Medication may be the most effective treatment for kids with ADHD but it’s not a cure-all, a new Consumer Reports survey shows.
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Parents surveyed by the magazine reported using a variety of strategies to improve their kids’ symptoms, such as hiring tutors, switching schools, modifying diets, and changing the way they spoke to their children.
The results are good news, says Dr. Orly Avitzur, a neurologist and medical adviser to the magazine. Kids improve the most when medication is coupled with complementary approaches, such as behavioral therapy and strategies to help with academics.
Consumer Reports interviewed 934 parents of children with ADHD, asking about a variety of topics, ranging from the impact of medications to the effect of complementary strategies, to which physicians provided the most help.
Most families — 84 percent — tried medication at some point, with 67 percent reporting that the drugs helped “a lot.” In general, kids who got a prescription for ADHD were older: The average age of children who had tried medication was 13.
Another strategy that got good marks was switching a child to a school that was better suited to handle ADHD. A full 45 percent of the parents who tried this approach said the switch helped “a lot.” A similar strategy, hiring a tutor, got thumbs up from 37 percent of the parents who tried it.
Parents also reported changing the way they interacted with their children. Some started giving their kids only one instruction at a time — that helped “a lot” for 39 percent of the parents who tried it.
Other parents tried tweaking their child’s nutrition. Adding a vitamin supplement and paying more attention to what a child was eating helped “a lot” in 17 percent of families, while the addition of fish oil supplements got the highest marks from 12 percent of those who tried them.
Parents who suspect that diet has an impact on their children’s symptoms may have gotten some validation from a study published this month in the Journal of Attention Disorders. The study, which followed 1,799 kids from birth to age 14, found that kids had more than twice the risk of developing ADHD if they ate a “Western diet” that consisted of energy dense, heavily processed foods that were rich in saturated fat, salt and sugars and low in omega-3 fatty acids, fiber and folate.
There is some evidence that certain dietary factors — such as omega 3 fatty acids — may play a role in symptoms, says Patrick Tolan, a professor in the Curry School at the University of Virginia and director of Youth-Nex: The UVA Center to Promote Effective Youth Development. But it’s possible that studies that show a connection between ADHD and a bad diet may simply reflect other lifestyle factors, like parents who are very busy.
Tolan isn’t surprised to see parents searching for complementary strategies. “With medication, the child isn’t so distracted, and that makes it easier to learn,” Tolan says. “But it’s not going to teach the child problem-solving skills or give him the ability to stop and think things through like other kids do.”
Those are the kinds of skills a kid will get out of behavioral training and social skills training, Tolan says.
What was surprising about the new survey was how dissatisfied parents were with medications even while reporting that the ADHD drugs were very effective. Only 52 percent of parents agreed strongly that if they had to do it all over again, they would have their kids take medication. And 44 percent said they wished there was another way to help their child.
Those findings may have something to do with side effects, which were reported by 84 percent of the parents. That may be a sign that doctors aren’t spending enough time adjusting medications to get the least amount of side effects while maintaining effectiveness, says Avitzur.
“It’s not like you can just give the child a pill and you’re finished,” she explains. “There’s a lot more to it in terms of management.”
Some parents may just not like the idea of their kids being on a medication, says Alan Kazdin, the John M. Musser Professor of Psychology and Child Psychiatry at Yale University and director of the Yale Parenting Center.
“They think of it as a Band-Aid or a crutch,” Kazdin says. “But, I’ve heard from many, many children who couldn’t believe how well the medication worked, who were amazed at how they were now able to pay attention in class.”
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