ADHD

Updated 09 February 2013

Early ADHD treatment wards off problems in school

New research suggests kids who get early treatment for their ADHD don't have as much trouble on national standardised tests as those who aren't prescribed medication.

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New research from Iceland suggests kids who get early treatment for their attention-deficit/hyperactivity disorder don't have as much trouble on national standardised tests as those who aren't prescribed medication until age 11 or 12.

Common medications used to treat ADHD include stimulants such as Vyvanse, Ritalin and Concerta.

"Their short-term efficacy in treating the core symptoms of ADHD – the symptoms of hyperactivity and attention and impulsivity – that has been established," said Helga Zoega, the lead author on the new study from the Mount Sinai School of Medicine in New York.

"With regard to more functional outcomes, for example academic performance or progress, there's not as much evidence there as to whether these drugs really help the kids academically in the long term," she said.

How the study was done

To try to answer that question, Zoega and colleagues from the United States and Iceland consulted prescription drug records and test scores from Icelandic elementary and middle school students between 2003 and 2008.

Out of more than 13,000 kids registered in the national school system, just over 1,000 were treated with ADHD drugs at some point between fourth and seventh grade - 317 of whom began their treatment during that span.

Kids with no record of an ADHD diagnosis tended to score similarly on the standardised math and language arts tests given in fourth and seventh grade. Those who were medicated for the condition were more likely to have their scores decline over the years - especially when stimulants weren't started until later on.

For math exams in particular, students who started on stimulants within one year of their fourth grade tests had an average score decline of less than one percent between that and their seventh-grade exam - compared to a more than nine percent drop for those who didn't get treated until sixth or seventh grade.

Benefits in starting sooner

The difference was especially clear for girls, Zoega and her colleagues reported in Pediatrics.

According to the Centres for Disease Control and Prevention, parent reports suggest close to one in 10 kids and teens in the US have ever been diagnosed with ADHD, and two-thirds of those with a current diagnosis are treated with medication such as stimulants.

J Russell Ramsay, who studies ADHD at the University of Pennsylvania's Perelman School of Medicine in Philadelphia, said kids' trouble in school is usually one of the top reasons parents seek help for their ADHD.

When it comes to school performance, "There are obvious benefits of getting started sooner rather than later," he told Reuters Health.

"Especially if students are struggling later on, this study would suggest it may be at the very least useful to explore and consider certain treatment options."

Families can see a mental health professional and discuss the pros and cons of medication and other treatments, he added.

Drugs come with side effects

The researchers noted they didn't have information on kids' exact underlying ADHD diagnosis or its severity, and they also couldn't tell whether youngsters were getting behavioural treatment or extra school help along with stimulants.

"Not all kids need medication," Zoega said. "It's important to think about whether alternative treatment options, whether earlier intervention with those could have a beneficial effect."

ADHD drugs can come with side effects, including appetite loss, sleep problems and stomach aches.

One of the other researchers on the study has received funding from pharmaceutical companies, including those that make stimulant drugs for ADHD.

"Medications are probably still the reflex response, with a good evidence base," said Ramsay, who wasn't involved in the new research. "But there are other things that can be added in later or concurrently that can also provide support to the child, to the family and to the educators."

(Genevra Pittman, Reuters Health, June 2012) 

Read more:

ADHD over-diagnosed in young kids

Attention-deficit hyperactivity disorder

 

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ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation (www.gb4adhd.co.za) She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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