Areas › Focus, starting, and ADHD › Treatment and medication
Paediatric and psychiatric bodies have moved towards treating earlier than used to be usual. The reasoning is that the damage builds on itself.
A year of falling behind makes the next year harder, a reputation among classmates is quick to form and slow to shift, and a household that has been fighting for two years is more raw than one that has been fighting for two months. Treating early is aimed at that accumulation rather than at this week's symptoms. If your child is already older, none of this is a verdict. It is an argument for starting now rather than waiting to see.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
Do not despair of God's mercy. God forgives all sins (Quran 39:53). For a parent who feels they left it late, the door is not described as shut.
۞قُلۡ يَٰعِبَادِيَ ٱلَّذِينَ أَسۡرَفُواْ عَلَىٰٓ أَنفُسِهِمۡ لَا تَقۡنَطُواْ مِن رَّحۡمَةِ ٱللَّهِۚ إِنَّ ٱللَّهَ يَغۡفِرُ ٱلذُّنُوبَ جَمِيعًاۚ إِنَّهُۥ هُوَ ٱلۡغَفُورُ ٱلرَّحِيمُ
Say, ‘[God says], My servants who have harmed yourselves by your own excess, do not despair of God’s mercy. God forgives all sins: He is truly the Most Forgiving, the Most Merciful
Qur’an 39:53read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A systematic review of controlled and naturalistic studies found that stimulants are recommended first and work well in the short term, while much less is known about their effect on long term outcomes in adults. That is precisely the ground the early intervention argument stands on, and it is thinner than the argument sounds. The case for treating sooner is reasonable and it is not the same as a demonstrated long run benefit.
Fredriksen M, Halmøy A, Faraone SV, Haavik J. (2013). Long-term efficacy and safety of treatment with stimulants and atomoxetine in adult ADHD: a review of controlled and naturalistic studies.. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Difficulty that goes unhelped tends to add to itself, so acting earlier means there is less piled up to undo.
When not to
When to start treatment is a decision for the family with their doctor, taking in the child's age and everything else going on.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
The stack goes: understand it, medicate where that is right, change what the adults do, change what the day asks, and keep arguing the child's corner. Each layer does a job the others cannot.
A great many people are diagnosed and then left with a starting dose nobody ever revisited, no reading, no group, nothing else at all. If things have stalled, the first thing to check is whether the treatment was ever actually finished.
People who are sleeping properly, eating properly and moving a bit tend to want each other more. The unglamorous parts of life management run closer to the bedroom than either of you might expect.