Re "ADHD drugs for lagging students" (Page A1, Oct. 9): The Bee article about ADHD treatment did not represent the standard of care provided by pediatricians and child psychiatrists treating this disorder. First of all, there are specific criteria for the diagnosis and treatment for ADHD. Up to 20 percent of school age children have this condition. One thing that was not pointed out was that this is spectrum disorder; i.e., it ranges from mild to profound in severity. The milder forms clearly respond to accommodations in the classroom, behavior modification and counseling. However, many children suffering from ADHD have more severe disability and it can profoundly affect school performance and many other aspects of the child’s development. It is these children who need and respond so well to stimulant medication. Children with mild-moderate ADHD and learning disorders could benefit from smaller class sizes and many of these could be on less or no medication if our class room sizes were 10-20, but that is not the reality of our current fiscal crisis in education. Larger class room sizes does mean more children with less severe ADHD need medication because there is more distractions and less availability of accommodations available. There is also a myth that children who do not have ADHD respond to stimulant medications. That is simply not true. Non-ADHD children may be a little more alert and can increase their “cram” sessions studying for exams, but they have no significant improvement in attention and learning. On the other hand, children with significant ADHD have a remarkable improvement in attention and other symptoms in 80% of treatment with stimulants. The ethics and standards of both the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry clearly prohibit the use of stimulants or other medication purely for educational benefit or to control behavior. Both societies require careful evaluation of the child and have specific criteria for diagnosis and treatment of ADHD and all the other conditions we treat. I hope this clears up many of the misconceptions in the article and will help parents get the help they need for their children with ADHD. James A. Margolis, MD, Sacramento

© Copyright The Sacramento Bee. All rights reserved.

Order Reprint