ADHD Drugs Don't Boost Kids' Grades [Excerpts]
Studies of Children With Attention-Deficit Hyperactivity Disorder Find Little Change
It's no longer shocking to hear of children with attention-deficit hyperactivity disorder—and others simply facing a big test—taking ADHD medicine to boost their performance in school. But new studies point to a problem: There's little evidence that the drugs actually improve academic outcomes.
Stimulants used to treat ADHD like Ritalin and Adderall are sometimes called "cognitive enhancers" because they have been shown in a number of studies to improve attention, concentration and even certain types of memory in the short-term. Similar drugs were given to World War II soldiers to improve their ability to stay alert while scanning radars for enemy aircraft.
However, a growing body of research finds that in the long run, achievement scores, grade-point averages or the likelihood of repeating a grade generally aren't any different in kids with ADHD who take medication compared with those who don't. (Typically, studies take into account accommodations schools provide kids with ADHD, such as more time to take tests.)
Dr. Martha Farah and colleagues found no cognitive benefit from Adderall taken by students.
"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.
A central question puzzles those researching ADHD: If its drugs demonstrably improve attention, focus and self-control, why wouldn't grades improve as well?
According to the Centers for Disease Control and Prevention, some 2.7 million kids were taking medication for ADHD in the U.S. as of 2007, the most recent data available. Some experts estimate that 15% to 20% of all ADHD medicine in the U.S. is diverted or shared with people who don't have a prescription. Whether the drugs help the academic performance of kids without the disorder is even less clear.
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.
For the first year of the study, the 8- and 9-year-old children who received medication and a combination treatment saw greater improvements in ADHD symptoms than the other two groups. Kids taking medicine also exhibited some improvement in educational outcomes in that first year.
But any benefit of the drug on symptoms dissipated by Year Three. At the most recent set of assessments, the eight-year follow-up, there were no differences between any of the groups on symptoms or academic achievement measures, suggesting that there wasn't any long-term residual benefit of the treatments during childhood.
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.
(Wang, "ADHD Drugs Don't Boost Kids' Grades," Wall Street Journal Online, 7/8/13).