Lynne Edris is a Pennsylvania-based life coach who specializes in working with the parents of children who have attention deficit hyperactivity disorder (ADHD). Edris helps clients develop strategies for addressing their child’s troublesome behaviors and helps them decide whether to put their child on medications such as Ritalin or Adderall to help them focus in school.
For Edris, business is booming. ADHD, characterized by difficulty staying focused, impulsiveness and hyperactivity, impacts nearly nine percent of American children according to the Centers for Disease Control, or 5.4 million kids. Traditional thinking is that the behaviors associated with the disorder make it more difficult for afflicted children to succeed academically.
The current course of treatment for many is to give kids with ADHD Ritalin or Adderall, sometimes called “cognitive enhancers” for their ability to improve focus and lessen hyperactivity. The rise of high stakes testing in the last ten years has put more pressure on families and educators to make sure their kids stay on track academically, according to research by Ken Livingston, professor of psychology at Vassar College. In fact, according to Edris, concern about academic performance is the number one reason parents seek out her services. She’s of the opinion that medication helps with academic concerns. “Anything you give to a child to improve their focus will help them learn better,” said Edris, “and that will help them do better in school.”
But this might be a faulty assumption, according to a report published in June 2013 by the National Bureau of Economic Research, a nonprofit research organization based in Cambridge, Mass. Researchers looked at the educational outcomes of more than 4,000 students between the ages of four and 14 over an 11-year period. They found that boys who take ADHD medication actually do worse in school than boys with similar symptoms who did not take medication. Girls who took ADHD medication reported more emotional problems than girls with similar symptoms who were not medicated.
While those who have successfully used Ritalin or Adderall scoff at the idea that these drugs could actually lower the test scores of kids, others are inclined to take the data more seriously. “The possibility that [medication] won’t help them [in school] needs to be acknowledged and closely monitored,” said Princeton University professor of economics Janet Currie, who specializes in health policy.
Support for Ritalin
Edris worries about the impact of studies that question the effectiveness of drugs like Ritalin or Adderall. “I hate to see studies like this get attention in the media,” she said, “because this is the information many parents will use to make their decisions about medication. It means that some kids who need help won’t get it.”
Edris said that in her professional experience she has seen time and again how medication can be a game changer for children with ADHD. She said she's seen children, including her own teenage son, go from being difficult to being pleasant, from struggling academically to focusing on school and from being socially isolated to having friends. “It is a hard decision to put your child on medication, but I’ve never met a parent who regretted it,” she said.
A considerable body of research backs Edris’s position. For example, a May 2013 study by Claire Advokat, a professor of psychology at Louisiana State University, found that medication improves memory. Her research suggests kids diagnosed with ADHD who do not take medication do worse on tasks requiring verbal and visual recall. By contrast, children with ADHD on medication performed just as well as children without ADHD.
The two studies, taken at face value, seem to contradict each other, but according to Martha Farah, a University of Pennsylvania neuroscientist, the findings aren’t necessarily inconsistent. One way of interpreting the seemingly paradoxical findings, she said, is that medication improves immediate classroom behavior like sitting still and interrupting the teacher less, but it doesn’t help with other factors important to successful completion of homework or test-taking.
To illustrate her point Farah recalled a conversation with a college-aged student with ADHD. The student told her that when she takes her medication, goes to the library, keeps her head down and studies, she gets a lot done. But if instead of getting straight to work, she stops to chat with a friend, she becomes engrossed in the conversation and won’t do any work. While students without ADHD will eventually be able to buckle down as their test or deadline approaches, students with ADHD are unable to prioritize even as tests and assignment due dates loom over their heads. This combined with a lack of impulse control, makes it difficult for them to focus on what is important when it is important. This is why Farah believes medication complemented by skills-training (such as teaching prioritizing and organization) is the best course of treatment for most children with ADHD “Medication alone isn’t enough to improve academic performance. The medication may help with focus, but it doesn’t help with deciding what to focus on,” she said.