Dear ADDitude: What If We Don’t Want to Medicate?
“My 7 year old was just diagnosed, and we don’t want to put him on medication yet. But his teacher says he makes humming sounds, gets up from his seat, and can’t concentrate. He tells us he tries hard to behave but he just can’t. What alternatives to medication should we consider?”
First, your guiding principal in parenting him should be what he has pointed out to you: “He tries so hard to behave but just can’t.”
ADHD is a neurological and physiological condition. His brain and neurological system are different, and that affects his ability to make good decisions, think before acting, keep his body calm, etc…
All the discipline in the world will not change his brain. Positive parenting and reinforcement is much more successful for kids with ADHD.
Here’s what I tell parents with kids just diagnosed:
1. There is a learning curve to parenting a child with ADHD. My learning curve took about two years, but my son also has pretty severe ADHD and well as LDs, and he is very sensitive to medication.
Start with reading all you can about ADHD. There are some great books available on parenting a child with ADHD. My favorites starting out were Superparenting for ADD and The Explosive Child (great for all special needs parenting, not just explosive, my son is not explosive and this book changed our lives).
2. Get treatment. Medication was a game changer for my son (diagnosed at 6), after trying behavior modification techniques at school and home. When you learn the facts about ADHD medication, it can help that decision. Treatment of some kind is a must.
Studies show that medication coupled with behavioral therapy is the most effective ADHD treatment for kids. A therapist can help you with skills and strategies for this special parenthood, and work with your child on developing lagging skills like frustration tolerance, regulating emotions, etc.
Keep a daily journal! Oh how I wish someone had advised me to do that at the start! Every day write down the following:
- Time woke up
- Time medication taken, with med and dosage (also vitamins and supplements)
- Breakfast, lunch, dinner and snacks, time and foods eaten
- Any positive behavior moments/improvements and time
- Any negative behavior/outbursts and time
- Time goes to bed + time fell asleep
Many things can affect the efficacy of treatment and writing all of this down daily will help you and your doctor see precisely when and how treatment is working.
Set a daily schedule with routines (another thing I wish I knew earlier). The more structure the better, as kids with ADHD do best when they know exactly what to expect and when they form habits.
Finally, traditional discipline and punishment often doesn’t work for kids with ADHD. Positive parenting is much more successful. These articles provide tons of strategies and tips on this:
- Parenting Through Positive Reinforcement
- 12 Parenting Strategies That Work for Kids with ADHD
- ADHD Parenting Tips for Better Discipline
- Smart Discipline Strategies
You have a long adjustment period, but knowledge is power so start there first.
Posted by Penny
ADDitude community moderator, author on ADHD parenting, mom to teen boy with ADHD, LDs, and autism
A Reader Answers
Wow I remember being in your place having to decide what to do. In the end, I asked myself what would be best for my son to succeed in class. I asked him (he was in first grade at the time) whether he wanted to try medication and he said yes.
The first day he took the meds he told me, “I listened today”. So I think for him, meds is the right decision. Also I have an ongoing relationship with his teacher. I speak with her by email at least once a week if not more – just about how he’s doing etc. I was upfront with her from the beginning of his diagnosis. He was first diagnosed by our family doc and then formally diagnosed by the school and an outside child psychology group. I recommend the outside testing because they also made recommendations to help increase my son’s success in school. I am one of the lucky ones, his school is completely onboard and willing to put in place every single accommodation that I requested.
So long story short, I think that your son is old enough to give input into this decision. I told my son that he had a race track brain it was so active and always trying to go down more than one track at a time. I told him this was great in a lot of ways – he’s the one who is always coming up with the games that he and his friends plays. But I asked him if our car can drive down more than one road at a time, he said no. I told him that was what it was like for his brain in the classroom. He has to pay attention to one thing for an extended period of time. And that one thing might be something that he is not interested in which makes it twice as hard. You are the best person to decide whether your son is ready to be an active player in his health.
Posted by faye
A Reader Answers
Been there, done that! One thing to know, every child can be different. But, if a teacher is letting you know that she is having trouble teaching the rest of the class (where some others may be ADHD, too!), then it sounds like she just may be frustrated, and wants you to look into speaking with a doctor to get a professional opinion on what you may be dealing with.
