Medication for ADHD in Elementary School

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• My son has received an ADHD diagnosis, now what?
• ADHD-- dd on meds ; no change in productivity
• Medication and therapy for 9-year-old with ADD
• 10 year old boy with ADD - after the meds wear off
• Have ADHD meds affected your child's height?
• 8 year old with ADHD: Meds stop working?
• 6 year old was recently diagnosed with ADHD - therapy, meds?
• 7-y-o with ADD diagnosis: did you try meds?
• How did you decide to try ADD meds (7 and 8 year olds)?
• Alternatives to Ritalin for 8-year-old
• Do you tell friends & family your child is on meds?
• Helping child with ADHD, not on medication

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My son has received an ADHD diagnosis, now what?

March 2013

My son just participated in a 6 hour neuropsychiatric session with Carina Grandison and the ADHD evaluation through Kaiser. Both reports point to the hyperactive, impulsive child. He has always been strong willed and full of energy but his behaviors have started causing him to be in trouble at school. His kindergarten teachers have been great with daily communication, but he tends to get put on time outs frequently for being silly and disruptive while waiting his turn. He often wiggles, fidgets or displays sillyness to try and cope with his difficulty sitting still or maintaining focus. His teachers and coaches get quickly frustrated with his behaviors and he often has to sit out the very activities we sign him up for to use up that constant energy. I would love to hear from parents who have had a similar diagnosis and what behavior modifications, parenting classes or medications supported your child in participating in his/her childhood with more self regulation. I want nothin more than my son to create good relationships with his friends, teacher, and coaches. I appreciate you sharing your experiences. Looking for some guidance

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Hi Mama, My son also has ADHD, he is almost 11 now. This is the short version of what has worked for us, there are a lot of options out there and every kid is different, but here goes. We did put him on medication starting in 1st grade. He was falling behind in class and often felt stupid (he isn't). The impact on his self esteem was awful. We tried EVERYTHING before the meds. We tried putting him in an ''office'' (cardboard cubical looking thing on his desk) so he wouldn't get as easily distracted, we tried moving his desk, he had already been seeing a therapist since about 4 years old and we continued that.

The medication helps my son perform the way he sees himself in his mind's eye. They don't want to be impulsive, lose their temper, be combative about every little thing, etc. They usually want to succeed. As he gets older some things get harder and some things get easier. He also has some learning differences so he sees an educational therapist in addition to his regular therapy. I strongly recommend therapy. Especially since my son loves his therapist, it helps him navigate all the emotions that seem to just burst out of him. We tried social learning groups, those were not for us. It is a slow process with little to no measurable impact. It seems to depend a lot on the therapist that leads the group, but we just couldn't afford the Ed Therapist and the social learning group and in our case the learning differences are a large player in his poor self esteem. Feel free to email if you want more. Hope this helps.

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IMHO you can rely on a diagnosis from Carina Grandison -- hers have long been the gold standard.

I suggest that you enroll your son in either (a) active sports or (b) Boy Scouts. Burning off the excess energy will be good for him. Of course, it can be high maintenance for the parents to arrange transportation, and the child may have a difficult transition between the activity and the parent's need to get dinner on the table. Some Scout meeting are scheduled for one evening per week after dinner.

Team sports and Scouting are venues where young males are socialized and trained to support each other, and there is adult supervision. That makes it better than school playground situations where bullying can more readily occur.

Good luck -- he will improve with age! Veteran of the Hyper-Years

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Hello, I am sorry to hear your son has received a ADHD diagnosis. As a mother with a son in the public school system, I understand completely how you feel, from every angle. I am also a student of nutrition and I learned there is a strong link between ADHD and certain foods. If I may give a few suggestions, please refrain from giving him these foods if possible: -foods containing artificial coloring or flavoring (this includes candy) -foods that are refined and processed such as crackers, cookies, pre made meals -foods containing MSG or aspartame (chewing gum is a big culprit)

As well, please encourage more consumption of these foods: -clean proteins from pastured eggs and meats -free range and organic poultry -good fats such as avocado, wild salmon, sardines, flax seed

There is so much more I could write but I think it best to make little changes, as you would be more successful. There is no doubt your son would understand the true meaning of this diagnosis, since he is in school every day and is not blind nor deaf to comments made by other people. My son also gets labelled but I have been fighting the system. Ugh! It is important to understand that this is not his fault. Certain children process foods differently and it affects their brains. My own son was 'crazy' two days ago and when I questioned him, I found out they were given marshmallows and jelly beans during science class. No wonder!!!! Please don't give up and give him medication. The medication would not work and would cause more damage in the long run. You have rights as a parent and if it helps, explain to the school that you are making adjustments to his diet. Monitor his behavior with these changes. Good luck. Nancy

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The person who told you not to give your son medication made an incorrect and irresponsible statement: ''Please don't give up and give him medication. The medication would not work and would cause more damage in the long run.'' It is possible that she has had some success changing her own child's diet, but she is in no way qualified to say that medication will not work for your child and will make things worse. My own son who is nine has been taking medication for ADHD for 3 years and is also receiving emotional and educational support and these three things together have made an immense difference. I'm not saying you SHOULD give your child medication, but please consider that it might be helpful. Also, my child was diagnosed with ADHD at Kaiser Oakland and we (2 years later) saw Carina Grandison for a neuropsychological evaluation to find out more about his makeup and issues, and we found her to be extremely knowledgeable, thorough and professional as well as warm and an excellent advocate for our son's success. I believe you went to the right person. If you do feel you need a second opinion, may I recommend that you see Dr Raymond Hearey in Rockridge. He is making adjustments to our son's medication and it seems to be helping him a great deal so far. Giving medication is not giving anything up. It might just be the difference between what works and what doesn't. Medication is not evil.

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I felt compelled to respond after reading what others wrote. My son also has ADHD like symptoms and we tried EVERYTHING. Our lives were hell. We were unhappy, my son was unhappy, and even worse, was starting to have rock bottom self esteem and feel like he was a terrible person. The stress he and our family were under can not even be described. I also was very resistant to medication after hearing stories about how all he needed was a better diet and ''don't give up.'' Well, now on the other side, I can say that medication truly changed all of our lives for the better. We tried one medication that did nothing (but did not make him worse) and then the second one we tried was very helpful. It is not a magic bullet by any means, we still have to stay on top of keeping a very structured life at home and at school. If sprinkling flax seed or whatever else people suggest was so effective then why wouldn't more people be doing it?!? The research does not support that these diets do much if anyting and trying to actually adhere to it is a herculean effort. This is not to say that your child does/does not need medication, but just know there are serious and unfortunate consequences to NOT medicating and if you do need to go down that road, it isn't that you are ''giving up'' but rather that you are weighing the consequences for not medicating against the benefits of the medicine and trying to help your child reach his potential. I also have to say that the horror stories of zombie like children with medicine were not true in our case. My child has the same beautiful spark as before, he just can control his negative behaviors better and doesn't feel like a failure all the time. We have experienced almost no side effects. The only one was eating slightly less at lunch, but he makes up for it with an after dinner snack. A healthy diet never hurt anyone, but it also does NOT WORK to address behavior issues for everyone (or maybe even most kids). Good luck to you and your son! ADHD mama

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Receiving an ADHD diagnosis is so hard on so many levels - I feel for you. I have a 7-year-old boy with ADHD, and I've been on this path for a while. I would work with a trusted child psychiatrist or other specialist to determine what kinds of therapies would help most for your particular child. For social issues, I would suggest looking into a ''Social Thinking'' play group, or some other type of peer group therapy that deals with self-regulation, social interactions, etc.

And, contrary to other advice you received here, I would not rule out medication. While I wholeheartedly agree that good nutrition and whole organic foods are a great thing, I take issue with the advice not to ''give up and give him medication'' and that medication ''won't work''. Medication DOES work for a great many (not all) children with ADHD, and indeed can change their lives. Stimulant medications, typically used to treat ADHD, are among the most studied medications out there, have been in use for decades, and are generally considered very safe. There are many variations that have varying results and side effects depending on the individual child (what works for one child may cause unacceptable side effects in another). It is often a case of trial and error before you find the right medication and dosage for your child. Talk to an MD specializing in ADHD, gather as much information as you can, then make the choice that feels right to YOU.

Good luck to you - I wish the best for you and your son! BTDT

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I am very sympathetic to your situation, as we were in the same boat a year and a half ago when my son, then 7, received an ADHD diagnosis from two different sources. This came after two absolutely miserable years of school experience, during which his self-esteem had completely eroded.

To counter one of the previous responses suggesting that this condition can be cured by your intake of food - my son's diet has been stellar since his birth. He is 9 now, and to this day, neither soda nor artificial coloring has passed his lips. His favorite meal is a plate of salmon and steamed broccoli. So if a diet can change ADHD, I would question if this was ADHD in the first place.

Before we ''gave up'' and tried medication we:

1) Switched from a public school to a private one in the hopes of small class size and better resources creating a more positive environment for our son - this did not address the underlying challenges;

2) My son was the youngest child in the classroom, so at the suggestion of the teachers we held him back a year - this had no impact on his academic performance, but made positive changes in his social life, as his apparent immaturity due to impulsiveness seemed to blend in much better with a younger grade;

3) One of us became a stay-at-home-parent in order to be more involved at school and provide a more balanced and calm life at home.

