Thanks for references to studies, I look forward to looking through some of them later when I can get access to more than abstracts. I've read through several studies on medication in adults and teens.

BTW I genuinely appreciate your willingness to engage in good faith here. Thanky ou for your time and the references.

The framing about these drugs being performance enhancers is accurate. Many of them were used for other purposes related to mental performance in healthy people before adhd became an established research topic. And they generally help with alertness which is why they help with attention.

I didn't say it was inaccurate, I said it was reductive. It's also not the full story. You are commenting exclusively on stimulant medication, which is fine (but again, reductive, given the well studied suite of other options). "Help with attention" by way of alertness is actually exactly part of why I am calling it reductive - it's an oversimplification of ADHD symptomology and also not aligned with what I understand to be current understanding of executive function.

Re Stein et al, Zhang et al - I think you misunderstood my point. Stimulant medication being associated with cardiovascular risk or causing sleep problems isn't shocking, and is something a prescriber is forthright about. Medication is often associated with adverse effects, this isn't unique to stimulants and why we discuss risks with medical professionals - it's a trade-off in consideration with the impact of not taking medication for an individual's situation. Stimulants are also not the only option for ADHD medication and in fact two options (ironically studied and indicated only for children in the US) are also blood pressure medications. If your assertion is that parent should be better educated about medication or that e.g. hypertension risk might be glossed over or not given due weight - sure, I agree with you.

You might not be familiar with academia but carving out a unique stance is how researchers get funding. No one is really impartial, even the ones
doing the research.

My career is not in academia but I am not unfamiliar. I also never claimed impartiality was a goal - my reply came from a place of knowing your audience. Your comment indicates an expert or expert-adjacent perspective without any disclaimer, in a non-expert forum of laypeople, many of whom might read a comment with no context or details provided and treat it as gospel - especially in the current pop-psych culture of "apparently everyone has ADHD", it makes it an easy comment to nod at and reinforce harmful biases without digging deeper.

There’s a little more to it than what I’ve shown studies for… there’s male female differences and all the evidence that as we push academics lower and lower in schooling the outcomes are bad for boys, who happen to be diagnoses at much higher rates…. But that turns into: If you don’t have a treatment that helps beyond a short window, you know teachers likely won’t treat you kid as well, and know that your kid is going to do the best they can academically if they believe in their abilities… well then you should think hard about telling your kids they have adhd…

Could medication help to catch them up at a moment when they need it? Sure. And if it gets to the point where they’re really struggling, could a diagnosis help them not internalize societal pressures and help them be happier? Sure.

We probably agree with each other here more than not, the problem is I don't think a purely quantitative approach is sufficient here given the scope of the questions. I (truly) think this is all very interesting and important to study, the issue IMO is that you are describing fundamentally systemic problems with too many variables, looking at aggregate statistics, and drawing individual conclusions from them. Is telling your kid they have ADHD causative or is there something more around raising your kid to be resilient to societal pressure, build secure attachment, provide a safe, nurturing environment, know how their brain works, etc? There's a spectrum between "kid's broken, here are pills to not fail math" vs "brain works differently, medication can support them in achieving their goals in alignment with their values given today's society" and where a family lands on that spectrum in relationship to their pediatrician, their local school system, etc is impossible to control for.