ADHD and Medication

The following is a discussion post for my online chemical dependency class this week. It will be interesting to see if there are any students who start to moralize the issue. There are always one or two.

Let me share my experiences as a school social worker who worked with Special Education (SPED) students for 27 years. Contrary to what we might read in the media or hear second-hand, ADHD and ADD are real diagnosable syndromes. I have definitely seen an actual difference between the two and I think that the hyperactive part gets misconstrued.

Firstly, most children are active and some are more active. This, in and of itself, does not indicate a diagnosis of ADD/ADHD. As a practical matter, students are identified initially in school. Here’s where it gets dicey. If a school has a good, sound SPED program, it can be a valuable asset to parents who are having difficulties with their child. Referral and placement in the proper classroom with medical referral to a qualified specialist can make a world of difference. The problem occurs when a teacher has a difficult time with a student and uses the blanket assertion that the child must be ADHD based on their behavior alone. Parents usually trust teachers and as a result, family physicians prescribe amphetamines when there may in fact not be a diagnosable condition. In working with many high school students with ADHD in a self-contained classroom, it was very clear who was really ADHD and who was not. Students identified correctly as ADHD showed a profound improvement in their behavior when they were taking their medication. If this same student came to class and during group sessions I had to literally sit them next to me and put my leg over their leg to stop them from moving, the student invariably did not take their medication. The teacher and I knew within minutes whether they did or not. If a student is diagnosed correctly, there is almost always a change in behavior.

If there is not proper SPED placement, there may continue to be behavior problems. However, all students who are ADHD/ADD are not necessarily SPED students. If they do not meet the very specific criteria for placement in a SPED program then they aren’t and that’s a good thing. The fewer labels the better. This student may need a 504 plan to accommodate his education. When overworked teachers who have no training in this area are confronted with an overly active student, the call for medication is made. This is not right. Unless schools are funded properly and parents are supported and referred correctly, students will be unnecessarily placed on medication that does no good and may in fact do harm. A lot of Ritalin® and Adderall® ends up being abused because if a child does not experience the paradoxical reaction of becoming calmer when taking amphetamines (this being the true test of whether or not a child is diagnosed correctly), then they were misdiagnosed and there is the possibility of abuse of the drug by themselves or their friends. Adult ADD (ADHD is more rare in adults) is something that may be more accurately diagnosed because of an adult’s ability to use critical thinking in the dialogue with their doctor. This is wholly my own impression, as I do not have experience with adult ADD. I would suspect however, that there are adults who present themselves to their doctor with symptoms of an inability to concentrate and a doctor without the requisite experience may prescribe stimulants when they are not necessary.

NOTE: Two things to keep in mind:

1. Some children are medicated unnecessarily.

2. The fact that some children are medicated unnecessarily does not mean that ADHD is not a real syndrome. Medication works wonderfully for properly diagnosed children.

Finally, there seems to be students every semester who persist in stating that there is no such thing as ADHD and that children should never be medicated. This is ignorance and it has no place in college discourse. If I see any of these moralizing posts, they will be deleted. You are all entitled to your own opinions but you are not entitled to your own facts.

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7 Responses to ADHD and Medication

  1. Dr X says:

    Interesting to read about your experience with this. Since I don’t work with kids I don’t have broad exposure, though my partner has a son who is diagnosed ADHD. She actually had to join a support group for parents of kids with ADHD. Her son bounces off the walls without his medication. And the improvement when he takes his medication is dramatic.

    • I think that’s a perfect example of what I’m trying to tell my students. Every semester I have at least one or two students who start this ridiculous moralizing about the issue. Drives me nuts. Thanks for reading good Doctor.

      • Dawn Morris says:

        I know I’m not in your chem dependancy class but I wanted to respond to your posting anyway. 🙂 I agree with you completely on this issue. I’ve been exposed to both sides of this issue and it makes me very angry seeing a normal energetic child get popped on meds for no reason. They become very lethargic and spacey. On the other side of the coin, my daughter has been diagnosed ADHD. For now, before I try meds, I decided to try behavior and impulse control sessions with her doc in hopes she can learn how to deal with this issue. She’s doing great so far but if it starts getting worse I’m all for trying meds.
        Wow…this is lengthy so I’ll end my commentating for now.
        🙂

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  3. Debra says:

    I struggled with the decision to try medication for my daughter (age 10). She is not hyperactive at all, in fact she seemed to lack any motivation. She does very well academically but couldn’t remember to turn in assignments, bring homework home, would doodle during tests, etc. Even daily tasks at home were a challenge. I made daily checklists for her to use at school and at home. I’ve even put labels on a ribbon around her wrist to remind her to turn in homework, etc. It was so frustrating. Now that she is taking medicine she is getting straight A’s, she is more alert and doesn’t forget her homework anymore. It is such a relief and to see her doing so well is worth everything to me. Not knowing the long-term effects of these meds, I would love for her to be this way without having to take medicine. I’m looking into more about the Gluten-Free diet and want to try that over the summer. I’m so glad that I decided to give the medicine a try because now that I see how well she does on it, I’m convinced that she does have ADD. It hurts me more to think about how she must have been feeling this whole time without medicine and I’ll keep her on it until I find a natural remedy and hope that as she gets older, she’ll be able to manage her symptoms without it.

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