Long Term Stimulant Use Improves School Grades

When kids or teens are diagnosed with ADD/ADHD, doctors generally recommend medication to help to control the symptoms.The most commonly used medications include the stimulant medications – namely medicines like: Concerta, Adderall, Adderall XR, Vyvanse, Metadate CD, Ritalin LA, Methylphenidate, Dextroamphetamine, and others.

While there are many studies showing that the ADHD symptoms of inattention, hyperactivity and impulsivity improve with the medicine, and cause short term academic improvements, there has been a lack of research to show long term academic benefits.

The studies summarized here clearly document that ADHD stimulant medication helps with long term academic success.

In this research, the research team followed 5700 children from birth until 18 years old. In that group, 277 boys and 93 girls were diagnosed with ADHD. Of those with the diagnosis, some decided to use medication, and some did not. When kids took ADHD medication, they generally started in elementary school, and took it for (on average) 30 months (i.e. just under 3 years).

Of the ADHD kids who were taking medication, by 13 years old, the medication children had improved reading scores compared to the kids with ADHD who had not taken medication. Children taking medication were more likely to attend school (i.e. less absenteeism), and they were 1.8 times less likely to be held back a year at school.

The lead researcher, Dr. Barbaresi was quoted as saying: “We can’t simply focus on the symptoms of ADHD,” Barbaresi said. “We really need to be focusing on the risk for poor outcomes in school and in other aspects of the child’s life,” he said. “That’s why we have to recognize these children and make sure they get appropriate treatment.”

To read more about these studies, click here.

What do you think? Has ADHD medication helped your child (or yourself) over the long term? Please share your thoughts in the comments below.

Best,

Dr. Kenny

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Comments

  1. No question about it! The kindergarten screeners wanted to hold our son back due to his delayed academic and social scores on their placement test…this was prior to his diagnosis. We KNEW deep down that he was not truly academically lacking, but that he simply lacked focus and the ability to sit still long enough to complete educational tasks. We chose to enroll him in a private Montessori kindergarten where the education would be structured more around his needs and abilities. He was diagnosed 6 months later with the support of his teacher and our pediatrician. Within a week he was reading.

    Now he is in 5th grade and his fifth year at a public Montessori charter school. He has reading comprehension abilities at the high school level. His state standardized test scores have always been average to above-average, across the board. He still struggles with the physical act of writing (as do I, his mother…I cannot hand write fast enough to keep up with my thoughts. I believe that once he is able to type that writing will no longer be such a task for him).

    Without medication he can’t focus on anything and is an overly active and noisy distraction to himself and those around him. On his meds no one would ever suspect that he struggles with this disorder.

    • Kirsten,
      Thank you for sharing your experience. I believe it is very helpful for parents who are very worried about starting their kids on medicine for ADHD (even though their child is struggling a lot!).
      Best,
      Dr. Kenny
      p.s. I like zoomylicious!

  2. Hi Dr. Kenny,

    These studies are interesting, but as you know, there are others that show that medication makes no difference to educational outcomes.

    Also, even the studies that show an improvement in outcomes for children with ADHD who are on medication vis-a-vis those who are not, show only marginal improvements. The medication only goes a small way to close the gap between kids with ADHD—whether on medication or not—and those without ADHD.

    I am also frustrated by the fact that these studies do not compare alternative methods of addressing ADHD issues in the classroom. For example, what are the comparative outcomes for medication versus intensive tutoring? or smaller classroom sizes? or increased physical exercise during the school day? or a teaching environment geared toward the needs of children with ADHD?

    I still think we are trying to force ADHD kids into the pre-existing classroom box, instead of seeing how we can make the classroom fit them.

    I realize this is a difficult hurdle to overcome, (I am still working on these issues myself with respect to my daughters) but it seems to me to be necessary.

  3. Hello Dr. Kenny,

    I absolutely agree 100% with everything that Sarah said on the comment above. My 9 yr old daughter has been recently diagnosed with ADHD and is currently on Concerta 27mg. She has always made good grades and has been in the gifted and talented classrooms in her school. She mainly struggles with impulsivness, defiance and being a distraction to others. I believe that if I could find her a school with smaller classrooms and certified teachers that specialize in teaching kids with ADHD then us parents would not have to resort to putting our kids on medication just so that they can fit in with the other average children. Concerta has helped a little in regards to her impulsive behavior and defiance on a daily basis but my daughter is still human and her personality is still the same. I said that to say that she still is defiant and impulsive when she chooses to be and I dont think there’s any safe/healthy medication out there to control some one (especially a child) from being who God created them to be!

  4. Even in a Montessori environment with 30 students 1 lead teacher, and 2 aids, my son was not able to focus enough to start work independently, complete assignments, so far with medication he can write out an assignment plan for the week and stick to it. I may wish I could afford a private school or move to an area with a school that specializes in educating kids with ADHD, but practically speaking we are putting him in the best affordable environment we can, plus our employment is here. I’ve looked at natural foods and found that the diet plans are time consuming, my kids won’t eat most of the foods on the plan, and I just end up feeling guilty because I’ve found them to difficult to follow. More power to those who can do those things successfully. As far as letting my child be who God created him to be naturally, my feelings are why did God let people create glasses, wheel chairs, and other assistive devices? Should we get rid of those because they are not natural? I had 3 kids as home births with midwives so I’m all for natural when it works, but if medication helps my son live up to his full potential, isn’t that a greater good? Just something to ponder.

