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Advice about ADD Medication & Treatment

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Dr. Stein's book about parenting ADHD no drugs

Feb 2009

Hi, I'm reading dr. David B. Stein's book ''Unraveling the ADD/ADHD fiasco, successful parenting without drugs''. Anyone read this book and followed his Caregivers' Skill Program (CSP)?

My position is that I don't want to give my children drugs.

Dr. Stein's CSP is about behavior modification implementing a firm program with time-outs for target (mis)behaviors, at the same time as you lovingly encourage the positive behavior. So, no positive or negative reinforcing of bad behavior, just time-outs, and lots of positive reinforcement for behaviors we want to keep.

The only thing I really have a problem with is the spanking. He says to spank the child three times on the bottom if he's not complying with going to time-out. I don't want to spank my children but he says it's necessary in the beginning to get started and showing them that you mean business. After that, just the threat of spanking could suffice.

Any comments, views, opinions? K


Do you have ADD or ADHD? I do. I knew that I had problems focusing as a child. My parents talked about more discipline, that it's all in self-discipline and parental discipline. I believed the hooey until I became an adult.

As an adult in my early 40s I had the courage to bring this up to my doctor. I have been on medication since. After medication for the first time in my life, I could take my 170 point IQ (yes, really), slow it down and actually concentrate for 2 or more hours at a time. Before medication, my mind would race, here's how it looked. Okay, students open your math books to page 151, lets begin with problem three - my mind would then think 3 is a prime number I wonder how many other number problems are prime numbers? What about the answers to the problems do they create prime numbers? Why don't they teach us early on about the specialty of prime numbers? Surely the teachers must recognize it, because they begin teaching prime numbers in middle school. Then the teacher would make me stay in - I could do the assignment in less than a quarter of the time as other students - if I could only concentrate - and so it goes.

Imagine what I could have accomplished if only the chemicals in my brain had been balanced?

My guess is that your kids are really smart. I would like for you to try one thing. Try the method you say for 30 days. Then try medication for 30 days. Let the results of each guide your decision. You sound like a great mom; you'll know what to do with the simple experiment over 60 days. ADD Mom


Please don't spank your ADD/ADHD child. It won't work. The brain chemistry of these kids is such that punishments like that aren't effective--they don't have as much self- control and ability to inhibit their own behaviors and think about future results as typical kids. Most of ADD/ADHD kids already are confounded by what they do and why everyone around them is so exasperated or they have trouble with friends. Keep reading books and exploring websites that offer solutions you are comfortable with and that resonate with what you think will work for your child. Good luck. Another mom of an ADD/ADHD kid
Please go to the CHADD website: http://www.chadd.org/ It's stands for Children and Adults with Attention Deficit/Hyperactivity Disorder. I am an adult with ADHD. I strongly disagree with the ideas you mentioned. ADHD, while called a disorder, is not something to punish for. The brain is malleable and there are many tools and programs to help ADHD children (and adults) improve their focus and behaviors. SM
First of all, many people I know with extensive experience working with children feel that time-outs don't work.

Second, while as a parent you always want to reinforce good behavior and discourage bad behavior, you have to look for the source of the behavior. Kids with ADHD aren't just being bad to be bad. For a child with ADHD, behavior problems result from an inability to direct or focus their attention appropriately to cope with the demands of the world (in school in particular). ADHD is not a lack of attention per se, but a lack of an ability to direct the attention as needed.

So, while you may develop a program to deal with a child's behavior at home, if you don't deal with the underlying cause, how with the child get along in the world away from home, especially at school? Will you expect your child's teacher to follow this program? In which case you will be out of luck because I don't think a school exists that will use spanking as a punishmet. At least I hope it doesn't exist.

You don't say why you are opposed to medication, but I think you should talk to some parents and children who have gone that route. The brains of children with ADHD are wired differently, and the medication is very effective in helping them control impulses and focus their attention. It is not the answer by itself, usually these children also need help in other ways; often accomodations need to be made in the way lessons are taught or tests are administered.

