Thursday, November 30, 2023

Is Amphetamine Truly the Solution For Managing Rambunctious Children?

 

https://www.additudemag.com/misunderstood-adhd-in-the-classroom/


Imagine yourself as a parent, receiving a call from school because your child keeps interrupting class and will not sit still. You think to yourself, “But aren’t kids always bursting with energy?” The teacher urges you to put your child on medication to calm him or her down. You are not sure, but you decide to accept. Everything will go back to normal with a handful of pills, no? Or is the problem something deeper?

All About ADHD

Attention Deficient Hyperactive Disorder, shortened to ADHD, is a neurodevelopmental disorder that impairs the brain’s executive functions. Organization, planning, time management, and paying attention becomes extremely difficult for those with ADHD. You may know a friend or parent with an ADHD kid. ADHD is a relatively common disorder, affecting 11% of children and 5% of adults (1). Even I have ADHD and can relate to all these symptoms. I best described my struggles to a friend as, “Having a hundred computer tabs open and rattling around in your head but you can’t close any of them”. Not only does the condition impact your personal or social life, it can detrimentally affect your work or schooling. Being forced to sit still in class while a teacher is lecturing about some uninteresting topic is agony. Back in the early 20th century, unruly students would be kicked out of class or smacked with rulers, but there is a modern solution: Medication.

Prescription Problems

There are many different types of ADHD medication. Some act instantly and allow for powering through a morning test and some are slow acting and facilitate survival of the school day. The most commonly used drug are stimulants which increase the neurotransmitters dopamine and norepinephrine in the central nervous system. Because dopamine is in short supply in those with ADHD, they struggle with mood and concentration (6). In the United States, 8.5% of children, about 1 in 12 children, are on some form of medication to treat ADHD (1). And with the whirlwind of COVID causing kids to be cooped indoors, ADHD prescriptions are at an all-time high (7). These medications are not without their problems. As some medications use amphetamines, they are tightly regulated, punishing the absentminded for forgetting their refills. Medications are also expensive and difficult to force children to take. Finding the correct type of prescription is an added challenge. Not enough dosage and the children are bouncing off the walls, too much dosage and the children are mindless drones. It is a nightmare for everyone involved. Maybe ADHD is not the fault of the children, but of the school system.




Schooling Situation

Public or private, children are in school for eight hours a day. They have many classes, but not a lot of free time. According to the National Association of Early Childhood Specialists, 40% of schools have removed or are considering removing recess. Removing a well needed break for children is problematic. Stewart Trost, a kinesiologist, believes kids who have recess have improvements in staying on task, are less fidgety in the classroom, and are more well behaved (3). Participating in sports have the same beneficial effects. Physical exercise raises those needed dopamine levels and clears the mind to improve students’ social skills and focus in the classroom (2, 5). There are many more ways the United States’ school system could be improved. ADDitude, a magazine devoted to understanding and triumphing over ADHD, provides solutions. Teachers should be trained in recognizing ADHD symptoms instead of considering it as unruly behavior. Class lessons could be more interactive which decrease the amount of time required for students to sit quietly at a desk. Recess breaks should be non-negotiable (4). So the next time little Timmy is squirming in his seat, don’t throw pills at the problem, let him be a kid! Exercise and fresh air are far less expensive.

By Carmen Harper, a Master's of Medical Science student at the University of Kentucky

References:

ADDitude Editors. “What Is ADHD? Attention Deficit Hyperactivity Disorder in Children and Adults”. ADDitude. 2019. https://www.additudemag.com/what-is-adhd-symptoms-causes-treatments/

ADDitude Editors. “Exercise and the ADHD Brain: The Neuroscience of Movement”. ADDitude. 2022. https://www.additudemag.com/exercise-and-the-adhd-brain/

Silver, Larry. “No Recess for Recess”. ADDitude. 2017. https://www.additudemag.com/benefits-of-recess-for-adhd/

ADDitude Editors. “10 Ways We Would Fix the U.S. School System”. ADDitude. 2021. https://www.additudemag.com/slideshows/how-can-we-improve-education-for-students-with-adhd

Stewart, Kristen. “How Exercise Works Like A Drug for ADHD”. Everyday Health. 2013. https://www.everydayhealth.com/add-adhd/can-you-exercise-away-adhd-symptoms.aspx

