Fears loom young New Zealanders with ADHD are being medicated unnecessarily after a study revealed the rate of prescribing has boomed.
ADHD (attention deficit hyperactivity disorder) is a condition affecting part of the brain responsible for filtering and controlling attention, behaviour, emotion, energy, motor control and judgment. In New Zealand, about one in 20 people live with the condition.
Left untreated, ADHD can cause a significant impact on learning development and social interaction.
A study published in today's New Zealand Medical Journal (NZMJ) found that the rate at which New Zealanders aged 1-24 were being prescribed ADHD medication had doubled from 516 to 996 per 100,000 from 2007 to 2017.
One of the authors of the study, Stephanie D'Souza, who is a University of Auckland researcher in psychology, said it was alarming as there was no evidence that the rate of ADHD itself had increased over this time period.
She said the jump could be due to more people getting picked up which was a good thing but there was also concern for over prescribing of medication which had been seen overseas.
Another worry was that children were being prescribed medication without the right support network, which was a crucial part of treatment, D'Souza said.
In the study researchers said not every child diagnosed with ADHD needed to be on medication.
"The choice to medicate should depend on what is best for the child and family preferences, with particular consideration given to the benefits of going on medication against the potential risks associated with medication side effects."
Researchers found youngsters aged 7 to 17 had the highest prescription rate, while the rate for children aged 0 to 6 had barely moved over the decade.
Stephen Lethbridge, principal of Point Chevalier School and president of the Auckland Primary Principals' Association, said he hadn't seen an explosion of children coming through with ADHD but at his school he did see about a handful each year who were commonly picked up at ages 8, 9 and 10.
"We encourage any parents who are having issues to talk to schools as we do have additional funding to help cater for high needs students."
He said overall the support had improved as teachers were building their adaptive expertise as more and more children presented with different learnings needs.
D'Souza said the study also found that for European children the rate of prescription was higher among poor families but for Māori and Pacifica communities it was much lower for children from poorer families. She said more research was needed to address those barriers.
ADHD New Zealand chair Darrin Bull said he had seen a huge increase in children and parents reaching out but support was still lacking.
"It can be very expensive to get counselling and speech therapies. I have seen children getting kicked out of school because their ADHD went undetected or there wasn't the right support available."
Researchers of the study were calling for the Ministry of Health to review New Zealand's ADHD assessment and treatment guidelines that were published in 2001.
They said the guidelines were flawed because:
• It did not include all publicly funded medications, for example atomoxetine, let alone internationally approved and recommended ADHD medication such as clonidine and guanfacine.
• The diagnostic criteria was outdated and did not consider the ethnic and socioeconomic inequalities in ADHD medication use.
Ministry of Health clinical chief adviser Andi Shirtcliffe said a review had not been considered but additional research around equity of access to medicines and health services was a priority and important.
"In the meantime, we will share the paper with the relevant clinician colleges in the interests of ensuring that the most recent research contributes to individual clinician approach to care," Shirtcliffe said.
"It's interesting to see in this paper that the New Zealand trend is similar to what has been seen internationally. The increase has been seen particularly in school-age children and does demonstrate variations in the increase seen across ethnic groups."
At the age of 6, Matthew Bull was suffering from delayed speech, anxiety and school was a battle.
Now, aged 16 he's taking advanced math NCEA level 1, his reading and writing has improved far beyond initial expectations and he is learning to connect with people.
None of which would have been possible without his ADHD and autism diagnosis and the combination of counselling, a teacher aid, speech therapy and medication, his dad Darrin Bull told the Herald.
"Medication is not the magic bullet but it can help. It shouldn't be taken without the added support."
Though Darrin said there were still barriers to access treatment and support.
For Matthew getting a diagnosis for ADHD wasn't easier.
There was a two year wait to be seen by a specialist publically so we had to go private and ended up paying $400 for an appointment and then $1500 for a educational psychologist report, he said. Even then it took months for a diagnosis.
Darrin credited Northcote School for his son's success saying the teachers now recognised ADHD not as a disability but an advantage.
Matthew takes a drug called Concerta, also known as Ritalin, which basically slows his brain down so he can think more clearly and it reduces his anxiety.
"Honestly, he wouldn't be as successful as he is without that but it was with counselling, teacher aid, speech therapy."
He said there was a stigma attached to ADHD medication with parents thinking that if they medicate their child they will be a zombie.
"We have never had that with Matt - he is still his happy cheeky self."