ADHD drugs don’t raise kids’ grades

Attention Deficit Hyperactivity Disorder medications don’t improve academic achievement, according to new studies, reports the Wall Street Journal.

Stimulants used to treat ADHD like Ritalin and Adderall are sometimes called “cognitive enhancers” because they have been shown in a number of studies to improve attention, concentration and even certain types of memory in the short-term.

. . . However, a growing body of research finds that in the long run, achievement scores, grade-point averages or the likelihood of repeating a grade generally aren’t any different in kids with ADHD who take medication compared with those who don’t.

Boys who took ADHD drugs performed worse in school than those with similar symptoms who didn’t, according to the study, which tracked students in Quebec. Girls on ADHD drugs reported more emotional problems.

Teach to boys’ energy, curiosity, drive

Stop Penalizing Boys for Not Being Able to Sit Still at School, writes Jessica Lahey, who teaches middle school, in The Atlantic.

“Something is rotten in the state of boys’ education,” she starts. Boys are kept back at twice the rate of girls, according to Reaching Boys, Teaching Boys: Strategies That Work and Why Boys are “diagnosed with learning disorders and attention problems at nearly four times the rate of girls,” do less homework, earn lower grades and drop out of high school in higher numbers. Only 43 percent of college students  are male.

Many teachers and school administrators think “boys are too fidgety, too hyperactive, too disruptive, derailing the educational process for everyone while sabotaging their own intellectual development,” Lahey writes.

Peek into most American classrooms and you will see desks in rows, teachers pleading with students to stay in their seats and refrain from talking to their neighbors. Marks for good behavior are rewarded to the students who are proficient at sitting still for long periods of time. Many boys do not have this skill.

What works for boys?  Teaching Boys: A Global Study of Effective Practices recommends lessons:  that result in an end product (a booklet, a catapult, a poem, a comic strip), that are structured as competitive games, that require movement, that require boys to assume responsibility for the learning of others, that address open questions or unsolved problems, that combine competition and teamwork, that focus on independent, personal discovery and realization and that introduce drama in the form of novelty or surprise.

In short, ‘the most effective way to teach boys is to take advantage of that high energy, curiosity, and thirst for competition,” Lahey concludes. And it’s not as if girls can’t learn from these sort of lessons.

Attention deficit or sleep deficit?

Some cases of Attention Deficit Hyperactivity Disorder may be a sleep disorder in disguise, writes Vatsal G. Thakkar, a psychiatry professor, in the New York Times.

Eleven percent of schoolchildren have been diagnosed with ADHD, he writes. Adult diagnoses are up too.

For some people — especially children — sleep deprivation does not necessarily cause lethargy; instead they become hyperactive and unfocused.

Adults and children are sleeping less, Thakkar writes.

The number of adults who reported sleeping fewer than seven hours each night went from some 2 percent in 1960 to more than 35 percent in 2011. Sleep is even more crucial for children, who need delta sleep — the deep, rejuvenating, slow-wave kind — for proper growth and development. Yet today’s youngsters sleep more than an hour less than they did a hundred years ago. And for all ages, contemporary daytime activities — marked by nonstop 14-hour schedules and inescapable melatonin-inhibiting iDevices — often impair sleep. It might just be a coincidence, but this sleep-restricting lifestyle began getting more extreme in the 1990s, the decade with the explosion in A.D.H.D. diagnoses.

Children with an A.D.H.D. diagnosis are likely to also have “sleep-disordered breathing like apnea or snoring, restless leg syndrome or non-restorative sleep, in which delta sleep is frequently interrupted,” he writes.

In a 2004 study, 34 children with A.D.H.D.  all showed a deficit of delta sleep, compared with only a few of the 32 control subjects.

Sleep disorders can be treated, writes Thakkar, who has a rare form of narcolepsy.

Early high school start times don’t fit adolescents’ sleep patterns, research shows. “Tor a teenager, a 7 a.m. alarm call is the equivalent of a 5 a.m. start for people in their 50s,” writes Russell Foster in New Scientist. It’s the hormones.

Pushing drugs in school

Diagnosed as hyperactive in first grade, Ted Gup’s son was prescribed Ritalin and Adderall, Gup writes in the New York Times.

In another age, David might have been called “rambunctious.” His battery was a little too large for his body. And so he would leap over the couch, spring to reach the ceiling and show an exuberance for life that came in brilliant microbursts.

When he was older, he sold his Adderall to classmates, who saw it as a performance-enhancing drug.

As a 21-year-old college senior, he was found on the floor of his room, dead from a fatal mix of alcohol and drugs.

“I had unknowingly colluded with a system that devalues talking therapy and rushes to medicate, inadvertently sending a message that self-medication, too, is perfectly acceptable,” writes the grieving father.

