Q: I have long suspected that too many children were unnecessarily medicated with Ritalin and other ADHD drugs as a quick fix for minor behavior problems. Now my son has been diagnosed with ADHD. I’m very conflicted about medicating him. What guidance can you offer to help me do what’s best for my child?
Answer from Eugene Borkan, M.D., child/adolescent psychiatry, Providence Portland Medical Center:
I share your concern about the unnecessary use of ADHD drugs for children who don’t have the disorder. However, for many children who do have ADHD (attention deficit hyperactivity disorder), these medicines can make a very positive difference. To make sure that ADHD medication is a good choice for your son, you should consider it only after a comprehensive evaluation, and only as part of a comprehensive treatment program.
I’m glad that you are weighing this decision carefully and thoughtfully. The following guidelines and information should help you and your family reach a decision that benefits your son, eases your conflicted feelings, and feels right for all of you.
First, make sure your child has a comprehensive evaluation.
A diagnosis of ADHD can’t be confirmed in a 10-minute exam. To be thorough, a clinician should observe the child’s behavior in multiple settings, and/or collect observations about the child’s behavior from multiple sources. In addition, the evaluation should include a complete physical, a thorough health history, selective laboratory evaluation, a full family history and a clinical interview of the youngster by a trained professional. (Read more about evaluating a child for ADHD.)
Taking the time for a comprehensive evaluation is the first step in making sure that a child is not put on medications unnecessarily.
Be aware that medication is not the only treatment option.
If a thorough evaluation confirms a diagnosis of ADHD, then medication may be an appropriate option to consider. However, it is not the only option; it should be considered only as one part of a comprehensive treatment plan that may include several other strategies. These other strategies may include any of the following:
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