Children with ADHD often struggle in school, not because they are unable to do or understand the work, but because, in part, distractions cause them to miss important details and teacher’s explanations. As most parents of children with ADHD already know, as the work becomes more demanding, children’s grades suffer even more. By middle school, those with ADHD who are not receiving treatment may fall significantly behind their classmates.
A new study, completed in Iceland and published in Pediatrics, shows that children with ADHD who started medication within 12 months of fourth grade had better math scores than those who began medication closer to sixth or seventh grade. This study reviewed medical records of almost 12,000 children who were born between 1994 and 1996. All of the children in the study took a standardized academic test in both fourth grade and seventh grade and began taking medication for ADHD sometime between those grades.
Results of the study showed that children who began treatment from 24 to 36 months after the fourth grade test did not perform as well on the seventh grade test as those who began treatment within 12 months of the initial test, most notably in math scores. Specifically, those beginning medication shortly after the fourth grade test dropped math scores by 0.3 percent on the later test. Those who did not start medication for 24 to 36 months after the test dropped math scores by 9.4 percent.
ADHD medications help children (and adults) with ADHD pay attention. In a 2011 interview with the NY Times, Dr. Russell Barkley explains, “the distraction associated with ADHD greatly limits a person’s ability to concentrate, especially on relatively uninteresting activities, and to sustain that concentration as long as others. This is one of the features that ADHD medications can markedly improve.” 
The years betweenfourth grade and seventh grade give children a foundation on which to build, especially in math. The skills learned during those years are essential to understanding more complicated and difficult concepts. Does this study indicate that children with ADHD, who are not taking medication during these years, may be missing some of these essential lessons that impact their understanding and performance for years to come? While the study did not specifically address this question, it is certainly a possibility.
While ADHD medications are much more accepted today than in the past, there is still a great deal of controversy surrounding the issue. When should a child start stimulant medication? What are the long-term effects if a child is on this type of medication for many years? Many parents resist putting their child on medication in the early years and the American Academy of Pediatrics recommends using behavior therapy as a first line of treatment in children ages 4 and 5 before using medications. But as their children struggle in school, medication often becomes a consideration.