If you are a parent of a school-age child who takes medication for attention deficit disorder (ADD ADHD), you must pay close attention to how the medication is taken and monitored. A team effort involving you, your child’s teachers, school administrators, and your prescribing doctor will help. First, you need to make sure that you and your child’s doctor have determined the right dose. Then take steps to ensure the medication’s continued effectiveness throughout the school year.
Watch the timing
Four-hour tablets of medications should last four hours. However, some last three and some last five hours. Eight-hour tablets or capsules should last eight hours. But for some they work for 10 hours or six hours. The 12-hour form of Ritalin (Concerta) may last 14 hours or 10 hours. You and your child’s teacher need to observe when the medication wears off and base the timing of each dose on your observations. For example, your child might take an eight-hour capsule at 7:30 a.m., expecting it to last at least until 3:30 p.m. But the teacher notes that by 2 p.m. he is restless and off kilter. So the next dose may be needed at 2 p.m. If your child takes Concerta at 7 a.m., but the old behaviors are back by 5 or 6 p.m., he may need further coverage starting at about 5 p.m. This is especially true for high school students, who might be doing homework until 10 p.m. or later.
Assess the need
Your child should be on medication whenever hyperactivity, distractibility, and/or impulsivity interfere with his success in life at school, at home, and in peer/social interactions. If he is on medication during school hours and cannot focus on homework, or is a behavioral problem at home, coverage should expand to include after-school hours. Think about weekends the same way.
Watch for side effects
We don’t want our children not to eat, not to sleep, to live with headaches or stomach aches, develop tics, have negative rebound experiences, or be over-focused and appear “zombie-like.” If you or your child’s teacher notices any of these behaviors, discuss them with the prescribing doctor. The dose, timing, or type of medication might need to be adjusted or changed.
Work with the school
For most children on ADHD medication, a long-acting form is best. They won’t have to leave class and go to the health room at noon to get medication. If such a plan is not possible and a noon dose is needed, your prescribing doctor must fill out a form provided to you by the school. In addition, the pharmacist will have to provide a separate bottle labeled for the school, which specifies the dose and timing. (The label might read: “Adderall, 5 mg tablet. Give one at noon.”) Be sure to provide the doctor’s form and the labeled bottle to the school staff at the start of the year. Have a plan for being alerted when a refill is needed.
Your child’s teacher and the person dispensing the medication need to know about potential side effects, and should inform you if they notice any. Discuss these observations with the prescribing doctor. This feedback is equally important when medication is first begun, to help determine what dose is best and how long each dose lasts.
Finally, have a back-up plan for those school days when you forget to give your child his or her medication. This will be easy to implement if you and the school have an open-communication arrangement in place.
This article comes from the August-September 2004 Issue of ADDitude.
To read this issue of ADDitude in full, ORDER THIS BACK ISSUE!
Subscribe to get every issue of ADDitude delivered.
