Research ADHD Medication, what the research says and media didn't

My take on the research conducted through Deakin University and what the media didn't say

 “The long-term Impact of ADHD on Children and Adolescents’ Health-Related Quality of Life: Results from a Longitudinal Population-Based Australian Study” by Ha Nguyet Dai Le, Courtney Kelly, David Coghill and Lisa Gold.

Over the past couple of days Australian mainstream media have been talking about this study in what I can only describe as click bait. Talking about how the research on ADHD medication reduces the quality of life in ADHD kids. As a Mum who medicated my own children this scared me, did I do something wrong or harm my kids (even though the lived experience was different). As an ADHD Coach I knew I had to read the research myself to see what it said. Was I a bad Mum?

On reading the study I became irate at the media. I am so sick of ADHD being beaten up, ostracized and incorrectly represented in mainstream. No other neurodevelopmental conditions receive this much negative, fault pointing in accurate discrimination. ADHD people get no funding, no support, and there is no Government Supported public education to correct the public view of ADHD and increase the understanding of the presentation and condition (which was recommended by Senate Inquiry and not actioned on). What the media didn't say about the research is in this study Medication impacts are mentioned 3 times with referenced studies not including conclusions, one even mentioned the positive impacts and one delineated the information used for the study was a small study size especially in early childhood!!!!!! This even had a caution written –

“due to the small sample size of children taking ADHD medication, especially in the early childhood phase (4-8) in our study, may affect the reliability of this finding. Caution must be taken when interpreting this result”

Note: there were way more significant findings in this study that have significant impacts on wellbeing for those with ADHD.

Research ADHD Medication

As a Mum I am well aware of the challenges of titrating (finding the medication that works best and the right dosage) my children and myself,  of course that would have been a lower quality of life point in treatment, titrating can be a nightmare, kids not wanting to eat and then when medication wears off the exacerbated behaviours at home being hangry but still not able to eat combined with (depending on the school) being one of THOSE kids that has to go to the office for the lunch medications. I am not surprised with these issues; I am grateful that there is Study currently running to help identify the right ADHD medications for each individual which would remove the titration process, the study is working on a process where a blood test can determine which ADHD medication and the correct dose.

Interestingly the study we are focused on today actually shows that children that have ADHD and are medicated have a higher Health Related Quality of Life (HRQoL) [this is the wording from the study that children with ADHD that are not medicated. All Children with ADHD have a lower HRQoL than their peers that do not have ADHD.

Note on page 3 “There are effective treatments for ADHD. A recent review and meta-analysis found that pharmacology treatment as efficacious in improving children HRQoL and ADHD Symptoms (Bellato et al., 2024). (debunking the whole click bait mainstream media BS)

What all these media outlets failed to do was analyse the data and conclusions. Even if they had just read those ….. like seriously!!!!! ADHD gets attacked all the time, it has been proven to be neurodevelopmental condition (meaning it’s in our genes, it’s how our brains develop, the differences can be seen in brain scans). ADHD is not widely understood and still miss identified by the general population with most having no idea of the actual impacts are, nor the positives it can bring to so many situations, workplaces etc (if there is psychosocial safety). Can we please remove the stigma!!!!!

This study looked at data collected from clinical study groups where the child was aged 4 – 17. Some data is from the parents’ perspective and other from the children. They looked at those with ADHD symptoms reaching a particular score and internalised and externalised symptoms associated with ADHD (internal – anxiety/depression, external – oppositional defiance disorder etc). This study found that this caused poorer peer functioning, reduced daily functioning and resulted in lower HRQoL than those without ADHD.

What the research says and media didn't

I found it very interesting that the study conclusion identified that there is a need to make sure there are no co-occurring conditions (like Autism etc) and that there is a very strong need for mental health support for the caregivers (I would also suggest testing for the caregivers given that ADHD is 70-80% genetic indicators).

The other things I found interesting in this paper from a lived perspective is that they identified that

“being a female or having autism or other medical conditions or taking ADHD/ADD medication or caregiver having mental health problems was associated with poorer HRQoL while have two or more siblings was associated with better HRQoL” (page 1 of the article in Results)

Firstly, this is a quote from the research, there is nothing in the research about gender identity or sexual preference in the study group (some of the studies used are over 20 years old). I do believe there is more study required to identify the HRQoL of those with Gender incongruence and sexuality questioning. However, as a biological female myself with ADHD and having children that fit this quote, I am going to expand on this from MY lived experience. When I was a undiagnosed child (the on the roof type of ADHD), the feedback I received from the people around me be it parents, teachers, other adults and even my “friends” was you’re a girl you can’t do that, you have to keep your dress looking nice, you’re a girl you’re not meant to …, your too much, mind your manners, don’t speak up, etc etc etc at the same time my brother was not given the same corrections, I saw the “boys will be boys” played out time and time again. Not only that but as a female growing up, I found friendships tricky, especially in the teens, now as a Mum, I see it still with my daughters (starts in primary school and into high worst usually around year 9), and my one with autism but not my son. There has not been the same social issue, peer rejection or bullying, it seems the social acceptance of ADHD with peers is more tolerated with his male peers.

