The primary purpose of ADHD medication is to make it easier for kids to concentrate in school. After all, the classroom setting is where the concept of ADHD was born into existence, and it’s where the problems typically emerge that result in a child being given the ADHD label. Doctors and teachers frequently use this argument as a way of guilt-tripping parents into putting a child on medication, suggesting that academic peril lies in wait if they don’t. So when considering whether ADHD drugs benefit children, it’s only prudent to look at how children fare on the drugs.
The perceived benefits of ADHD drugs
A number of small scale studies have determined that children with ADHD have improved attention, episodic memory (memory pertaining to experiences), and increased academic performance while on medication. Experiments have found, for example, that children with ADHD taking stimulants are better at remembering scenes from a story that is read to them. (Wang, 2013)
However, virtually all of the studies showing benefits from ADHD medication have been done in laboratory settings, which may or may not transfer into benefits in the real world. Helping a child score better on a computer-assisted memory game is not necessarily going to benefit them in any appreciable way.
The long-term effects of ADHD drugs
More encompassing and longer term studies, on the other hand, paint a much more sobering picture. They find that over the long term, a child’s grade-point average, achievement scores, or the likelihood of repeating a grade aren’t any better for ADHD children who are medicated than for kids with ADHD who aren’t.
A study released in June 2013 by the National Bureau of Economic Research tracked the educational outcomes of nearly 4,000 students with ADHD in Quebec over the course of 11 years. Some were on medication, others weren’t. It was found that boys who took ADHD drugs actually performed WORSE in school over that period than other children with a comparable number of symptoms who weren’t on medication. Furthermore, girls taking the medicine suffered more emotional problems than those who didn’t. (Wang, 2013)
Another major study, this time a government-funded study in the U.S. known as the MTA, looked at the long-term effects of ADHD treatment. Five-hundred and seventy-nine children were randomized into one of three different types of treatment groups or a control group for a period of 14 months. There were then follow-ups of the different groups beyond this period.
During the first year of the study, 8- and 9-year-olds who received medication and a combination treatment did show greater improvements in their ADHD symptoms. Children taking medication alone also showed some improvement in educational outcomes over that first year, though less than those in the combination therapy.
Follow-up studies, however, showed that any benefit the drug had on symptoms completely dissipated by year three. At the eight-year mark, there were absolutely no differences between any of the groups on either symptoms or academic achievement measures, showing any drug benefits are superficial and do not translate into long-term academic success. (ibid)
This diminishing return by ADHD medications could be due in large part to the habituation effect, discussed in our book Truth In Medicine. As a child’s brain is continually doused in artificial stimulants, it adjusts accordingly, so that the beneficial effects of the drugs slowly disappear. Moreover, even if the medication does help kids focus, it doesn’t help them decide what to focus on. Therefore other factors such as teacher support or parental involvement may have a more lasting impact on education.
The effects of medication versus behavioral interventions
Other studies have found that kids who take ADHD medication and study early for an exam typically do as well (or even better) as those kids without ADHD. If, on the other hand, they are on medication and study at the last minute, they don’t do any better than kids with ADHD who aren’t on medication. In other words, the key variable seems to be what kids do and how well they are prepared, i.e., behavioral habits. The medication is irrelevant: It won’t change a child if they aren’t prepared, and the preparation is what leads to success, not the medication.
The bottom line on ADHD medication
“The possibility that [medication] won’t help needs to be acknowledged,” says economics professor Janet Currie, director of the Center for Health & Wellbeing and an author of the Canada study. (Wang, 2013) Dr. Martha Farah, a cognitive neuroscientist and head of the Center for Neuroscience & Society who has also studied the issue, says that ADHD medications produce “very small effects–not zero but not a whole heck of a lot of difference.” (ibid) Pediatrician Lawrence Diller, M.D., also weighs in, saying that while drugs like Ritalin may make someone more alert and attentive in the short run, “There is no evidence in either children or adults that taking Adderall has long-term benefits.” (Diller, 5-13-2015)
This isn’t exactly the message parents hear when they’re told their child needs medication. Putting a child on a stimulant like Ritalin or Adderall gets you PRECISELY ZERO long-term improvement, and it comes at a hefty cost, as we’ll explain in the upcoming sections. Never before have parents paid so much (in both financial and emotional terms) to get nothing in return.
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