ADHD and Schools

Hello, I have a 9th grader with ADHD. I can say it hasn’t been easy with the NY schools. Mostly because many teachers feel ADHD is something we make up to have an excuse for a misbehaving child. Of course, we know better. But then there are many good teachers. Keep talking to the administration to make sure the school is working with your child and you need to insist you are very involved. Next as for meds, I have never put my son on meds even though the teachers along the way have told me I should. I have my son on a vitamin regimant and I have been very active in working with his foods. I also have given all his teachers and nurses the list of things he can and cannot eat. (teachers love rewarding with candy, not good for ADHD). I have a wonderful book that I have read and then shared with my doctor for guidance. It is called The Bible Cure for ADD and Hyperactivity by Don Colbert, M.D. $6.99 at most book stores. Has alot of great infor. and has helped us tremedously. It has been challenging at times with my son but I have stayed very involved and don’t regret one moment. He is a lot of fun and has a 91 average. Good luck and I hope I have helped a little. God Bless. P.S. Also research your rights as a parents and the rights of your child and be equipped with your information.

We also did not use medications and chose to go the alternative school route. While the academics were not as rigorous, my sons are both very smart and academically capable, so I never worried that they would not “get it”. When my oldest was in second grade, we took him out and homeschooled for 4 years. We didn’t follow a specific curriculum, but did a lot of trips and practical problem solving and reading and community classes, etc. as seemed best for the time. He chose to return to school in 6th grade and did GREAT. He had some academic “holes”, and his handwriting will never be pretty (he is left-handed to make it worse!), but he caught up on the things he hadn’t learned in homeschooling pretty quick, and of course, he knew a lot of things that other kids did not which put him in very good position to be an excellent student. Interestingly, no one every suggested that he “had ADHD”, and they were very surprised when I described his earlier behavior patterns at home and in school. He ended up taking AP classes in high school and graduating with honors.
Organization and study habits were always a challenge, and work took him longer to complete than for other kids, but overall, it was a very successful experience for him.

One thing you should know that is consistent with our experience: long-term studies on ADHD kids have consistenly shown little or no difference in long-term outcomes for medicated vs. unmedicated kids. I looked into this as far back as 1989, and the references suggested that this fact was already being established in the first big review of the literature in 1978, by Russel Barclay et. al., who found that there was no indication of academic achievement scores improving for kids on stimulant medication. I had researched this before my oldest was in school, and it cemented my instinctive tendency to look at other options besides medicating. We were fortunate to have a school system in Portland, OR with lots of alternative public school options, and we were fortunate to be able to homeschool, plus my wife and I both had training and experience in child behavior management, which helped a lot with being able to teach Patrick the appropriate skills. But he certainly was not harmed by the approach we took, and is a very responsible and hard-working 21 year old today. So I encourage you to look around and find the best educational environment for your child. I think standard, average public school classrooms are poison for an ADHD child, generally speaking, unless you get a very capable and sympathetic teacher, which do exist and are wonderful but are not necessarily the teachers your child will get. I don’t really blame the teachers - the structural expectations are just not appropriate for bright, active, kinesthetic learners. So we emphasized finding a place that fit our children, rather than making them fit into a place that didn’t work for them. I think that decision was definitely the right one for us and paid off big time.

Hope that is helpful!

[quote:2cb82c818f=”Steve”]

One thing you should know that is consistent with our experience: long-term studies on ADHD kids have consistenly shown little or no difference in long-term outcomes for medicated vs. unmedicated kids. [/quote]

One more recent study has shown improved school performance over the period of the study in teens treated with stimulants. http://www.apa.org/monitor/may01/stimulants.html, http://www.apa.org/releases/adhdteens.html As I read it, the study does not really address long-term outcomes, however. I don’t think that there are any studies that show stimulants do or don’t improve long-term outcomes. There simply aren’t any studies published that address that question. See the 1998 NIH Consensus statement, for example. http://consensus.nih.gov/cons/110/110_statement.htm#4_3._What

Actually, while no one has done double-blind placebo studies over a course of many years, there have been retrospective studies on this question going back to the 1960s. You might want to look at:

Swanson, J.S., et al., “Stimulant medication and the treatment of children with attention deficit disorder: A Review of Reviews,” Exceptional Children, 1993, Vol. 60, pp. 154-61.

