(Adapted from an article by Arlene Karidis, “Still more questions than answers about how to treat ADHD,” The Washington Post, June 1, 2015)
The Centers for Disease Control and prevention reports that 11 percent of U.S. children age 4-17 (one out of nine) had been diagnosed with ADHD as of 2011.
Yet health care professionals, educators and patient advocates debate endlessly over attention deficit disorder. Some argue about the cause of the condition, which is associated with inattentiveness and, often, hyperactivity. Many disagree on treatment and parenting techniques.
Some practitioners and researchers say drugs are by far the most effective treatment. Others argue that long-term drug use addresses symptoms only and does not provide important tools to help people manage their inattentiveness. They say it is more helpful to focus on behavioral interventions, nutrition, exercise and special accommodations at school.
Many parents of children with attention problems struggle with how best to help them. They seek guidance on whether to medicate. They want to know how to advocate for them in school and with their doctors. They look for ways to help them grow into well-adjusted, successful adults.
Science recognizes ADHD as involving brain development, although there is disagreement over exactly what happens in the brain to trigger ADHD symptoms. Russell Barkley, a neuropsychiatrist and professor of psychiatry and pediatrics at the Medical University of South Carolina who has published more than 300 peer-reviewed articles on the condition, says there is an inherited aspect, though the condition can be triggered by environmental factors such as exposure to smoke and alcohol before birth. He describes ADHD as a disorder that impairs self-regulation of behavior and emotions, and also impairs regulation of thoughts involving planning, organizing and problem-solving.
Research shows that the maturation of brain regions associated with these functions is delayed by about three years in people with ADHD. Studies also suggest that these regions are smaller than normal and that they are less active.
The Medication Question
Whether children should be treated with medication sets off debate. “Some families say medications changed their child’s life for the better; others tell you horror stories,” said Ruth Hughes, former chief executive of Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).
Advocacy groups such as CHADD suggest a mixed approach that may include medication but also entails the application of parenting skills, behavioral interventions and school support.
Hughes says parents should decide with their children’s doctors whether to use medication; for additional advice, she recommends “ADHD: Parents Medication Guide,” a booklet prepared by the American Academy of Child and Adolescent Psychiatry and American Psychiatric Association.