Treating ADD and ADHD: a Pediatrician’s Perspective – Part II

Visiting the doctorAfter the appropriate diagnosis is made and the correct testing and observation has been performed (see Diagnosing ADD or ADHD: a Pediatrician’s Perspective), a more secure diagnosis can now be entertained and we can move on to treatment.

At first, parents might very well take the stand of further observation as their children change classes and friends. This is not at all unreasonable, especially if medications are discussed, but medication for ADD or ADHD should be the last resort on the list of possible treatment options to help your child use all of his/her resources to reach the best goal. The first and the “easiest” intervention should be educational. Teachers should receive the results and suggestions deriving from those results that are directly related to the organizational aspects of the classroom. Many educational institutions are fully capable of employing the suggested techniques regarding the special nature of teaching children with such problems. Many schools are limited by space or funding for such programs but every effort should be made to involve the school first.

As I alluded to in part one of this series of posts, there are many conditions that mimic ADD or ADHD in presentation and actions. If any of these are found, the appropriate psychological help and input should be sought. Even in the absence of such specific emotional or psychological problems, I feel that counseling should be obtained for the entire family, as it can be a struggle for family members to deal with such a child. Counseling can help family members to handle certain situations in an appropriate and non- traumatic way to them and the children.

Finally, when all treatment options are brought to bear in an effort to ameliorate the issue and the problems still exist, medication should be discussed and considered. There are several ADD and ADHD medications available on the market right now. Generally they are broadly divided into stimulant and non-stimulant medications, and there are several medications within each division.

  1. Of the stimulant medications there are derivatives of methylphenidate and amphetamines: different forms of these medications allow for various routes of administration, side effects and overall effects on the child. Side effects of all of these medications are very similar but are not very common. The most common of these side effects can be decreased appetite and even slow weight gain as a result. Others include poor sleeping, increased activity and heart rate and a period of downtime as the medications wear off. All of these are usually short lived and can be altered by changing the type and/or dosage of these medicines.
  2. The second broad category of medicines are the non-stimulant variety. Although these are “non-stimulant” in chemical nature, the end effects of both types of medications can be the same, with the same side effects.

Having said all that, if the appropriate medications are used for the correct diagnosis in the proper dosage and form, the results can be astounding and lead to a much more stable and enjoyable family situation. There is much written about these medications (see recommendation below) and certainly no medicine should ever be used for an inappropriate reason.


Dr. Joe Recommends:

  • Running on Ritalin: A Physician Reflects on Children, Society, and Performance in a Pill by Lawrence Diller, M.D.

Editor’s Note:

  • A terrific example of using a psychological approach to help manage some of the symptoms of ADHD can be seen in a post called ADHD and “Menditation” by pediatric psychologist Dr. Lynne Kenney.


About the Author

Dr. Joseph Skoloff received his undergraduate degree from the University of Pennsylvania and his medical degree from The Jefferson Medical College in Philadelphia. He is a past Vice Chairman of the Department of Pediatrics, a past Chairman of the Infection Control Committee at the Loudoun Hospital Center and a Fellow of the American Academy of Pediatrics. In his 41 years as a practicing pediatrician he has kept hundreds of kids and families healthy and safe and plans to continue to do so for years to come. Dr. Joe believes strongly in the combined power of parent and physician working together for the health of their children. He is an advocate for children everywhere and and adheres strongly to the principles of the American Academy of Pediatrics. Dr Joe is a member of the PedSafe Expert team


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