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Column originally published Feb 28, 2023

Long-Acting ADHD Medications Can Help Children With ADHD To Pay Attention And Reduce Impulsive Behaviours

Question: Our nine-year-old son was diagnosed with ADHD last year by a child psychologist in Toronto. We were surprised because he could focus for hours on things that he was interested in. We didn’t realize that he has difficulty paying attention until after the diagnosis. We accidentally found that he could pay better attention on his homework when we have audiobooks playing in the background. His biggest issue is impulsivity. He argues with his classmates when they break minor rules; he would point out their mistakes and tell on them. As a result, he is losing friends all the time. Now, whenever he does anything impulsive, he would beat himself up, saying “this is my stupid ADHD.” He is losing his self esteem. We are considering whether we should give him ADHD medication, even though he is still doing well in school. Does ADHD medicine helps both inattention and impulsiveness equally?


I am glad that your son is still doing well in school. However, he is not doing as well socially, getting into arguments with his classmates, and losing his self esteem. This is an important reason to consider ADHD medications.

Attention deficit hyperactivity disorder (ADHD) is the most common psychiatric or mental health condition in children. It is present in five to 9% of children in many cultures, although this is often not recognized. Some are physically hyperactive; they are constantly running and climbing, which is easy to recognize. However, all of them are hyperactive in their brain. It is always busy with many thoughts that makes it difficult for them to pay attention to what is happening, including paying attention to teachers in school, in doing homework, or when you are trying to tell him something.

It is wonderful that you accidentally discovered that he can pay better attention in doing homework when you have audiobooks playing in the background. Others have noticed that they can pay better attention when listening to music, or when they doodle. On the contrary, if a child is able to focus when playing videogames, this doesn’t mean he cannot have ADHD. Videogames are designed to draw their attention, and it is very hard to stop.

Being impulsive is a hallmark of ADHD: they often say or do things without thinking. This can harm relationship with friends and family. Impulsivity affects both children and adults with ADHD, and greatly impacts their self esteem.

Fortunately, ADHD medications can help with inattention, physical and mental hyperactivity, as well as impulsivity for children and adults. Decades ago, we only have short-acting Ritalin and Dexedrine to help them. Nowadays, we have long-acting Ritalin- and Dexedrine-based medications that can work for ten to 12 hours or longer. They can help your son in school, as well as with homework and after-school activities.

Some of these medications are in capsules that can be opened and mixed with food, or dissolved in water. Others are in pills that need to be swallowed. If he hasn’t learned how to swallow pills yet, it is a good time to teach him.

One common side effect of ADHD medications is suppressing appetite at lunch. You need to encourage him to eat some healthy food, and drink lots of water. His appetite should return by suppertime. It is important that he takes the medicine every morning, including weekends and holidays. He needs to pay attention and have control of his impulse every day.

He should be started on medicine at a relatively low dose to allow his brain to get used to the medicine. The dose should be increased steadily until he has benefit; it needs to be optimized so that he has good control of his attention and impulse most of the day, not just when he is in school. As he grows, the dose of medicine has to be adjusted as needed. Don’t be afraid to adjust, otherwise he may believe that medicine is ineffective and stops it, especially in his teen years. This is the critical time when he needs medicine the most.

Look for physicians, including family doctors, paediatricians, and child psychiatrists who are knowledgeable about ADHD in your community. They can give you guidance on medications. There are also ADHD therapists and coaches who can give additional support in managing relationships with friends and family.