ADHD Kids may need to be checked for growth, but for a reason your not expecting.

An interesting article appeared on MEDPAGE recently addressing a concern that many patients have about ADHD (Attention Deficit Hyperactivity) medication and their child: "Doesn't medication stunt growth?" Well according to this research in children with attention deficit hyperactivity disorder, short stature may not be related to treatment, but rather an underlying growth hormone deficiency. In a retrospective chart review of 6,887 children, growth hormone deficiency cases in those with ADHD occurred about as often as in the general pediatric population, Vidhya Viswanathan, MD, a pediatric endocrinology fellow at the University of Indiana School of Medicine in Indianapolis, reported here.

"Growth hormone deficiency affected 12% of the children who were not diagnosed with ADHD and 18% of the children who were diagnosed with ADHD (P=0.18)," she said in a Lawson Wilkins Pediatric Endocrine Society poster session, included in the Pediatric Academic Societies annual meeting. She also found little evidence in the general pediatric population that would support the notion that ADHD-treated children as a group are shorter than children in the general population. This runs counter to "common knowledge" or assumptions parents, and often doctors have, about the effects of medication.

"Previous studies have demonstrated a relationship between medication treatment for ADHD and short stature with slow growth noted initially, followed eventually by catch up growth," noted Viswanathan. So, studies have shown that for an initially period of time a child's growth might be slowed ....but THEN the child's growth becomes faster until it catches up. So, for the most part, we would expect normal growth as the average outcome. So one wonders why this is even a concern? Often, this study proposes, the ongoing slow growth continues not because of the medication, but because of growth hormone deficiencies that we can expect to see in children with ADHD, taking medication or not. She said that assuming that children on ADHD medication are exhibiting slow growth that will change with discontinuation of medicine might mean that clinicians are missing cases of growth hormone deficiency.

"Short stature in children treated for ADHD should not solely be attributed to medication," Viswanathan told MedPage Today (click above to see the original article). "An endocrine evaluation is warranted in children treated for ADHD who display concerning growth patterns."

In the study the researchers also sought to see if there were differences in outcomes regarding short stature on the types of ADHD medication used. About 74% of the children with ADHD were taking various forms of stimulant medications, while 26% of the children were prescribed atomoxetine hydrochloride (Strattera). They found that, "There were no differences in mean height, weight, and body mass index standard deviation scores between [children] taking stimulant medication versus those taking atomoxetine."

"Based on this careful review, I think that the recommendations to check children with ADHD and short stature is justified," Jonathan Winikoff, MD, MPH, of Harvard Medical School, told MedPage Today. They may have a gtrowth hormone deficiency that needs to be considered in addition to the issues of ADHD.

Again, a great article, and great piece of research that demonstrates that correlation does not equal causation.

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This blog is not offered as medical advice or as a means of diagnosing or treating ADHD or any other disorder. Don't go on line and take an ADHD "test." The diagnosis is complex, and it involves not just looking for symptoms of ADHD, but also ruling out other disorders that might look just like ADHD. So avoid these on line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for that. Medical doctors can diagnose ADHD, but the diagnosis is complex and often they will make a referral to a Registered Psychologist. You can obtain a referral from the British Columbia Psychological Association for a psychologist near you.

My web page lists a number of resources you can make use of yourself in dealing with Attention Deficit Hyperactivity Disorder (ADHD). Please visit it at www.adhdhelp.ca or one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site.

Attention Deficit Hyperactivity Disorder (ADHD) assessment and treatment services are offered for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com