Now psychiatrists have defined grief as depression, which “runs the very real risk of delegitimizing that which is most human — the bonds of our love and attachment to one another.”  Gup does not plan to take a pill to dull his grief for his son.

Huck Finn, 2013


– Signe Wilkinson

School is tough? Take a pill

Some doctors are prescribing medication for Attention Deficit Disorder to low-performing children, even if they don’t fit the diagnosis, reports the New York Times. Well, at least one doctor is.

CANTON, Ga. — When Dr. Michael Anderson hears about his low-income patients struggling in elementary school, he usually gives them a taste of some powerful medicine: Adderall.

The pills boost focus and impulse control in children with attention deficit hyperactivity disorder. Although A.D.H.D is the diagnosis Dr. Anderson makes, he calls the disorder “made up” and “an excuse” to prescribe the pills to treat what he considers the children’s true ill — poor academic performance in inadequate schools.

“I don’t have a whole lot of choice,” said Dr. Anderson, a pediatrician for many poor families in Cherokee County, north of Atlanta. “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.”

“It is not yet clear whether Dr. Anderson is representative of a widening trend,” reports the Times. That means they could find only one doctor willing to admit he’s handing out ADHD pills as a performance enhancer. However, there’s some evidence that affluent students “abuse stimulants to raise already-good grades in colleges and high schools.”

Are there side effects to these medications? Yes, there are.

Raising the Ritalin generation

We’re way too quick to label active boys as hyperactive, writes Bronwen Hruska in Raising the Ritalin Generation.

Will did not bounce off walls. He wasn’t particularly antsy. He didn’t exhibit any behaviors I’d associated with attention deficit or hyperactivity. He was an 8-year-old boy with normal 8-year-old boy energy — at least that’s what I’d deduced from scrutinizing his friends.

But the third-grade teacher suggested an evaluation.

. . .  once you start looking for a problem, someone’s going to find one, and attention deficit has become the go-to diagnosis, increasing by an average of 5.5 percent a year between 2003 and 2007, according to the Centers for Disease Control and Prevention. As of 2010, according to the National Health Interview Survey, 8.4 percent, or 5.2 million children, between the ages of 3 and 17 had been given diagnoses of attention deficit hyperactivity disorder.

There’s no test for ADHD, she writes. Teachers’ impressions —  they’re asked to rate “squirminess” on a scale of one to five — make a big difference.

Will was diagnosed as being inattentive in distracting situations, such as school, and prescribed Ritalin. “It was not to be taken at home, or on weekends, or vacations. He didn’t need to be medicated for regular life.”

He took the drug in fourth grade and had a great year, but quit in fifth grade. He’s done fine without it. “For him, it was a matter of growing up, settling down and learning how to get organized,” writes Hruska. “Kids learn to speak, lose baby teeth and hit puberty at a variety of ages. We might remind ourselves that the ability to settle into being a focused student is simply a developmental milestone; there’s no magical age at which this happens.”

 

 

Why so many hyperactive kids?

Nine percent of school-age children in America have attention deficit disorder, according to a health professional.   Why so many? Pediatrician Lawrence Diller blames a growing willingness to medicalize childhood misbehavior.  Uncertain about discipline and worried too much about self-esteem, parents turn to professionals, who are quick to prescribe drugs for what may be “minor differences in children’s behavior or performance.”

Children are under more stress at school, Diller adds.

. . . more than 20 years ago kindergartners only had to sing the ABCs and play “ring around the rosie.” Now, they are expected to read and do simple math before the start of first grade.

When both parents are working, children spend a long day trying to meet the “behavioral demands” of structured preschool and  after-school programs, he writes. “Parents are tired, too, when they finally get their kids at the end of the day.”

Via I Speak of Dreams.

It’s not the sugar

Don’t worry too much about the post-Halloween sugar rush. Sugar doesn’t make kids hyperactive, writes Dan Willingham on The Answer Sheet, citing dozens of studies.  If children act crazy after eating candy, it may be the excitement of trick or treating or the birthday party or just the thrill of a sweet treat.

Or it may be parental expectations:  In a study, supposedly sugar-sensitive boys were given a drink sweetened with aspartame.

Half of the moms were told that the drink had a lot of sugar in it, and half were told it had none.

Mothers and sons then interacted on several tasks (e.g., building a Lego house together). Moms who were told their children had had sugar later rated their sons’ behavior during this interaction as more hyperactive.

Sugar also has no effect on children diagnosed with ADHD, Willingham writes.

No waiting for hyperactive kids

To prevent tantrums, British amusement parks let hyperactive children go to the front of the line, reports the Times of London. Children with attention-deficit disorders “cannot cope with the stress of waiting,” tourist boards say.

Teachers have criticised the scheme, saying that it undermines their efforts to encourage patience and it would be better for children with ADHD, attention deficit and hyperactive disorder, to learn how to wait.

Via Nothing To Do With Arbroath.