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Areas › Focus, starting, and ADHD › Treatment and medication
The chain people worry about runs from constant friction at home to entrenched defiance, and from there to difficulties in the teenage years that are much harder to shift. What keeps it moving is the sheer number of times a day an adult and a child collide. Bring the collisions down, by treating the ADHD and by softening how corrections land, and the child has less reason to learn that adults are something to fight.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Were gentle in your dealings with them, had you been harsh, or hard-hearted, they would have dispersed and left you (Quran 3:159). Gentleness is not a soft extra in this. It is what keeps a child close enough to be helped.
آل عمران
فَبِمَا رَحۡمَةࣲ مِّنَ ٱللَّهِ لِنتَ لَهُمۡۖ وَلَوۡ كُنتَ فَظًّا غَلِيظَ ٱلۡقَلۡبِ لَٱنفَضُّواْ مِنۡ حَوۡلِكَۖ فَٱعۡفُ عَنۡهُمۡ وَٱسۡتَغۡفِرۡ لَهُمۡ وَشَاوِرۡهُمۡ فِي ٱلۡأَمۡرِۖ فَإِذَا عَزَمۡتَ فَتَوَكَّلۡ عَلَى ٱللَّهِۚ إِنَّ ٱللَّهَ يُحِبُّ ٱلۡمُتَوَكِّلِينَ
By an act of mercy from God, you [Prophet] were gentle in your dealings with them- had you been harsh, or hard-hearted, they would have dispersed and left you- so pardon them and ask forgiveness for them. Consult with them about matters, then, when you have decided on a course of action, put your trust in God: God loves those who put their trust in Him
Qur’an 3:159read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
The nearest evidence here is a review of pharmacoepidemiology studies built on linked prescription databases, which looked at the real world behavioural and neuropsychiatric risks and benefits of ADHD medication as it is actually prescribed. That sort of work can show what changes alongside treatment in ordinary life, and it carries the usual caution that treated and untreated families differ in other ways too. Read it as support for treating early and watching closely, not as proof that any particular chain of events was prevented.
Chang Z, Ghirardi L, Quinn PD, Asherson P, D'Onofrio BM, Larsson H. (2019). Risks and Benefits of Attention-Deficit/Hyperactivity Disorder Medication on Behavioral and Neuropsychiatric Outcomes: A Qualitative Review of Pharmacoepidemiology Studies Using Linked Prescription Databases.. Biological psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Defiance is largely learned in repeated tussles, so fewer tussles means less of it gets learned.
If the rows at home have tipped into anything frightening for either of you, that needs help in its own right and not only better ADHD treatment.
Two ideas will let you judge most claims for yourself. In a good trial nobody involved knows who got the real treatment, and a study of five people can be swung by one of them having a good month.
Decide at the start what you are actually aiming at. Eight difficulties down to six, then to four, then perhaps to two. Never zero, because zero was never on offer.
Do not write off simply sitting with someone. When researchers looked into why dummy treatments helped, one of the things they kept finding was half an hour of a person's full attention.