Ritalin, Behavior Modification Make the Grade for ADHD
About 80% of the students showed some degree of academic improvement while taking Ritalin. The biggest improvement occurred at the smallest drug dose (10 mg), with lesser improvements seen when the dose was doubled or tripled.
Pelham tells WebMD the study focused only on daily productivity in the classroom, and not long-term effects on academic performance. In fact, says an education specialist who was not involved in the study, it's not clear whether taking Ritalin now will help with a student's chance of getting into a good college later.
Judith Wiener, PhD, professor of human development and applied psychology at the University of Toronto, tells WebMD studies have shown Ritalin to have inconsistent effects on academic performance.
"What seems to be the case is that if you look at long-term outcomes of kids with ADHD who have or have not been on Ritalin, that you get no differences," she says. "On the other hand, if you look at things like task engagement -- short-term gains on specific tasks while they're taking the drugs vs. not -- then you tend to get better results from the Ritalin group."
Wiener suspects Ritalin has no effect on long-term academic performance because over time, other factors interfere with academic achievement.
Still, Pelham tells WebMD, behavior modification -- working with children in the classroom to provide positive incentives for appropriate behavior and penalties for inappropriate behavior -- may be all that some children or teens with ADHD need to work well in school.
"If a parent wants to take a conservative approach, behavior modification is all you need -- that's simple to do and it doesn't put a drug in the child's brain," he says. "For a lot of other kids, they need something beyond that; I don't ever think they need something instead of that. So you train parents to be good behavior modifiers, you intervene in the schools and work with the kids, and if that's not enough you add medication."