ADHD meds don’t lead to higher grades or more learning, FIU study finds

Miami Herald | By Jimena Tavel | May 24, 2022

Every year, tens of millions of kids and teens with attention-deficit problems in the U.S. take medications to try to do better in school, but a new groundbreaking study released Monday concluded the drugs, usually stimulants with side effects, don’t boost academic achievement.

The research, conducted by Florida International University experts, contradicts a longstanding belief among doctors, teachers, parents and patients that those with attention deficit hyperactivity disorder (ADHD) perform better in class while on prescription drugs like Adderall, Ritalin and other amphetamines and stimulants.

“It’s a very surprising finding,” said William Pelham Jr., senior author of the study and director of the FIU Center for Children and Families, which aims to improve mental health among children and their families.

“Medication helps a child behave better in school, and doctors and teachers think that is going to result in better achievement so they won’t be falling behind and they won’t fail. What this study shows is the medication has no effect on how much kids learn in the classroom setting,” added Pelham, 74, a clinical psychologist who has worked in this line of research since the 1980s and joined FIU to open the center in 2010.

In other words, while the pills may help a student sit still longer or listen to directions closer, they don’t actually help them score higher grades. In order to improve their studies, Pelham said, students must be treated with behavioral therapy and other psychological methods.

The groundbreaking 14-page paper, published in the Journal of Consulting and Clinical Psychology for the American Psychological Association, wrapped up an about decade-long effort by Pelham and about 15 other researchers.

1 IN 10 U.S. CHILDREN DIAGNOSED WITH ADHD

Symptoms of ADHD, one of the most common neurodevelopmentalchildhood disorders, include inattention and hyperactivity. Nearly 10% — or about 6.1 million — of children ages 2 to 17 in the United States have been diagnosed with ADHD, according to a national 2016 parent survey. And more than 90 percent of them are prescribed stimulant medication as the main form of treatment in school.

Students with ADHD struggle in school, getting lower grades, lower test scores and are more likely to be retained a grade or drop out before graduation, according to studies.

Physicians treat the vast majority of the cases with stimulant medication, which increases activity in the parts of the brain that enable people to control impulses, Pelham said.

The drugs have side effects and can affect children differently. Side effects include loss of appetite, sleep problems, crankiness and tics. The Food and Drug Administration has also studied whether the drugs could increase risks of heart and psychiatric problems.

Pelham said the study indicates that what helps the student more is reinforcing behavior through positive messaging and building an infrastructure that gives feedback, such as a daily report card, as well as providing accommodations such as more time to take tests.

“Over the last 30 to 40 years, it has been clear that ADHD kids have had problems in learning … and this has happened despite the fact that the percentage of ADHD kids who are medicated has skyrocketed,” Pelham said. “Almost every child with ADHD gets medicated. Unfortunately, most of them only get medication.”

CAMPERS BETWEEN 7 AND 12 WERE STUDY GROUP

Pelham’s team looked at 173 children between the ages of 7 and 12 with ADHD participating in the center’s summer treatment program, an eight-week summer camp for children with ADHD and related behavioral, emotional and learning challenges. They examined children in the summer of 2014, 2015 and 2016.

Researchers divided the summer into two periods and the students into classes of 10-14. Some kids randomly and unknowingly got medication during the first part of the summer and then a placebo during the second, and others vice versa in the control group. All were tested at the beginning of the summer and at the end of each summer period.

Researchers compared the test scores as well as their daily assessments, and concluded all children learned the same amount of content regardless of the drugs. Medication slightly helped to improve test scores when taken on the day of a test, but not enough to boost most children’s grades.

“The children who were medicated for that period didn’t learn any more than the children who weren’t medicated despite the fact that they were behaving better in the classroom,” Pelham said.

Dr. Jeffrey Brosco, professor of clinical pediatrics and associate director of the Mailman Center for Child Development at the University of Miami Miller School of Medicine, said the FIU study confirmed his belief that drugs are only a part of the solution and hopes to see the study replicated in larger, more traditional classroom settings to see if the results hold up.

“This study has fascinating results,” said Brosco, who has an MD and Ph.D. “It’s a reminder that medicines alone are insufficient and that there needs to be behavioral and academic interventions if we want children to thrive.”