Cochrane, Zara. “ADHD Medications List”. Healthline. 2023. https://www.healthline.com/health/adhd/medication-list

Kritz, Fran. “The Adderall Shortage: Why It’s Still Happening and What to Do if You Can’t Get Your Meds”. Everyday Health. 2023. https://www.everydayhealth.com/adhd/the-adderall-shortage-why-its-still-happening-and-what-to-do/

 


19 comments:

  1. Hi, Carmen!! I thought this was a great blog post. I feel like ADHD is a topic that has been increasing in popularity recently, which does probably have something to do with the pandemic like you described. I actually worked in an ADHD lab a few semesters ago that dealt with this exact problem! Our research was focused on after school programs for children with ADHD to help with behavior management and comprehensive skills with activities. I agree that many children are unnecessarily prescribed ADHD medication and personally know many parents that refuse to medicate their children for the effects they have. I even have a friend with diagnosed ADHD that took Adderall and talks all the time about the horrible side effects she had while taking the medication. While ADHD is definitely a disorder that effects a lot of people's quality of life and mental health, I think it is a great idea to look at treatment options other than medications, especially for children. Again, I thought that this was a great blog post to bring awareness to ADHD in children! It would be great for parents to read this. I feel as if it can scary to have a provider tell you your child has ADHD and push to prescribe medication, so this post could provide them relief and reiterate that while sometimes medication may be necessary, there are other options to treatment as well. Great job!

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  2. Hi Carmen! I think that this is a wonderful topic as I know many people my age and younger who have ADHD. Your analogy is like what my friends also describe. I think that you bring up an important discussion in that the older generations would be physically punished whereas this generation's method of approach is medication. I think that with all the research that is going on in terms of ADHD, it is definitely clear that more exercise does help children. I am surprised that more schools are pushing to remove recess time with all that research pointing to it being beneficial. All in all good job!

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  3. Hi Carmen! This was such an interesting read and, from my own experiences working in a pharmacy, I have seen first-hand how large of an issue this has become. Over the past few years, it seems that the stigma surrounding this disorder has diminished, but in my opinion there is still a lot that is misunderstood surrounding its causes and how best to manage it. I think you provide great insight on the deeper roots of ADHD and why medication may not always be the best solution. Particularly, your mentioning of the fact that some schools are considering eliminating recess, on top of an 8-hour school day, sheds light on the fact that it is easy to overlook what is worsening this condition for children. I think your idea of "letting kids be kids" is so important as it is often the simple things that we tend to overlook - sunshine, fresh air, etc. - before identifying medication as the best solution. As we still continue to feel the effects of the pandemic and our use of technology increases, it seems that this problem is only going to grow larger, so the need for further awareness and further research on how best to manage ADHD is going to be as important as ever. Thank you for such a great post!

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  4. Hi Carmen! This was a great blog on a topic that I think is not talked about enough! COVID definitely had a big impact on this issue and I think it has caused a lot of young children to develope learning deficits or it has made their symptoms significantly worse and there hasn't been a good solution to solve this. The article you attached talking about the school restructure is very interesting and it is sad to see schools talking about pulling recess as part of the daily routine. This could result in many other health problems and cause an increase in behavioral issues from student suffering from ADHD. It is also interesting to look at how ADHD medications are prescribed. I've read a few different articles that discussed how women are often times underdiagnosed because the symptoms appear differently than symptoms in men and I don't think they have found a way to navigate treating ADHD because it presents differently in everybody. I think there is still a lot to do moving forward to help with this issue!

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  5. Hey Carmen! Great post! I think it is so important to discuss how quickly medications are prescribed to those who may not need it, or are being diagnosed incorrectly. I was recently diagnosed with ADHD and the analogy of having too many tabs open without being able to close them, is definitely accurate. Growing up, I did really well in school. 8 hour school days sectioned into multiple classroom subjects as well as lunch and recess breaks seemed to provide a nice balance to my shorter attention span. In high school, I had block scheduled classes where the number of classes was fewer and the time spent in each one was longer. This is when I started to notice myself becoming easily distracted and less focused. Children are supposed to be are energetic, like you said, that is perfectly normal, which is why recess periods can be so important for them. They are also learning to adapt to being occupied for long school days with new class material everyday. Managing children with ADHD at school can definitely be a challenge, but I agree that medication is not always the best solution for every child. Continuing to do research on the subject will help parents and teachers identify the signs that point to an ADHD diagnosis as opposed to typical behavior of energetic children. Again, great post!