Neither these steps, nor the balanced diet ''cured'' his ADHD. A year after the diagnosis we tried our last option - the medication. It was not the magic bullet as so many people have suggested to me it would be, but it is still the most effective tool at my son's disposal.

I am not suggesting that the medication is the only route, but I thought I would share our experience with you so you have one more anecdotal evidence in your arsenal.

I would like to mention one more thing. If you can, try to reach out to other families with ADHD kids. It is so great to be able to talk to other parents who know what you are going through based on a personal experience, not some book or a college lecture. As a bonus, playdates with these kids are awesome and you don't feel guilty, because your child is not the only one running and jumping like crazy. Best and warmest wishes

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ADHD-- dd on meds ; no change in productivity

Jan 2013

10 yr old dd has been on various ADHD meds for 2 yrs. Teachers have not noted much improvement on focus and productivity. Still requires lots of one on one prodding to get work done. Evaluated by neuropschy, high IQ thus capable of doing work, but low processing skills (16% percentile). Dislikes and avoids writing, says that mind goes blank when it comes time to put thoughts on paper. Mom concerned about middle school and future. In public school with IEP to help with writing and study skills. Has anyone with similar issues found a way to resolve them. Help worried mom

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Been there! Contact Phyllis Koppelman at Strategies for Learning. She got my child writing which was a MIRACLE! (http://www.strategiesforlearning.com/) She is funny, warm and so experienced!

Meds should work, period. However, I learned that my kid's doc was not giving him a 'clinically significant dose' that is not enough to help, just enough to disturb his sleep! We switched to Dr. Brad Berman who is heaven-sent.

In both cases it was critical that our child LIKE the professionals. These two really do love kids and interact with them, not just you. Good luck!

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My son had ADD and several learning challenges including processing and focusing, as well as severe anxiety. When I put him on a gluten free diet years ago he changed almost magically. We also gave him high doses of Omega 3 fish oil which was RX'd by his wonderful shrink. Previous to that,when he was on meds for 2 years there was NO change except they stunted his growth (GRRRRR....Mama bear comes out) The meds were RX'd by a Kaiser shrink. The meds were more for his anxiety, which the Omega 3 took care of beautifully. Anyway, give gluten free a try. Most Dr's. don't know much about the negative effects of gluten but it can really change one's focus, personality, brain chemistry. Today my son is a healthy and well adjusted 17 yo who has ways to deal w/ his challenges and gets his school work done. If you want to talk further about this, please e-mail me. Good luck. june

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People with ADHD have different challenges and to varying degrees. In order to be successful in life it's important to come up with creative solutions. If writing is difficult, perhaps being interviewed or talking into a recording might be a good alternative. ADHD and thriving

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Seems like the first thing to do is take him off the meds. Then I would suggest that he learn to use a keyboard. Sometimes that is easier than using a pencil. Then, if a keyboard doesn't work, either, the physical act of writing and the mental act of composing should be separated. While he talks, you write it down. Scribing is a wonderful way to connect with your kids and is wonderful for those who have trouble with the pencil. Then have him copy it so he continues to get practice putting words on paper. Anon

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I'd look into getting some voice recognition APP for your computer and let him dictate his stories and then edit them after they've been typed. He could use this type of system at school too. anon

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Our son struggled with trying to produce all through elementary school - well, he wasn't really struggling, he was indifferent. He had an IEP. We were very worried. But now he is a successful college senior with a high GPA. While it is true that every special-ed kid is unique and you can never generalize, here's what worked for us: Three things: First, behavior modification. During one of the OUSD regimes with an enlightened head of the Programs for Exceptional Children (PEC) department, they brought in special-ed aides who were hugely overqualified. Ours was a licensed special-ed teacher in another state.

Now, our kid was beyond the stage where he would work in return for stickers. What did our son value? Time off. So this marvelous teacher made a deal with him: he got 15 minutes off for each 45 minutes that he stayed on task writing an essay on the computer. So our son began to negotiate. Could he save up his increments of 15 minutes to have an entire afternoon off? Well, okay. And what would he do with his afternoon off? He wanted to stay in the school library and help the librarian. She, too, was a jewel.

This process made him into a writer who got A's in college fiction-writing. Second thing: Emotional support. When kids are struggling, especially if there are social deficits involved, they need a trusted adult to confide in, so they do not experience ''collateral damage'' of loss of self-esteem and inability to stand up to any bullying. For our kid, a good therapist using sand-tray methods helped enormously.

Finally, Maturity, We parents tend to suspect that speaking of ''developmental delays'' is a euphemism for''not smart enough''. But in our son's case, I am here to say that he has grown out of a lot of the problems we suffered with in the earlier grades. And I am proud to say that we were able to protect him from ''collateral damage''. Yes, there were nights when I went crazy -- sitting over him for two hours trying to get him to complete a simple work sheet in third grade; wondering what medication to try, arguing with my husband who was/is anti-med. I have to say now that the meds had little impact and were not worth trying. The biggest piece of the puzzle was the behavior modification, and to make that work, the teacher or parent must really understand what motivates the kid. Keep your sense of humor and your faith. Alan's mom

 

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Medication and therapy for 9-year-old with ADD

Nov 2012

Hi, We just found out that our daughter who is 9 is ADD. Since she turned 3, we have had difficulties with her at school/home. We feel relieved to have a diagnostic and to be able to help her. We are looking for a doctor for medication and a therapist for behavior in the east bay (Albany/Berkeley/Oakland) who has experience in that area. We are with Anthem HMO and Alta Bates medical group and would like a provider in that network. We heard about Dr Landman. Any opinions ? We would love also to talk to people who went through this. Thanks for your help anon

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We recently started seeing Dr. Burhmann in Albany for my 10 year old son with ADHD and some learning differences. Dr. Burhmann did a very thorough examine/evaluation of my son. Even before wew made out appointment she called me back on a Friday evening to discuss my son and why I was seeking a developmental pediatrician. ALL of the other offices I called at the time did not even get back to me. It took me almost a year to sort out my son's insurance and how we were going to pay for this service and both she and her assistant, Sally, remembered me and some things about my son. We live in Alameda, so Albany is not exactly close but it is very worth it. Provide any other insight let me know, A.

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10 year old boy with ADD - after the meds wear off

Sept 2012

My son is 10 years old and has ADD. He is on 10 mg of Focalin XR that he takes in the morning. On his meds he is just a super great kid. He is sweet, helpful, kind, behaves well in class, never much trouble. Other parents like him, teachers like him, family members like him...

BUT.....after the meds wear off (about 5pm) its a 180 degree difference!! Like Jekyll and Hyde! He is loud, impulsive, doesnt listen (Stop teasing the cat. Leave your brother alone. Dont splash water--purposely--all over the bathroom, and on and on.) Every 5 minutes he is being reprimanded for something. On his meds he is nothing like this, I swear. He has brought me and my husband to tears many nights due to complete exasperation and/or feeling guilty for how we are treating him (yelling, anger etc).

I know about the ''rebound effect'' of these medications. But we just arent sure which avenue to go to make things better for him and for us. Wondering what has worked for others out there with boys with ADD, who can be a complete nightmare when not on their medication. (Of course we are going to run everything by our pediatrician, but you all are experts too!) Have you noticed a difference in your kid if youve given him an afternoon dose of meds? (Our pediatrician has suggested it.)

Should we bring him to a developmental pediatrician (except the good ones have wait lists months and months long!!) And what would a developmental pediatrician do exactly? We dont need more testing, a diagnosis or someone to dispense medicine, weve already had all that done.

Are there counselors/psychologists that work with behavioral issues of this kind? (I went for an intake at the Ann Martin Center. Left there feeling it just wasnt a good match. I could be wrong.) What parenting classes are out there in the Bay Area for parents of kids with ADD? The only ones I know of are at Kaiser and we arent Kaiser members. Some have said you dont have to be Kaiser members, but every time I go on their website, 90% of their parenting classes say you have to be a member. Any advice would be SOOOO appreciated! Thanks.

PS Oh and yes, we do have reward systems at home with consequences and/or positive rewards. Feeling Sad and At Wits End

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Since you say your son does so well on school on meds, would you consider a small afternoon dose to get you through the evening? Focalin XR is a long-acting form of Ritalin. You could do a small (say, 2.5 or 5 mg) dose of regular (4 hour) Ritalin in the late afternoon and that should be enough to get through homework but still not keep him up at night. I am not one to push meds, but I think in this case the advantagese might greatly outway the disadvantages. A pediatrician

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I feel for you. Our son is younger (7) and not medicated all the time (wears out by evening and not on weekends). He seems tired and has a hard time controlling himself when he is not on medication. We went to a parenting coach - MARCIA S TROJAN LMFT RN in Berkeley. She helped me understand that I have to stop myself before I get angry. She taught me to notice the feelings - emotional and physical - I have before I react in anger. When I notice these feelings/tightness/pressure I give myself a time-out and walk away - if possible - from the situation to take a deep breath and get a grip on myself. Just an example of how the kid is not always the one who needs the fixing. I can also develop skills and think differently about my reactions, actions, and attitudes. I try to remember every day - and many times in a day - that my son is doing the best he can. That thought encourages me to do the best I can. I try to look at the fun loving nature of my son - who makes everything a play opportunity - and try to laugh with him. I also try to notice when my energy is low, or I feel stressed, and treat myself a little better. I try to not be punitive or shaming while correcting my son. I don't manage to stay positive every time, but I keep trying. Every case is different. I hope this does not sound like its all the parent fault. Just suggesting that parent reaction can make a difference in lowering the tension.

