When 11-year-old Jack’s younger cousin Michael came to town to spend a week, he was getting over a respiratory infection but still taking his last antibiotics and decongestants. Jack’s parents were amazed. Not only did Michael know to take his medication, he knew when and how much. Jack, who had been taking daily ADHD medication for five years, still didn’t have a clue about his medicine schedule or proper dosages.
Poor memory and lack of organization are two ADHD symptoms that interfere with ADHD kids taking responsibility for their own medication regimen. Other obstacles are external. Some ADHD medicines can be abused if they end up in the wrong hands. And legally, children are prohibited from self-administering medicine while at school.
Even so, keeping children dependent on their parents for this routine task can delay independence and create friction at home — with some teens even refusing their medicine. And children who don’t feel like an integral part of the “treatment team” can’t provide effective feedback about whether the treatment is working. Therefore, parents must move their children toward this responsibility over a period of years.
The first step is to make sure your child understands what the medication is and why it’s taken. (Never tell your child the medicine is a “vitamin.”) Explaining these matters is like teaching kids about sex: describe a little at first, adding details when the child is ready to understand more.
First explain what ADHD is: For a young child, you might discuss the parts of ADHD they have, such as, “You know how you sometimes have trouble sitting still in class?” or “Sometimes it’s hard to pay attention because everything you see says ‘pay attention to me.’”
Later, introduce descriptive key words: “When your brakes don’t work, you sometimes do and say things you don’t mean,” or “When your filters don’t block out other things in the room, you get distracted.” This language enhances parent-child communication: “Billy, your brakes are not working well today.”
Then use the language to talk about medicine: “This medicine helps the filters work better.” It also enables your child communicate with you and the physician: “Mom, the medicine helps my brakes but the filters still aren’t working at school.”
Discuss particulars as your child matures, such as, “I gave you the medicine this morning at 7:30. When did you feel the brakes begin to work? When did they stop working?” Such discussions provide information on the medicine’s effectiveness and duration, and increase your child’s awareness of its effects.
Give your child the opportunity to use this knowledge: Ask your child to participate in your discussions about the medicine with teachers and doctors. As the child gets older, encourage him or her to discuss medication with teachers at all meetings, which will foster self-advocacy skills.
If you’ve done a good job to this point, it will be easier to explain to your teen why it is important to stay on the medication, and why medications are to be respected and used properly. Begin discussing the difference between a medication (given by a physician to treat a problem) and drugs (something teens may use illegally to experience feelings that are different from their normal ones) in early adolescence.
Once you’re convinced your child fully understands the purpose of the medication, the ramifications of going without it, and the dangers of sharing it with others, you can provide practical tools to help your child become responsible for taking it when not at school.
Since memory is often a problem, many families use special watches such as the Watchminder (or any watch with multiple alarms), multi-compartment pillboxes in which you can divide dosages by the day and hour, and pillboxes with built-in alarms. If possible, use medications that require dosing only once a day, or that can be integrated into daily rituals such as waking, mealtimes and bedtimes.
Names have been changed.