Do Meds for ADHD Symptoms Improve Daily Functioning?

Maintaining stimulant medication for children with attention-deficit/hyperactivity disorder (ADHD) symptoms improved their adaptive functioning, reported a recently published prospective assessment.

Ida Lindblad, PhD, Gillberg Neuropsychiatry Centre, Gothenburg University, Gothenburg, Sweden and colleagues undertook the study while acknowledging others who considered ADHD to be an executive function impairment disorder with consequences for adaptive functioning.

Their assessment of the performance of daily activities required for personal and social sufficiency, prior to and after several years of medication for ADHD symptoms, suggests it may have a place among the measures of medication effectiveness.

"To our knowledge, very few, if any, studies have included an adaptive scale in the follow-up of pharmacological treatment," Lindblad and colleagues stated.

The opportunity for this study emerged from a larger project comparing adaptive functioning, measured with the teacher-administered Adaptive Behavior Assessment System (ABAS), across a group of children with mild intellectual disability. Subsequent to the assessment, some students were diagnosed with ADHD, and many of these received treatment with stimulant medication, principally methylphenidate (Ritalin, others).

Lindblad and colleagues identified 12 children, seven boys and five girls with a mean age of 15 years who had received stimulant medication treatment for ADHD symptoms along with psychoeducational sessions for more than four years. They administered the ABAS again, and compared ratings to the baseline obtained prior to the ADHD diagnosis and treatment.

The researchers reported that, as a group, there were significant increases in the conceptual domain, practical domain and general adaptive composite score, while an increase in the social domain was not statistically significant. They noted individual variations; however, with few children showing no significant change over baseline.

Interestingly, the five girls increased their baseline ABAS score by at least 15%, while only three of the seven boys attained the same level of increase.

The study group was too small to infer that differences were related to gender. Indeed, the small number of subjects, and the lack of a control group with ADHD not treated with medication prevented clear association of medication effect with improvement in adaptive functioning.

Despite the study limitations, the researchers asserted that a measure of adaptive abilities such as the ABAS is useful in both the primary assessment of ADHD in children and in follow-up of the children and adolescents

"An assessment of the adaptive abilities provides a broader clinical view of the child's daily functioning and will guide in pharmacological decisions with regard to the optimal treatment response and when changes in the treatment regimen should be considered," Lindblad and colleagues indicate.

Their report, “Adaptive Skills are Useful for Evaluating the Effect of Pharmacological Treatment in Children with Attention-deficit/Hyperactivity Disorder,” is published in the January issue of Acta Paediatrica.

Related Coverage:

Focusing on Behavior to Help Children with ADHD Complete Homework

Academy Questions Value of QEEG in Attention-Deficit Disorder

Online ADHD Program Helps Children and Their Parents