On parenting classes: I see that there are classes for parents online. I don't know how good or bad they may be. Just do a search on any search engine. Kaiser classes - through behavioral health - tend to be both for members and pay-for-service. The classes through psychology department seem to be more members only. I plan to take more Kaiser classes to keep learning how to cope. Good luck to you and to your family. Evelyn

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Your life and your son's sound exactly like mine. Our son had ADHD and his meds wear off at about 6pm and we go through exactly the same thing-leave the dog alone, stop harassing your dad or me, please keep the noise down a notch (yelling goofy songs so the neighbors hear, etc) What we have done is something that might seem counterintuitive. We let him play Algodoo (a free physics game you can download which has him fascinated) while we make dinner and while we eat dinner we watch a Star Trek episode with him on Netflix. During the halfway point of the movie, it is 5 mg of chewable melatonin and dessert, and when the episode is over, we brush teeth read and go to bed. We do this every single night, and while the sillies and crazies do sometimes rear their ugly heads during the computer time, he is usually so fascinated by this game that he's able to calm down if one of us asks about what he's doing. I know every family is different but this works really well for us. I think the melatonin does a really good job with helping him wind down and be ready to sleep. He takes Ritalin LA at about 8am and this wears off at about 6pm. On another note, he has been going to the Ann Martin Center since he was five and he is turning 9 in December. It seems to be a pretty good fit, but it took a while to figure out the best method to get him to share information which he does through a method you'd use for much younger children-a duck puppet. Since he is emotionally immature, it works for him. He's brilliant with a 147 IQ and a sponge for anything technical, but this duck, somehow he relates to it in a way that makes him feel safer than a grownup, who he often doesn't trust. Anyway, good luck and if you want to email me, I hope the moderator can give you my info. Know what it's like.

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Your experience sounds just like ours--it was IMMEDIATELY obvious to us, teachers, and camp directors for my younger son when he missed even one day of medication. Medication was the difference between his being able to participate and interact vs being thrown out of programs. When he was taking a relatively short acting medication, we had a prescription for a short acting stimulant for the late afternoon-evening. So I would encourage you to see your behavioral pediatrician soonest.

Medication did not substitute for the demanding parenting skills needed for our son--but it made it possible to make progress--and also minimized the frustration and anger that is destructive for everyone in the family. I am astonished at the number of folks on BPN who congratulate themselves on NOT using medications--would they be so proud of dealing with a seizure condition without meds???

And our son has just gone off to college with a substantial merit scholarship. He recognizes the value of medication and manages it himself. Everything is not perfect--but I can't imagine the past twelve years without the assistance of medication. using the help we all need

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I highly recommend Russell A. Barkely's book ''Taking Charge of ADHD: The Complete Authoritative Guide for Parents.'' Tracy

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We have had that same problem and we've changed meds several times to try to give him enough to get throuigh homework, but not so much that he can't get to sleep at night. It's hard! We got an enormous amount of help from a child psychiatrist at Kaiser who was able to suggest a number of different meds at different dosages until we found one that works for us. As he's gotten older we have revisited it a couple times. Don't give up!

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Have ADHD meds affected your child's height?

Nov 2011

I was wondering if any of you parents out there had experience/advice about your child being on ADHD meds and their heighth being affected by it. Our son is on the short side (the shortest one in his class and his athletic teams as well) and while he has always been on the short side, we wonder if his meds are going to continue to slow his growth rate. We don't know if its just genetics, the meds or both. We have been told by the doctors that the meds DO affect growth rate *temporarily* but that the child eventually does catch up, that its not a permanent state (ie, they wont always be shorter/behind just because of the meds.) Do any of you with older kids perhaps, have any experience with their growth being temporarily (or permanently??) affected and then they caught up to their peers eventually? Thanks much. Concerned mom

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I had to chuckle at your request. My daughter is on ADHD meds and is 5'8'' and still growing. She wears a women's size 10.5 or 11 shoe. She's been on meds since 5th grade and is in 8th. There is at least one girl in her class who I believe is on similar meds and is of the same height. So, I would hate to see how tall they would be if the meds stunted their growth. I fully understand your concerns as I am still short, and would have hated to take anything that could have potentially stunt my growth, but I have not seen that as an effect. On the other hand, my daughter has next to no appetite at lunch. I've had to reassure many people at her school, family, friends, etc. that she makes up for it at breakfast, after-school ''snack'' and dinner. She eats a healthy mix of food so I feel her good nutrition offsets any issues resulting from many skipped lunches.

Good luck with your son. My daughter says that starting meds was ''the best.'' Totally turned around her grades, her behavior, etc. She has thanked me many times, and I'm only sorry I did not follow the suggestions to do it earlier. Mom of Tall Girl

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Many parents worry about this. Steve Hinshaw,PhD,Chairman of the Psych. Department at UC Berkeley was one of the leading researchers in the NIMH Study of ADHD. This 5 year study with thousands of kids found that there was only a slight difference between children taking stimulants and those who didn't. The difference was calculated as 1 inch. Personally I feel that is a small cost for the great improvement found with proper treatment. It is important to assure that your child has proper intake of calories to maintain weight. This is especially true with entrance to puberty. There is a necessary balance. Modification of dosage or switching to another stimulant may help. Robert

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Dear Concerned Mom, I can appreciate your concerns for your son and I hope our experience will help put your mind at ease. My son, who is now 15, has been taking ADHD medication since he was 7 years old. He is now the tallest one in the family, at over 6 feet. He is on the slim side, as the medication did suppress his appetite, but it definitely did not slow down his growth in terms of height. And now that he has entered adolescence, the medication is still working for him in terms of allowing him to concentrate when he needs to, but it doesn't seem to be affecting his appetite as much as it used to when he was younger. He eats all the time, as most teenage boys do! I hope this helps. A fellow mom

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For what it's worth - a close friend of mine whose son was on ADD meds for a while had your same concern, and her child did appear to be on the short side. He has since had a big growth spurt, however, and is now very tall (though pretty thin). The meds did help him a lot.

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My 12 year old has been taking ADD meds for 4 years. He is now and has always been off-the-charts tall and generally runs a head taller that other kids his age. Right now he is approaching 5'10. So, I have not observed any stunted growth although I sure do hear a lot about it from people who disapprove of ADD meds!

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8 year old with ADHD: Meds stop working?

Oct 2011

Has anyone had experience with this? Our 8-year-old, diagnosed last year with moderate ADHD, had an amazing response to Vyvance (one of the stimulants) -- big increase in ability to focus and follow directions in school, major decrease in agitation at home. But after about 2 months we noticed at home and teachers independently noticed at school that her response significantly decreased. Although she didn't go back to her pre-medication state, her focus and behaviors are only a small amount improved now. (There weren't any other life changes or environmental reasons we could identify.) We've been consulting with a doctor about adjusting dose and type of medication and other factors. But we are just wondering if anyone had an experience with a change in efficacy of these stimulant meds and what worked for you. Thanks.

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My daughter has been on ADHD medication for about 4 years. We've had to change or adjust dosages -- and even change medications -- several times over those years. I wouldn't be overly concerned. After trying a couple that didn't work well, she was on the Daytrana patch for a few years - it worked great but we changed dosages as she grew. She is now on Vyvanse, and we had to play with the dosage for a few weeks to get it right. The start of the school year, any changes in her height and weight, a lot of things could affect the effect of the medication. It is hard at your daughter's age, but you will need to check in with her on how well she perceives the effect on her symptoms.

It is worth sticking with it. My daughter has thanked me multiple times for having her start taking medication. She is at the age where she realizes how much it helps her scholastically, socially, etc. Anon.

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In a word: Yes. Meds need adjustment. Kids grow, things change. Our child's meds were changed (new medication) and dosages changed. As they get older the child (young adult) tunes in to their response to their meds and they eventually work directly with their doctor to get the best drug and dosage. mom of a college kid with ADHD

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We've changed meds several times and also increased doses as my son has grown and as puberty kicked in. Be aware that there is a tendency with some docs to be overly cautious on the initial dosage and not give a kid the dosage that he/she really needs. This could explain why the teachers noticed an amazing difference when she first went on the meds - it was enough of a dose that teachers noticed a dramatic change when she first went on the meds, but not enough to get your daughter where she needs to be. Talk to your doctor. Meds adjustment is the status quo for us parents of ADD kids!

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6 year old was recently diagnosed with ADHD - therapy, meds?

Aug 2011

Hello there. I have a 6 YO son who has sensory processing disorder, and was also recently diagnosed with ADHD (combined type). I'm looking for thoughts/experience in two areas:

1) We are looking for a good psychiatrist or pediatric behavioral therapist to help us with a plan to help our son. Brad Berman is someone we'd LOVE to see (and I see recommended here quite often), bur unfortunately, he's not available until MARCH! So, I've made an appointment, but need help before that. I'm overwhelmed by the long list of doctors to choose from, and wondering if any of you have experience with (or heard of) the following Blue Shield of CA-contracted doctors: Diller, Akindele, Zuberi, Simon, Levine, Towery, Kokade, Isenstadt, Massie, Fink, White, Hartog, Michel, Pollatsek. Any feedback you can provide would be greatly appreciated.

