ADHD Treatments for Children - Medication Considerations

Attention Deficit Hyperactivity Disorder (ADHD) is a neurologically-based condition, resulting from a lack of or imbalance in certain chemicals in the brain having to do with self-regulation. Children who actually have this chemical imbalance have difficulty in their ability to manage themselves in a number of ways. As a result, an ADHD child has a weak regulatory system, or what I call a weak governor. So, if parents truly understand that this is a biochemical conditions, why would they not want to balance out their child's chemicals? Why would parents want their child to struggle and suffer when the problem is neurologically-based and not within the child's total control? In my 25+ years of working with 100's and 100's of kids, the most effective way I have seen to treat a child who is truly and accurately diagnosed ADHD is to balance his chemicals. Since I am not a medical doctor, I cannot say that a child needs medicine. What I can recommend, however, is that a child be seen by a physician with expertise in ADHD and be evaluated for medication based on my clinical findings. There are many considerations that can come up when medication is being recommended:

• Parents don't want their kids on "drugs." I don't either. However, if their child was an insulin-dependent diabetic, they would give them insulin. The need for chemical balance is the same whether they can actually be measured (like insulin levels) or they cannot (like neurotransmitters.)


• Parental concern about their kids being on 'speed' (psycho-stimulants.) So far, stimulant medication has been found to work the best; many think it is paradoxical to give a hyperactive child 'uppers.' However, stimulant medication stimulates the governor. It supplements the deficiency. This results in improving the child's ability to regulate himself.


• Giving up too quickly if the first medication or dosage is not effective or has some side effects. There are numerous medications and combinations from which to choose because not everyone responds to or tolerates all medications the same way. Be patient.


• Resisting a higher dose because, "It's good enough." Some parents become concerned about how much medication is being prescribed. The dosage needs to be adjusted to alleviate their child's symptoms and balance his chemicals. Don't settle for a 60% improvement to avoid going up on the dose. Focus on the results not the dosage.


• Wanting to limit when their child takes medicine, by not giving it on weekends or holidays or over the summers (by choice, not by physician's orders.) This is a tremendous disservice to the child. ADHD is a self-regulatory problem, not a school-based problem. A child's chemicals are imbalanced 365 days per year, not just during school days. He needs to function as optimally as possible all the time.


• Setting a goal to get the child off medicine. Again, if the body needs it, the body needs it. Trying to work a child off medication is telling him that it's not really good for him in the first place and setting up a negative connotation. This also can put a great deal of pressure on a child to try to make his body stop needing something it needs. Kids don't outgrow a chemical imbalance. The symptoms of the imbalance may change, but the disorder remains. That's why so many adults are actually finding it much easier to function successfully on medication, as well.


• Thinking medication is the magic bullet. For some kids, simply balancing out chemicals is all that is needed to treat ADHD. For others, there continues to be a need to implement other interventions, such as academic, behavioral or clinical planning.


• Creating unrealistic expectations of what a child should now be able to do. Even when chemicals are balanced, it can take time for a child to demonstrate improved academic performance via grades, for example.


• Expecting behavior to be the same while on the medication and when the medication wears off. Stimulants do not build up a blood level. This means that they go in and then leave your child's body anywhere from 4-12 hours. The behavioral improvements cannot be expected to remain when the chemical imbalance returns.


• Deciding whether their pediatrician is an expert in treating ADHD or whether to seek the services of a pediatric neurologist or pediatric psychiatrist specializing in prescribing medication to alleviate ADHD symptoms.

Medication has been found to be a highly effective intervention in the treatment of ADHD. There are many issues for parents to address when medication is prescribed for their ADHD child. Keeping an open mind and gathering all the information is important when their child's well-being is at stake.