VU-research leads to different view on use of ADHD-medication in class

Anne Fleur Kortekaas-Rijlaarsdam   Anne Fleur Kortekaas-Rijlaarsdam

Based on the results of the research of clinical neuropsychologist Anne Fleur Kortekaas-Rijlaarsdam, the national network-based organization for professionals in the child- and youth psychiatry has adapted its information provision to parents, teachers, and practitioners. Medication for children with ADHD appears to have a positive influence on behavior; but, there is little or no influence on academic performance. She therefore advices practitioners not to prescribe medication with the aim of improving academic performance. Kortekaas-Rijlaarsdam promoted on Tuesday, the 18th of September, at the Vrije Universiteit Amsterdam.

The adjustments in the provision of information are aimed at parents, to raise awareness among them what to expect and what not to expect of medication. Kortekaas-Rijlaarsdam: “This way, they can understand for example that their son or daughter feels more relaxed in the classroom, and that perhaps they are able to have better contact with their peers. However, not to the extent that they actually perform better on tests or that they progress to a higher level of high-school.”

Kortekaas-Rijlaarsdam also shows that the minor effects ADHD-medication has on the learning efforts of children with ADHD cannot be explained by improvements in their behavior in class. Kortekaas-Rijlaarsdam: “You would expect that the improvements we see in academic performance are explained by the fact that children are less distracted and that they can work for longer periods of time on a particular task. But that is not what we’ve found.” Kortekaas-Rijlaarsdam also revealed that ADHD-medication has no effect on memory- and attention functioning, which are important in the process of effective learning. Moreover, it was found that children with ADHD do not have an increased motivation for school when using ADHD-medication.

Of the number of children with ADHD, 70% benefits from medication in terms of decreasing known complaints, such as lapses of attention, hyperactivity and impulsivity. Methylphenidate, the working component in medication such as Ritalin or Concerta, results in an increase of 8% in math productivity and 3% in math accuracy. Yet, it does not lead to improvements in reading accuracy. Overall, academic effects are small compared to behavioral effects.  

Kortekaas-Rijlaarsdam: “In 2014, the Health council reported the amount of children between the age of 4 and 18 who were prescribed methylphenidate to have increased from 1% to 4% since 2003. In treating mild and severe ADHD, practitioners should first focus on a psychosocial approach of the problems, before they move on to medication. Practitioners should be cautious in prescribing medication when they perceive an emphasis on tackling declining academic performances.”

To read the full doctoral dissertation of Anne Fleur Kortekaas: