By Ernie Hood
Your child has just been diagnosed with ADHD, and finally all of the perplexing behaviors have an identified cause and a clinical name—plus, now there is hope for effective treatment.
What’s next? A series of vitally important decisions for you to make in collaboration with your healthcare provider, whether it’s primary care physician, pediatrician, clinical psychologist, psychiatrist, or other healthcare professional.
The first – and what you might expect to be the most difficult – decision you face is whether to put your child on medication to treat the ADHD. Most parents are rightly reluctant to commit their children to a drug regimen, especially one that is likely to last for years.
Treatment options for ADHD
There are two major modes of ADHD treatment today: prescription medications and behavioral psychotherapies. Fortunately, thanks to extensive scientific research (such as the landmark Multimodal Treatment of ADHD or MTA study, first published in 1999, with follow-up data still coming out) much is known about the condition and the various forms of treatment.
Your first priorities should be to learn as much as you can by exploring the wealth of reliable ADHD information sources available on the web (the nonprofit group Children and Adolescents with Attention-Deficit/Hyperactivity Disorder, CHADD, is a good place to start), and to ask many, many questions in order to fully participate in the choice of treatment option or options. And don’t forget: You are the best advocate for your child, so don’t hesitate to take full advantage of the resources available in your community to help shepherd your child to success.
In the end, the decision about whether to medicate may actually be relatively straightforward. The most recent clinical practice guidelines issued by the American Academy of Pediatrics in 2011 recommend both medication and behavior therapy for children 6-11 years old and adolescents 12-18 years old.
Choosing the best medication
Words you don’t want to hear from your doctor when considering that first prescription: “Let’s try [drug X] for a while and see how he does. We can always try something else if it doesn’t work or he has side effects.”
ADHD is a “highly heritable” condition—in other words, it runs in families. A person’s genes also substantially influence their response to drugs, with a lot of variation in the drug’s effectiveness, how long the effects of the drug are expected to last, and how much or how little is appropriate for the medication dosage. That’s why a drug that works wonders in one child may have no effect on another, or may cause intolerable side effects.
But too many providers still think there is no way to predict who will benefit from a particular ADHD medication or who will not improve, and all too often precious time is wasted by the trial-and-error prescription approach.
Recent advances have made that approach outmoded. There is now a simple and reliable tool to make the first prescription choice with an increased level of confidence that it will be the right one for the individual child.
Tests like GeneSight ADHD analyze a child’s unique genomic profile and help doctors individualize medication selection. Armed with that important information, there is no longer a need for trial and error.
Words you do want to hear from the doctor: “Let’s get a cheek swab, send it off for testing, and know in advance what our best bet for the first medication will be.”