2) Also, dare I ask the question: to medicate or not medicate? I'm not looking to stir up controversy or get super strong opinions... I respect both sides and just want to hear different thoughts - and would especially want to hear from other parents in our situation with a really young child. Part of me feels he's too young to start meds, but the other part of me just wants to make it a little easier for him as he starts school (he is very aware of his issues staying on task, focusing, sitting still, etc.). And if you were in our situation with a young child diagnosis, what did you do, are you glad you did it, and what would you have done differently? I should also say that there are other things we're going to look at to create a full treatment plan for him/us.

Thank you in advance for any help/guidance! anon

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Hi, We used Dr. Lane Tanner with Children's Hospital Oakland and he was awesome, although I don't think he was on your list. Same deal with the long wait. In terms of medicating - we didn't medicate for years because we were already using lots of asthma meds. But after many years of fighting over homework and school being a let down for our son, we started using adderal. The very first day (he was older than your son, maybe 11 or so) he said ''wow - everything made sense.'' So in retrospect I do wish we'd medicated earlier. Although we do have to really watch the appetite and we don't medicate on weekends or holidays unless he has a big soccer game or something. We were told we could probably stop medicating at around 14 or 15, and I can see that being the case. He just turned 14 and he is much more capable of monitoring his attention. Good luck! another mom with an ADHD kid

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If you are considering meds, I highly recommend reading the recent articles in the New York Times Review of books (June 23 and July 14). I debated whether or not to use meds for both of my children, now in their early teens. The argument ''for'' was that meds would work quickly and help them focus more in school. I decided to take the slower approach, which was a combination of neurofeedback and academic coaching. Academic coaching gives kids specific strategies for focusing in class, doing homework, etc, and a good coach understands strategies that are age appropriate. Neurofeedback is a way of training the brain (giving feedback) to do what it takes to be more focused. Research shows that results are long lasting, while with meds the benefits stop as soon as you stop the meds. For us, the results have been a complete turnaround in school performance. Several friends of mine tried meds for their kids diagnosed with ADD and ADHD, and report that it ''seems to help a bit'' - weak praise in my book. Another friend tried them for her child, and is already on a second set of meds to manage the side effects. I'm really happy about the path I took. Good luck

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Medication Question Response: My son was diagnosed with ADHD (inattentive type) as well as sensory issues and many OT issues at an early age (3 1/2). I was adamant that my child would not be medicated and so we tried *everything* (as well we should), and some things did help him. He was fortunate to have great teachers that were willing to constantly redirect him when his attention wandered, and I spent nearly all evening redirecting him so that he could get his homework done. Finally in 4th grade I was willing to consider medication since there had been no real improvement and the increase in workload/expectations was becoming very challenging for him. His teacher at the time was very supportive, and a comment she made about the reversibility of this decision is what finally convinced me to give it a try. Her point was that we could stop medication at any time (if the side effects were unmanageable, if the desired results weren't achieved, etc.), and no harm would have been done. Well, in his case the results were immediate, positive, and the best thing I could have done for my son. His new found ability to focus and work independently were an immediate source of pride for him. It is 4 years later and he still takes medication, and it is a very conscious choice on his part. He is very aware that his ability to focus is greatly compromised without it (as evidenced by weekend days when he has forgotten to take it and then had homework to do--it takes us right back in time). My only regret (with the benefit of 20-20 hindsight) is waiting so long to give it a try. Just Our Experience

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I was diagnosed with what is now considered ADHD very young, but that was in the early 70's when it was still being referred to as mild brain damage and hyperactivity. First, how lucky your child is to have parents and a medical community who will support and understand, it will make all the difference! I started with Ritalin at 7 yrs old, but it made me so spaced out and mellow that the teachers decided they would rather do things like give me structure, routine, and no sugar. 33 years later, those still seem to be the most effective things for me, along with a cup of coffee! The drugs are so much better now, available in lower doses and time released doses, and a variety of combinations to experiment with. I have taken them all over the years to some advantage, and you should be prepared to be patient and know that experimenting for the right drug and dose is a long journey, but can be very worthwhile. I would say that as a kid, the social problems of being not very self-aware caused more grief than the focus issues of not getting work done. Just so you know, I have a masters degree and am highly regarded in my field, and have a great husband and child, while always managing ADHD. ADHD also has it's benefits, as a totally different neural thinking path allows for really creative problem solving. ''attention deficit'' is such a misnomer; it should be called ''attention abundance'', with everything being so interesting and stealing our focus! I wish my parents and teachers had given me insight as to the benefits and treated it as just a different way rather than a curse. Good Luck!!!! anon

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Just thought I'd chime in on this one. I, too, ''fought'' the concept of medicating. At the end of 4th grade, on the recommendation of several people ranging from my daughter's therapist, physician, friend who is psychologist, etc. I finally started meds over the summer. The next school year was amazing. While she still has ''executive function'' issues, her homework was getting done in record time, I had zero disciplinary notices sent home from the school (except one for not wearing the correct uniform socks - lol), she made more friends (because she was no longer engaging in ''annoying'' behavior), and her grades went up such that she was on honor roll (this was an academically strenuous school in another state). My daughter thanked me for having her take the medications. She is about to turn 14 and is still on them, although we recently switched meds following a huge growth spurt.

As several people pointed out to me, if she had another disease (such as Type 1 diabetes) would I hesitate to give her the medication she needed? Keep in mind, it may take a few months to figure out what ''works'' for your child. Some of the ''extended'' meds don't work that way on all kids. (My daughter ''crashed'' after lunch on one that was supposedly all-day ''extended release''.) Also, some of them gave her an upset stomach, others not. But it is worth it in the long run, for your child, on so many levels: educational, social, etc. Wish I'd done it sooner

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How did you decide to try ADD meds (7 and 8 year olds)?

Nov 2005

Both of my kids, now 7 and 8 (20 months apart) have been little handfuls since birth- very active, very verbal, very intense, very creative and very bright. In fact, they were great babies, and we gave ourselves all the credit for raising them ''right''. Both of us parents were similar as kids and it was not thought to be more than a strong personality. We used to joke about ADD, but imposed as much structure as possible and learned to enjoy the chaos...then they started school. Both have problems there, primarily impulsiveness and emotional reactivity. One is gifted based on testing and off-the-charts active, the other distracted, dramatic and dreamy. After one too many discussions with schools, we started family therapy directed at behavioral modification (1-2-3 Magic, etc.) and have instituted every nonpharmacologic approach to ADD on the books. I am a researcher, but I have even done things that have no proven benefits based on research, such as limiting sugar.

Nothing is working for school and whenever we go out to public events (BD parties, etc get them overexcited) although their behavior is markedly better at home. I have tried to think of their ADD as a personality type that can be adaptive in many ways. I work with alot of successful adults who were hyper kids. I cannot seem them as ''diseased'' or having a brain disorder.

But we now are beginning to understand why people medicate their children like ours- the reaction of teachers and other kids and their parents to them causes us and the kids alot of anguish. People are quick to assign blame. It's assumed we do not discipline our kids (and yes, we don't hit them but there are very clear consequences when they misbehave, but impulsive kids still lose control of themselves at times) or spend enough time with them (both parents work), etc. I am tired of yelling at them and dampening their exhuberence, which I have been advised I must do to get them to be able to behave at school and in public. They never were allowed to run around screaming, but you have to shout to keep them in line and impose consequences daily. I am NOT setting expectations too high- as if!- I'm sure half the parents we come in contact with assume I'm too lax. But they also think it's unseemly that when one of the kids get revved up, I have to speak firmly to them in public.

They have friends because they are creative and funny, but if a kid wants to be mean, they choose one of mine. When my kids get upset, they often cry or ''take a swing'' back- very rewarding to tease with low risk of retribution. They both do well in school, but are felt to be underperforming by teachers- one's messy handwriting is said to be a sign of insufficient pride in work product, the gifted one can't sit still for reading aloud. It's one month into the school year and I have been to 2 ''conferences'' about my problem children. I am in tears and stressed out daily- trying to hold the line on their behavior and bear up under criticism, snide remarks and ''advice''.

Here's the dilemma- do we give them medication? We promised ourselves we'd give the other path a full year to work and if anything, things are worse as one year later. I just can't yell anymore at kids who really are trying their best. I know they will gain self-esteem if their schoolwork begins to show their potential (I myself am less concerned about ''grades'' at this age but they both are very invested in school despite daily negativity there). Our medical advice is that it's time to give it a try. One kids is getting too dispirited from all the criticism and the bouncier one is starting to lose his temper from the same. I know I will likely be judged negatively for medicating the kids too, but I am concerned that they used to be hyper and happy, and now they are hyper and anxious.

I am asking for support in general from parents of kids like mine. If you gave your kids medication, what tipped you over into that decision? Did the ''shame and blame'' from outside the family play a role? Did it just wear you down to deal with their behaviors constantly? Did the meds make them into zombies? Some days, I really just want a quick fix, but my real concern is their happiness and future well-being- and it's starting to seem one or both might be happier on meds. not quite super-mom

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There are two things that made me feel better about trying medication on my child: 1. There is nothing irreversible about the decision. If you do not like it you can stop ANY TIME! This is not surgery or switching schools or even making a big financial purchase. This is trying a cheap drug with an extremely short half life that will be out of my child's body in a few hours. It is called a drug trial because you are trying it to see if it works. 2. If my child needed glasses or insulin or other medical care I would provide them. Why is the cultural assumption that drugs are so bad?

