Social impact of stimulant treatment for hyperactive children

Most children diagnosed with ADHD have extensive and enduring problems in the social arena. Despite its limitations, the standard stimulant treatment regimen for children with ADHD is a useful therapeutic modality as well as an heuristic tool for increasing our understanding of both optimal and problematic interpersonal functioning. This article explores the social impact of stimulant treatment, delineating documented improvements, identifying elusive domains and puzzling patterns, and highlighting unintended and potentially undesirable outcomes. Medication-related changes in the behaviors and perceptions of the diagnosed child's adult caretakers are distinguished from those observed in peers, and the need to enhance our understanding of peer cultures is underscored. We present new findings on the effects of stimulant treatment on social cognition and affect, and then discuss the critical need to map the attributional sequelae of any treatment approach. The final sections explore contemporary controversies and improved strategies for balancing the costs, risks, and benefits of stimulant treatment in the service of enhancing interpersonal competence, satisfaction, and harmony.