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  6. Hi Carmen!
    Your analysis of ADHD and how it interacts with school systems is really insightful. Your analogy of having "a hundred computer tabs open" to describe ADHD is a sentiment my siblings and friends with ADHD have echoed. I think it really captures the overpowering aspect of the disorder. It's important to understand that ADHD affects so many executive processes, it's really not as simple as being energetic or disorderly. The discussion about drugs is especially engaging. Even though some people benefit from medicine, the difficulties and complications involved in determining the appropriate type and quantity are frequently disregarded. Increasing prescription rates as a result of COVID and its effects truly highlight the need for a holistic approach to treating ADHD. This approach most definitely requires the cooperation and training of teachers who are with the kids the most during the day. Overall, your post is a call to prioritize holistic solutions that allow kids to be themselves while learning effectively. Great job!!

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  7. Carmen, this is a GREAT post. While reading, all of the questions or thoughts I had about the post were discussed in the subsequent section... I have always been weary about kids starting on ADHD medications because of the knowledge I have gained so far as a Neuroscience major. There is no way these meds do not affect the neural plasticity of the child! Also, the stat you mentioned about how 11% of children are diagnosed with ADHD but only 5% of adults diagnosed is very interesting to me! The stigma regarding this diagnosis has definitely changed throughout the last generation or two. Personally, a very close family friend has struggled with her ADHD child, and I remember her being so excited for him to reach age 6 in order to be put on medication; but after he reached this age, their medication journey has been a nightmare, and she has said over and over she misses his "spark" and regrets the medication choice in the first place. The situation is sad for everyone involved. There definitely is a need for more research regarding alternate therapy options not including medications, and I believe you conveyed this very well in your post! Great job!

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  8. Hi, Carmen! You did a fantastic job on this post. While I definitely know people who have ADHD, I was shocked to learn how prevalent it is. It's intriguing to me that ADHD affects 11% of children but only 5% of adults. This may be due to increasing ADHD incidence or under-diagnosis in adults, but it makes me wonder if ADHD symptoms resolve as patients age. I'm not sure if that's true at all, but I would be interested in learning more! I completely agree with you that trying exercise, fresh air, and "brain breaks" should be the first method of managing ADHD before jumping to medication. Is there any sort of therapy that is commonly used for children with ADHD? I think it would be great if schools had somebody that was specifically trained in managing ADHD to provide strategies and techniques for children to cope with this disorder, especially because of its high prevalence. I'm also interested in learning more about ADHD medications. For example, once an individual starts taking ADHD medication, is it difficult to stop? Are these lifelong medications? Overall, this was an exceptional post and I will definitely be doing some additional reading into this topic.

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  10. Hi Carmen! This was an amazing blog post. I loved how you incorporated your own experience into this blog post. I also loved how casual but also informative you kept this blog post. It always blow my mind to see teachers and parents rushing to get young children on these intense medications, so I completely agree that recess and fresh air are a much cheaper and more sustainable alternative to medications. Obviously, we know people do struggle with ADHD and I don't want to lessen their need for advancements in medication. I think we should reevaluate how teachers and parents look at ADHD in children. I also enjoyed how you included what schools in America can do to help these children. It blows my mind that some schools are thinking about getting rid of recess as I personally remember that being the highlight of my day! Recess is so important for kids to get out their energy and run around and interact with friends. Great blog post!

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  11. Hey Carmen!
    This was an amazing read! I liked how laid back the tone was, yet informative on the topic. I struggled with ADHD as a child, and still do today, so this topic was of particular interest to me. I really enjoyed how you described having ADHD as having a hundred tabs open all of the time; this is so true. However, I was shocked to see that approximately 11% of children today have ADHD, but only around 5% of adults have the disease. This leaves we wondering if people can truly 'grow out of it'. This also shows how we're surrounded by children with ADHD, and how we need better tools for detecting and treating this disorder other than medications. Looking back on my childhood, my teachers probably would not have allowed me to be in their class if I didn't have recess. This was my chance to unwind my thoughts and get rid of some energy. As most students are, I was always more calm and ready to learn after we went outside for 30 minutes. Your call for teachers to be better equipped in identifying ADHD early on and offering support to parents navigating its challenges is spot-on. Great job, Carmen!

