Child lost in medication maze

ADHD Meds: Are They Overprescribed to Elementary Students?

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"New research reveals that stimulant use among young students with behavioral issues extends beyond ADHD diagnoses. Here's what parents and educators need to know."

The number of children taking medication for mental health issues has been steadily increasing since the 1990s, with stimulants for conditions like Attention-Deficit/Hyperactivity Disorder (ADHD) leading the charge. While these medications can be beneficial, questions arise about their appropriate use, especially in young children with behavioral challenges.

Many elementary school students referred for behavioral issues receive prescriptions for central nervous system stimulants (CNS), often because they display symptoms of ADHD. However, a new study from Quebec, Canada, prompts a deeper look into the factors influencing stimulant use in this population.

This article will explore the findings of this research, investigating whether CNS stimulant use is solely tied to ADHD or if other behavioral and socioeconomic factors contribute to the decision to medicate young students. The goal is to provide parents and educators with a clearer understanding of this complex issue.

Beyond ADHD: What Else Influences Stimulant Use?

The study, conducted with 341 elementary students (average age 9.9 years) receiving school-based services for behavioral issues, revealed some surprising insights. While a significant portion of the students were taking CNS stimulants, the connection to ADHD wasn't always clear-cut.

The research indicated that 39.9% of the students were using CNS stimulants. More strikingly, nearly one-third of the students without a diagnosed TDAH were also taking these medications. So, what else could be driving stimulant use in these children?

Hyperactivity-Impulsivity: Students exhibiting these symptoms, even without a full ADHD diagnosis, were more likely to be prescribed stimulants.
Oppositional Defiant Disorder (ODD): Symptoms of ODD also increased the likelihood of stimulant use, suggesting medication is sometimes used to manage disruptive behaviors beyond ADHD.
Age: Younger children (6-8 years old) were more frequently prescribed stimulants than their older counterparts.
Socioeconomic Status (SES): Surprisingly, children from middle-to-high SES families were more likely to be on stimulants, potentially reflecting greater access to healthcare or heightened parental concern about academic performance.
Special Class Placement: Students in specialized classrooms for behavioral issues were also more likely to be prescribed stimulants, indicating a possible link between medication and more severe behavioral difficulties.

These findings suggest that the decision to medicate isn't always a straightforward response to an ADHD diagnosis. A combination of factors, including specific behavioral symptoms, age, socioeconomic background, and school environment, can play a significant role.

Implications and Next Steps

This study highlights the complexity of medication decisions for children with behavioral challenges. It emphasizes the need for comprehensive assessments that go beyond simply identifying ADHD symptoms.

A more thorough evaluation should consider the child's overall behavioral profile, family circumstances, and school environment. This approach can help ensure that medication is used appropriately and that other interventions, such as behavioral therapy, are also explored.

Longitudinal studies are crucial to understand the long-term effects of stimulant use on children's academic, social, and emotional development. Further research is also needed to determine the most effective strategies for supporting children with behavioral issues, with or without medication.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.7202/1048898ar, Alternate LINK

Title: Utilisation De Stimulants Du Système Nerveux Central Chez Les Élèves Du Primaire Suivis À L’École Pour Des Troubles Du Comportement

Subject: Psychiatry and Mental health

Journal: Mosaïque

Publisher: Consortium Erudit

Authors: Mélanie Lapalme, Caroline Temcheff, Stéphanie Boutin, Michèle Déry

Published: 2018-06-20

Everything You Need To Know

What are central nervous system stimulants (CNS), and why is their use in elementary students being questioned?

Central nervous system stimulants, or CNS stimulants, are medications that affect the central nervous system. While frequently prescribed for Attention-Deficit/Hyperactivity Disorder (ADHD), their use is expanding to address other behavioral issues in children. This raises concerns about whether they're being overprescribed and the long-term effects of using stimulants to manage behaviors beyond ADHD.

What were the key findings regarding stimulant use among elementary students with behavioral issues?

The study revealed that nearly 40% of the students were using CNS stimulants. Surprisingly, a substantial portion of these students, almost one-third, did not have an ADHD diagnosis. This suggests that factors beyond ADHD, such as hyperactivity-impulsivity, symptoms of Oppositional Defiant Disorder (ODD), age, socioeconomic status (SES), and special class placement, can influence stimulant use.

Besides an ADHD diagnosis, what other factors might contribute to a child being prescribed stimulants?

Several factors beyond ADHD can influence the prescription of CNS stimulants. These include hyperactivity-impulsivity, symptoms of Oppositional Defiant Disorder (ODD), younger age (6-8 years old), middle-to-high socioeconomic status, and placement in special classes for behavioral issues. These findings indicate that medication decisions are complex and multifactorial.

What are the implications of this study for how doctors should assess and treat elementary students with behavioral challenges?

The research highlights the need for comprehensive assessments that extend beyond simply identifying ADHD symptoms. It suggests that healthcare professionals should consider a child's specific behavioral symptoms like hyperactivity-impulsivity and ODD, socioeconomic background, and school environment before prescribing CNS stimulants. Additionally, it brings into question the use of CNS stimulants for children under 6-8 because younger children are more likely to be prescribed CNS stimulants.

How might a family's socioeconomic status affect whether a child with behavioral issues is prescribed stimulants, and what does this suggest about healthcare equity?

The increased likelihood of stimulant use among children from middle-to-high socioeconomic status (SES) families could reflect greater access to healthcare and specialized services, as well as heightened parental concern about academic performance. It raises questions about whether children from lower SES families, who may have similar behavioral issues, are receiving the same level of assessment and treatment. It prompts a broader discussion about equity in access to mental health resources and the potential for disparities in medication management based on socioeconomic background.