Study finds ADHD meds may help decrease risky behavior, but says more research is needed; ADHD is most common in Ky.

Researchers have found that medications for attention-deficit/hyperactivity disorder, which is more common in Kentucky than any other state, may offer some additional long-term benefits by discouraging children from risky behaviors.

"Treatment with ADHD medication made children less likely to suffer consequences of risky behaviors such as sexually transmitted diseases, substance abuse during their teen years and injuries," says a Princeton University news release abotu a study in South Carolina.

"ADHD is such a major issue, but no one seemed to be able to give a very definite answer to the long-term effect of the medication," researcher Anna Chorniy said in the release. "For our sample population, we were able to see everyone who had an ADHD diagnosis and track their health over time to identify any potential benefits of the medication or the lack of thereof."

The study looked at Medicaid claims for nearly 150,000 children diagnosed with ADHD in South Carolina between 2003 and 2013.

Percent of Youth Aged 4-17 with ADHD by State:
National Survey of Children's Health

The latest data from the U.S. Centers for Disease Control and Prevention show Kentucky leads the nation in the percentage of children ages 4-17 with ADHD at 15 percent; the national percentage is 11 percent. Almost 70 percent of children who are diagnosed with ADHD are treated with medications.

ADHD is a behavioral condition characterized by difficulty focusing, acting without thinking, and hyperactivity. Children with ADHD are known to be at higher risk for risky behaviors such as dangerous driving, drug use and risky sexual behavior.

The study, published in the journal Labour Economics, compared ADHD-medicated children to those who were diagnosed with ADHD, but not on medication. Those who took medication were 3.6 percent less likely to contract a sexually transmitted disease, 7.3 percent less likely to have a substance-abuse disorder and 2.3 percent less likely to be injured.

"In absolute numbers, in a sample of about 14,000 teens diagnosed with ADHD, it translates into 512 fewer teens contracting an STD and 998 fewer having a substance abuse disorder," teh release says. "There also would be 6,122 fewer yearly injury cases for children and teens under 19 years old."

Although research supports the use of drugs for treating core symptoms of ADHD, the release points to the need for more research on the long-term effects of ADHD medications, which thus far has produced mixed findings. It notes that a 2014 study found "such treatment is associated with a decrease in academic performance, a deterioration in relationship with parents and an increased likelihood of depression" while another shows "some reduction in hospital visits and police interactions."

Study shows students, especially those with ADHD, have improved academic performance after they exercise

Children do better in school when they aren't forced to sit still all day, especially those with attention deficit hyperactivity disorder, Gretchen Reynolds reports in The New York Times.

Recent research, published last year in The Journal of Pediatrics, suggests that even small amounts of exercise enable children to improve their focus and academic performance.

The study looked at 40 boys and girls, age 8 to 10, half of whom had ADHD. Researchers gave the students a baseline academic test and also one that tested their attention. They then gave the same tests two more times, first after they had sat and read quietly for 20 minutes and the other after they had walked briskly or jogged 20 minutes on treadmills. Brain activity was recorded as they repeated the original tests.

Little difference was found in any of the students after quietly reading, but "they all showed marked improvements in their math and reading comprehension scores after the exercise," Reynolds writes. Students with ADHD showed significant increases on their scores and had brain-wave readings that showed them better able to regulate their behavior, which helped them pay attention.

"The results should make administrators question the wisdom of cutting P.E. classes," Reynolds writes.

This information is a valuable tool for educators, especially in Kentucky, which leads the nation with 19 percent of children ages 4 to 17, compared to 11 percent nationally, who have ever been diagnosed with ADHD, according to the federal Centers for Disease Control and Prevention. The level of exercise needed to show academic and attentional improvement involves activities that can be done in the classroom throughout the day, like marching or hopping in place.

Kentucky leads nation in percentage of children who have been diagnosed with attention deficit hyperactive disorder

Kentucky leads the nation in the percentage of children who have been diagnosed with attention deficit hyperactive disorder, according to the latest available data, which "showed that ADHD levels have risen steeply in the past decade across the nation," Laura Ungar reports for The Courier-Journal.

