treatment must be decided upon. There are many treatment options. Most commonly children are prescribed a medical stimulant, such as Ritalin, to increase their focus. Sinha (2003) says that Ritalin and its longer acting versions Concerta and Aderall have increased nearly five fold since 1996 and numbers are continuing to sky rocket. Many people tend to choose to medicate their child for an easy fix, instead of looking into the problem and determining the best solution. Diller (2002) states that "our culture sometimes uses medication to shoehorn our children into a one-size-fits-all mold of smiling compliance." (p.6) Barkley (2000) himself admits that culture has an effect on America's obsession with performance pills. However Diller (2002) states that in his opinion and experience stimulants have about 90 percent success rate and near immediate effect. That is when they are properly prescribed and taken as directed. While much is still not understood about medicating those with ADHD, Ford-Martin(2001) said that:

Approximately 70-80% of ADHD patients treated with stimulant medication experience significant relief from symptoms, at least in the short-term. Approximately half of ADHD children seem to "outgrow" the disorder in adolescence or early adulthood; the other half will retain some or all symptoms of ADHD as adults. With early identification and intervention, careful compliance with a treatment program, and a supportive and nurturing home and school environment, ADHD children can flourish socially and academically.

With no sound cause for ADHD, it is not proven that medication for the disorder is effective or necessary. This fact brings forth many arguments pertaining to medicating versus other treatment possibilities. Several researchers are reevaluating data and are finding that medication plus behavioral therapy was more effective than medication alone.

ADHD medicine may help with impulsivity and concentration problems, but your child may still forget their homework as well as continue to have social awkwardness. Real treatment for ADHD involves family therapy, psychotherapy, social skills training and parent skills training along with the medication. When medication is used as a quick fix, it is not being used properly. Sinha (2003) says that although stimulants are proven to to stifle hyperactivity and sharpen focus it is still unclear how they do so. If you have a child with ADHD who is hyperactive, impulsive, and inattentive, clearly a medicine that reduces reaction time and motor activity and increases cognitive performance is going to address this child's ADHD symptoms. But what happens when you have an inattentive child that is neither hyperactive nor impulsive and you give that child a stimulant? Those children will develop decreases in activity and response times that are probably not beneficial to their overall learning. There is always the option of behavioral therapy without medicating.

Medicating your child along with other treatments such as therapies and home skills can be a very effective way to help you child not only cope with their disorder, but possibly also overcome, or at minimum deal with it.

Children being treated for ADHD, whether it be by mean or medication, therapy or a combination of the two, have an easier time focusing and have an increased alertness.(DuPaul and Stoner, 2003) For short term use the medication in conjunction with therapy seems to have a very positive effect on the children. They increase their social comfort ability and academic learning level. With this raise in self esteem and status many children either overcome their disorder or develop the self control and will power to better handle or deal with it.

In the same breath medication on its own can have very negative effects on children. As Sinha (2003) states it "ADHD is over diagnosed" (p. 52). Most children are restless in a class room setting. Just as most will forget their homework, or not focus on their assignments when there is something near that will easily distract them. It's not that they have ADHD, it's the simple fact that they are children. Ford-Martin states that "Communication between parents and teachers is especially critical to ensuring an ADHD child has an appropriate learning environment."(p. 3) Children who go untreated can be a huge disruption to the class. In many instances children who are not properly treated cause enough problems in a class that instead of getting to the bottom of the problem, the child is passed along for the next teacher to deal with. In this case the child never has the chance to learn the proper material and falls further and further behind in their schooling. This in not fair to the child, the child's parents, the teacher or the classmates. Every child deserves a fair chance at life. By remaining blind to a situation the chance for more complex problems becomes greater.

Attention deficit/hyperactive disorder is a rising problem in society today. Both by its over diagnosis and by those who ignore it in their children. By being aware of it, as well as it's possible causes we can increase our chances of recognizing ADHD in those around us. Remembering that only professionals should diagnose as many conditions are similar to those of ADHD. When it comes to treatment, keeping an open mind to many options is the best way to handle it. Both medicinal and therapeutic. Since there is no single cause for ADHD, it is hard to believe that there is one single solution. It's never a bad thing to ask to change treatments. Medicating can have side effects. Staying in touch with others who have a part in a child's life can help you increase not only the value of the child with ADHD, but also those who associate with them.

References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4^th ed.). Washington, DC: Author

Barkely, R.A. (2000) Taking Charge of ADHD: The Complete Authoritative Guide for Parents. New York: Guilford

Brock, Jimmerson, Hansen(2009) Identifying, Assessing and Treating ADHD at School. New York: Springer

Diller, L.H.(2002) Should I Medicate My Child?: Sane Solutions for Troubled Kids With-&Without- Psychiatric Drugs. New York: Basic Books

DuPaul, G.J.,Stoner, G. (2003) ADHD in the Schools:Assessment and Intervention Strategies (2^nd ed.).

New York: Guilford Publication, Inc.

Ford-Martin,P.A. (2001) Attention Deficit/Hyperactivity Disorder (ADHD), Encyclopedia of Medicine

Sinha, G. (2003, June). Out of Control, Popular Science, 258, 48-52