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Areas › Focus, starting, and ADHD › Medication and how it works
Growth speeds up and slows down for all sorts of reasons during the years a child might be medicated, and one measurement tells you almost nothing. A line across two years tells you a great deal. If it drifts away from where the child had been tracking, that becomes a conversation about dose, timing, food and possibly a change, and it is a far easier conversation to have with the numbers in front of you.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Give full measure when you measure, and weigh with accurate scales (Quran 17:35). Careful measuring is named as a virtue, which is a fair description of a growth chart kept properly.
الإسراء
وَأَوۡفُواْ ٱلۡكَيۡلَ إِذَا كِلۡتُمۡ وَزِنُواْ بِٱلۡقِسۡطَاسِ ٱلۡمُسۡتَقِيمِۚ ذَٰلِكَ خَيۡرࣱ وَأَحۡسَنُ تَأۡوِيلࣰ ا
Give full measure when you measure, and weigh with accurate scales: that is better and fairer in the end
Qur’an 17:35read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
A long term follow up of the main childhood ADHD trial took the cohort into young adulthood and looked at height suppression alongside symptoms. What that follow up reports is that the early advantage of assigned treatment faded and adult outcomes were worse than in comparison peers whatever the childhood treatment arm. It does not hand you a clean all clear on growth, which is exactly why measuring this particular child beats relying on a general reassurance.
Swanson JM, Arnold LE, Molina BSG, Sibley MH, Hechtman LT, Hinshaw SP, Abikoff HB, Stehli A, Owens EB, Mitchell JT, Nichols Q, Howard A, Greenhill LL, Hoza B, Newcorn JH, Jensen PS, Vitiello B, Wigal T, Epstein JN, Tamm L, Lakes KD, Waxmonsky J, Lerner M, Etcovitch J, Murray DW, Muenke M, Acosta MT, Arcos-Burgos M, Pelham WE, Kraemer HC, MTA Cooperative Group. (2017). Young adult outcomes in the follow-up of the multimodal treatment study of attention-deficit/hyperactivity disorder: symptom persistence, source discrepancy, and height suppression.. Journal of child psychology and psychiatry, and allied disciplines doi
Strength of evidence: one line of research. A single study, or a theoretical account.
A change in growth only shows itself as a pattern over time, so it has to be measured rather than remembered.
If growth is flattening on the chart, raise it with the prescriber rather than making any change at home.
A long acting injection into muscle releases its medicine slowly over weeks. It lifts the daily burden of remembering, at the price of not being able to stop quickly if the medicine disagrees with you.
Mechanism is a moving thing, so it is easier to watch than to read. A university made animation of what happens at the junction will teach you more in ten minutes than a page of description.
Doing the behavioural work alongside a medicine can mean managing on less of it. That matters most for the side effects that follow the size of the dose.