Finally, I would ask myself why instead of using medication, you would consider an approach that depends on a threat of physical violence as a way of modifying behavior. Skeptical


I work with adults and adolescents who have AD/HD. The damage that methods such as these have produced is heartbreaking to witness. It's really unfair to punish a child for something he or she cannot control, and it doesn't teach successful self-control either. All it does is raise the saliency of the desired behavior, using fear, at the expense of the relationship with you and the child's sense of self-worth. Better to teach enlightened self-control, practice greater patience (as all parents of kids with learning differences must), and protect and help the child more. Discipline has it's proper place in every family, but it is NOT a cure for AD/HD.

It's really hard to parent kids who don't fit society's expectations of what's possible, especially when the kids don't show any visible signs of their difference. I teach a special parenting class developed by CHADD for parents of kids with AD/HD, ''Parent-to-Parent Family Training in AD/HD''. There are lots of useful, practical and scientifically valid techniques that you can use to help your child. LL


Adderall and facial tics

Nov 2007

does anyone have any info on adderal and facial tics? my 17 yr old was put on adderal for a diagnosed adhd, which he took sporadicaly, maybe a total of 10 times. i removed him when i noticed the facial tics. he has not been on any medication for about 4 months, but the tics have gotten worse, with the neck stretching, grimmacing, etc. thank you kat


It sounds like you need to get back to the doctor and report this, as well as the fact that the first trial of dosage and type of medication didn't seem to work out. Those facial tics sound noticeable enough that they might produce some social fallout and embarrassment for your child. There is really great information about AD/HD and co-occuring conditions on the websites of schwablearning.org and the National Resource Center on AD/HD at www.help4adhd.org. In my experience as an educational therapist who treats adolescents and adults with AD/HD, the road to optimal medication can be a long one, and working closely with your doctor is important. Don't give up too soon. These facial tics are probably distressing, and your doctor may want to change medications because of them. You're an important partner in the treatment because you provide the observations in real time. Good luck. linda

Helping child with ADHD, not on medication

Oct 2005

My son has mild ADHD, and has never had medication. He does well at school, except for homework, which often is incomplete. Also, his spelling is very non-standard, so to speak. I wanted to talk with other parents of kids with ADD/ADHD that do not medicate their child (I am not interested in any advise that is pro-medication) and ask how they deal with homework, the intensity of anger with parents and siblings, the distractability, etc. How are you able to help channel your child's strengths in a productive way?


It is very important to keep in mind that just because your child has ADD, it does not mean he does not have any other problems. I say this with regards to his spelling. Many different things can cause spelling trouble, and many with ADD have no trouble with spelling. I am not saying ADD is not the problem, I am just saying that there may be other problems.

With regards to controlling ADD, and channeling the energy, deciding not to medicate often means deciding to allow your son to live a slightly different life than traditional children live. Students with ADD/ADHD tend to have higher energy, and they therefore require a high energy lifestyle. He will require more activity, more attractions/distractions, more behavior management, especially with regards to conflict and boredom. PaulTheTutor


I'm sure you'll get lots of advice on this. As a teacher of kids w/ ADD/ADHD I will give you my single best suggestion for homework... predictable routine. I would try to work with your child's teacher and ask him or her to reduce the amount of homework (only for a while) and see if she/he can allow for predictable assignments (i.e. a mathwork sheet each night in math, the same part of a spelling unit every Tuesday, etc.) That way, you child will know exactly what needs to be done. If your child can start getting into the habit of doing a little homework, and realize that it is something he/she can do and complete, a routine will get established. You can gradually add more and include different types of assignments. It will take some communication with the teacher, but it is worth a try. Best of luck. I think you will be able to do it w/o meds. -a teacher
Have you tried books on food allergies and how diet affects children with ADHD? There are several out there. I have a friend whose son was diagnosed with ADHD, and wasn't convinced his medication was the right thing for him. She spent countless hours researching foods on the internet, and found which foods to avoid -- many contained high levels of sugar and sodium. Her child's behavior changed dramatically as a result of his new diet. Hope this helps. anonymous
Sometimes people who are trying to avoid or reduce medication try The Listening Center in Walnut Creek. It is very expensive and very time consuming. They do Tomatis based therapy for auditory processing disorders. This may help your child if he also has auditory processing disorders in addition to ADHD. If it is 'just' a question of 'pure' ADHD which is a neurochemical imbalance then I doubt this method would help him. They do an evaluation($375)for auditory processing disorders. A LOT of intensive excercise may also help with the neurochemical imbalance in the same way that regualar cardiovascular excercise has been shown to be as effective as an antidepressant in some studies. My daughter does better sleeping and being calm when she gets LOTS of excercise. good luck

