It’s a question often met with varying viewpoints: Are we overmedicating children who have attention deficit hyperactivity disorder?
A study conducted by researchers from the University of Florida’s College of Pharmacy found there to be about a 40 percent chance that a 3-year-old diagnosed with ADHD would end up taking three kinds of mental health drugs by the age of 8. This percentage drastically dipped for an 8-year-old diagnosed with ADHD; the likelihood he or she would be on three types of mental health drugs at age 8 was less than 10 percent. Drugs included antipsychotics, anticonvulsants and other “multiple mental health drugs.” The findings, published in the Journal of Clinical Psychiatry in July, bring the topic of overmedicating children with ADHD in the limelight.
The study’s co-author, Dr. Rene Soria-Saucedo, assistant professor of pharmaceutical outcomes and policy at the University of Florida’s College of Pharmacy, says that the findings are concerning because “usefulness of medication at this early age is poorly understood.” He adds that use of medication among young children sometimes precedes a behavioral therapy or parental training approach, which ideally for kids this age should be attempted before turning to medication. He explains that the ability to turn this around mainly rests on the shoulders of primary care professionals, specialists and parents. All of these people, he says, must communicate needs and expectations more effectively.
[See: Hoarding, ADHD, Narcissism: Inside the Minds of History’s Great Personalities.]
The Need for Less Aggressive Treatments
Some parents, he says, may hold tight to a desire for seeing “faster results and remission of symptoms,” which he feels may be driven by pharmaceutical industry promotion of medications. He says that such promotion may have more of a lasting influence on parents compared to the often short time frame some primary care professionals spend assessing a child. “Parents should be asking for less aggressive treatments,” Soria-Saucedo says, adding that they should also understand that ADHD management can “be a long process that takes time.” Questioning medical professionals is also key, he says, encouraging parents to inquire as to why providers may opt to start certain medications for children so early. “I’d love to see behavioral techniques used more often.”
“On the preventative side of things, there needs to be an ongoing process of improving coordination of care between primary care and specialists,” he adds. “Better communication with psychologists and psychiatrists would enhance how we’re dealing with patients.” He explains that primary care professionals and specialists “tend to act as silos,” and says that closing the gap of “communication challenges between these two worlds” is “an urgent necessity.” This applies not just to ADHD, but to other mental health issues such as depression and post-traumatic stress disorder, or PTSD.
But are findings like ones from the University of Florida really cause for concern, or should parents and medical experts feel content that they’re doing what’s appropriate for children?
Working With Our Hands, Returning to Basics
Temple Grandin, author of “Thinking in Pictures” and professor of animal science at Colorado State University, who has interacted with people with various disorders including ADHD and autism (she has autism herself), thinks medication is too hastily prescribed to children with ADHD. “People need to be more conservative about this instead of giving it out like candy,” she says, adding that a conservative approach should especially be employed when dealing with young children whose brains are still developing.
She adds that medication is just one of many tools in the toolbox to explore. In keeping with this analogy, she says “medication is a heavy tool and shouldn’t be the first one to reach for.” Instead, Grandin explains that getting back to the so-called basics — which have seemingly faded from many school and home environments — is essential.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
Schools that no longer teach trades or have less of an emphasis on them is “the worst thing ever done,” she says, arguing that brain-boosting, hyperactivity-reducing activities have been stripped away from many youngsters. Today’s technology and incessant screen time, she says, adds to the challenge. She says that hands-on classes such as woodworking, music and art are beneficial and that the lack of them may be a contributing factor behind some children’s inattentive or impulsive behaviors. Grandin says she’s seen firsthand the improvements that manifest when medication isn’t a first line of treatment, including one young man who experienced a reduction in his hyperactivity after taking a robotics class and yet another who enjoyed working with his hands and, despite his ADHD, dyslexia and stuttering, now owns a successful metal fabricating company.
Exercise a Cautious Approach When Considering Medication
At the same time, Grandin is not suggesting that children with ADHD should never take medication. “This isn’t a matter of totally banning medication, but about thinking about it more carefully and using it more sparingly,” she says. “There are some who really need it and those who might not need it as much.” She encourages “careful, conservative use and trying other things” before parents immediately seek ADHD medication for children or before medical professionals prescribe ADHD meds.
Dr. John Ratey, an associate clinical professor of psychiatry at Harvard Medical School and the author of “Spark: The Revolutionary New Science of Exercise and the Brain,” explains that the topic of whether children with ADHD are being overmedicated “cuts both ways.”
On one hand he says that, yes — for people concerned about changes in the developing brain — being on such medications may “change the brain sometimes.” But he emphasizes that so, too, can the repeated negative thoughts and emotions related to guilt and shame that many children and adults with ADHD who aren’t taking medication may experience. ADHD medication may help manage the symptoms that lead to negative self-talk while doing so, he says, with “relatively few side effects” to boot.
Still, he’s aware that many parents have reservations about giving their child ADHD medication, explaining that parents may have concerns that medication of any kind could pave the way for children to be on a host of medications down the road, or that long-term consequences could arise. “Now maybe more than ever, a lot of people don’t want to use ADHD medication, and they try desperately to do other things for treatment,” he says. “No one likes to be on medication if they don’t need to be,” Ratey says.
[ See: 8 Things You Didn’t Know About Counseling.]
He emphasizes that people establish a diagnosis with a knowledgeable professional. It’s also important, he says, for experts and parents to understand the benefit of making lifestyle changes. “In general, we’re learning that lifestyle changes are good for most disorders,” he says, noting that proper sleep hygiene, making sure children interact with kids their age, “especially in today’s age of cellphones and computer games,” and sports involvement can “bring about significant improvement in just about anything, including focus and attention.” He explains that martial arts in particular may be worth exploring, as it allows people to be active while developing confidence, pay attention while moving and focus.
“It’s not as simple as just turning to a drug,” Grandin says. “People need to take a more holistic approach; meds should not be the first thing to reach for. People are too single-minded sometimes.”
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Are We Overmedicating Our Children With ADHD? originally appeared on usnews.com