If your son is in a public school, then most districts won’t administer benefits or support (most are FREE, btw!) without a ‘professional’ diagnosis. At least, then you’ll know what you’re dealing with. Whether or not the course of action you and your doctor then decide on includes medication, that’s up to you. Your school will be able to assist you AND the teacher, and determine what services they may offer are best for your son going forward.
A diagnosis, in my opinion, is an absolute must. You can help your son only so much, but you cannot do it alone. Use the resources available in your district. I talked with my district’s social worker, special education director, school psychologist, and district IEP/504 administrator. Hold these people accountable for helping your son. If you request it, they HAVE to help you. I truly believe your son will benefit from some outside help, if he does have ADHD.
You are correct, without some intervention now, the expectations by teachers will grow as he gets older, and will frustrate you more as well. My gifted son was diagnosed with ADHD in first grade, he is now in 9th grade. I have never had to pay a thing, and he continually gets support each year as his needs grow or change. He is well adjusted and happy, but will need help through his senior year and in college. I wish you good luck in your pursuit!
Posted by WhoAreYou4
A Reader Answers
You have to follow your gut on this and don’t let anybody talk you into – or out of – anything that you feel is best. In kindergarten, I was told that my son was “involved” in everything and that he was able to learn that way, but was disrupting others. I said he was gifted, they said he was ADHD. We got a lot of feedback about redirection and impulsiveness through first grade and it did tend to spike toward the second half of the year.
At that point, he started getting upset because he was embarrassed about the way he was acting and couldn’t stop. At that point I paid someone independent to do a full evaluation, including observing in the classroom. He turned out to be gifted with severe ADHD (especially concentration issues). I lost so much sleep over the question of medication, but because he was starting to have self esteem issues over his behavior I tried it.
He had a terrible reaction to Ritalin, but I tried one more (Vyvanse), and for him it was the right solution. His teacher said that his concentration improved 100 percent. And, I told him what was happening every step of the way and asked if he felt better or worse with the medication and he said much better, so for us, it was the right decision.
After 4 months on the medication, the school finally recognized the giftedness and they tested him and he came out at almost 150, about 20 points higher than without medication. They have uncovered some anxiety too, but even at a young age, I have talked to him about how he’s feeling, the fact that medication is a choice and whether it helps. We still struggle with large amounts of homework and some stress in the evening, but there are no notable classroom issues to speak of and he is in a gifted class. I am actually more worried about when he goes to middle school into the general population! Best of luck to you and remember – trust yourself.
Posted by HeartMom
A Reader Answers
Your son has a medical condition that manifests in behavioral problems that he can’t help, which is why discipline and convincing won’t work. When your child has a medical condition you treat it like any other one or your child is the one who suffers the most.
The only thing to feel guilty about is if you don’t follow your doctor’s or the school’s advice and help him first in the most vital way which is medication to treat the neurological condition he has.
Parental guilt is something every single one of us has felt over the years, often repeatedly. Unlike other disabilities we’re convinced that if we just make enough rules, talk enough, punish/reward enough, we’re going to fix ADHD ourselves given societal norms. Can’t work because they never address the real cause of ADHD.
Kids with ADHD need to hyperfocus which is why computers/tablets are easy for them to concentrate on. Maturitiy wise your son is on average three years behind his peers. Your 7 yr old may be acting like a 4 yr old. Most kids often suffer from a learning disability or are so overwhelmed with ADHD symptoms that it impedes his school work.
My son is on 15mgs of Ritalin 2x a day and life would be dreadful without it since he’d find it hard to function. All it does is help along the lack of activity going on in the frontal lobe of the brain. The worst side effects are a lack of appetite and, if he takes it later at night, trouble sleeping.
Please help your son by following the advice of the people who know this well and have the knowledge to help your son. You won’t be doing him, or yourself and family, any favors otherwise and he’ll suffer for it.
Posted by Havebeenthere
A Reader Answers
Most of us have been in your shoes. One of the hardest parts for me was accepting and then grieving and feeling sorry for myself about how I seemed as a parent.
Until my oldest son, who is now 10, was properly diagnosed and began meds and behavioral therapy, I thought I was a failure as a parent. In reality, we are actually better parents because parenting them is so hard!
The sooner you take action, the better for all of you. There will not be a magic bullet. Meds will give him the ability to control himself so he can focus and learn. He will still need other interventions. Trust your instincts and don’t give up. It will get better! It is a marathon, not a sprint.
