To Medicate or Not To Medicate: That is the ADHD Question
With Attention-Deficit/Hyperactivity Disorder (ADHD), to medicate or not to medicate has always been the question. What is a parent to do when even the experts cannot agree on the answer?
In a recent Washington Post article, “Still More Questions Than Answers About How to Treat ADHD,” author Arlene Karidis states that health-care professionals, educators and patient advocates still debate endlessly over ADHD. Many disagree on treatment, medication, and parental intervention.
Parents seek guidance on whether to medicate their children. They want to know how to advocate for them in school and with their doctors. They look for ways to help their ADHD children grow into well-adjusted, successful adults.
Karidis explains that some practitioners and researchers believe drugs are by far the most effective treatment. Others argue that long-term drug use addresses symptoms only and does not provide important tools to help people manage their inattentiveness. They say it is more helpful to focus on behavioral interventions, nutrition, exercise, and special accommodations at school for the ADHD individual.
Whether children should be treated with medication usually sets off hot debates. Ruth Hughes, former chief executive of Children and Adults with Attention-Deficit/Hyperactivity Disorder, shares, “Some families say medications changed their child’s life for the better; others tell you horror stories.”
Parents should decide with their children’s doctors whether to use medication. For additional advice, Hughes recommends “ADHD: Parents Medication Guide,” a booklet prepared by the American Academy of Child and Adolescent Psychiatry and American Psychiatric Association.
“It is based on science, but it’s not all about ‘Yes, medicate your kid,’ ” Hughes said. “It takes a thoughtful approach.”
Hope Scott, a developmental pediatrician in Reston, prescribes medication to most of her ADHD patients. But drugs are only one part of the plan. She uses a multi-prong approach.
“Medications improve distractibility,” Scott said. “But they do not touch development of time management or organizational skills. They help you focus on cleaning your room, but you still need to learn how to do it.”
Karidis shares the story of one student who worked with an ADHD coach. This student said, “We focused on organization strategies like breaking tasks in small steps. We worked on time management, to help me think about how long something would take and planning ahead.” Taking breaks and exercising were also tremendously helpful.
The coaching helped him learn how his mind worked. Now he is completing a graduate program at Maryland Institute College of Art in Baltimore, focused on developing design concepts (such as communications tools) to address social problems.
“Once I had skills,” he said, “it was okay that I have a million thoughts coming at me at once.”
Studies have produced contradictory results on the effectiveness and safety of medications for ADHD. Karidis cites one 2014 meta-analysis of 25 studies that concluded, “Short-term [drug] treatment is safe and superior to placebo for ADHD symptoms and secondary outcomes.”
Most advocacy groups suggest a mixed approach that may include medication but also entails the application of parenting skills, behavioral interventions, and school support.
In addition, Karidis, a freelance health writer, offers quite a few pearls of wisdom for the family struggling with an ADHD individual. Check out her article: Still More Questions Than Answers About How to Treat ADHD.
In addition to teaching a multitude of skills and strategies, and providing support to people dealing with AD/HD and other executive functioning challenges and disregulations, coaching helps people track the effects of medication.