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The Hyperactive Child

Medicate -- or not?

Getting the Right Treatment

In a perfect world, a child's school, health insurance company, and community resources all work together to provide the right treatment. But the reality is that sometimes a child's needs can slip through the cracks. This is especially true of children whose insurance companies and schools simply refer the child to resources in the community for treatment rather than offering assistance through a private doctor or working with the school's resources. The children in the study who were referred to community resources had the least improvement of ADHD symptoms (though all the children improved somewhat).

According to Jensen, community services -- such as locally funded health clinics -- often fall short of providing optimal care for ADHD kids because of inadequate monitoring of medications, lack of follow-up care, and restrictions on mental health services by managed care companies. "Treatment [in the community] is so haphazard. You can't just eyeball a kid and know the correct dose of medication," says Jensen, who is also professor of psychiatry and director of the Center for the Advancement of Children's Mental Health at Columbia University.

What can a parent do to ensure the best treatment? For starters, make sure your child has been correctly diagnosed, possibly by getting a second opinion. "Many children are mistakenly diagnosed with ADHD," says Jensen. "Other problems, such as depression, can be the real cause of symptoms like an inability to stay focused."

If the diagnosis of ADHD is accurate, discuss the medication dosage with your child's doctor to make sure it is appropriate, says Jensen. Also, explore the possibility of administering medication three times daily instead of two.

Talk to your child's teachers about his or her behavior in the classroom (which can be better or worse than behavior elsewhere), and share the information with your child's doctor. "Know what type of help your child is entitled to in the classroom, through your insurance, and via programs funded by the government," says Kaplaneck. And join a parents' support group, she says, where you can swap information with other parents.

The Right Treatment Pays Off

With carefully monitored medication, psychological counseling, and special help in school, Kaplaneck's son graduated from high school this year and will enroll at Adelphi University in New York in the fall. His major? Psychology. And he intends to work with ADHD kids. "His experience will make him a wonderful mentor and advocate for those children," she says.

Kaplaneck acknowledges, though, that it has been a tough journey. "You have to realize that there is no quick fix here, but you can succeed if you're aggressive about getting help," she says.

Rochelle Jones is a writer based in Bethesda, Md. She has covered health and medicine for The New York Daily News and The St. Petersburg Times.


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