For some families, drugs that treat attention deficit hyperactivity disorder (ADHD) are magic pills that hold the promise of turning their scattered kids into academic super-performers. Earlier this year, a study published in Neurology warned about the growing number of ADHD drug prescriptions being written for kids as doctors have increasingly hopped on the bandwagon, too.
Leaving aside the sparse knowledge of the impact these drugs might have on children's development, a number of new studies provide a whole new reason why doctors and parents might want to avoid them: they don't work when it comes to improving academic performance.
Shirley S. Wang of The Wall Street Journal writes about one such study published in June which looked at academic outcomes of Quebec students prescribed ADHD drugs like Ritalin and Adderall over a span of 11 years. Researchers concluded that boys who were taking drugs academically underperformed peers with the same symptoms who were not medicated. The working paper published by the National Bureau of Economic Research also reported that girls who took ADHD drugs had higher incidence of emotional problems than ones who did not.
"The possibility that [medication] won't help them [in school] needs to be acknowledged and needs to be closely monitored," says economics professor Janet Currie, an author on the paper and director of the Center for Health & Wellbeing, a health policy institute at Princeton University. Kids may not get the right dose to see sustained benefits, or they may stop taking the medication because side effects or other drawbacks outweigh the benefits, she says.
Why drugs that claim to improve concentration, focus and emotional control don't lead to academic improvement is a question that has puzzled researchers for some time — and answering the question could be the key to effective ADHD treatment in children. Finding an effective treatment regime could help a lot of kids; according to Centers for Disease Control and Prevention, there are 2.7 million children currently on ADHD drugs of some kind in the United States alone.
The lack of academic benefit has been surprising because the drugs seem to have the potential to improve memory, among other cognitive skills. For instance, Claire Advokat, a professor emerita in the psychology department at Louisiana State University, and her colleagues found in a small study that episodic memory—memory for experiences—improved when kids with ADHD took relevant medication.
It isn't that drugs don't do what they claim to do. On the contrary, children with ADHD symptoms who were medicated outperformed symptomatic children who were not on tests involving memorization and recall. Medicated children performed as well as their non-ADHD peers on similar tests. However, better performance on diagnostic tests hasn't translate to better performance in an actual classroom.
One way of interpreting the findings is that the medicine proves effective on immediate classroom behaviors like sitting still and interrupting the teacher less, but it doesn't help with other factors important to successful completion of homework or test-taking, like family encouragement. Other studies have shown that kids who take ADHD medication and study early for an exam tend to do just as well, if not better, than kids without ADHD. But those who take medication and study at the last minute don't do any better.