Ask the pediatrician: ADHD treatment

(WWLP) -
Q: One week ago, we talked about the difficulties in diagnosing Attention Deficit Hyperactivity Disorder , but today you said we would talk about the treatment. Now, most folks think that treatment is restricted to medication, but isn’t there more to it?

A: Most definitely. Physicians treating ADHD generally use what is called multimodal treatment. This includes dealing with behavioral issues, educational issues, and the improvement of symptoms including hyperactivity, inattention, impulsiveness, and distractibility. Educational interventions include changing class size, altering the pace of teaching, break times, tutoring arrangements, and of course dealing with the learning disabilities that often accompany ADHD. Behavioral interventions include strong guidance relationships, social skill development, both in and out of school, and behavioral training for parents. Medication is primarily focused on symptom improvement, and is often an important part of the treatment, but seldom the only one.

Q: Still, it seems as though the controversy over ADHD treatment seems to revolve around the use of medication. Why do you think that is the case?

A: It should be no surprise that parents take seriously the decision to use medication for a child to improve behavioral symptoms, especially behavior that looks like it should be under voluntary control. The truth is that children with ADHD don’t have full control over their symptoms. These symptoms can interfere with school performance and produce frustrating relationships with friends and family. As I pointed out one week ago, if this interference were not occurring, the diagnosis of ADHD would not be made and no medication would be recommended.

Q: What kinds of reassurance would you give to a parent whose child you might recommend for a trial of medication?

A: First, no one can force medication on your child. This is a decision that only you can make and it is an entirely reversible decision, at any time. Second, there would be no reason to continue with any medication if you were not happy with improvement. Third, these are among the most studied medications in pediatrics and most have been in use for more than thirty years. I have been prescribing them myself for about that long. Fourth, as many as half of the children placed on these medications are not taking them after their teens. Again, I recommend the link on the station website to the National Institute of Mental Health for more details.

Helpful Link: From our National Institute of Mental Health
http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/medications.shtml