Ungar writes that "19 percent of Kentucky children ages 4-17 have been diagnosed with ADHD at some point, compared with 11 percent nationally and 16 percent in Indiana." Almost 15 percent of Kentucky children had the diagnosis in 2011, based on polling by the U.S. Centers for Disease Control and Prevention.

"We're probably over-diagnosing it to a certain extent," Dr. Christopher Peters, a psychiatrist and assistant professor of pediatrics at the University of Louisville, told Ungar. "But these numbers indicate a problem. There are many kids in need."

The high numbers could "reflect the state's rampant poverty, since ADHD is identified more frequently in the poor," Ungar writes. "Others say more children here may be genetically prone to the disorder or face other risk factors. . . . Studies show that at least a third of parents who had ADHD as children have kids with the diagnosis."

Any over-diagnosis may stem from "overworked primary care doctors who aren't experts in the disorder" and may be over-diagnosing — and possibly over-prescribing — both locally and nationwide," Ungar writes. "Roughly 8 percent of of school-aged boys nationally and nearly 4 percent of girls took ADHD medications in 2012, according to data from the pharmacy benefit management firm Express Scripts."

There are "financial incentives" for an ADHD diagnosis, Ungar notes. "A diagnosis may translate into disability payments if a child has measurable and serious problems, and students with ADHD can get extra help in school. . . . Experts say the higher numbers may also indicate greater awareness of the disorder, meaning the truly needy are getting the medication, therapy and support they deserve."

However, Dr. Carmel Wallace, pediatrics chairman at the University of Kentucky, "said parents rarely push for a diagnosis to get a disability check," Ungar reports. "And the threshold for disability is high."

Still Kentucky has high rates of children and adults getting Social Security disability payments, and ranks high in some risk factors for ADHD.

"Scientists also have linked ADHD to alcohol and tobacco use during pregnancy — although doctors said it's unclear whether smoking is a cause or simply occurs more often in families with afflicted children," Ungar reports. "Kentuckians smoke at the nation's highest rate and also have high rates of substance abuse overall."

Ungar's example of an ADHD child was, in preschool, "a tiny tempest — at times defiant, other times bouncing distractedly from toy to toy at daycare, while other children were absorbed in play," but as a second-grader "is doing well . . . with a mild stimulant and counseling." Here's a C-J video of another ADHD child and her mother discussing how they deal with it:

Georgia doctor prescribes pills to help in school -- whether or not the ADHD shoe fits -- to level the playing field for the poor

Amanda Rocafort and her son, Quintn,
who takes Adderall for his ADHD.
(NYT photo by Bryan Meltz)

In light of last week's news that the number of poor children on Medicaid in Kentucky are being prescribed anti-psychotic drugs at alarming rates for such diagnoses as attention-deficit and hyperactivity disorder and depression, the New York Times reports that some doctors are making "no excuses" for prescribing psychostimulants in other locales for children of the poor.  Dr. Michael Anderson, a pediatrician in a poor county north of Atlanta, Ga., said he thinks ADHD is "made up" and "an excuse" to prescribe pills to treat what he "considers the children’s true ill -- poor academic performance in inadequate schools." Still, "I don’t have a whole lot of choice,' said Anderson. “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.'"

Dr. Anderson is one of the more outspoken proponents of an idea that is gaining some ground: Prescribe drugs to struggling students in schools not to treat ADHD, necessarily, but to boost their focus and impulse control.  Alan Schwarz reports that Anderson figures that he is arming them with the only tool he has because these children can't afford family therapy or tutoring or behavior-based counseling or any of those other tools that other children might have at their disposal to help them learn.

Of course, Anderson is not without his critics. Many doctors, writes Schwarz, warn of the dangers of exposing children to the unwarranted physical and psychological risks of powerful drugs on everything from mood to blood pressure to the suppression of growth. (Read more)