Attention Deficit Hyperactivity Disorder (ADHD) is a condition in which there is developmentally inappropriate attention, hyperactivity and/or impulsive behaviour. These difficulties are so pervasive and persistent as to significantly interfere with a child’s daily life. In the third article of a three-part series on the condition, the Learning Assessment & Neurocare Centre discusses the critical issue of medication.
Medication is frequently suggested as part of a multi-modal management plan in a child with significant ADHD. This is based on a wide range of international data that shows clear improvement in core symptoms and complications when ADHD is effectively managed as part of an overall treatment plan. In addition, there is very strong evidence that the basis of most children’s ADHD is an underlying neurobiological or brain chemistry difference. The use of medication should be seen as providing a window of opportunity to put a floor into the situation and stabilise it so that educational, behavioural and other strategies can be more effective.
The media has tended to grossly over-emphasise the side effects of these medications and only rarely point out the reasons why medication is considered in an individual child. It is therefore critical that parents place side effects in perspective, look at the relatively low incidence of short term side effects with these medications, the paucity of evidence of long term side effects, and the fact that at least 90% of children with significant ADHD can be effectively helped with the use of medication.
It is also important to recognise that ADHD is rarely a static condition, its difficulties frequently persist and often magnify with time. The decision to medicate is never one that is taken lightly and should always be done after a comprehensive assessment to assess if the child has ADHD.
The child may well benefit from medication for several years. Whilst some children outgrow the need for medication and their symptoms improve with time, in the majority clinical experience shows that medication is generally helpful on an ongoing basis throughout school years, especially until the child has passed GCSEs.
Depending on other environmental supports then available, the child’s intelligence, the adolescent may outgrow the need for medication, however, in others the need for medication persists into adulthood. It is always important at that stage to try to encourage your child to become good at topics that interest them as many children with ADHD are able to over-focus in such areas.
Whatever combination of treatment is eventually decided on, in conjunction with the parent it is crucial that the child’s progress is monitored. This will involve monitoring of their own views on their progress, as well as the view of their teachers and parents. However, remember that all children with ADHD – and no doubt your own child – have very marked strengths, as well as the difficulties of their ADHD.
It is important that the effective management of your child’s ADHD effectively addresses these difficulties, whilst enabling his/her very real strengths to show through.
Also, remember that ADHD is frequently genetic and that quite often one or other, or both, parents might have ADHD. An awareness of this sometimes does not happen until the child is diagnosed, but it can be very useful, both in helping the parent’s life, and that of the family as a whole.
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