By Lucy Maher
Ask any parent what it’s like to get their tween or teen to do their homework and they might say “hard” or “impossible.” Some resort to positive reinforcement while others withhold screen-time until math exercises and social studies reading is done.
For the parents of kids with Attention-Deficit/Hyperactivity Disorder (ADHD), a chronic condition that results in difficulty maintaining focus, hyperactivity, and impulsive behavior,
that battle takes on a new meaning.
That’s because, “ADHD brains are now/not brains,” says Sharon Saline, Psy.D., and the author of What Your ADHD Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life. “If something is interesting, compelling, meaningful and satisfying now, great—let’s do it! If a task seems boring, unfulfilling and tedious, it’s hard to work up any initiative to start it, keep doing it and finish it.”
About 6 million kids have ever been diagnosed with ADHD in the U.S., according to the Centers for Disease Control, with about half of those diagnoses occurring between the ages of 12 and 17, the time when homework takes on new intensity and importance.
To help with the transition, many parents turn to prescription medication once behavioral therapy has proven not to work, says Dr. Saline.
“Kids with ADHD have lower amounts of two neurotransmitters: dopamine and norepinephrine,” she says. “Dopamine has been found to highlight what’s important, help with motivation, and foster pleasure, interest, and internal rewards about activities. Norepinephrine has been found to be associated with sleep, alertness, attention, concentration, and judgment. Medications for ADHD specifically target these neurotransmitters by making them more available at critically important areas between neurons.”
ADHD medications fall into two categories: stimulants, which work shortly after taking them for a period of time before exiting the body, and non-stimulants or antidepressants, which can take longer (usually between two and eight weeks) to start working. The two most common types of stimulants, says Dr. Saline, are methylphenidates, such as Ritalin, Concerta, and Focalin, and dextroamphetamines such as Dexedrine, Adderall, and Vyvanse. Common non-stimulants include Intuniv, Tenex, or Straterra and anti-depressants such as Wellbutrin, Effexor, and Vybrid.
Ari Tuckman, Psy.D., a psychologist, author, and speaker specializing in ADHD, says stimulants are best at “reducing or even eliminating the symptoms of ADHD.” Stimulants “make it easier for kids to redirect their thoughts and actions toward tasks that have more of a future benefit, such as getting homework done, or cleaning up their room, by making it easier to resist the temptations of the moment, like looking out the window to see what that sound was or checking their phone.”
Those that take stimulants may feel jittery when they first begin medication or increase the dose, but the side effect goes away in a few days, explains Dr. Tuckman. Kids taking stimulants may also lose their appetite. To make sure kids are properly nourished, Dr. Tuckman suggests parents focus on a large breakfast to counteract any loss of hunger later in the day.
“It can also help to make a point of eating even if the medication is suppressing the feelings of hunger and to not only rely on that hungry feeling,” he says. “Even if one doesn't eat a full meal, even just a few bites, especially if done several times over the course of the day, can go down easy and help with keeping blood sugar up.”
Non-stimulants, Dr. Tuckman says, while treating symptoms like concentration and impulse control, tend to be less effective as stimulants, and may trigger side effects such as nausea, fatigue, and dry mouth. As such, they are typically prescribed only when stimulants don’t work or cause unpleasant side effects for the patient.
Parents may also opt for antidepressants, which can treat depression, anxiety, and similar issues that people with ADHD may experience. These would be used in conjunction with a stimulant.
Whichever medication you choose, Dr. Saline says it’s important to remember that “pills don’t teach those all-important executive functioning skills, such as organizing, planning, prioritizing, understanding different points of view and self-monitoring. Those require direct instruction. Medications, however, help kids be more available to learning, absorbing and recalling the tools that assist them in organization, planning, time management.”
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