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Amy Petrillo
11/13/14
English 111
Instructor Nancy Elliott
Should We Be Medicating Youth For ADHD?
ADHD is a growing problem among children throughout the world. According to the
book Medicating Children: ADHD and Pediatric Mental Health, ADHD is defined when
brain development in a child starts off normal, but then is delayed started around the age
of three. This is believed to be the most common disorder of the brain, which continues
with the child into adulthood. A child with ADHD usually struggles with the ability to
learn in school. The common symptoms for ADHD include the inattention of a child,
hyperactivity, and being impulsive. The National Institute of Mental Health (NIMH)
believes that a child must be experiencing these symptoms for at least six months and
must be more severe than a normal child who experiences the symptoms before getting a
definite diagnosis. NIMH defines the three symptoms as being distracted easily, inability
to focus on one task, constant fidgeting, nonstop talking, being impatient, and blurting
out inappropriate comments. Although ADHD does not have a known cause, studies done
by NIMH show genes may play the biggest role. Other studies done to find a cause have
shown environmental factors, brain injuries, sugar, and food additives may also have a
part in how ADHD appears in a child. This illness is fairly hard to diagnose due to the
fact that every child ages differently. One single test does not determine if a child has
ADHD, it is determined over time while a professional examines that specific childs
tendencies. Once a child is diagnosed with ADHD, there is medication to treat the

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disorder, psychotherapy, behavioral therapy, or a mixture of the therapies. NIMH states
that medications help to reduce the hyperactivity and impulsivity, while also helping to
improve their ability to focus, learn, and work. Methylphenidate and amphetamines are
the most common types of medication used to treat ADHD. That brings up the topic of
whether or not a child who is diagnosed with ADHD should be medicated to treat the
disorder. Some arguments say that Doctors are just giving out medications assuming that
one size fits all. In reality, it may take numerous different medications to treat a childs
symptoms. Some childrens case of ADHD is severe enough to where they cannot
function without the help of some type of medication, where the proper dosage amount
must be properly given. It is shown that medication is effective when given to children.
Medicating children is an effective way to treat ADHD, as long as Doctors and parents
are monitoring it.
As a less severe case of ADHD might not need to be treated with medication, a
very severe case may have no other option other than to use medication to help the child.
According to the Clinical Practice Guideline, stimulant medication is the most effective
way to reduce the core symptoms that come from ADHD. A child may do well only
being in behavioral therapy, or psychotherapy but cannot achieve maximum
improvement unless medication is included along with those treatments. A child who is
not a severe case and can function normally without medications should not be given
medications. The Clinical Practice Guideline says that before medication is given that the
physician should be doing assessments to determine the severity of ADHD in the child.
Physicians also have a list to determine when a case is severe enough to administer
medication. From the Clinical Practice Guideline the list includes, (1) symptoms that

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have persisted for at least 9 months, (2) dysfunction that is manifested in both the home
and other settings such as preschool or child care, and (3) dysfunction that has not
responded adequately to behavior therapy (1017). Physicians can then prescribe the
medication based on the symptoms. As risks for children who have severe ADHD and are
under the age of six, the FDA has only approved dextroamphetamine. This is only given
if the young child is severely suffering and cannot function properly without it.
According to Heidi Duerr, the use of stimulant medication is also believed to be helpful
in most severe cases. In Duerrs article, Timothy Wilens, MD, says, children with
ADHD show cortical thinning (1). He discussed a study done with those who received
psycho-stimulant medication and compared cortical thickness of those who did not
receive treatment. The children who received the medication showed cortical thickness
like normally developing kids, where as the children who did not receive medication
showed more rapid cortical thinning. Without this kind of treatment, Duerr believes that
the children that go untreated with show academic failure, low self-esteem, and suffer
from being anti-social.
Having a better understanding of the medication can be very helpful. A person
may not allow their child to go on medication because they do not know the main
purpose of it and is too scared to ask. Treatment Guidelines: from the Medical Center
explains medication used to treat ADHD. As for all of the drugs, they reduce ADHD
symptoms. Dextroamphetamine, the most common for children under the age of six, is
used mainly to reduce the overactivity, inattentiveness, and impulsivity. This starts
working within an hour of intake, lasts about five hours, and is taken twice a day.
Another popular medication for treating ADHD is methylphenidate. There is the short-

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acting and long-acting methylphenidate. Short acting is absorbed more rapidly and can
show effectiveness within thirty minutes. A peak of effectiveness happens within one to
three hours, while lasting anywhere from three to five hours. This is mainly for a boost in
the morning, or a smooth withdraw later in the afternoon. The Treatment Guidelines
suggests a dosage of five mg two or three times day for children intake. Long acting
treatment has three to five hour duration, usually needing a second administration during
the school day. As for non-stimulant medication there is efficacy. Efficacy is best used
when children do not respond to the stimulant medication and show no improvements in
their symptoms. According to the Treatment Guidelines, the best choice of medication for
school aged children is an oral stimulant of amphetamine or a methylphenidate.
Implementing the Key Action Statements: An Algorithm and Explanation for Process of
Care for the Evaluation, Diagnosis, Treatment, and Monitoring of ADHD in Children
and Adolescents states that the FDA has approved more medications recently, so there is
a lesser chance that they will use off brand medication on a child. This makes it so
parents feel safer about what types of medication is taken by their children.
Most importantly, medicating children for ADHD has been proven to be effective.
In Medicating Our Youth: Who Determines Rules of Evidence, Robert Foltz demonstrates
the effectiveness of medication on children. Methylphenidate has had an eighty percent
increase from 2004-2008. The United States has surpassed every other country in the
amount of drugs prescribed, which has been effective. As said by Robert Foltz,
methylphenidate provides all day symptoms control; covers the all-important homework
hours between 4-6 p.m.; helps your child focus at school and at home; and can help
improve your childs social interactions (1). The Multimodal Treatment for ADHD

