The topic of medication for treating ADHD has been in the news again lately. In case you missed it, the New York Times recently published an article titled Ritalin Gone Wrong [Jan. 28, 2012]. The media does a tremendous disservice when they choose to highlight only one side of a complex and controversial issue. Several prominent experts responded with informative, factual information that corrected some of the misleading and incorrect statements the original article contained. While I am grateful that social media now facilitates the swift spread of rebuttals to articles such as Ritalin Gone Wrong, there are still countless individuals who are unaware that what was initially presented was full of erroneous and biased information.
[Note: You can read the rebuttals as well as other related articles on my Facebook page https://www.facebook.com/PTSCoaching]
As a Parent Coach, I work closely with the people most intimately involved in the decision, impact, and fallout of the complex issue of medication – mom and dad. Especially while a child is young, it is the parents who are charged with the ultimate responsibility of how to best help their child. One of the first things parents often tell me when they seek out my support is their stance on ADHD medication. I often hear either “we decided we had to try medication” or “I don’t believe in medication and I will not consider it”. Parents are often passionate and anxious to defend their position. The tremendous burden of this choice and its layers of implications often receive little attention by the media. It is these issues that I want to address here.
The recognition that a child has ADHD is often not an “ah-ha” moment; rather it is a murky journey through a forest of darkness, confusion, missteps, and the unknown. ADHD is a complex disorder that goes way beyond an inability to focus and resist impulsive action. By and large, the parents I work with are caring, loving individuals who have been blindsided with unexpected challenges, without the resources or knowledge to initially process or respond effectively. Knowing where to turn and what to do is often filled with fear and conflict. Who do you trust, whose advice is correct?
Regardless of what some in the general public may believe, the decision to give a child medication is rarely done without tremendous trepidation and hesitation. Parents who choose to explore and use medication for their children deserve respect, understanding, and support as they seek to help their children. To state in the NY Times article that “Drugs get everyone – politicians, scientist, teachers and parents – off the hook” is inflammatory and baseless.
I will leave the medical facts to those who have done the direct research and meet the qualifications to dispense and monitor medication, but medications for treating ADHD have been in use since the 1930’s and there is significant proof to support their safety when properly used. So how does a parent, faced with new information that their child has ADHD, decide whether or not to try medication? As I sit with parents, I recommend the following:
- Make sure you have gone beyond hunch and assumption and gotten an accurate diagnosis by someone truly qualified to diagnose ADHD (for an excellent article on this matter, see Who Can Diagnose ADHD?) There may be other explanations for poor performance and /or challenging behavior that an ADHD expert can uncover.
- Consider who will dispense and monitor the medication. There are many different ADHD medications available now, and a wide range of ways to put together a medication plan for your child involving the type of medication, dosage, duration, timing of coverage and consideration of co-existing conditions. You will want to work with someone who takes the time to understand your child and their unique needs.
- Some ADHD medications have side effects such as suppressing appetite and/ or making falling asleep more difficult (though each child is impacted differently). Give careful consideration to how you will help your child manage these situations.
- Depending on your child’s age and awareness of their challenges, consider what you will tell your child about the medication. This is a complex issue in itself with many considerations. (What will others think of me? Can’t I just be trying harder? Am I cheating when I do better as a result? What’s wrong with me? …) It is vital to uncover stereotypes, myths, and misinformation that your child may have heard. It is also vital that you help your child communicate how they are feeling both on and off the medication. This is important information for both you and the doctor prescribing the medication.
- Will your child want to share this information with others and if so who? What are the costs and benefits in doing so?
- Will your child’s awareness of the potential side effects magnify their impact or help your child manage their impact better?
- Consider how you want to involve the school. Their feedback may be important since much of the time the medication is in effect is during school hours. You will want to be very clear about respecting your child’s privacy and insuring that the school does so as well. Many teachers are unaware of the complexities of ADHD and the role medication can play. Teachers are individuals and have their own views and opinions. It’s vital to make sure that their own bias does not cloud their collaboration with you and your child. When appropriate, you may want to offer insights, education and support about ADHD, how it impacts your child, and the role that medication is intended to play.
- Consider how you will want to handle weekends and vacations. There are positives and negatives to holding back medication that will need to be fully explored and planned for.
I have sat with parents during school meetings as they listened to the painful stories of how their children try, unsuccessfully, to do the “right thing” in class and conform to classroom rules and expectations. I have held parents hands as they cried, hearing how their children can’t seem perform up to their potential because they can’t attend long enough to learn or produce. But I have also shared the joy as parents report that their child smiled as they proudly showed their improved test scores, once medication has been used. And I have heard first hand the amazement and delight of a child discovering that they can pay attention and understand the lesson as never before. Pills don’t teach skills, however they make learning time more constructive and allow individuals with ADHD to regulate their emotions more effectively.
We know this: Parenting cannot and does not cause ADHD – it is a neurobiological condition. It impacts the entire family system – from simple play dates for siblings, to carefree nights out for parents, to enjoying family gatherings. But mostly, it affects the child who each day has to pick themselves up and face a complex world full of judgment, expectations and challenges they are not always prepared to face. How we parent can greatly impact how children will learn to cope, persevere, and interact with their world – whether they have ADHD or not. Even well-meaning, caring parents don’t always have the natural instinct to respond effectively to the atypical behavior often present in a child with ADHD. These parents must be armed with accurate scientific knowledge about ADHD, more sophisticated, specific parenting techniques than commonly practiced, and a stronger constitution to stand up to both the challenges they face with their child and, unfortunately, the challenges they often face in advocating, defending, and championing for their children.
Medication is a complex issue – but not one to be overlooked as an option. When used properly, medication should be viewed as one of several tools to help a child learn to manage and succeed. Your close and connected relationship with your child is the most important variable in helping them succeed. The greatest gift you can offer your child is yourself, as a safe, educated, welcoming place for them to explore their concerns and questions about medication and ADHD.
Written by Cindy Goldrich, Ed.M., ACAC © 2013 PTS Coaching. All rights reserved. Articles may be reproduced or electronically distributed as long as attribution to PTS Coaching is maintained.