There a number of factors to consider when making a decision about medication, in particular how old a child is, the extent that ADHD is affecting their life, and what has already been tried. In general the older a child is, and the more severe the symptoms, the more likely it is that medication will help.
For younger children, the first step is to work on behavioural strategies (such as reward charts and praise) to reinforce desirable behaviour along with strategies to improve parent-child relationships. The latter is not because of bad parenting, but because ADHD behaviours can be incredibly frustrating and strain even the most loving parent. These behavioural approaches are usually developed with the assistance of a specialist paediatrician or a psychologist, but someimtes a detailed history (which may take several hours) reveals that parents have already tried variations of what would be recommended. Medication is best considered if these initial approaches are insufficient on their own.
For older children and teens medication is more likely to be required. However, while medication is sometimes offered on it's own, this is not recommended as it doesn't change the underlying neurology. This means that, once medication is stopped, the original issues usually resurface. In contrast, when offered in combination with behavioural and self-regulation strategies, medication can help people with ADHD focus enough that other strategies will begin to be effective. There is evidence to suggest that many of the benefits from this combined approach can continue even when medication is no longer prescribed.
There is some evidence indicating that physical exercise, “brain training” and mindfulness will help, and there is also some reseach to suggest that diet may help. So far, however, nothing has proved to be as effective as the combination of medication and behavioural strategies.
In summary, medication is not always needed and so it is certainly worth considering other approaches first. This is especially true for younger children or those with mild symptoms. As children get older, it becomes increasingly likely that medication along with other approaches will be most effective and this combination may even reduce the likelihood of requiring medication in the future.
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