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  12. Hey Carmen!
    I had a great time reading this blog! Not only was the writing style informative, but it was also personable. Growing up, a lot of my friends and classmates were diagnosed with ADHD. Most of them were on the mild side, but some had severe ADHD. With that being said, all but few were prescribed medications like Adderall from a very young age. After reading your blog, I have now realized that most of them did not need to get prescribed medicines like Adderall and didn't need Adderall after years. I think it is very easy for parents, teachers, and others to automatically assume that a kid showing ADHD symptoms needs medication, which is a shame. Another factor that does not help with situations like these is physicians readily prescribing medicines for attention disorders. As a future physician, I hope to take the extra step in evaluating disorders like the ones described in the blog and hopefully prevent unnecessary prescription of medications. Another thing I found interesting in the blog is the increase in ADHD rate after the pandemic. Again, thank you for the great read.

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  13. I want to say that this topic is amazing and it was a great read. As someone who has ADHD and takes Adderall to deal with it, I think it needs to be talked about more when it comes to the younger individuals who are prescribed amphetamines. As you stated in your blog there are too many types of ADHD medicine, which means it is hard for doctors to find the correct medicine for children dealing with ADHD. Some of the drugs may end up affecting the child in less than optimal ways. I also think it is important like you said for teachers to be aware of ADHD and be able to recognize it. I would have been diagnosed at an earlier age in elementary school and not have fallen behind in class if my teachers were aware of what ADHD looked like. I think this post was amazing and needs to be continuously talked about, especially with the increase in ADHD diagnoses.

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  14. Carmen, you did an amazing job with this blog! I really liked how you questioned the need for amphetamine-based medications. I completely agree that the schooling system needs to reevaluate their curriculum and make adjustments for people suffering with ADHD. With social media and especially TikTok I feel like the national attention span has decreased and it will be interesting to see how schools adapt to this.

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  15. This was a phenomenal post as it highlights that ADHD medication is commonly used and helpful but not without problems like regulation, cost, and finding the right dosage. Schooling situations where recess and sports are removed could also contribute to ADHD symptoms. Improving the education system could include teacher training to recognize ADHD symptoms, interactive lessons and non-negotiable recess breaks. Exercise and fresh air are more affordable and beneficial solutions.

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  16. Hi Carmen! This was a very kind and well-written post. As someone with ADHD (and a whole family with ADHD), I know that there is a lot of stigma associated with the condition. I have a nephew who is struggling with this blog topic currently. It was especially difficult during the lockdown in 2020-2021 because he was confined to Zoom classes with no time to play, go outside, or socialize. I think it exacerbated his symptoms and negatively impacted his mental health. I wish that the school systems prioritized a more holistic approach and that people, in general, were more educated on what ADHD looks like. Great blog!

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  17. Hello, Carmen! Your blog article emphasizes the significance of tackling ADHD and its treatment. Your observations into the possible over-reliance on medicine are critical in today's society, when ADHD diagnoses appear to be growing. It's troubling to learn that schools are contemplating eliminating recess, an important break for youngsters. Your recommendation to look into alternate ways such as exercising and getting some fresh air is both realistic and cost-effective. Furthermore, increased teacher preparation to detect ADHD signs is critical. Your piece emphasizes the importance of a more comprehensive approach to ADHD management, and it's a topic that requires greater attention. Excellent work!

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  18. Hi Carmen! I really enjoyed reading this blog article! I was recently diagnosed with ADHD and both my younger sisters also have it. My younger sisters have been taking Adderall since they were around 8, they're now 13 &14. I remember that it was so pushed for them to be on medication, instead of trying to find ways to manage their symptoms that weren't medications. I completely agree that it is so important for kids to have recess and have breaks in between learning! During the pandemic when schools were online, I feel this absolutely had a big effect on younger kids that were still developing. I agree that it is definitely important for teachers to be able to recognize these ADHD symptoms and discuss them with the parents. This blog post was super great to read!!

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  19. Carmen, I love the choice of topic and I myself am very passionate about it. I see small children all the time that are medicated when there is absolutely no need for it! Sure, there are small percentages of this population that might actually have behavioral issues to the extreme that require medication. However, I mostly observe it being attributable to lazy parenting. Our youth is entirely overmedicated; I myself was on a couple of different ADHD medications recently and the side effects were something else. Great observations throughout this blog!

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