New Research Shows ADHD Medication Doesn’t Help Kids Learn

Taking Prescription Medicine Concept

According to new research, stimulant medication has no detectable impact on how much children with ADHD learn in the classroom.

For decades, most doctors, parents, and teachers have believed that stimulant medications help children with attention deficit hyperactivity disorder (ADHD) learn. However, in the first study of its kind, scientists at the Center for Children and Families at Florida International University (FIU) found medication has no detectable impact on how much children with ADHD learn in the school classroom.

Approximately 10 percent of children in the U.S. are diagnosed with ADHD. Of those, more than 90 percent are prescribed stimulant medication as the main form of treatment in school settings because most doctors believe that medication will result in better academic achievement.

“Physicians and educators have held the belief that medication helps children with ADHD learn because they complete more seatwork and spend more time on-task when medicated,” said William E. Pelham, Jr., senior author of the study and director at the Center for Children and Families. “Unfortunately, we found that medication had no impact on learning of actual curriculum content.”

Researchers evaluated 173 children between the ages of 7 and 12 with ADHD participating in the center’s Summer Treatment Program, a comprehensive eight-week summer camp program for children with ADHD and related behavioral, emotional, and learning challenges.

Children completed two consecutive phases of daily, 25-minute instruction in vocabulary and subject-area content in science and social studies. The instruction provided to each student during the three-week phases was at their determined grade level. Certified teachers and aides taught the material to groups of 10-14 children in a classroom setting.

Each child was randomized to be medicated with a sustained-release stimulant medication during either the first or second of the instructional phases, receiving a placebo during the other.

Contrary to expectations, researchers found that children learned the same amount of science, social studies, and vocabulary content whether they were taking the medication or the placebo.

While medication did not improve learning, the study showed that medication helped children complete more seatwork and improve their classroom behavior, as expected. When taking medication, children completed 37 percent more arithmetic problems per minute and committed 53 percent fewer classroom rule violations per hour.

Additionally, consistent with previous studies, researchers found that medication slightly helped to improve test scores when medication is taken on the day of a test, but not enough to boost most children’s grades. For example, medication helped children increase on average 1.7 percentage points out of 100 on science and social studies tests.

Improving academic achievement is important for children with ADHD because compared to their peers, children with ADHD exhibit more off-task classroom behavior, receive lower grades, and obtain lower scores on tests. They also are more likely to receive special education services, be retained for a grade and drop out before graduation. Poor academic achievement is one of the most debilitating impairments associated with ADHD, often leading to the long-term vocational and financial difficulties that characterize ADHD in adulthood.

Previous research conducted by Pelham, an ADHD research and treatment pioneer, has found that behavioral therapy — when used first — is less expensive and more effective in treating children with ADHD than medication. Stimulants are most effective as a supplemental, second-line treatment option for those who need it and at lower doses than typically prescribed. Additionally, the Society for Developmental and Behavioral Pediatrics (SDBP) has published new clinical guidelines that strongly recommend behavioral intervention as the first-line treatment for youth with ADHD.

“Our research has found time and time again that behavioral intervention is best for children with ADHD because they, their teachers, and their parents learn skills and strategies that will help them succeed at school, at home and in relationships long-term,” said Pelham. “Medicating our children doesn’t solve the problem—it only takes away the symptoms temporarily. Instead, families should focus on behavioral interventions first and add medication only if needed.”

Behavioral and academic interventions that meaningfully improve functional impairment long-term for youth with ADHD include parent training and classroom-based management tools like a daily report card, and school services specific to academic achievement such as 504 plans [accommodations provided under Section 504 of the Rehabilitation Act of 1973] and special education individualized education plans (IEPs).

Researchers note that the study was conducted in a controlled summer school-like environment and results may be different in a regular classroom setting. They would like to replicate this study in a natural classroom environment using academic curricula over the duration of a school year to further evaluate the impact of medication on learning.

Reference: “The effect of stimulant medication on the learning of academic curricula in children with ADHD: A randomized crossover study” by Pelham, W. E. III, Altszuler, A. R., Merrill, B. M., Raiker, J. S., Macphee, F. L., Ramos, M., Gnagy, E. M., Greiner, A. R., Coles, E. K., Connor, C. M., Lonigan, C. J., Burger, L., Morrow, A. S., Zhao, X., Swanson, J. M., Waxmonsky, J. G., & Pelham, W. E., Jr., 23 May 2022, Journal of Consulting and Clinical Psychology.
DOI: 10.1037/ccp0000725

This study was published in the Journal of Consulting and Clinical Psychology and was funded by the National Institute on Mental Health.

10 Comments on "New Research Shows ADHD Medication Doesn’t Help Kids Learn"

  1. Interesting.

    Attention Deficit Hyperactivity Disorder! (ADHD).

    Is it a disorder? The information is unable to attract and retain the interest of the person diagnosed as having ADHD. The Brain Neurons are hyperactive? . How well have wee mapped the Neuron Network? Is there a defined Normal? Does it vary with time and other factors?

    Why do we attempt to fit everything into a “Normal distribution curve”?

    Maybe, the outliers on the curve can turn all of current knowledge on its head. There isn’t a white or colored pill for everything under the sun, which we don’t understand!

    We need to create a environment for these differently abled persons to flourish.

