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ADD/ADHD and Medication in Children

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Medicating children who have ADD/ADHD is a difficult issue for many parents. Parents fear the effect of powerful drugs on children, and their concerns are justified. Caution argues that if a child's disorder is mild enough to be treated with behavioral and educational techniques, this should be our first approach. The danger, however, is that these attempts will be ineffective and our child's condition will worsen. Vital emotional and social skills development may be delayed and a pattern of pathology become ingrained.

One of the surprising results from the NIMH Multimodal Treatment Study of Children and Attention Deficit Hyperactivity Disorder was the improvement in social skills in the intensive medication management group. This finding supports the observation that ADD children miss the indirect social cues in their interaction with others and are often out-of-step with their social milieu. It may also be related to the child's improved ability to attend to the relationship between their actions and the consequences, whether they be natural and environmental or imposed by parents and teachers.

For developing children, every day is important and the sooner that psychiatric symptoms are treated the better the child's normal development will progress.

Some families rightly complain that either the effects of medication are minimal or the side effects are unbearable. The NIMH study used an approach that parents should follow. The optimal medication treatment for children with ADHD, according to the study, is described in the findings.

During the first month of treatment, special care was taken to find an optimal dose of medication for each child receiving the MTA medication treatment. After this period, these children were seen monthly for one-half hour at each visit. During the treatment visits, the MTA prescribing therapist spoke with the parent, met with the child, and sought to determine any concerns that the family might have regarding the medication or the child's ADHD-related difficulties. If the child was experiencing any difficulties, the MTA physician was encouraged to consider adjustments in the child's medication (rather than taking a "wait and see" approach). The goal was always to obtain such substantial benefit that there was "no room for improvement" compared with the functioning of children not suffering from ADHD. Close supervision also fostered early detection and response to any problematic side effects from medication, a process that may have facilitated efforts to help children remain on effective treatment. In addition, the MTA physicians sought input from the teacher on a monthly basis, and used this information to make any necessary adjustments in the child's treatment. NIMH

Parents should seek treatment for their ADHD child from a provider who uses this approach. Don't give up if medication doesn't seem to work or side effects make matters worse. A physician who will hear your concerns and make medication changes will help you find relief for your child. With proper medication management, your child will reap the benefits of improved social, emotional, and behavioral development.

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