Australian children with attention deficit hyperactivity disorder are leading most of their young lives without medication, quashing “drug-and-shrug” assumptions on how families address the condition.
One-third of children have stopped taking medication within a year, while three-quarters cease medicating within five years, according to a 20-year study led by University of Canberra senior research fellow Brenton Prosser.
Dr Prosser said the findings, based on two decades of NSW state health records, raised a serious question: if children with ADHD are not being medicated, what other forms of support are available to them?
“Quite possibly, many young people are going through their childhood and adolescence without any support for ADHD and that’s a really difficult challenge for families and for the young people themselves,” he said.
“It is the first time an Australian study has identified this. We don’t know yet the exact reasons for this.”
The average duration of drug treatment among children with ADHD is less than two years, with more girls than boys medicated at a ratio of 4:3, according to the study.
Dr Prosser said a multi-nodal approach was the internationally recommended way of addressing the disorder, combining medication with behavioural therapy, educational supports, health supports and education for children and their parents.
Although no formal information has been collected about the use of non-medical supports, anecdotal evidence from families and teachers suggested extra services were not available or too costly.
“One of the problems is ADHD is recognised at a federal level under disability discrimination legislation but it’s not recognised by many state or territory legislation or equal-opportunity acts.”
“Young people fall through the cracks. There’s no provisional support on a local or state level and that leaves families in a really difficult situation. If young people are only getting medical support and then the medical support is ceasing … are they getting these other supports or are they being left unsupported?”
Dr Prosser said the findings also busted stereotypes that parents readily medicated children with the disorder.
“The assumption is that children remain on these drugs long term. Instead, many stop medication treatment within a year,” he said.
“It seems to confirm that parents are reluctant to put their young person on medication and keep them on medication. People are not in a hurry to keep young people on medication.”
While the ACT is too small to produce reliable data alone, Mr Prosser expected the findings to be reflective of Canberra children.
He said patterns of prescribed medication use were recorded state by state rather than nationally, but the NSW data was indicative of national habits and supported a similar study based on South Australian data.
Meanwhile previous studies involving parents of children with ADHD have reaffirmed a reluctance to medicate as families grappled with the diagnosis and concerns about school and service support.
“It’s quite a long journey for parents to get to the point where they say, ‘I’ll give my child amphetamines to help them’,” Dr Prosser said.
“Parents tend to only get to this point when they find the other supports are not available and they just want to do the best thing for their child.”
The study has also found new cases of drug treatment for children with the disorder are stabilising.
Dr Prosser attributed this to heightened awareness of the disorder, treatments and seeking support for alternative conditions such as autism.
He said determining areas where additional support or policy changes could assist families to more easily address ADHD was key.