A new study by the National Institute of Mental Health in which hundreds of children were followed for several years, found that medication did not have a significant impact on grades in the long term. This finding was corroborated by other studies. An article in Nature poses the question, "How can medication that makes children sit still and pay attention not lead to better grades?" The answer, it suggests, may be that children develop tolerance to the drug or that while the drugs impact concentration, they do not impact intelligence and therefore as school becomes more complicated, grades do not improve. "When the MTA team examined the follow-up data, it found that many non-medical factors play a big part in whether improvements last. The best predictor of a child's response to treatment wasn't which treatment they were assigned, but a cluster of factors that were present at the start. Children with more advantages — higher intelligence, better social skills, intact families, higher parental education, fewer conduct problems or higher socioeconomic status — were likely to make big strides and hold onto them no matter what the treatment was, whereas children without these advantages typically progressed more slowly and regressed after treatment stopped.But disadvantaged children benefited when they received both medication and behaviour therapy. “The kids with the most problems needed the combination,” says Jensen, who adds that parents should have easier access to proven behaviour therapies. The effects of behavioural treatment don't seem to be longer-lasting than those of medication, however: once active treatment stops, they dissipate."
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