Ongoing Evaluation

As most teachers can attest, ADHD is a major issue in education today. More and more students are diagnosed with ADD or ADHD, and more and more of those students are taking medication like Ritalin to help control the symptoms. The rise in the use of this medication has even led to the coinage of the expression, the “Ritalin Generation” because so many young children seem to be on a Ritalin treatment program.

However, medication is not the only treatment option for ADHD. Behavioral therapy is also an important option for students and their families. The question is, however, which treatment approach is most effective?

A recent study by the NIH and the NIMH suggests that there is no clear answer and, in fact, the “right” treatment answer is different for each child and even differs over time for each child.

The study began in 1999 by tracking the outcomes of four different treatment options for almost 600 ADHD kids aged 7-9. One group took medication managed closely by a specialist; a second group took medication and received behavioral therapy; a third was treated by the family doctor, and a fourth group only received behavioral therapy.

Over the first 14 months of the study, the children in the first two groups (drugs or drugs-and-therapy) experienced significantly more improvement than the other two groups. But over the course of the next two years, the families were free to choose whichever treatment course they preferred, and the gains eventually evened out among the four groups. At the end of the three year study, the students were all basically at the same level.

The implications are clear that treatment can be effective, but that the “best” treatment can change over time. Scientists involved in the study recommend adjusting treatment according to the severity of ADHD symptoms. Peter Jenson, the lead author of the study, said, “Many of these kids do better over time, and they should start [taking medication] and stop it as they need it.” Another expert in the field reported that his practice “reevaluate[s] our patients’ needs each time they visit so that they don’t get stuck in a rut.”

As teachers and parents, this study is an important reminder that our students are dynamic young people who are constantly developing, changing, progressing, and regressing. A diagnosis, whether for ADHD or something else, does not lock the student into a fixed state, one that can be treated the same way all the time. Rather, an ADHD student needs the same individualized, flexible, and reflective approach that we should offer to all of our students. For the ADHD student, such an approach must also be taken by the medical professionals involved so that the student can benefit from the most beneficial form of treatment that is appropriate at the time.

The study also has promising implications for those parents or advocates who are wary of over-medicating young people. Because treatment efficacy can change over time and because improvement was proven to not be dependent on medication, students, parents and advocates can seek out alternative treatments or reduce the predominance of medication in a child’s life.


McMillen, Matt. “ADHD Treatment Pays Off.” The Washington Post. 31 July 2007. 31 July 2007. <>.

This page was created by Dan Gordon