Updated 12 July 2017

Ambitious parents put ADHD kids on meds so they perform better

Researchers found that parents of children with ADHD who want their children to achieve are twice as likely to have the child started on medication.

Parents' goals and concerns for their children with attention-deficit/hyperactivity disorder may influence their decision to start behaviour therapy or medication, according to a new study that researchers say supports a shared decision-making approach to ADHD treatment.

Researchers found parents who were focused on their child's academic achievement were twice as likely to have the child started on medications, which include Adderall and Ritalin, as other parents.

Read: FAQ on ADHD medication

Parents who expressed goals of improved behaviour and interpersonal relationships were 60% more likely to start behaviour therapy – which involves parents meeting with a counsellor to learn how to manage a child's behaviour.

"Studies like this really suggest that taking a shared decision-making approach may be one way to match the kids for whom (medication) is warranted to the best treatment," Dr Alexander Fiks, from The Children's Hospital of Pennsylvania in Philadelphia, said.

"For parents, the real thing is to ask paediatricians to really explain the pluses and minuses of all of the different options, and to make sure they can articulate what they're really most hoping to achieve," Fiks, the study's lead author, told Reuters Health.

Read: More and more kids on meds for ADHD

Treatment plan

According to 2011 guidelines from the American Academy of Pediatrics, "family preference is essential in determining the treatment plan" for children diagnosed with ADHD. But Fiks said no one had looked at whether there were benefits to assessing parents' preferences and goals for treatment. "There are barriers in real-world settings," he noted.

"It takes time, people are busy." For their study, Fiks and his colleagues surveyed the parents and guardians of 148 children with ADHD, aged six to 12, about their goals for treatment and the acceptability, feasibility and side effects they associated with different treatment options.

None of the children were using a combination of behaviour therapy and medication at the outset, although some were using one or the other.

Six months later, 46 of the 108 children not initially using medication had started on the drugs and 30 out of 124 had started behaviour therapy, according to findings published in Pediatrics.

Not surprisingly, researchers said, parents who had initially agreed with statements such as, "Medication is a reasonable way to help my child" and, "I would have trust in my doctor to treat my child's ADHD with medicine" were more likely to go that route.

Likewise, children whose parents rated behaviour therapy as more acceptable and said they would be comfortable working with a counsellor were more likely to be receiving therapy six months later.

Behaviour therapy

What was newer and more surprising, Fiks said, was how closely treatment goals aligned with which families opted for medication and which started behaviour therapy.

Dr Laurel Leslie, who has studied treatment of ADHD at the Tufts University School of Medicine in Boston, said those goals and subsequent choices are consistent with scientific evidence.

"What we do know is, a lot of the medications last under eight hours. So if you're taking a medication, it's probably only working during school time," Leslie, who wasn't involved in the new study, told Reuters Health.

Behaviour therapy, on the other hand, is going to have the strongest effects with the family, at night and on weekends, she said.

Read: Common treatment options for ADHD

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

"I think this particular study speaks to the need to spend a little bit more time getting to know families... their own hopes and wishes for what is going to improve and preferences for how to go about making those benefits happen," said Dr Alice Charach, the head of neuropsychiatry at The Hospital for Sick Children in Toronto.

Charach, who also wasn't involved in the new research, recommended parents collect ideas and information before meeting with their child's paediatrician.

"It's helpful to have thought about what you hope to get out of the appointment and what your goals are for the child. By the time children get to be nine or 10 years old, they should be involved in the shared decision-making process as well."

Read more

Children, ADHD and coping in the classroom 
Parenting a child with ADHD 

Image: working mother and child, Shutterstock


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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 ( 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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