  5. Lisa, you nailed it. No one would ever suggest that we not treat a type 1 diabetic or asthmatic, simply because nature gave them organs that aren’t properly functioning. It irritates me to no end when mental health disorders and other behavioral disorders caused by a brain abnormality are stigmatized or viewed differently than the disfunction of any other organ.

    Studies can show all they want about an entire population with ADD/ADHD, but it doesn’t really matter on an individual level. No 2 people with these diagnoses are the same or respond to treatments in the same way. A lot of how medications do or do not work hinges on the severity of a person’s symptoms. Were my son mildly ADHD we might be able to forgo meds or a significantly smaller dose. As it is, we try to harness his activity levels, but that can only go so far. During the warmer months he’ll put in 50 or more miles on the back of our tandem bike like it’s nothing. This helps, but is of little help during the school year when recesses are short and gym class is only once/week.

    While it’s nice to think that schools could cater to each individual student in a classroom, there are only so many hours in a day and teachers are already being pulled in too many directions as budgets have been slashed and classroom sizes have ballooned. I can’t expect my son’s teachers to make exceptional sacrifices for my child at the expense of every other student in the class.

  6. Just wanted to chime in and agree with the two latest posts made by Lisa and Kirsten.

    I’m basically the prime example of what might happen if you don’t medicate your child. Granted, people are more aware of ADD/ADHD these days than when I grew up in Norway in the 80s. Basically what happened to me was.. Second grade.. I was pretty much done with school. I knew it would be futile, so I just gave up. Everything I learned I did by myself. I knew English two years before we started English classes in school. I was also one of the first to learn how to read and write. Those were the two things I cared about, and that’s basically all I ever learned in my childhood. When it comes to stuff I have an interest for, it seems I have a heightened capacity for learning. Everything else… No way. My brain just goes “nope, not bothering.” Maths is the perfect example. By 4th grade I no longer brought books with me home because I knew I wouldn’t bother with homework anyways. And after about 3 years of daily fights over homework my parents were just done trying. Every time I actually made an effort in school I came short and felt like a complete failure, which, in turn, made me hate school even more. In the end what I got out of school was a sense of humor, because the only thing I excelled at was being funny. You end up playing to your strength when everything else fails.

    To parents who are against medicating your children. If you see your child falling behind, please reassess the medication situation. You REALLY don’t want your child to end up like me. I’m somewhat bitter about not being diagnosed as a child. I am by no means stupid, which makes me speculate that if I actually got the help I needed as a child, my life would be very different indeed. At the very least I would have a job, maybe. And perhaps I wouldn’t have become bipolar. An alarming amount of ADD/ADHD diagnosed people end up with a comorbid bipolar condition. No one quite knows why, but there may be some links between the two. Purely speculation until some studies are done, though. If you become bipolar in addition to ADD/ADHD, the medicating of the ADD/ADHD part becomes extremely tricky because most stimulants have a chance of triggering manic episodes. Not good.

    Sorry about the lengthy post.

  7. At the end of grade 3, my son cried because he didn’t want to go on to grade four and that he felt school was too hard for him. I am a teacher myself who provided him with all the support I could and was getting so tired and fustrated. I had to reteach him everything at home. He just was’t focussing in the classroom and I had to stay ahead of his teacher so that when she taught concepts because he already was exposed to it from me he would be better focused in class and started to gain confidence. Having Diabetes as well, he would often forget to take his insulin , test his blood sugar, and count his carbs (insulin pump therapy). I had to always have him attend the school I taught in because he was such a big responsibility. At the end of grade three he was tested and only came up as a low average scores, but 2 years behind peers with some aspects of reading and writing. At the beginning of Grade 4, his pediatriction decided to try him on Biphentin.The difference in him was amazing! He became more independent, less lathargic, socially got along better with peers, more tolerant at home with reading and writing homework, easier to talk to (more compliant). His teacher could not get over the difference in him. My husband and I were astonished with his progress. This year in Grade 6, I have a confident 11 yr old boy bringing home 4s ans 5s on his report card ( rating scale in NL for 4-strong 5-outstanding). He is managing his Diabetes independently and is proud of himself because he can finally go on sleepovers and weekend scout trips without his parents. I don’t think this would of been possible without medication. Putting him on medication was a hard decision for me to make, however there are now no regrets. I have had students in my classrooms diagnosed with ADHD whose parents decided to not medicate them. They are like Tyler in the beginning, 2-3 years academically behind their peers, fustrated in the classroom and being disturbances, impulsive and non- compliant. They will not attempt anything on their own without 1-1 help or instructional support. This is not something I would of wanted for my son am so glad that everything worked out for him.

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