ADHD, Amphetamines, and School Performance
I have consistently taught that taking medicine is a Romans 14 issue of Christian Liberty. I have also taught students that the question should not be “is taking this medicine right or wrong?” The question should be does the medicine actually work and are the benefits worth the side effects. Well in the case of ADHD and amphetamines, we now have some research that helps answer the question.
ADHD is an educationally driven phenomenon. The primary rationale for using amphetamine derivative medications is that it will improve the mental focus of the child allowing them to receive instruction and learn. The medicines used are also supposed to reduce “hyperactive” behavior that disrupts classrooms. In theory it would make sense that if the child could sit still and pay attention without having to be constantly corralled by the teacher he or she might learn more.
Research made available by the National Bureau of Economic Research[i] and commented on in the Wall Street
Journal[ii], would indicate otherwise. While teachers and parents may perceive their children are doing better a long term study would indicate that there is little to no educational benefit from treating boys and girls with medications such as amphetamine derivatives Ritalin and Adderall.
The basis for the research was a long term study in Quebec that looked at the outcomes of a pharmacy insurance program on the prescribing of stimulant medication and the effect of the medicine on the children who took it. Several things were noted in the study that run counter to current wisdom in the arena of ADHD. Instead of seeing an improvement in outcomes among the children treated, the children seemed to struggle in several areas.
Instead of having improved learning, there was “short term deterioration in academic outcomes among both boys and girls.” Boys were more likely to drop out of school and girls were more likely to be diagnosed with a mental disorder such as anxiety or depression. One of the conclusions that the study arrived at was that perhaps the medication was becoming a “substitute for cognitive and behavioral interventions that might be necessary for the child to learn.” In an odd turn, they concluded perhaps the reduction of hyperactive behavior resulted in the child getting less attention of the kind that might help learning.
Research is a great thing. This study was done by economists who probably were wondering if the cost of the medication in dollars was really gaining the benefit hoped for. I think it tells us that there is no good substitute for educating a child in the way that he or she can learn. (My interpretation of Proverbs 22:6) I think it also tells us that in the significant majority of boys and girls there is very little benefit to the medication if measured in educational terms.
Certainly not enough to make it worth the considerable side effect problems.
[i] “Do Stimulant Medications Improve Educational and Behavioral Outcomes for Children with ADHD?”, Currie et.al.,
Working Paper 19105 http://www.nber.org/papers/w19105 , National Bureau of Economic Research. It will cost
you $5 do download the paper in pdf format. Quotes in the blog come from pages 23-25.
[ii]
http://online.wsj.com/article/SB10001424127887323368704578593660384362292.html?mod=wsj_valetbottom_email
The paper is quoted heavily in the Wall Street Journal “ADHD Drugs Don’t
Boost Kids Grades,” by Shirley Wang. July 8, 2013.
I have consistently taught that taking medicine is a Romans 14 issue of Christian Liberty. I have also taught students that the question should not be “is taking this medicine right or wrong?” The question should be does the medicine actually work and are the benefits worth the side effects. Well in the case of ADHD and amphetamines, we now have some research that helps answer the question.
ADHD is an educationally driven phenomenon. The primary rationale for using amphetamine derivative medications is that it will improve the mental focus of the child allowing them to receive instruction and learn. The medicines used are also supposed to reduce “hyperactive” behavior that disrupts classrooms. In theory it would make sense that if the child could sit still and pay attention without having to be constantly corralled by the teacher he or she might learn more.
Research made available by the National Bureau of Economic Research[i] and commented on in the Wall Street
Journal[ii], would indicate otherwise. While teachers and parents may perceive their children are doing better a long term study would indicate that there is little to no educational benefit from treating boys and girls with medications such as amphetamine derivatives Ritalin and Adderall.
The basis for the research was a long term study in Quebec that looked at the outcomes of a pharmacy insurance program on the prescribing of stimulant medication and the effect of the medicine on the children who took it. Several things were noted in the study that run counter to current wisdom in the arena of ADHD. Instead of seeing an improvement in outcomes among the children treated, the children seemed to struggle in several areas.
Instead of having improved learning, there was “short term deterioration in academic outcomes among both boys and girls.” Boys were more likely to drop out of school and girls were more likely to be diagnosed with a mental disorder such as anxiety or depression. One of the conclusions that the study arrived at was that perhaps the medication was becoming a “substitute for cognitive and behavioral interventions that might be necessary for the child to learn.” In an odd turn, they concluded perhaps the reduction of hyperactive behavior resulted in the child getting less attention of the kind that might help learning.
Research is a great thing. This study was done by economists who probably were wondering if the cost of the medication in dollars was really gaining the benefit hoped for. I think it tells us that there is no good substitute for educating a child in the way that he or she can learn. (My interpretation of Proverbs 22:6) I think it also tells us that in the significant majority of boys and girls there is very little benefit to the medication if measured in educational terms.
Certainly not enough to make it worth the considerable side effect problems.
[i] “Do Stimulant Medications Improve Educational and Behavioral Outcomes for Children with ADHD?”, Currie et.al.,
Working Paper 19105 http://www.nber.org/papers/w19105 , National Bureau of Economic Research. It will cost
you $5 do download the paper in pdf format. Quotes in the blog come from pages 23-25.
[ii]
http://online.wsj.com/article/SB10001424127887323368704578593660384362292.html?mod=wsj_valetbottom_email
The paper is quoted heavily in the Wall Street Journal “ADHD Drugs Don’t
Boost Kids Grades,” by Shirley Wang. July 8, 2013.
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