Parents often ask me whether their kids really need to take ADHD medicine during the summer. Many hope that a summer break from stimulants will help their children eat more and gain a few inches and pounds.
Actually, there's little evidence that ADHD medicines have permanent impact on ultimate height. Some children who use stimulants may not grow as quickly as their peers, but they often catch up eventually.
Still, when parents feel a medicine break would be beneficial, I usually have them ask themselves honestly: "Will hyperactivity, distractibility or impulsivity interfere with your child's success in summer camp or other vacation activities?" Think of each part of the summer.
- If summer camp is planned: Would ADHD behaviors make it difficult for your child to relate to peers and adults, or to participate successfully in group activities?
- If the plan is for a relaxed summer at home playing with neighborhood friends: Would ADHD behaviors make home life difficult or impact negatively on play activities and peer interactions?
- If you're planning family vacations and long car rides: Would these behaviors make it difficult for your family to survive the trip?
In answering these questions, remember that medication is not prescribed to make parents, teachers, and camp leaders happy. It's used to help your child have positive, successful life experiences. Recurring failure at activities and repeated unsuccessful peer interactions can devastate a child's social confidence and self-esteem. Think about what how it would feel to be told constantly: "stop that," "sit still," "behave yourself," "pay attention," or "keep quiet!" If that's likely to happen to your child without medication, don't discontinue it.
Even if you conclude that a full medication vacation won't work, there still may be circumstances that can allow for short medication breaks. If your child can maintain equilibrium under some conditions and uses short-acting medicines, such as Ritalin, Dexedrine or Adderall, you may be able to target these medications for the most challenging activities or events. If he or she uses a long-acting medication that lasts 24 hours, discuss with your prescribing physician a plan for phasing off.
In fact, be sure to discuss any summer medication changes with your child's doctor. Also discuss with the adults in charge of each summer vacation setting how and when to give your child medicine, and how to monitor for any difficulties or side effects. Take some time to explain what ADHD is, how it affects your child, and how they can best help your child achieve success.
Remember, whether a child or adolescent should continue to take ADHD medication over the summer is not a black and white decision. It should be based on your overall and specific summer plans. Always keep in mind that at the heart of this decision is your child's self-esteem, self-image, and peer acceptance.