Kids on Medication: The Parent's Dilemma

Media coverage of the use of prescription drugs to treat childhood disorders has been extensive, particularly since the Federal Drug Administration (FDA) has issued warnings about the use of antidepressants and stimulants. One of the targets is the use of stimulants and other medications in the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). Such reports usually focus on the following questions:

• Do medications contribute to suicidal thoughts?

• How can parents interpret the actions of the FDA in regard to warning labels?

• Are drugs over-prescribed or under-prescribed?

• Are schools and parents overusing drugs for the purpose of curbing behavior?

• Can medication improve a child's behavior?

• Can even prescribed drugs be addictive?

• Are kids with ADHD at risk for later illegal drug use?

A healthy debate of issues can be productive, but the pursuit of reliable, accurate information should be the objective of any discussion. How can parents decide what to do?

• There is no one-size-fits-all approach when treating children with any illness. Treatment for ADHD and other conditions can involve any or all of the following: behavior therapy, medication, parent counseling, educational modification. Not all children respond equally well to the same intervention.

• Mental health professionals specially trained to evaluate children are the best resource for parents concerned about their child's behavior and effective treatments. Treatment should always begin with a proper diagnostic evaluation of a child, taking into account multiple sources (home and school) and multiple aspects of a child's functioning. Continued monitoring is essential.

• School teachers and educational staff are experts at understanding children's learning and are essential for providing feedback to parents to insure the optimal management of a child's problems. They can provide valuable information about a child's functioning in an educational setting but should not be expected to perform as health care professionals and make treatment recommendations.

• Treatments for specific diseases -- asthma, cancer, anxiety, depression or ADHD -- must keep pace with the changing scientific findings. Parents should be sure that the treating professional stays abreast of research and tailor their child's treatment accordingly.

• Any treatment or medication carries risks. Untreated illness also causes risk. Parents and professionals must always work together to establish the optimal treatment while weighing the costs and benefits of any intervention.

• Parents are the best advocates for their children. Anything that enables them to be better-informed consumers and more savvy users of medical technology is of benefit to their children

References and Related Books

The MTA Cooperative Group (1999). A 14-month randomized clinical trial of treatment strategies for Attention-Deficit/Hyperactivity Disorder. Arch Gen Psychiatry . 56, 1073-1077.

The MTA Cooperative Group (1999). Moderators and mediators of treatment response for children with Attention-Deficit/Hyperactivity Disorder: The multimodal treatment study of children with Attention-Deficit/Hyperactivity Disorder. Arch Gen Psychiatry . 56, 1088-1095.