This article reviewed all of the literature reviews going back into the ’60s and concluded that there is little or no benefit in any area for the aggregate of children who are given stimulant medication. (And Swanson is definitely not arguing against the use of stimulants, in fact he is a big supporter of stimulant therapy.) This doesn’t mean that there is no individual benefit for individual kids, but if there are such individuals, there would have to be just as many that do worse on medication to balance it out. What it suggests to me is that most kids will do just as well LONG TERM on or off medication, and that other variables (such as good teaching, parental interventions, level of maturity and commitment) probably are more important than whether or not you choose to medicate. That is not to say that the short-term benefits are insignificant - it means to me that just because a child is paying attention in school or completing his/her work or getting good grades is no guarantee that s/he will end up doing well (or poorly!) in life. I think this is important to keep in mind, as I am aware of another study from the ’70s that suggests that ADHD kids who received medication got less help from school teachers, partly because the teachers thought the problem was taken care of by the medication. Once the child is “paying attention”, it behooves us to make sure that what they are paying attention to is actually providing them with an education.

[quote=”Steve”]Actually, while no one has done double-blind placebo studies over a course of many years, there have been retrospective studies on this question going back to the 1960s. You might want to look at:

Swanson, J.S., et al., “Stimulant medication and the treatment of children with attention deficit disorder: A Review of Reviews,” Exceptional Children, 1993, Vol. 60, pp. 154-61.”

This article reviewed all of the literature reviews going back into the ’60s and concluded that there is little or no benefit in any area for the aggregate of children who are given stimulant medication. ”

I will take a look, but quite a lot more research has been done since 1993, much of it concluding that stimulants do improve ADHD symptoms. The real problem is that apparently no one is doing research over the long-term, which means we just don’t know whether the improvements continue or whether they would occur without the benefit of medication. That makes it harder for parents to engage in the risk/benefit analysis.

” That is not to say that the short-term benefits are insignificant - it means to me that just because a child is paying attention in school or completing his/her work or getting good grades is no guarantee that s/he will end up doing well (or poorly!) in life. ”

I agree completely. Medication is a tool, not a magic potion. Medication alone will not give a child organizational strategies, teach that child to read or spell, or otherwise create a super student. It may be useful to make a child more available to be taught and to learn the necessary skills but those skills won’t grow if no one teaches them. Good grades aren’t a guarantee of success, any more than bad grades are a guarantee of failure. One thing is for certain, however, and that is that many doors are closed to an individual who cannot read or write commensurate with peers. Even more are closed to a person who is demoralized by years of feeling like a failure. We have to work hard, not only to give these kids the skills they need and deserve to learn, but also to let them know that school isn’t everything. We have to find their strengths, academic or otherwise, and work as hard to develop them as we possibly can.

The research I recall reading concluded that medication plus other interventions provided the best outcomes. Of course, medicating a child is a complicated decision that involves personal values as much as research evidence.

My own 11 year old ADD son is not medicated and so far we are doing OK. We are fortunate that he is interested in most everything which mitigates the ADD. I also am tolerant of the occasional Fs in religion and english grammar (he attends a parochial school and has no interest in learning the parts of the mass and cannot seem to retain what a noun and verb are despite repeated reteaching). He is not a behavior problem at all so all the is really available to us is reteaching at home (which I do) and interventions to improve concentration (which we have done) and of course all the organizational tutoring. Unlike more active children, he has no difficulty with the structure of school.

He also is primarily LD which we have worked hard at remediating. It has made the ADD clearer but also easier to manage. Of course, middle school looms and the routines we have worked out may not be sufficient.

Beth

…I have to add that I have looked over occasional reviews since that time and find that retrospective studies have continued to find little to no benefit over time in the aggregate of ADHD-diagnosed subjects. Even the most pro-medication researchers, like Barclay and Swanson, have made statements that long-term outcomes are not likely to improve from the use of medication alone. Medication appears to be primarily effective for symptom reduction. If you can find anything to the contrary, I would be interested, but everything I have read is consistent with this conclusion. I think there are way too many variables for this one intervention to ever come out as a big winner. Fact is, every kid is different and they all need a different approach. I think that’s what really made the difference in the end, at least with my kids. We adjusted the enviroment to what they needed to succeed when they were younger, and as they got older, they were confident enough to lean how to adust to the environment better.