The ADHD Road Map, Part 3
Given the risk of side effects--and the persistent stigma surrounding the use of psychotropic medications--parents are often reluctant to start their children on drug therapy. In many cases, some family members oppose drug therapy, while others figure it's worth a try. In any case, drug therapy is a matter that warrants thorough discussion by all parties involved, including the parents, of course, the doctor who would prescribe the drugs, and, depending on his or her age, the child.
Finding the right drug
With most pediatric medications, the proper dosage depends upon the age and/or weight of the child. But with the stimulants used to treat ADHD, proper dosage depends upon how rapidly the child's body metabolizes the drug—body weight is seldom the deciding factor. Consequently, finding the right dosage—and the right drug—typically involves trial and error.
At first, your child may need to see the doctor every few days or so. If your child becomes unusually irritable or tearful or seems to be "in a cloud," the dosage should probably be reduced. If side effects continue, or if there's no change in your child's behavior, a different medication should be tried.
In most cases, the right drug and dosage can be discovered within a month. But there are exceptions.
For Mitchell Haus, the process took eight months. During that time, says his mom, Mitchell suffered insomnia and "zombie-like" behavior. But once the right medication was found, she says, "Mitchell's behavior calmed down. He's still a handful, and his ADHD symptoms haven't disappeared, but they're manageable—which makes a huge difference."
As medication questions are being resolved, it's a good idea to sit down with the doctor to discuss other forms of treatment. Your family might benefit from sessions with a family therapist--especially if there are disagreements over how the child should be treated.
In addition, your child might benefit from sessions with a child psychologist who specializes in behavioral therapy. And many parents benefit from "parent-training" classes, in which they learn new ways to set and reinforce rules governing their child's behavior. (To find parent-training classes in your area, go to taalliance.org.)
If testing indicates that your child has a learning disability, your school is required to develop a treatment program to address the problem. Don't be shy about asking the school for "reasonable accommodations" for your child--for example, letting her sit at the front of the class to minimize distractions, permitting occasional breaks for physical activity, or allowing extra time for test-taking.
Within three months of your "Aha" moment, this is how things should look:
- If your child is on stimulant medication, you should now be calling in monthly to your pediatrician (or other physician) to get the prescription renewed, with visits scheduled every few months to monitor progress.
- All of the supplemental treatments (psychotherapy, parenting training, and so on) should also be up and running, if not completed.
- If your child has a program of special education (or accommodations) at school, it may be reviewed and extended on a year-by-year basis, depending on future test results.
Whew. You've made it--welcome to Point B!
This article appears in the Winter issue of ADDitude.
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To share your experience with other parents of ADHD children, visit the Parents of ADHD children support group on ADDConnect.