I have always told my son the truth about ADHD and the dyslexia he has. It’s important they know there is nothing wrong with them. It is neurobiological in origin. That you will do everything you can to help him.
No one likes to feel out of control of themselves, like your son does.
Do all the research you can, and have full academic and psychological testing done if you can. Many other things can co-occur, like dyslexia. You’ll want to know everything in play. All this will take time, trial and error. Getting the right med and right dosage can take awhile. Find a doctor who will work closely with you. Let go of the shame. Own it. You will feel relief. Hang in there. Good luck!
Posted by Pdxlaura
A Reader Answers
Everything you’re feeling is normal. Both of my sons were diagnosed with ADHD when they were in first grade. With my older son, it hit me like a ton of bricks! He had another diagnosis and I couldn’t understand how I didn’t see it before his doctor. We were pushing for an IEP and butting heads with the Child Study Team when suddenly we were put on the path to a 504 plan with this diagnosis. It was still a rough journey with ups and downs but by 4th grade, he was in a great place! No medication for him so far, but not ruling it out at some point.
For my younger son, the diagnosis was from his neurologist who found very mild cerebral palsy when he was in K, then dx his ADHD the following year. She thinks it’s secondary to the lesion and won’t recommend medication, but I do wonder sometimes if it isn’t a combination? We’re also using a 504 Plan to accommodate him and it’s helping. I’m now looking for a tutor who will help him with some executive function skills since that seems to be his real weakness in class & at home. He’s in 2nd grade.
It’s funny – my younger son butts heads with me on a regular basis… he fights me on HW (or tries to) and he bugs his brother frequently, too. But more than one teacher has called him “a pleaser.”
I love the better perspectives here on ADHD medicine! It’s far more realistic because it’s from professionals and parents who are in situations just like ours. No 2 children are alike, even ones with the same diagnosis.
Take a deeeeep breath, and take this one step at a time. If medication is recommended, it’s usually trial-and-error and that’s because no one wants your son to have negative side effects, just to be the best he can be. The doctor will change doses or medications until the right fit is found. Good Luck!
Posted by aveline
A Reader Answers
I know from lots of experience just how difficult a situation that you are in. While I am sure that there is a lot of good info that you read, there is probably some that didn’t help either. Here is a classic situation where YOU need to let the pros do their jobs, and NOT second guess them. I promise you, both my wife and I initially thought we were murderers when we put our six year old on meds, but he was driving my wife nuts – not ready to really listen/follow instructions – and thank goodness we stuck to it. As our doc gave him more (the pros call it titration) it was terribly painful for us-we kept talking to him-got appropriate reinforcement-and as that med increased our son’s overall behavior improved both at school and at home.
One thing that we learned from the doc that we didn’t know previously, is that meds can be added to or switched as is needed by the patient. Please read this next sentence very carefully: THE PROBLEM IS NOT THE MEDS, IT’S THE NON-COMMUNICATING PHYSICIAN!! S/HE leaves his patient (or parent) totally out in the cold with no information.
Thank goodness we not only had a doc who talked to us in our language, the meds and other things he recommended worked! We trusted him, and never second guessed him!
Posted by Jdrey71
A Reader Answers
We researched all meds and after 6 months of soul searching decided to try stimulant meds when our dtr was 7. Life changing! She had already started to fall behind in reading due to non-focus on words and inability to follow a line on the page. The day she started meds was the day she started to read. The fact that we could stop the drugs at any time with no ill affects is what helped us to take the leap. Once we saw the improvement in her behavior and academics there was no going back. Her personality changes were all for the better. Our life and stress level became so much calmer. That being said, it is a long road with many med changes and dosage changes along the way. We have a great doctor we trust, and never went beyond recommend dosages. Also, diet (protein) and sticking to routines, behavior expectations, help immensely
Posted by boomer
A Reader Answers
Yes it’s scary putting these kids on medication. My 10 yr. old has been on and off of medication since he was 7 or 8. I have tried modifying his diet, therapy, and different behavioral charts, you name it. We are researching two medications the doctor recommended. She is a psychiatrist and knows how we feel about medicated our child. I’ve come to the conclusion if I can find the right medicine for my son and it helps him, I’m going to stick with it. His self esteem is so low from this year’s teachers. He tells me all the time he can’t help it and apologizes. Good luck with your decision.
Posted by Bae