Children with ADHD Need Personalized Care and Treatment
There are many options for managing ADHD, and what works for one child may not work for another.
One of my sons was 4 years old when I was told he could not return to preschool unless I agreed to medicate him. Rather than medicate him, I changed his preschool, and he had no further problems. My son is currently a successful college student, and has never taken medication for his symptoms.
Not all children diagnosed with ADHD (attention-deficit hyperactivity disorder) need medication in order to manage their symptoms, but how do parents decide? As a teacher and as a parent, I understand the struggle and the confusion that parents feel.
ADHD is one of the most common diagnoses given to children, often when they start school because children with ADHD may struggle with academics and social interactions. If your child is experiencing difficulty at school, talk to a school psychologist or counselor for a referral to a specialist or visit with your child’s pediatrician to learn more about assessing your child’s symptoms and to find options for managing symptoms if ADHD is a diagnosis.
When facing the difficult decision of how to treat your child’s symptoms, it is essential to understand that there is no cure. The goal of any treatment is to manage symptoms.
There are two basic types of ADHD. One is primarily characterized by inattention. The other type consists of hyperactivity and impulsivity. A person may have symptoms of only one type, or a combination of both. Most children experience the combined type.
Some of the symptoms teachers notice is that the child has difficulty sustaining attention and doesn’t seem to be listening. Children with ADHD may lack attention to detail, which causes them to make careless mistakes. They are easily distracted, often lose things, and are forgetful. These children will often avoid activities that require sustained mental effort.
Children with hyperactivity and impulsivity suffer from different symptoms. These children fidget and squirm excessively, and they have trouble remaining seated. They may run and climb when it isn’t appropriate. These children find it difficult to engage in quiet play. They frequently appear to be “driven by a motor.” They talk excessively, habitually interrupt, and blurt out answers before questions are even finished. They often have trouble waiting their turns.
It is easy to see how these symptoms can cause academic and social difficulties. Parents want to help their children succeed, but often don’t know how to provide assistance. There are many options available for these children. Prescription medication, cognitive behavioral therapy, and psycho-education are among the most common interventions. With cognitive behavioral therapy, the therapist helps the child set goals and make plans for academic and social situations. Parents are provided with psycho-education to assist them with parenting challenges.
Medications to treat ADHD are usually stimulants. These include Ritalin, Concerta, Adderall, and Straterra. What works for one child may not work for another. Adjustments in medications and dosages are frequently required before achieving the desired results.
Linda Murphy, M.D., a local pediatrician, said that the earliest she would ever consider prescribing medications is at age 4 or 5, and only in extreme circumstances. Typically, Dr. Murphy doesn’t prescribe medication until a child is 10 to 12 years old.
Parents are understandably concerned about side effects and risks of medication, but if medications are taken properly and monitored, side effects should be minimal. Dr. Murphy stated that the side effects she observes with ADHD medications are less then those with antibiotics. However, if your child experiences an increase in heart rate and blood pressure, a lack of appetite, sleep problems, headaches, stomachaches, anxiety and personality changes, you should talk to your child’s doctor.
Contemplating the decision about whether to medicate children with ADHD is difficult for parents. I remember sitting in a meeting with several of my older son’s middle school teachers. They were hoping I would have him medicated. When asked why I wasn’t interested in this option, I replied, “Because he’s making As and Bs.” This son is currently a computer engineer.
Not every child with ADHD symptoms needs medication. However, some truly do benefit. As a third-grade teacher, I’ve witnessed the profound success of medications in certain situations. I recall one student who was failing my class. His desk was cluttered with an enormous amount of incomplete work. He couldn’t focus, and he wasn’t learning. With the addition of medication, this child became a straight-A student! When making this tough decision, parents should consider their child’s ability to be successful with or without the medication.
“If your work in school is not matching your ability because you can’t focus,” Dr. Murphy said, “then it’s worth a try.”