All you need to know if your child needs a school-time dose of his ADHD medication.
by Larry Silver, M.D.
Children with attention deficit disorder (ADD ADHD) need to take their medication daily to support school performance. Understandably, most students would rather not go to the school nurse's office or health room to take their medication. But sometimes this can't be avoided.
Let's look at the options to see what you need to do if a dose at school is needed.
That midday trip to the school nurse can be avoided if your child is on a morning dose that covers the entire school day. Most stimulants are available in a long-acting form that lasts for eight to 12 hours. If on the eight-hour form in the morning, it might be necessary for your child to take a four-hour tablet at about 4 p.m. to cover homework time and the evening. If your child is in an after-school program, she'll have to take this dose at school.
If your child does need a school-administered dose of medication, your physician must complete a form provided by your school. Usually, you complete the top portion, giving permission to administer medication; the physician completes the middle section, listing the medication, dosage, time to give, and possible side effects; and the bottom section may be for the school nurse to complete. Many schools require a separate bottle from the pharmacy, so your child's prescription might look like this:
Methylphenidate, 10 mg tablets, #90
Place 20 tablets in bottle
Place 70 tablets in bottle
Take the form completed by you and your physician, plus the bottle labeled for school use, to the health room or nurse's office. The school nurse or assistant should let you know when meds are running low, but you should also monitor this yourself.
The person responsible for giving out the medication should alert you if your child does not show up to get it. Did the teacher forget to remind him? Did he not want to leave class? Are the logistics in middle or high school such that there is no time to make the trip? If there is a problem, it needs to be addressed.
A patient of mine had a teacher embarrass him by stopping class to say, "John, it's time to get your medicine." Even worse, the nurse calls over the loudspeaker, "John, please come to the health room to get your medicine." If this happens, complain to the school to stop it.
The classroom teacher needs to know about possible side effects. If any are noted, you need to share this information with your physician. You also need to know how long the medication is lasting. If the teacher reports that your child does well until about 11 a.m. (and his next dose is at noon), you need to let your doctor know so that the dose or timing can be adjusted.
To be ready for this, I recommend having an extra supply of medication in the health room. Include instructions from the doctor saying that the nurse can give your child a dose if you call to report that you missed the morning dose at home.
As the parent, you are the center of your child's medication network. Keep information flowing among the teacher, the health room, and your physician. Your child will benefit.