Use your skills as a researcher and do a lit. search--look at what works, look at what people do in other countries, look at the risks and side effects of ritalin.

Honestly from your letter I couldn't figure out a reason why you wouln't want to try medication. Because people are going to judge you?

Keep in mind if your kids are zombies from the meds. then it isn't that they shouldn't be on them, it may be that they're taking too much.

Get a good doctor who knows about this and then go for it. What do you have to lose?

Also, your kids sound almost old enough and together enough to have an opinion about it themselves. Ask them whether they like it. Sometimes kids like it and feel so much better on medication and ask for their medicine when it is stopped. extremely thankful my child is on medication

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You are most certainly not alone! Every parent of a kid with ADHD goes though all this same agonizing. This is such a huge and difficult issue. And other parents can be quite judgemental about your kids, their behavior and if you choose to go with medication, about all that too. It's hard. Give yourself a lot of credit for understanding your kids are trying their hardest already.

If you have not yet seen this site, visit: http://millermom.proboards23.com/

It is a huge source of support on all these issues and includes a large section on complementary & alternative treatments, which work well fro some kids. There is also a large section on conventional medication.

We did a trial of medication when our daughter was your kids' age and the side effects were just too tough to deal with, due to her metabolism, I guess. A few years later we tried again, and it has been really, really good. The side effects have been tolerable, and most importantly, she feels like it is really helpful. It helps her with attention and also with impulsivity in her social interactions. I'm fairly certain that without the meds, her life would be much more stressful and home life would be much more bitter. She's not zombie-ish at all. It seems the key is a willingness to work through the trial-and-error period to find the right medication and dosage-- and that can be trying.

Best of luck on this journey, Sympathetic Parent

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You may wish to read Mary Ann Block's book on what you can do for your children through non-pharmaceutical means. Also, know that many modalities have been able to help gifted children (read THE EDISON GENE by Thom Hartmann) which may include: HANDLE (www.handle.org), sensory assessment and integration (http:// www.toolsforlearning.com/), Jin Shin Jyutsu (www.jinshinjyutsu.com), and neurotransmitter assessment with targeted amino acid therapy (www.neuroscience.com). Since ADD drugs work on neurotransmitters (such as serotonin, norepinephrine, and/or dopamine) amino acids (building blocks for all proteins in our bodies) can address the underlying imbalances, after first measuring what the body is making (via urine). You might call the company to locate a practitioner using this methodology. Nori

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Hi there, I am a former special Education teacher and am now the Assistant Director of a learning center (www.learningrx.com) in Pleasanton. Have you read ''Driven to Distraction'' by Ned Hallowell? I just heard him speak and he is an adult with ADHD and a very different perspective on things. Try reading his book (s). i was very impressed. Also, you may want to look into cognitive training, such as at LearningRx, or other treatments that involve brain science. Keep your great attitude! Cynthia

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You seem to be very thoughtful, ''on top of it'' parents who have done all of the right things to deal with your childrens' difficult behaviors but obviously the treatments and strategies you have tried have not been optimally effective. I would DEFINITELY give medication a try. I don't have children with ADHD children myself, but I am a child psychologist who knows the ADHD treatment literature very well. In the majority of cases children with ADHD respond positively to medication and their lives (as well as the lives of those around them) improve, sometimes dramatically. Of course there can be side effects and the effects of long-term medication use are not well understood. However, if I had a child with ADHD I would definitely give medication a try. If your kids are prescribed a stimulant medication (which is most likely), you will know very quickly whether the meds are having a positive effect. If they aren't or if you are concerned about side effects you can simply stop the meds. It is worth a try. Liz O.

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I have a child who somewhat fits the same description as yours. We held off on medication for 10 years, determined to work with our child. We tried EVERYTHING. The differences in raising a child who has ''issues'' really became apparent to us when we had other children and began realizing that ''normal'' children do not behave/react the way our oldest child does. This may seem obvious but if you don't have anything to compare it to it is not. We finally relented with the medication for many reasons, all of which you touched on in your email. Primarily though was finally getting to a point where I felt my child was enduring failure after failure no matter how hard he tried and that it was starting to shape his character and who he believed he was. As a parent I also had had enough of being judged and my child being judged. Because we had other children who were absolutely delightful we had a bit more faith that there was nothing wrong with our parenting but rather a roll of the genetic dice. But anyone who thinks that having a difficult child doesn't wreck havoc on your family, personal life, marriage, self-esteem etc. is fooling themselves. Likewise, I've come to the conclusion that to plod along in the hopes that things will improve for your child is naive at best and can be extremely damaging to the child who is experiencing all the frustration that impulsiveness and other strong behavior creates.

Medication is not a miracle although we saw a difference in our child within the first few weeks of starting. What it has done for our child is help him focus and control his behavior just enough that he can engage and learn in his school environment and start experiencing some of the success that is rightfully due to him because he is smart and bright and can be a pleasant guy. We use the lowest dosage that we are comfortable with and that appears to make a difference. We use his more balanced personality as teaching opportunities to empower him to take responsibility for himself. Now, I'm convinced we did the right thing and could kick myself that we waited 10 years before getting help for our child. Because he has had some real success, I hope that as he grows older and his maturity and physiological system catches up OR he learns about better behavior and can more control his actions he may be able to eventually be med free. But I would also support him staying on the med as long as he benefitted from it. We'll just have to see what the future holds. Happy to have a happy kid

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You sound like a great mom! It's very difficult, I know, and I give you a lot of credit for trying so hard and thinking this through so thoroughly. My son, who is now 11 and in 6th grade, was diagnosed with ADD at the beginning of 5th grade. Trust me, I was very opposed to the idea of meds, but I was also really tired from years of dealing with various behaviors that you described very well. More importantly, I was concerned about his growing frustration and discouragement as he got older and more self-aware and as the expectations at school increased. The thing that helped me most was that I have a tremendous amount of trust in his doctor, Brad Berman. I trusted the diagnosis, because it was certainly not something that Brad rushed into. Nevertheless, I felt very sad about it because I felt terrible that my son was going to have to deal with all this (meaning the ADD label, taking meds, etc). When Brad pointed out that my son was already dealing with it (meaning ADD itself), I realized that perhaps my resistance to meds was not helping my son. I was also terrified that my kid would be dramatically different and somehow not-himself if he took medication.

I wanted to write to tell you that trying meds was the best thing we could have done. My kid is still his same wonderful smart weird energetic (and occasionally very trying) self, but it is just much easier for him to focus and control his impulsivity. He handled what could have been a very difficult transition to middle school this fall beautifully. He likes school and is doing very well there, both academically and in terms of behavior. He would tell you himself that it helps him to take the medication. One initial issue was getting the right drug. He started on Concerta, which kept him up all night, but after switching to Ritalin, that was much better. The other, ongoing, issue is that he doesn't have much appetite in the middle of the day - we've had to be pretty vigilant about making sure he eats.

I would encourage you to get a second medical opinion if that would help, and then just to give it a trial of a month or two. You can always take them off medication if you feel the harm outweighs the benefits. I still cannot necessarily say I'm thrilled at the idea of medication, and I just have to tune out those who want to be judgmental about it, but our experience has been very positive. Good luck with your choice. Been there, doing that

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This is a very hard issue -- I know just what you are going through because we have faced this situation and are still grappling with it. Our son is now 12 and still struggling with ADHD/ADD symptoms, as well as some other symptoms that unfortunately also have left him without friends. We started trying medications because of very intense pressure from his school. We resisted for a very long time and also tried many different kinds of alternative therapies, none of which had much impact. We finally gave in because of the pressure as well as our feeling that we needed to do something to allow him to have as much of a ''normal'' childhood as possible -- which he clearly was not having. So we tried many different kinds of medicines, most of which had very little impact and some of which had horrendous side effects. About a year ago, we started him on Adderal time-release, which has had some impact. He still has problems when he gets frustrated and anxious, but in general has a much easier time focusing in school and maintaining a least a little more even temperment in school. However, night-time, when the medication wears off, is more difficult at home.

It is all a very painful process -- for both your children and for you. It never ceases to amaze me how other people make such negative assumptions about your parenting skills when your children ''act out.'' In our case, we had to battle not only other parents, but the school, where the principal was very unsupportive and, despite a public pronouncement of ''community,'' took a hands-off approach to creating a community for our son. We, like you, have clear rules and clear consequences and discipline at home, but suffer others' assumptions and implicit criticism when our child acts in a way that is contrary to their expectations.

