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Medication Management In Children With ADHD
The CDC estimates 4.4 million youth ages 4-17 have been diagnosed with ADHD by a healthcare professional and as of 2003 approximately 2.5 million youth are currently receiving medication treatment for the disorder. According to the United Nations, the United States currently consumes 85% of the world’s production of methylphenidate (commonly known as Ritalin®). Amphetamine prescriptions (primarily Adderall®) in the United States alone have increased dramatically since 1996: from about 1.3 million to nearly six million. These numbers demonstrate the disproportionate use of drugs to treat behavioral disorders compared to other countries (INCB Report, 1999).Although medication has been shown to help a child who has ADHD focus and reduce excess fidgeting and hyperactivity, it has not been demonstrated to decrease impulsivity. This means that although a child may be able to stay in his seat for a longer period of time, it does not mean he has developed the skills necessary to stop, think, and control his behavior. In addition, the many critics feel the short term side effects such as decreased appetite, irritability, and sleep disturbances may not outweigh the benefits of medication. The many unknowns of long-term side effects on the child’s brain development have also not been explored. Even still, many parents feel forced to medicate with no other alternative when pressures from health care providers and school administrators build.
However, frustrated parents are starting to take their child’s ADHD into their own hands, using a combined therapeutic approach to ensure their child is learning the skills necessary to control the behavior not just band-aiding it with medication. Recent studies demonstrate that those parents who combined behavioral therapy with medication gave their children much lower doses of medication. Parents are coming to the realization that these drugs are a treatment not a cure and should definitely not be used as a first line intervention, but rather once all other treatment options have been exhausted.
The National Institute for Mental Health recently conducted the most intensive study ever undertaken for evaluating the treatment of this disorder. The study’s results indicate that a Multimodel treatment, a combination of behavioral therapy and medication management is more successful than any one intervention alone. Researchers found that in areas such as anxiety levels, academic performance, oppositional behavior, parent-child relations, and social skill, the combined treatment method was superior. They also determined another advantage of combined treatment was that children could be successfully treated with lower doses of medicine, compared with the medication-only group.
Behavior interventions are often a major component of treatment for children who have ADHD. Behavioral therapy helps people develop more effective ways to work on immediate issues. Strategies include being consistent, using positive reinforcement, and teaching problem-solving, communication, organizational, and self monitoring skills. When developing treatment plans for the ADHD child, it is important to remember that each child’s needs are different and an individual treatment is a necessity to an interventions success.
Date: May 29, 2006
Content sources:
National Center on Birth Defects and Developmental Disabilities (2006)
Report of the International Narcotics Control Board (1999)
Statement by Terrance Woodworth Committee on Education and the Workforce: Subcommittee on Early Childhood, Youth and Families (2000)
The MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for attention-deficit hyperactivity disorder (ADHD). Archives of General Psychiatry, 1999;56:1073-1086.
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