This week I had a client whose son had been diagnosed with ADHD years ago. She had decided to not give him Ritalin, trying other techniques, and told him, ‘when you’re 16, you can decide.’
Now the boy is 16 and has asked to take Ritalin. Funny thing, I am that client and the boy is my son.
As a mother with a child with diagnosed ADHD, I get frustrated when people bandy about the title as if it were nothing. ‘Oh, I’m sure I have ADD,’ I’ll hear a great deal from adults, ‘I can’t sit through a lecture’ or ‘sometimes it’s really hard for me to focus on what I’m reading’ or ‘I can never remember directions.’ Obviously the golden age of 30 minute sitcoms, 40 character twitter, and the constant barrage of internet data, has conditioned us all to have shorter attention spans. But from the moment my son could crawl until he was about 12, he never stopped moving. He was constantly leaping from trees, hurling himself toward people and objects without thinking. I knew where every Terem (urgent care center) was wherever we were. The nurse in our community kept the glue in her house so she could fix us up. We chose his school because we knew they wouldn’t expect him to sit still. His kindergarten teacher tried a dozen different ways to get him to sit during circle time. We rarely went to other people’s house for dinner. It was too tiring to say, ‘No, don’t touch that! Don’t jump! Don’t swing! Don’t run!’
A pediatrician suggested Ritalin at age 5. In 5th grade, I took him to be evaluated by a neurologist, officially, even though I was pretty sure from all the reading that I had done, that he had ADHD.
Before the visit, the doctors require that you complete the Connor’s questionnaire (I recommend taking a look at it if you feel that your child may have ADD). My son scored very high. During the visit, the doctor (who I think had ADD herself), asked him a bunch of questions about school, paying attention, etc. My son sat in his usual position, feet up on the chair, hands moving, rocking. Needless to say, the doctor concurred with the ADHD diagnosis and prescribed Ritalin. But I didn’t fill the prescription.
I think I went to the doctor then to seek validation, for my child, for my parenting. I needed a professional to say, yes, your child has this disorder. It’s not you, or your permissive behavior, or his being out of control. I also knew, from watching his father (who was diagnosed because of his son) that ADD is with you forever. It is not a transient childhood phenomenon. It goes with you to adult hood and you need to manage it at work, in family interactions, in job interviews. I didn’t want my son to think that a pill would solve his issues. He would still need to learn how to study for tests, to figure out how to pay attention to the teacher. He often asked me during elementary school, “Why do I have to work so much harder than the other boys in my class, just to get the same results?” I knew this was a question that he would continue to ask himself throughout school, so we worked with him to try to give him another skill set to compensate.
But now he was 16. There was the bagrut, gemarah, challenging tests. He wanted to try Ritalin, the medication that many of his friends were and had been taking for years.
I was torn. On one hand, from watching my son, and yes, sometimes my husband, suffer, I knew, as much as someone who does NOT have ADD knows, that the impulsivity, distraction, and inability to focus that contribute to ADD, can be exhausting and frustrating. On the other hand, Ritalin, like so many other drugs, was originally intended for another use, and then researchers noticed an interesting side effect. Those rats given Ritalin navigated the maze faster and more easily than those without!
I have read so much research over the years about the elasticity and development of the adolescent brain, and the fact that researchers do not really understand how many medications affect children. Conducting clinical trials on children is notoriously complicated, leaving studies to focus on retrospective data gathered at the researcher’s (not the pharmaceutical company’s) whim in larger institutions among very specific populations.
I also feel as if I am medicating my child to fit into someone else’s definition of what good learning is.
However, as I realize in so many other areas of life, there is no black and white. I live in a world where teenage boys must pass tests and receive grades. To have a profession that earns a reasonable income, my son will need to receive a higher education. There is an element of having to play by the rules of the game in most things, and fitting into a classroom instead of having the classroom fit you, is one of those elements.
Some things to remember when evaluating your child for ADHD:
- Complete the Connors questionnaire.
- Make an appointment with a neurologist who diagnoses children/adolescents with ADHD (you must ask the secretary or look online on the kupah website). Not all pediatric neurologists do this.
- There are private centers that work with the kupot and provides both ADD and psycho didactic evaluations for possible learning disabilities for children. Ask the branch secretary if your kupah works with any of these centers.
- Only a neurologist can prescribe Ritalin, or similar medications. Once you have that prescription, your GP/pediatrician can renew it. If the original diagnosis is over two years old, you will need to renew the prescription with a neurologist.
- Many children have other issues in addition to ADD. Sensory Processing Disorder (SPD) can mimic or exacerbate ADD symptoms. Have your child evaluated by an occupational therapist as well, who can teach you additional activities to do with your child. If your child is under age 9, ask for a referral for the child development center of the kupah [machon hitpatchut hayeled]. Over age 9, ask for a referral for an occupational therapist from your pediatrician.