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Do ADHD Kids Really Take Their Medication?

In a 2009 study, children whose parents thought they were taking their medication were tested using saliva samples, 4 times over a 14 month period. 25% of children had skipped it half of those 2 times, and about 50% had skipped it at least once. Kids who were skipping it and also had behavioral intervention had less problems than those who were only getting the medication.
This is an interesting study for a number of reasons. What exactly happened? Were parents reporting they were giving the medications daily when they were actually forgetting, or were the kids pretending to take the medications and spitting them out? If the kids were spitting it out, I wonder why. Side effects parents were not aware of? Bad taste? Just being oppositional? Unfortunately the study did not investigate these issues, so we can only speculate.
The other interesting part is that the children receiving behavioral services did better despite not taking the medicine than those only getting medication. This once more shows the importance of behavioral management in the treatment of ADHD. I do wonder, though, how many families and medical providers forget about any behavioral intervention once they begin medication. In our fast-paced and busy world, that would be easy to do.
Reference:Molina BSG et al., J Am Acad Child Adolesc Psychiatry 2009 May; 48

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