New recommendations from the American Academy of Pediatricians call for doctors to screen children as young as 4 for Attention Deficit Hyperactivity Disorder (ADHD). More controversially, doctors are recommending giving mediations such as Ritalin and Vyvanse to children with ADHD who have moderate to severe problems when behavior therapy does not seem sufficient. The use of such medications for children under 6 years old has not been approved by the Federal Drug Administration; doctors can still prescribe the medications for younger children.
The AAP has also created a revised tip sheet about symptoms of ADHD for parents as well as revised its advice for doctors to diagnose children aged 4 to 18. Guidelines issued about 10 years ago had focused on diagnosing ADHD in children aged 6 – 12 years old.
Currently, nearly 1 out of 10 children are diagnosed with ADHD in the US. With pediatricians now encouraged to diagnose children at a younger age, it’s possible those numbers could go up.
Medication For Children With ADHD
Already, doctors are prescribing more and more stimulant medications for children diagnosed with ADHD, with prescription use growing the most among 13-18-year-olds, rising from 2.3 percent in 1996 to 4.9 percent in 2008. Prescription use for stimulants such as methylphenidate (e.g., Ritalin) and amphetamines (e.g., Adderall) was the highest among 6-12-year-olds (rising from 4.2 percent in 1996 to 5.1 percent in 2008), according to a recent study in the American Journal of Psychiatry.
Stimulant use has so far been very low (0.1 percent from 2004 onward) in preschool-aged children. Again, with the call to diagnose ADHD in younger children, it’s likely that stimulant use will also increase in that age group.
But are we turning too quickly to medication to help children pay attention in school and not “act out” impulsively? Are we in essence “giving up” too quickly? Besides behavior therapy to help someone with ADHD (including adults) pay attention and focus better, changes in the physical environment (such as the Stand-Up Desk) can help. Having ready access to exercise and even just to get up and walk around can also be helpful.
Adaptions, Accommodation, Acceptance
I’ve written before about my husband having struggled with severe ADHD all of his life. It’s fair to say that not only would he have been diagnosed as a young child; as he himself says, his late mother definitely also had ADHD,. Certainly more than a few students in my college classroom have ADHD and ADD and I’ve tried to adapt my teaching style to accommodate for their needs. For instance, I try to run my Latin and ancient Greek classes at a rapid pace (none of this standing at a lectern and droning on and on) and to repeat myself (and always to post assignments online and to be available via email). I write a lot on the chalkboard, show some video clips and webpages on an overhead projector and walk a lot around the room. I also don’t have the overhead lights at full strength: Something about the glare seems to detract from focusing. I try to be attuned to the fact that just because someone doesn’t seem to be paying attention, it doesn’t mean they are not.
If younger and younger children will be diagnosed with ADHD, we need also to consider teaching strategies and other accommodations that allow different styles of learning. Medication has its uses but there’s more than one way to help a child — to help anyone — pay attention and learn.
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