Good luck in your decision. anonymous

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I don't have advice, mostly because I'm right about the same place you are. But I sure do sympathize. I have a bright, extremely active, emotional, and impulsive 6-year old first grade daughter. During her troubled K year we sent her to a psychologist for play therapy and it seemed to help somewhat with the outbursts and periodic non-cooperation at school. This year started poorly and we are now getting a behavioral pediatrician to evaluate her. Maybe you've done something like that? It's a dozen sessions total with the doc plus he does numerous phone interviews with the people she interacts with. We will see what's on the other side of that, and although I will exhaust all avenues before medication, the downside of her behavior is so damaging to her sense of self I cannot let it go on indefinitely. Our options are 1)find a less structured school, or move to the outback and homeschool 2) commit to long term therapy to see if the psychological support helps 3) meds. Obviously keeping a solid routine at home -- guarding their sleep and eating habits -- helps quite a bit, but it sounds like you have that covered. My kid does no extra-curricular stuff outside of school since she's exhausted and fragile at the end of the day, and much more apt to lose control. Are your kids at public or private school? And did you find the Magic 1-2-3 program helpful at all? I'm not familiar with it. signed, sarah, a sympathetic mom

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I wish I could give you a hug! I too have been down the road of the judgement of others youre too permissive, but you shouldnt yell, your child is too loud, too active, calls out the answers, reacts bigger to teasing and such.

Do you know that your kids have ADD/ADHD? Have they been diagnosed? If they havent, you need to do that. If they have you need a really supportive doctor. I use Brad Berman who is WONDERFUL. He really likes my kid! He really cares. Hes told my son to call him anytime. They have one-to-one talks. Brad tells my son how terrific he is and is frank about the issues hes dealing with. My son too is gifted, cares about school, has friends. But the ability to control himself is not all there yet. We decided to put him on meds when he expressed his concern about how things were at school. He is very clear that having meds helps him focus on school and on his homework. It has helped with his cooperation as well. He was already a very self aware person not that he sat down and talked a lot about it, but at times he certainly does. It has made life much easier for everyone and school is much better. We also decided in middle school to put him in a private school with whole-child approach - that is they care about his mental and emotional state as well as his academic performance.

By the way, I got the recommendation for Dr. Berman a few years ago from this list. His office is in Walnut Creek and his phone number is 925-279-3480. There was a waiting list for new patients when we signed up. But I left a very frank message about how hard things were and they got me in earlier.

Good luck! Don't be afraid of meds.
a mom who has been there

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Phew! You have your hands full. A household full of ADHD is an exciting and demanding place to be a parent. I have three perspectives to offer you. I got a diagnosis of ADD Inattentive for my 7th grade daughter many years ago and followed the suggestion of the doctor to give ritalin. I was really shocked when she commented, ''Now I can follow the conversation at the dinner table mom!'' She was not really the shy, uninterested in people, more interested in TV kid that I thought I knew. She had a great, dry sense of humor and enjoyed eighth grade more than she had ever enjoyed school because she discovered that her ''exposed'' personality made her POPULAR. The key to getting this is to see that she was always there, but her distractibility (among other things I won't get into here) made it so hard for her to keep up with the action that she just gave up. She later went off meds in high school, the sense of humor and popularity stayed, the things she had learned while available on meds continued to help her stay organized and recognize when her ADD was getting in the way. The story is longer, and not everything is so lovely, so in other words, she is really a normal kid. That's my personal, indirect, experience.

I am also a volunteer facilitator for an adult support group and a certified parent trainer for CHADD. I hear a lot there from people who have experienced AD/HD from both sides, medicated and non-medicated. chadd.org has a national clearinghouse and it is a place to get information about medication and support groups for parents. Schwab Foundation has a parent message board.

In my private educational therapy practice I see people who have had both good and poor results with medication. It's not for everyone and it's a very personal choice. Medication works best with education - of kids, teachers, parents, family, friends.

The practical considerations you mention are the reality of life with ADHD in this time and place. It's not easy, but it doesn't have to be awful! Good luck to you. linda lawton

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Two words about your situation: Brad Berman. He is fabulous, thoughtful, and knows his stuff. Other postings have mentioned him as well. Our child is 100% better all the way around after starting on meds. Why have your child(ren) struggle and fail academically and socially if they can't help themselves because their brain chemistry is off? If your kid was diabetic and needed meds, you'd use them. It's the same deal with ADHD. If your child doesn't improve with meds, you can always stop them with no adverse affects. And forgive people who judge you and your children: they are clueless, thoughtless, and obviously need all the help they can get in order to be kinder and gentler in the world. It can get better

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Another perspective on meds for ADHD: I'm always wary of comparisons of ADHD with medical conditions such as Diabetes (as in advice like ''If your child had diabetes you wouldn't withhold insulin, would you?''), which are illnesses that involve the body failing to produce a needed chemical/hormone/whatever that it naturally produces--like insulin, or thyroid hormone for people with thyroid conditions or even seratonin for depressed people. Ritalin and many ADHD medications do not replace missing chemicals in the body--they introduce new ones, often stimulants, and the long-term results of medicating children like this are still being studied. The jury is by no means in, as far as I understand it, on those effects. For instance, I gather it is now proven that prolonged use of ADHD medication can permanently stunt a child's growth. Also, anecdotally, I know more than one child who has tried the spectrum of medications offered for ADHD and who may be doing better with attention, but whose appetite has not returned despite prolonged use and the promise that it will, and whose sleep patterns seem to be permanently disruptive. By no means do I think that medication should NEVER be tried, but I DO think that the argument that medication is THE answer to ADHD needs to be greeted with some sceptcism, especially when advocated by an organization (CHADD) that, while appearing to have sprung up from a grass-roots parent support group, is actually deeply funded by Ciba Geigy, the very drug company that makes Ritalin. (see this PBS report for more detail: http://www.pbs.org/merrow/tv/add/chadd.html). I say, don't rule out medication, but try everything short of it first! Susan

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Alternatives to Ritalin for 8-year-old

Sept 2004

I am trying to help a family member cope with her wonderful yet ''souped up'' 8 year old daughter, who is taking Ridalin to help her focus in school. She does not have the classic symptoms of ADHD, and the psychiatrist wonders if she could be manic. She took Ridalin for four months, and her reading improved 3 grade levels. Impressive, but she hates taking it (she cries every morning) and has no appetite. She literally did not gain one pound last year. While the drug does help her focus, her personality seems to be pulled back to the point where she doesn't quite have her usual spark. (In fact, she asked her class whether they liked her better with or without medication. The kids voted for without, while the teachers clearly saw better learning outcomes since she could concentrate.) Are there better alternatives? Someone mentioned the drug Straterra... Are there effective alternatives to drugs? I believe in a holistic approach but do not want to send the parents through a path of snake oils. I welcome your advice, which I will pass on. THANK YOU! Help Needed

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I have seen great results in treating issues like these (bipolar disorder, ADHD, ADD, etc.) with nutrient therapy. See www.hriptc.org for an approach. This clinic, although located in the midwest, does outreach clinics around the country and will be in the Bay Area next month. Feel free to contact me for more details. Robin

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I was diagnosed with adult ADHD and began taking Straterra about 8 months ago...it has been an incredible help to me. The advantage over Ritalin is that it is not a stimulant, and therefore not a controlled substance. The disadvantage is that it is patent-protected and therefore much more expensive. For me! the cost is very worth it. A holistic approach would include therapy but I don't have the time or patience. :-) Michael

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Hi There is a great organization called Feingold (http://www.feingold.org/home.html) that every parent should know about. My son was displaying behaviour problems often associated with ADD. He also had problems concentrating and sitting still at school. On the other hand, he was able to sit still for a very long time at certain times. The Feingold organization has done ''numerous studies that show that certain synthetic food additives can have serious learning, behavior, and/or health effects for sensitive people.'' My son has become a different person with the help of this organization. It is well worth the effort. happy without medicine

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Spending time in a leafy environment can reduce ADHD symptoms. http://cms.psychologytoday.com/articles/index.php?term=pto- 20040406-000015 Do you really have a proper diagnosis? Is it really ADHD? http://adhdparentssupportgroup.homestead.com/50conditionsmimicing ADHD.html Neurotoxins could be the problem: http://www.childenvironment.org/factsheets/neurotoxins.htm sunsol

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If you are dealing with ADHD the best first treatment is with either a stimulant med or a non-stimulant med (Strattera). Improving diet and lifestyle are definitely helpful, too. (I liked the comment you got from Michael about not being patient enough for therapy -- ADHD humor, ha ha). If you are dealing with something ''like'' ADHD then Feingold or a nutritional approach may be all you need. A child who is sensitive to additives could appear to be ADHD, and benefit from intervention -- but whether that child has ADHD is a different question.

ADHD is not a nutritional failing or a character flaw, its a genetic neurochemical disorder for which there is a known successful treatment. If you trust your diagnosis and the doctor who recommends Ritalin, try it If you aren't sure -- find another doctor and get a second opinion. Just because Ritalin is over-prescribed in general doesn't mean your child's life can't be transformed by appropriate diagnosis and treatment. Heather

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Do you tell friends & family your child is on meds?

Dec 2003

My child was recently diagnosed with ADHD and is now on medication (whoopee, it is really helping!) 1st question: do others of you tell family and friends your child is on a stimulant? Do you get unsolicited anti- med advice? How do you handle it?

2nd question: I have been diagnosed with ADHD too (no surprise) and have been prescribed a med. The psychiatrist I saw charges $15/month to process the triplicate. Is this typical? thanks!!

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It has been my experience that people have some strong feelings about ADHD meds and are not hesitant to communicate their personal biases if you give them an opportunity. I would advise giving yourself time to assess your own response to medication before inviting confusion into your decision. Your child's teacher should know that your child is medicated because that relationship is impacted and the teacher can offer valuable feedback. Teachers are required to maintain the confidentiality of that information. I am a teacher and an ADHD coach, so I have heard a lot about this! Linda Lawton

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My 8-year-old daughter was also diagnosed with ADHD (finally!). She is on Adderall, and is doing immensely better.

