It’s a tough call. If a child is diagnosed with attention deficit hyperactivity disorder (ADHD), when should treatment begin? Should medication be a part of the plan? And when is the right time to start?
Many parents may be hesitant to pursue a diagnosis of ADHD, says developmental pediatrician Robin Blitz, M.D. There are societal stigmas — and no parent wants a child to struggle academically or socially.
However, the purpose of making any diagnosis is to be able to treat the problem so that the child can be successful in school, in the family, and with friends, adds Blitz, who directs the Barrow Neurological Institute of Phoenix Children’s Hospital and is herself the mother of two successful adult children with ADHD.
Stimulant medications are widely used to improve the core symptoms of ADHD in children, including inattention, hyperactivity and impulsivity, according to the American Academy of Pediatrics (AAP). But experts say that there is less evidence that these medications improve academic performance over the long term.
Study findings published in the July 2012 issue of Pediatrics showed that children taking ADHD medications had lower scores on seventh grade tests, especially in math. But children who began taking medications soonest after their fourth-grade test showed the smallest declines.
The effect was greater in girls than boys and also greater for children who did poorly on their fourth grade test.
The researchers concluded that a later start to stimulant drug treatment among 9- to 12-year-old children with ADHD is associated with academic decline in math.
Although Blitz, a member of the Arizona Chapter of the American Academy of Pediatrics (AzAAP), declined to comment on the specifics of the study, she notes that it makes sense that children who are treated for their ADHD later may have lower math achievement scores in seventh grade than they do in fourth grade.
Beginning in preschool and kindergarten, says Blitz, children are laying the foundations necessary for future academic learning. “My theory goes back to the fact that people have to pay attention to the information being presented in order to learn that material,” she says. “If a child is not paying attention to the information presented from kindergarten through seventh grade, then it is likely that they have not learned the basic math skills that are the foundation for higher math abilities.”
As it is true for many developmental disabilities, says Blitz, early intervention leads to better prognosis. “For our children with ADHD, early identification and treatment can lead to improved academic performance, increased likelihood to graduate high school and attend college, improved ability to obtain and maintain a job, improved peer relations and improved family function. We all want the best for our children; we should give them every opportunity for success.”