Issue link: http://educator.cta.org/i/45361
medication for add Even if a child is bouncing off the walls, a teacher should never recommend or insist that parents put their child on medication, says Sandra Rief. "Teachers can get into serious trouble with Prescription their school district by doing so," she says. "We are educators, not medical experts, and medication decisions are strictly between parents and their physician." What teachers can do if they suspect undiagnosed ADD/ADHD is suggest a "team" meeting with teachers, parents, a school administrator, school psychologist, counselor and others to share concerns, discuss strat- egies that have been tried, and plan "next steps" to help the student. "If the recommendation to parents is to have their child evaluated, it is best com- ing from the team rather than an individual teacher," says Rief. The CDC reported in 2005 that 2.5 million children are being medicated for ADD/ADHD in the U.S., and that the rate of medication among students with a reported diagnosis is about 40.6 percent in California. A 2007 study by the Mayo Clinic in Minnesota states that medication has "long-term academic benefits" and that students taking medication show improved reading scores compared with those with the condition who do not receive medication. They also have better attendance and are less likely to be held back. But side effects steer some parents away, including lack of appetite, headaches, queasiness and insomnia. A National Institute of Mental Health study states that chil- dren who are treated with medication alone do not do as well academically as children who receive both medication and adjustments to the classroom environment. Short-term stimulants such as Ritalin are typically pre- scribed when a child is first diagnosed, says school nurse Dawn Fox, a member of the Sacramento City Teachers Asso- ciation. Because the medication is short-acting, parents and doctors must submit authorization forms for it to be dis- pensed at school. New forms must be submitted every time the dosage changes. Students may take longer-acting dos- ages after it is determined they have no adverse reactions. "Teachers may be under a misconception that these med- ications will decrease hyperactivity in a child," says Fox. "But these medications are stimulants that are prescribed to improve a child's ability to focus. Sometimes it will help with hyperactivity and children will become less impulsive, but not always. So teachers may think the medication isn't doing its job and the child needs a higher dose because the child is bouncing all over the place, but that isn't true." Teachers can judge the effectiveness of medication, says Fox, by answering the following questions: Are students completing homework more often? Are they more attentive in class and able to answer questions? Are they keeping up with the rest of the class and on the right page? One of the most difficult things for school staff is making sure that students actually take their medication, adds Fox. Teachers can walk students to the office at lunchtime to make sure they get their pill. School nurses try to keep an eye on students to make sure they are taking medication properly and not having adverse effects, but that is difficult in districts with very few school nurses or none at all. There are other ADD/ADHD medications that students can take that are non-stimulants and have a calming effect, such as Strattera, but they may take as long as six weeks to have an impact. Medication is not a cure for ADD/ADHD, but it can help those with the condition manage their symptoms. While some health care professionals such as Dr. Dean Edell believe children are overmedicated, others maintain that is not the case. CHADD supports the use of stimulant medications, with behavioral modification and counseling. "That may include things like social skills training. It may include family counseling, individual counseling, behavioral therapies, behavior modification," notes Evelyn Green, presi- dent of CHADD, in a CNN interview. "Medication is a piece of the picture, it works for lots of kids, it certainly worked for my child, and it works for a lot of adults. But it doesn't work for everybody, and it's not a magic bullet." MORE INFO ABOVE: School nurse Dawn Fox weighs in on ADHD medication in Sacramento. Visit WebMD at www.webmd.com/add-adhd/ guide/adhd-medical-treatment to find more information about the control of ADD/ADHD symptoms using medications. 16 California Educator / October 2011