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The Hyperactive Child

Medicate -- or not?
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Medication Still Most Effective Treatment continued...

Russell Barkley, PhD, professor of psychiatry and neurology at the University of Massachusetts Medical School and author of Taking Charge of ADHD, says the study should reassure concerned parents of kids correctly diagnosed with ADHD. "Parents should know that if their children are getting medication alone, they're getting the single most effective treatment."

(It's important to note that while medication alone worked best to alleviate the symptoms of ADHD, two-thirds of kids in the study had additional psychological or social problems that were most effectively treated with behavioral therapy.)

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.

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