Yes, I tell family and friends, and if I got anti-meds flak from them (which I haven't so far), I woudl offer to let them watch my daughter for a week or 2 without meds. People who haven't been in the situation and know nothing about it shouldn't be judgemental!

As far as your psychiatrist charging you to fill out the triplicate forms - mine doesn't, but I don't feel that it is unreasonable - since the meds are a controlled substance, there is probably a certain amount of extra paperwork/processing involved dealing with the triplicate forms and whatever regulations are involved.

feel free to contact me if you want a sympathetic ear! nkf

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In reference to the question about meds for your child, my child is diagnosed with another disorder and has been on meds for almost a year to control his aggression. I do not tell everyone, only select family members that will need to know for his care. There are some people, including family and parents, that have never accepted his disability from the beginning so they definately wouldn't understand the fact that he has to be on meds. I am very careful about who knows and it's not discussed very often. Anonymous

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Though I don't have enough experience to really answer your question, there is a great parent bulletin board/forum with a ton of parents who have dealt with this at www.schwablearning.org. Good luck! Anon.

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Initially I was pretty circumspect about telling people that my child had ADHD and was on meds. Then I decided that I was role modelling that it was something to cover up. So I started treating it like I did my other child having an allergy. Yes, people do sometimes offer unsolicited advice. But if you present the information with a tone of confidence (this is how it is) rather than inquiry (what do you think?) they are much less likely to say anything. If they do, you can say something like, thanks for your concern, we're doing fine. BTW, I realized from the tests that I have mild ADD and have developed coping mechanisms over the years. So you and I can attempt to explain what it ''feels like'' but the truth is they may never understand. anon mom

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The question isn't who to tell, but what to do with unsolicited advice? In this case I think I'd develop a stock and fairly harsh response for most people, along the lines of ''Thank you. I appreciate your insight, but of course you really know nothing about my child or our circumstances''.

Unsolicited advice is one of the more annoying by-products of life in Berkeley. PLEASE don't suffer it in silence...

But, if in fact the advice is from family who know and love you and your child --- I'd request that they withold judgement for six months and see how things are going. ...And, there's always the ''Stimulants for ADHD are like glasses for myopia'' argument. (Its not kind to withold them unless they aren't really needed).

p.s. My doctor charges $10 for writing the prescription. Heather treated. It is also likely that his father ''self medicated'' (ie: drug use) to deal with the challenges this condition brings. The doctor has suggested Ritalin and I have many questions. Will it turn my son into a zombie? What are the long term effects? I would like to hear from parents who have had to make this difficult decision. I would like to know about the good, the bad and the ugly. I want what is best for my son. I want him to have a chance to be successful.I have been doing some reading but I would love to hear from other parents about how you and your child are managing. Thanks. a mom

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There is a great book that I used for the Cody's Parenting book group called ''Smart Moves: Why Learning is Not All in your Head.'' The author, Carla Hannaford, offers a less typical approach for dealing with ADD that you may find helpful. She advocates for something called 'brain gym' which she believes has helped children with all different types of learning difficulties. Good luck! Ilona

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My now 14-year-old daughter had problems with organization and attention starting in 2nd grade. I felt that she might have ADD, but none of her care providers or teachers would acknowledge that ADD existed. I had her evaluated for all sorts of learning problems, put her in counseling, etc. Four years later, when she was ending 6th, I still was reading the same comments on the report card since 2nd grade: ''Talks too much in class, can't finish assignments--too distracted. Trouble paying attention.'' My daughter also felt like her impulsivity was irritating to her friends sometimes. Her self-esteem started really suffering. So I finally found a specialist who instantly agreed she had ADD. She has been on Concerta (timed-release ritalin) for almost 2 years. She is much happier. Her grades have improved significantly (Now As and Bs). I feel our family relationship is much better because there is less stress. Nightly homework used to be a nightmare. The main problem now is that some core academic skills (reading, spelling, vocabulary) were not instilled during elementary school and, now, in middle school, she has some problems in those areas. My suggestion is to try the ritalin and see what you think! It's not a lifetime commitment. You'll know pretty quickly if it works or if it doesn't. Hope this is helpful for you and good luck. PS--don't be surprised if you run into very strong anti-medication opinions. Read the studies in the clinical journals. Ritalin is one of the most tested drugs available. Anonymous

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My son also had trouble with focusing and getting things done and he had some really hellish years in school. No teacher ever suggested that I have him tested, they said he was smart and needed to pay better attention. He told me at age 10 that he wished he had ADD so people wouldn't blame him when he couldn't focus. He was VERY ARTICULATE. I talked to his pediatrician who talked to my son. They decided to have a diagnosis. The doctor found that he has ADD and we started on Concerta (later switched to Metadate because he didn't sleep well with the Concerta) but there were results right away. It was easier for him to complete a task from homework to chores. If you don't see a benefit right away then you can just stop the medication. It has really helped my son's confident. It hasn't changed his personality -- as he says ''I wish it made me want to do homework.'' But now he knows he can do it and he gets a lot of positive feedback in the classroom instead of constant reprimands to sit down, stop talking and not call out the answers. He feels like he's more under his own control. I really angsted about giving my child a drug for his brain but he is so much happier. I do keep reading about it and I subscribe to an e-mail newsletter about the lastest research findings. You can sign up to receive the newsletter at http://www.attention.com. Good luck I know it's a really hard decision and you know your child best. anon

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I've learned a lot about AD/HD lately as I recently made a career change and became a teacher -- a teacher of special needs kids with AD/HD and other Learning Differences. I also found out that I have AD/HD myself!

It is important to know that there are three potential causes for AD/HD in the brain, and that the medication that can work for your son must be targeted to the specific cause. What this means is that your pediatrician needs to try different medications, carefully monitoring the effects, and see which one works the best. Don't get discouraged if Ritalin doesn't seem to do the trick. You may just need to keep trying. Make sure that your doctor is willing to take this approach and doesn't just write you a prescription and not follow up.

Meanwhile, there are many things you can do to help. One of the most important is making sure that your son gets LOTS of vigorous aerobic excercise, every day! This has been clinically shown to have a therapeutic effect for people with AD/HD.

There are lots of other, simple ways that you and your teachers can help him cope. More information is available at a great educational outreach organization in Campbell (San Jose) called Bright Solutions. Their Web site is www.dys-add.com. The head of the company, Susan Barton, conducts workshops on dyslexia and AD/HD on a regular basis, and she puts aside a chair or two for parents, for FREE, at each seminar. Please contact her -- she is a great source of help and inspiration.

Finally, you should be aware that AD/HD, for all it's difficulties, is a gift. It is strongly associated with higher IQs and brilliantly creative minds. Tap into that, and your son will find that he has an incredible asset in his ''different'' ways of thinking. Colleen

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I don't know a lot about Ritalin or ADD, but I listened to an interview on NPR on the subject a week or so ago. A book was recommended which advocates against being too quick to label a child with ADD, when any of a number of attention deficits may be to blame for their behaviors. The author believes that many children are diagnosed with ADD who don't actually have it, and while Ritalin may be helpful in making their behaviors more manageable, it's not the best thing for them, because it's a drug ... for life ... which doesn't actually address their true problem. If you're interested, the name of the book is A Mind at a Time, by Mel Levine (sp?). Susan

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I just noticed postings about ADHD so I thought I would let people know about the free 4 week ADHD series for parents or teachers. On Thursday June 13th at 6:30Pm till 8:30Pm Dr. Mel Burman and I will discuss medication issues. We'll cover the pro's and con's of using medication. The classes are interactive with a focus on answering parents questions. Anyone is welcome to attend...no pre-registration is necessary and no childcare is provided. This will be class #2 . Weeks 3 and 4 will cover parenting and school issues. The classes are at Kaiser Permanente, Richmond Medical Center, 901 Nevin Ave in Richmond (off of Harbor Way) You take elevator ''C'' to the 3rd floor. Rona Renner

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7-y-o with ADD diagnosis: did you try meds?

March 2006

My 7 yr old first grader has been given a definite diagnosis of ADD Inattentive. My son is a highly compassionate, fun loving, creative ''space-cadet'' type, who gets along with all his peers. All the adults he interacts with think he is a delightful child, including his teachers. I would not call him hyperactive, although in a classroom setting he fidgets and seems unable to stay focused on classwork. The only challenges we have encountered with him are in the classroom, where he seems unable to stay on task.

The doctor who evaluated him did not observe any learning disabilities, and seemed very convinced that a 5mg dose of Ritalin would greatly help him during those morning hours in school. His learning would improve and we were not likely to experience any negative side effects. We obviously want the best for our child, and it seems to us that if this is the case, if medication will give our child an immediate benefit, that we should start treatment now.

I should note that the teachers and administrators at my child's school have been very helpful and supportive, and they have already taken (and will continue taking) all kinds of remedial measures to help our child in the classroom. However, there is only so much that they can do, and they have expressed concern that in later grades, when the learning is more challenging, and the workload is greater, our child will become frustrated and his self-esteem is likely to suffer.