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Study (MTA) did a study on four hundred children. The children were either given
medication alone, behavior therapy alone, standard community care, or a combination of
behavior therapy and medication. Once the study was over it stated, For most ADHD
symptoms, children in the combined and medication management groups showed
significantly greater improvement than those given intensive behavioral treatment and
community car (2).
On the other hand, some believe that children should not be medicated for
ADHD. Gregory Lamb said that some medications end up having a harmful effect on
kids. Dr. Matthew Rudorfer from the National Institutes of Mental Health said, Our
sense is that we would like, in the interim, the FDA to go ahead and issue stronger
warning indications to clinicians regarding possible risks of these medicines (1). He
feels that there should be limitations on medications given to children. There has also
been a study that has shown a link with taking medication for ADHD that has been linked
to suicidal tendencies. Personal tragedies have occurred more often in children taking
medications for treatments. David Antonuccio from the University of Nevada said
advantages for antidepressants in children is insignificant. Robert Foltz in an article said
the United States is medicating more than any other country. He says that if a childs
brain is exposed to psychotropic drugs while they are developing, short-term
consequences can happen. According to Foltz, seventy four percent of children who were
diagnosed were prescribed medications. Five and a half percent of youth is diagnosed
with ADHD and can now be diagnosed at four years old or younger. The Consensus
Conference said, There is no evidence regarding the appropriate ADHD diagnosis
threshold above which the benefits of psychostimulant therapy outweigh the risks (3).

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Even though medications have become more popular, it is believed they have a negative
effect on youth. Dr. Weiss at the Canadian Pediatrics Annual Conference said,
Misbehavior is a childs voice, and removing this means of communication is likely to
put them at a severe risk (1). Medications are taking that voice away from children and
their form of communication disappears. Also, pediatricians medicate children because
they feel pressured by the parents. Dr. Weiss also stated that some medications prescribed
to children can cause depression and the child could become withdrawn. Dr. Weiss cited
a study done in the U.S. by Marsha Rappley, which looked at two hundred and twenty
three children. Who were three years old and younger. More than half of the children
were given medication and the rest were treated with psychological services. The studies
showed that the medicated children were given close to twenty-two different medications
and were given in thirty different combinations. That was considered very dangerous for
the children, where the psychological services were just as effective and less harmful. All
these created the impression that medicating children is harmful and should not be done.
All options being considered, medication has been a controversial topic over the
years. Even though there are examples of why you should not medicate children, there is
more evidence to support that this is all right. Medicating children for ADHD is good as
long as the clinician and parents are watching the consumption of the medication. If a
childs case is severe enough, it should be treated with medication. Medication has been
proven to be effective on children with correct dosage sizes and supervision.

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Abramowicz, Mark. Treatments Guidelines: Drugs for Treatment of ADHD. The
Medical Letter 9.105 (2011): 24-26. Web. 1 Nov. 2014.
American Academy of Pediatrics. ADHD: Clinical Practice Guideline for the
Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity
Disorder in Children and Adolescents. The American Academy of Pediatrics
128.5 (2011): 1007-1022. Web. 1 Nov 2014.
American Academy of Pediatrics. Implementing the Key Action Statements: An
Algorithm and Explanation for Process of Care for the Evaluation, Diagnosis,
Treatment, and Monitoring of ADHD in Children and Adolescents. The
American Academy of Pediatrics 128.5 (2011) supplement 109-125. Web. 1
Nov. 2014.
Duer, Heidi. New Study Holds Additional Support For Benefits of Stimulant Use in
ADHD. Neuropsychiatry (2013); 1. Web. 1 Nov 2014.

Foltz, Robert. "Medicating Our Youth: Who Determines Rules of Evidence?" Reclaiming
Children and Youth 19.2 (2010): 10-15. ProQuest Criminal Justice; ProQuest
Psychology Journals; ProQuest Research Library. Web. 29 Oct. 2014.
Foltz, Robert. Twenty Years of Medicating Youth: Are We Better Off? Reclaiming
Children and Youth 20.4 (2012): 31-36. ProQuest Criminal Justice, ProQuest
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Godley, E. (2001). No Clear Evidence For Kids Medication Use: Studies Lacking
Support Medicating Young Children For Behavior Problems. Medical Post,
37(24), 1. Web. 29 Oct. 2014.
Lamb, Gregory. New Doubts About Medicating Kids; Pressure is Mounting to Ban or
Curtail the Use of Antidepressants on Children. An FDA panel Heard Evidence
This Week. The Christian Science Monitor (2004); 14. ProQuest Business
Collection. Web. 29 Oct. 2014.
Mayes, Rick; Catherine Bagwell; Jennifer Erkulwater. Medicating Children: ADHD
and Pediatric Mental Health. Harvard University Press (2009); 352. ProQuest.
Web. 29 Oct. 2014.
U.S. Department of Health and Human Services. Attention Deficit Hyperactivity
Disorder (ADHD). National Institute of Mental Health (2012): 12-3572. Web.
1 Nov. 2014.