Ten Most Common Reasons ADHD Treatment Fails   Frank Barnhill M.D.
 

1. The ADHD’er or his parents deny that symptoms and signs exist until a major crisis arises.  Maybe the child is about to fail out of school.  Maybe the parents were in denial and refused to admit that their child could be ADHD.  A lot of people consider ADHD to be a disease.  That is simply not true.  ADHD is an inheritable condition or may be caused by certain trauma to the brain, but it is not contagious.
   
    
2. Everyone expects behavioral treatment for ADHD to have an effect in one week.  Well guess what?  It’s not going to happen!  Behavioral treatment for ADHD without the use of medication isn’t going to produce positive effects for two to three months.  It’s really hard to change someone’s habits.  Remember the last time you went on a diet?  How long did you last?
   
    
3. Fifty percent of ADHD’ers or their parents will give up on medications if they don’t see a huge improvement after three or four days.  Of course, this is a mistake, as most ADHD medications aren’t going to work for at least seven to ten days.  Just like any other medicine, ADHD medications must be absorbed and really a steady level in the bloodstream.  Missing even one dose can doom an ADHD’er to treatment failure.
   
    
4. Assuming the ADHD’er is taking his medication.  I’ve had kids tell me of games they play with their parents and those pills.  They act like their taking the pill while mom or dad watch, but really hide it in their cheek and spit it out as soon as they make it to the bathroom.  It is important to get the ADHD’ers permission before initiating any treatment.  If this is not possible, then at least do so after a few weeks of therapy.  Most ADHD’ers are like the rest of us; they don’t like being told what to do.  They can become very oppositional to anything perceived as “not in their best interests”.  Once most ADHD’ers see that the behavioral changes or medications really do help them instead of messing with their brains.
   
    
5. Failing to recognize when behavioral training alone is not working.  About 75 % of all ADHD’ers who are successfully treated, will end up on medications to help them focus.
   
    
6. Thinking that medications alone will change an ADHD’er.  This is a very common misperception.  I often hear remarks such as “ He’s doing great with grades now, but the medicine hasn’t changed his attitude or impulsive behavior.”  Well, guess what?  Most ADHD medicines were designed to help the person focus.  They are not mood altering drugs.  Only hard work in behavior training will alter a person’s habits.  Stimulants should be used to help the person concentrate on learning appropriate ways to interact with his or her environment.  Once the person is able to focus on all the input we receive daily in the form of verbal, visual, and tactile cues, without feeling as if the world is crushing in on them, that data can be effectively evaluated and used to make better judgment calls.
   
    
7. Failing to give the medication or behavioral training during weekends, holidays, or when out of school during the summer.  Humans tend to learn in all seasons of the year, under all circumstances and regardless of school.  Learning doesn’t stop just because it’s the weekend or summer vacation.  A lot of social learning, such as interacting with others in the same age group occurs during holidays.  When the ADHD’er isn’t able to slow his thoughts down sufficiently to focus on that Christmas Church play, because he didn’t get his meds that day, guess who’s going to be the most embarrassed and frustrated.  At that point, you’ll probably swear the medicines aren’t working.
   
    
8. Using alternative medicines, such as herbs, vitamin supplements or minerals to treat the problems associated with ADHD.  Beware; the web is full of alternative treatments.  Ginkgo biloba, ephedra, Ginseng, and Saint John’s wort do have a place in some therapies, but rarely in ADHD.  The doses required for any positive changes would be so large that serious side effects will occur.  Remember, if a vitamin supplement is $49.95 on the web, you can probably buy it for $10 elsewhere.  Most tonics offered on the web are just concoctions of fruit juices and Chinese herbs.
   
    
9. Failing to remember that if you wish your ADHD’er to change, then you must change also.  Your child will never be you.  His or her life’s experiences will never be the same.  Their education level is far higher than the average adults. Just think, how old were you when you first learned how to use a computer.  So, their reactions to every day happenings are not the same as yours.  There peer pressures are ten times worse.  If you expect them to understand you, and communicate with your generation, you must learn what you can about there generation.  Can you name their best friends?  Do you know the classes they take?  What about their “real hobbies”?  You have to meet them at least half way.
   
    
10. Giving up on the person too easily is one of the most common points of failure in all families.  Are you really going to stop loving your ADHD’er if she frustrates you one more time?  Is her failure to clean her room after three warnings really when you’re going to quit trying?  When is the last time that you gave up trying to change her behavior?  Did you threaten to take away her television or telephone?  Are you going to quit introducing her as your daughter?  Get the point? 
    
     
11. Ok, I know!  There were supposed to be ten.  So, I fibbed and added one.  But, this is important.  When a parent destroys communication lines with their child, everything stops.  You can’t help them change, learn new skills or even respect you as a parent if you commit these errors.  Never tell them you don’t like them, much less no longer love them.  Remember, you dislike the behavior, not the person.  Never threaten to take away or deprive them of the basic necessities of life.  In the office last month, I heard a parent say; “if you don’t start throwing those drink cans away, I’m gonna quit buying food for you”.  I know they didn’t mean to say this, but it was too late.  The damage had been done.  Verbal things like this tend to cause feelings of insecurity and doubts about the parent’s ability to provide food and shelter.

Well, that’s all for this topic.  Once again I’m sure that there are dozens of other suggestions.  If you wish, you can e-mail me and we’ll share with everyone else.  I’m sure you’re all good parents.  Our goal should be to have your kids tell you so.

drhuggiebear, drhuggiebear.com and contained materials are the copyrighted and/or registered properties of Frank Barnhill, M.D. and may not be reproduced for profit without the express written permission of the author.  All materials may be photocopied in whole for educational use.  For information please contact us at drfrank@drhuggiebear.com.