My question is to parents who have a child with similar characteristics diagnosed with ADD: Did you try medication? Did it help? What were the negatives? I am especially interested in hearing from parents who decided to wait a couple of years: Do you see the benefits of having waited?

I know there are a lot of horror stories circulating about Ritalin, and I am not interested in hearing about this, unless you have had direct experience with your child. Also, please understand that we are not parents at the end of the rope who are desperate to fix some behavior problems, this is not the case. We have been told that the most effective treatment bar none for our child's problems is medication, and we are wondering if there are any reasons why we should delay it.

Thank you! Anon

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I worked for quite some time with children with ADD and have a husband who was diagnosed with adult ADD - though we now understand he has had it his whole life. From my experience and from speaking with my husband, I think this would depend on how your child views his life. Does he feel ''different'' from other kids? does he feel like he struggles when others are breezing through things? does he want to take the medication? Medication does help, but it always works best with behavioral interventions. There is some really well-written, kid-centerd, literature out there as well as workbooks and games for kids with ADD. Despite medication your son will need to learn coping mechanisms to deal with inattentiveness and other symptoms that are not helped by medication. It might serve your son to see if he succeeds with behavioral interventions first then if he still struggles, try the medication. With supportive parents (sound like you are) your child will succeed! anon

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My child was diagnosed at age 6, but we knew something was up since he was toddler. He is currently 11 and has been retested twice with severe ADHD. To get to the point of medication, there is little risk to give it a try. It goes in and out of their system in the same day. Doctors like to start with ritalin. We did and it didn't work. My son became withdrawn and just wierd. So we tried Adderall and we saw a wonderful difference. We have been using it ever since, upping the dosage as need be. Every child is different and I don't recommend medication for everyone. For us, it is the difference between night and day, sanity and insanity - really!! I encourage you to give it a try and see what happens. Personally, we couldn't and he couldn't survive without it. P.S. We also do therapy and bevhavioral modification. 5 years experience

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My daughter takes Ritalin and didn't know she was ADD (inattentive) until 15. The only reason to wait before trying meds would be some strange desire to witness more dramatic improvement... My daughter actually thought she was stupid, and that everyone who told her differently had missed something. We really didn't know what to think just that things seemed harder for her than they should be. Some ADD kids make it through to high school without treatment, but most suffer a lot, needlessly, on the way.

At your son's age organizational or occupational therapy might be great -- but I would not hesitate to give a 7 year-old the ability to be ''like everyone else,'' and that's what Ritalin has done for us.

I tell people that stimulant meds for ADD are like glasses for myopia... some folks do fine without them...if they're only slightly out-of-focus to begin, and can develop coping skills to deal with their challenges. No questions here!

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Our daughter was diagnosed with ADD inattentive type in fourth grade. Although we were skeptical, we took the psychologist's advice and put her on medication (Adderall extended release) primarily because of the social consequences that were beginning to appear as a result of her tuning out and then popping back into the interaction at the point she left it only to find everyone else had moved on and thus being labeled ''slow'' or ''weird''. The effects of the medication were subtle, but still obvious to us. She is now in high school, still on medication, and doing pretty well academically and fine socially. anon

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We are two years further down the path -- our warm, affectionate, creative and spacey son ''S'' is a nine year old in fourth grade. We decided to put him on Ritalin last month.

Although his teachers have consistently remarked on his attention issues, I resisted having him tested for ADD, in part because I was/am dubious about pathologizing what seems to be a common and benign characteristic -- i.e. dreaminess. Because S was basically mastering all of the skills he needed to until this year, I hoped that he'd learn to pay attention better as he grew up.

Fourth grade was a tough transition. As he is in public school, his class went from 19 students to 27. Assignments, both in class and homework, became more demanding, requiring more sustained effort. For the first time, S became conscious and bothered that he was not performing on some assignments as well as his friends. His self-esteem was plummeting during the first semester, especially as his teacher was big on timed arithmetic tests, which he found excruciating. He broke down on several occasions, telling me that he was going to flunk 4th grade.

So, we had him tested and diagnosed in November. His teacher made a bunch of accommodations, which have helped, but she says that he's shown marked improvements on math and writing since we began the Ritalin in February (confirmed by my own ''blind'' test - a series of math quizzes on and off the meds).

I'm not crazy about my kid being on a stimulant, and I am comfortable that we waited until the attention issue became a self-esteem issue for him. If we could afford to send him to an arts-oriented school with very small classes geared towards dealing w/ kids w/ ADD, I'd probably do it. Reality being what it is, I've accept him being on the meds because his attitude about school has improved dramatically, and he is now keeping up or excelling in each subject. (BTW, he started on 10 mg, which did nothing. He is now taking 15, which works fine.) Another mom of a space cadet

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When my daughter was seven, she also was diagnosed as having ADD. She was unable to concentrate in school. She seemed to be in a fog, while at the same time, hyper. Doctors suggested medication also. I decided to eliminate some simple causes first. I had her tested for foods. Although, the test showed she was not sensitive to any foods, I did remove gluten grains from her diet and she did stop having ear infections. The real turning point came when a friend of mine suggested that I read: ''The Yeast Connection''. I thought yeast was an adult female problem. Come to find out Candida can be passed on to our babies during birth. Well, it took some time before I could get a doctor to do a Candida Albican antigen blood test, but when a test was finally done, my daughter had highter levels of candida than I had. It has to do with antibiotics and all the simple sugars our children get at a very young age. The doctor didn't know exactly how to treat it, but we tried several months of the diet (mentioned in the book) and some Nystatin. What a change!!! The ADD symptoms dissapeared almost immediately. My daughter is much older now and she tells me when she over-does the sweets she gets a yeast infection and feels spacy. It's worth looking into. ADD and Candida connection

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Concerta helps my child. Whether the medication works, how much you need and what type will vary by the child so you just have to TRY it and play around with it. The research is clear that this is an effective treatment for ADHD.

Just remember it is called a drug TRIAL. You TRY the dosage and drug on your child to OBSERVE if it makes a difference. You get your child's teachers to fill out an ADHD questionnaire (like the SNAP) before medication has begun and then at the end of the 1-2 week drug trial so you have an objective measure (although it may be obvious that it helps or does not help). Your son sounds pretty insightful so you can also ask him how it makes him feel. Ritalin is a short acting drug that will leave your child's body FOREVER after about 8 hours. Giving your child a few pills is NOT like deciding to do some type of irreversible surgery. If you do not like the drugs, you will have the power to STOP or try a different dosage/type. If you decide to stay on the medication then every year or so you will see what happens if you stop the drugs and in order to decide if your child still needs them.

I am sorry if I seem impatient, but I have seen this question so many

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Helping child with ADHD, not on medication

Oct 2005

My son has mild ADHD, and has never had medication. He does well at school, except for homework, which often is incomplete. Also, his spelling is very non-standard, so to speak. I wanted to talk with other parents of kids with ADD/ADHD that do not medicate their child (I am not interested in any advise that is pro-medication) and ask how they deal with homework, the intensity of anger with parents and siblings, the distractability, etc. How are you able to help channel your child's strengths in a productive way?

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It is very important to keep in mind that just because your child has ADD, it does not mean he does not have any other problems. I say this with regards to his spelling. Many different things can cause spelling trouble, and many with ADD have no trouble with spelling. I am not saying ADD is not the problem, I am just saying that there may be other problems.

With regards to controlling ADD, and channeling the energy, deciding not to medicate often means deciding to allow your son to live a slightly different life than traditional children live. Students with ADD/ADHD tend to have higher energy, and they therefore require a high energy lifestyle. He will require more activity, more attractions/distractions, more behavior management, especially with regards to conflict and boredom. PaulTheTutor

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I'm sure you'll get lots of advice on this. As a teacher of kids w/ ADD/ADHD I will give you my single best suggestion for homework... predictable routine. I would try to work with your child's teacher and ask him or her to reduce the amount of homework (only for a while) and see if she/he can allow for predictable assignments (i.e. a mathwork sheet each night in math, the same part of a spelling unit every Tuesday, etc.) That way, you child will know exactly what needs to be done. If your child can start getting into the habit of doing a little homework, and realize that it is something he/she can do and complete, a routine will get established. You can gradually add more and include different types of assignments. It will take some communication with the teacher, but it is worth a try. Best of luck. I think you will be able to do it w/o meds. -a teacher

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Have you tried books on food allergies and how diet affects children with ADHD? There are several out there. I have a friend whose son was diagnosed with ADHD, and wasn't convinced his medication was the right thing for him. She spent countless hours researching foods on the internet, and found which foods to avoid -- many contained high levels of sugar and sodium. Her child's behavior changed dramatically as a result of his new diet. Hope this helps. anonymous

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Sometimes people who are trying to avoid or reduce medication try The Listening Center in Walnut Creek. It is very expensive and very time consuming. They do Tomatis based therapy for auditory processing disorders. This may help your child if he also has auditory processing disorders in addition to ADHD. If it is 'just' a question of 'pure' ADHD which is a neurochemical imbalance then I doubt this method would help him. They do an evaluation($375)for auditory processing disorders. A LOT of intensive excercise may also help with the neurochemical imbalance in the same way that regualar cardiovascular excercise has been shown to be as effective as an antidepressant in some studies. My daughter does better sleeping and being calm when she gets LOTS of excercise. good luck