    Views expressed are personal and not binding on anyone.

  2. James B. Hale, PhD, ABPdN | May 31, 2022 at 7:49 am | Reply

    Pelham’s research should be considered suspect. He has a long history of behavior-only approaches to ADHD. While titration was not mentioned in this brief article, I can almost guarantee that diagnoses were made on behavioral criteria alone and stimulant dose was also based solely on behavior as well. He’s an old school behaviorist in the medical field – there’s not much “medicine” in what he practices or preaches.

    As my research, and others like Arnsten and Berridge have shown, behavioral titration leads to impairments in working memory. Working memory is pretty important for academics, so it is no wonder the authors showed no impact of stimulants on achievement. Sure, they were compliant, but if you impair someone’s learning ability on psychotropic meds, you can’t expect them to do better academically. We show a linear effect for behavior, and a quadratic effect for cognition, with higher doses impairing cognition (which is consistent with neuroscience evidence and animal models). Our research also shows stimulants affect glutamate, an important neurotransmitter for learning. We showed glutamate increases when cognitive titration is used, but it decreases when behavioral titration is used. This is consistent with other research on stimulant effects on glutamate. No wonder these kids behaviorally titrated don’t show learning improvements, the medication dose you are using impairs their learning ability….

    Best, Brad, ABPdN

    James B. Hale, PhD, ABPdN

  3. If I stopped giving my child his ADHD medication, he wouldn’t be allowed to learn anything. He’d simply be too disruptive to the classroom. In fact on the weekends we allow him to take a break from the meds. He always comes down and asks for it himself because he realizes his game play and social interaction suffers.

  4. Joshua Jordan | May 31, 2022 at 1:24 pm | Reply

    This is a seriously flawed study from multiple regards; &, prima facie (i.e., it is behind a paywall), there are red flags as to how ethically sound this study really ever could be — particularly with respect to the APA’s own Ethical Guidelines & Professional Code of Conduct. That does NOT mean to imply necessity, but when it’s very difficult to understand how such an article could plausibly pass Peer Review & cohere with the APA’s own internal Institutional Scrutiny & still be approved for Publication…(?) This is one instance where closing off open, public Scientific & Ethical scrutiny with a paywall isn’t just (substantively) questionable, it’s outright fiscally irrational & self-defeating.

    Generally, I don’t really understand the claim to Science of that which escapes scrutiny behind a paywall; I look to Popper &, by default, regard this “Science” as unfalsifiable; but the paywall is normalized in the contemporary Sciences & is an unfortunate reality (& probably why Science receives so much over-skepticism & distrust). Ethics, however, especially as it relates to claims that are made to effect real world Clinical Psychiatric Practices &/or Treatment, & accompanied by alleged Scientific discourse behind a paywall — that, in my opinion, is unacceptable to the point where it is indistinguishable from the very worst of pseudoscience.

    Why would the APA choose to undermine their own authority & their own legitimacy…?

  5. But everyone knows that, it’s used to help with focus. The clue is ADHD attention deficit hyperactivity disorder. Parents learn to do your research most children with redirection out grown this without taking numbing meds

  6. MiddleSchoolTeacher | May 31, 2022 at 5:03 pm | Reply

    25 minutes? That’s like half a class period. The real test is how well they learn 7 hours into the day.

  7. I’m a college professor, researcher, and I have Adhd.

    From my personal experience and those with students, this does not surprise me. I never thought stimulants helped students learn, but rather it helped them fit in to class and get respect from teachers and classmates. That is the real benefit. Fighting both the biases of peers and teachers is what makes stimulants worthwhile… I never believed it to actually help me while medicated… It just helps everyone else accept me and test me with respect.

  8. Geologist, environmental regulator, jack of all trades.

    I was diagnosed with combined type ADHD in 2020 at 41 years old. No, I do not believe that the stimulants make me any smarter, DUH Donald Trumpster. I typically find that the medication only helps me to focus on my tasks when I can get myself started on those tasks. It’s like I forget that the boring tasks are boring sometimes. Without stimulants I am very easily distracted. There are tons of symptoms beside what is discussed/researched in the article – for a lot of them, like the forgetful/relationship oriented ones, the stimulants help. I do think that I could use a lot of help with organization, but that’s not quite what he’s pushing is it? “Behavioral intervention” whatever that means. The therapy based treatments do make sense to me, but they are more expensive and hamper independence. Nobody wants to be 40 years old and need a mommy to help you get your s*** done. Do I need a nag to tell me to do the things that I know that I haven’t done yet???? Maybe. Without looking into it, this study does seem to support the do-gooder agenda that is biased against pharmaceutical treatments. It has that same hospital chapel smell.

    I have about 50 things that I need to be doing right now and responding to this article isn’t one of them. Somebody call the nanny.

    Wes

  9. Ian Marteens | June 2, 2022 at 12:49 am | Reply

    I’m 58 and I’m on Vyvanse. Vyvanse doesn’t make me smarter. I’m already 145 IQ. It just allows me to complete more things, to be most focused in things that I don’t normally like. And to keep my big mouth closed when needed. No: I haven’t had my pill yet…

  10. John Houseman | June 2, 2022 at 10:42 am | Reply

    Had to bring “The Donald” into it, simple minded fools and their clichés are readily available everywhere.

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