The Hyperactive Child
Medicate -- or not?
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
(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
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
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
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.