Time to Talk, Part 2
ASK FOR INPUT: "Mary, I need your help. Do you think the medicine is helping your brakes work better? How about your filters? Maybe we need to speak to the doctor about adjusting the amount you take."
The more your child understands the purpose of medication and how it works, the more likely she is to cooperate. If there are side effects, she will be less upset if you explain them, and assure her that you'll talk to her doctor about it.
Offer some control
Being actively involved in the decision-making increases a child's cooperation. So let your child have a role in assessing the effects of his medication. For example, set up a chart for each day of the week, divided into time periods (before school, after lunch, after school). Across the top write brakes, filters, and reflectors. At the end of the day, have your child tell you how his medicine worked during the day. Mark his findings in the chart, and you can see when it's working and when it isn't. Your team effort can help determine his medication dose and timing.
Sometimes a child is afraid to swallow pills or doesn't know how. If he tries to chew (a natural instinct), the taste of the medication can be a turn-off. Rather than assume your child knows how to take pills, teach him. Offer a pill-size piece of candy (he'll feel safe with this), and explain that there are no taste buds on the top of the tongue, only along the sides. Help him put the candy on the top of the tongue, away from the tip. Explain that a whole pill doesn't taste bad. Then have him wash down the "pill" with some water. Most children can learn to swallow pills with a little practice. If this doesn't work, ask your doctor to prescribe an eight-hour capsule (such as Ritalin LA or Adderall XL), which can be opened and sprinkled over food.
Tread lightly with preteens
Most children will learn to take their medicine. They'll understand that it helps and will cooperate. But problems can arise during the early-adolescent stage. Middle-school kids don't want to be different. It's essential that they be accepted as "normal." Suddenly, at this age, a once-cooperative child will rebel and resist his medication. Pill time becomes a battle, and parents usually lose.
I counsel parents to try again with education. Maybe the family doctor can help. Explain again — but don't lecture — about brakes, filters, and reflectors. Say that if these areas of the brain are working well, he is more likely to be seen as normal rather than different. Respect an adolescent's fear that someone might find out about his ADHD. All-day coverage might help. Ask your child's teacher to refrain from saying publicly, "James, did you take your pill today?" Find some way to elicit understanding and help.
Sometimes family dynamics contribute to medication refusal. A sibling may tease the child who takes medication, calling him a "retard" or "mental." If this happens, you first handle the sibling. Perhaps one parent doesn't agree that "my child" should be on medication. He or she might verbally agree to it, while sending a clear, nonverbal message of disapproval. The child sees this and resists taking the medication. If this sounds like your family, consider family counseling. Talking to a therapist — or at least talking with your family doctor — may be in order, if the consequences are significant and if all your other efforts have failed.
Even the best plans flop with middle-school students. Sometimes I advise parents merely to try to minimize the damage caused by being off medication. It may not be until their child is older and more comfortable with himself that he again agrees to take it.