-The strongest outcomes pair cognitive therapies with medication. Taking a kid who has only had medication intervention off of the medication leaves them back at the starting line with no coping skills.
And the behavioral/cognitive therapy that works is hard to obtain for many (most) people. This is a serious failing of the medical establishment. I will not editorialize further, but ugh.
Important to note that behavioral/cognitive therapy alone doesn't necessarily work that well for most children with ADHD. In many cases, the child cannot really access the therapy without medication, which is why the combination is often the strongest choice for moderately to severely affected children (for people who actually have ADHD, not talking about misdiagnoses here).
The choice to medicate is not IME usually taken lightly; nobody's a huge fan of giving medications to kids in principle. In our community, I see it operating as a last-ditch thing that people try after having tried a number of other ways to make life workable for their children, and I see that it is typically associated with unjustly shaming the parents first for having an uncontrollable or out-to-lunch kid, and then for drugging the kid.
Unmedicated ADHD is associated with some other really undesirable things in young adults, like alcohol and drug abuse; if you let a person's frustration level climb sky-high over years by letting them feel like a failure for how their brain works, lots of really bad things can happen. This ought to be factored into decisions. I think families mostly try to do right by their kids; I do not think most families are trying to drug their children into submission and so on.
I would like so much of this public shouting and judgment to stop: the shaming, the overdiagnosis, the pressure to medicate or not medicate. I suppose that's unrealistic of me.
DeeDee