As a coach I see this social side really play out hard in my clients that were born and have grown up female and or autistic, and even though it is not in the research or defined in this study, I feel the same to be true for with those with Gender incongruence and sexuality questioning (which generally begin before 17 years of age). The social norms in the “female friendships” are extremely hard to decode and often ended in tears, and heartbreak. SO this paragraph made me feel really seen. I certainly in many times of childhood (and even now as an adult) have had a lot of moments where I did not feel psychologically safe. Where I over thought every move, every syllable, every look I was given. This certainly had a massive impact on my sense of wellbeing.

The two or more siblings – this made sense, my experience was with one sibling, I now have 4 children and see how different that plays out differently and how the psychosocial safety in that is supportive in my home.

Me at school camp

As a person that has run workshops for leaders and educators on psychosocial safety in the classroom or workplace, I was not surprised to see that the domain of HRQoL that was most affected by ADHD was psychosocial. My workshops are based on psychosocial safety and how it not only benefits the ADHD person but also has a significant positive impact on classrooms (all students and all workplaces), I guess that is why it is now part of the WHS legislation.

The Key points made in this Research (the media didn't mention)

-          At all age points between 4 and 17 years a child with ADHD had a much lower HRQoL than their peers that do not have ADHD in: physical, social, emotional and school domains the most significant differences were in the areas of social and emotional domains

-          Co-Occurring conditions impact kids with ADHD (anxiety, depressions, autism, ODD, sleep issues )

-          Children with ADHD face social difficulties including peer rejection (including bullying), inappropriate behaviour and learning difficulties

-          Kids with ADHD have poorer outcomes and HRQoL when the caregiver has mental or physical illness

Treatment recommendations from this Research

Children with ADHD who DO take medication have a higher (better) HRQoL when compared with children with ADHD who DO NOT take medication. All ADHD children still have a lower HRQoL than children without ADHD.

-          Effective Treatment (there is no FIXING ADHD)

-          Medication

-          Mental health Support and education for families

-          ADHD support services in all educational areas (and of course into adulthood the workplace)

-          Non-Pharmacy treatments to assist in improving the behavioural, psychosocial and educational needs of the child

Me being a little "too much" at high school

The study showed that with these results there is a need for ADHD interventions/treatment to comprehensively address the behavioural, psychological and educational needs of the child to improve the overall health and wellbeing and not just manage the underlying symptoms. This includes using pharmacological treatments to reduce core ADHD symptoms and improve HRQoL. Increasing physical activities with children may also improve ADHD core symptoms. And interventions targeting caregivers’ mental health and family dynamics.  And the need to explore the effects of combining pharmacological and non-pharmacological interventions for a more holistic improvement in children’s wellbeing (this really aligns with the AADPA Guidelines for the Diagnosis and treatment of ADHD – a multi module approach) or as many of my Certified ADHD Coach colleagues say pills don’t develop skills.

ADHD treatment needs to address psychosocial and learning needs in addition to ADHD core symptoms.

Here is the link to the study so you can read it for yourself and when the next “well meaning” person shares miss information you have the information to and evidence to refute their arguments.

As a coach and a Mum of 4 this study when taken in its true context and NOT used as click bait shows how significant the difference and wellbeing of our ADHD kids are. And really start to show the major gaps in mainstream knowledge and treatments.

As a member of AADPA (Australasian ADHD Professionals Association) with over 800 members from psychiatrist, psychologists, GP’s ADHD Coaches, researchers, OT’s the list is extensive of people passionate about ADHD. There is a guideline that has been created based on peer reviewed research that defines pharmacological and non-pharmacological treatments.

As a ADHD Coach this manual states to be classed as a ADHD Coach in Australia you MUST have a Certified ADHD Coach Training and be either a member working towards credentialling or a credentialed member of the International Coaching Federation ICF (which is an ethical body – to obtain a credential it involves certified training (of a specific number of hours that meet core coaching criteria), experience in coaching hours, coaching demonstrations (that MUST meet the Core Coaching Competencies), and a proctored Ethics exam, for my credential that was longer than 3 hours.

I am acutely aware people calling themselves a ADHD Coach yet do NOT meet these requirements, (including people the media might choose to interview), they have no Certified ADHD Coach training, yet they are calling themselves either an ADHD Coach or Neurodivergent Coach. There is a directory for all ADHD Coaches that do have certified ADHD Coach training and are ethically aligned with the ICF, and you can search and find Real ADHD Coaches here. https://www.adhdcoachesaustralasia.online/

Here is a link to the research for you to read for yourself (or to pass on to a "well meaning" friend or family member https://journals.sagepub.com/doi/full/10.1177/10870547251353366