Rages in 13 y/o on Concerta/Ritalin

Nov 2006

I am interested in what other families have done if the Ritalin or concerta for ADHD seems to be causing rages in a teenage girl but no other medications works well enough to get her through a day at school. This has happened with my daughter. The rages were so bad that she almost had to be hospitalized. We have Kaiser Insurance and I am frustrated with the lack of coordination between the pediatric department and psychiatry (the only discipline who can prescribe something other than stimulants)

There is a similar question in the archives but I would like to know if any other family is currently dealing or has dealt with this issue and how they handled it.

My daughter has tried adderal and a high blood pressure medicine without success. Any advise appreciated
worried mom


Have you considered getting your child off of the meds and in a school that has a different sort of structure that may be more conducive to her personality? While ADHD certainly has a basis in the individual, it is also a social construct. Meaning, in a different sort of situation, a different sort of schooling atmosphere, the ''problems'' of ADHD - the lack of focused attention, hyperactivity, etc - would not be the level of problem that it is in a traditionally structured school. Perhaps a smaller, more collaborative, more physical type of environment would suit her personality and allow her to succeed without the potentially scary side effects of the meds, like the rages or whatever else. Just a thought. Anon
As I have stated before, I do not accept the designation of ADHD as a ''disease'', and feel that the use of stimulants to ''treat'' this condition is misguided in almost all cases. I am not a psychiatrist, but, as a neuroscience professional, I am very concerned about the effects of stimulants on the developing brain. In my experience, many kids with the diagnosis of ADHD are, in reality, bored and/or underchallenged in their school situation, or are sufficiently ''different'' that they disturb the status quo; and, as is common in our culture, need to be ''medicated'' so that they ''fit in''. Often, changing the school situation, and use of physical activities can go a long way to deal with ''hyperactivity'' and other ''learning disorders''. Get another opinion from a good psychiatrist, preferably of academic standing . Robert A. Fink, M. D.
My son had and has trouble with anger and rage. For him it isn't caused by meds but I think some meds are better than others. We are using strattera now and things are not perfect but we're managing. We followed the advice on this list and went to Dr. Berman. He has been terrific. I hope someone with Kaiser can help you. Best of luck to you. This is so hard! still working on it
I have to ask some hard questions here: what is this child's diet? how much sugar? wheat? dairy? meat? and what kinds of sugar, wheat, dairy and meat are being imbibed? what excercise is this child getting? as in how many HOURS a day? how much television is this child watching? what kind of television? how much time playing or watching video games? what kind? how much time on a computer? is this time on the computer supervised. what attention 1-on-1 is this child getting? how much of the time each day, of this child, is supervised by the parents, grandparents, aunts and uncles and caring adults in the childs life? it sounds like you are solely ''working'' with allopathic dr's and, frankly, you are getting the results you are... it is no wonder. i do not believe in medicating our children. i believe that there are better answers than poisoning our up-and-coming generations. hopefully, you will see the answers not hidden within the questions that i have asked above. finally, i dont know if you meditate (and i am speaking of non-christian eastern type meditation) however, if you do not, it is time to learn how to and then teach this child. there are MANY MANY forms of ''skilled relaxation'' meditation, guided meditation, all sorts of tapes/recordings, self hypnosis (my favorite) and so much more. do not be brainwashed by the allopaths. they are NOT the sole answer, and frequently, they are no answer at all, as you are experiencing. this, of course is only my opinion, however, if you look at my questions and find some non=allopathic pysicians with whom you can work, you will be amazed at the speedy recovery of your child.
cw
How long has your daughter had these rages? My son (12) had a terrible time at school last year because his teachers ignored his special ADHD needs (he just got angrier and angrier) but now that he is in a new school with teachers who know his issues and how to work with him he is much happier. If these rages have been going on for some time you need more help than you are getting from Kaiser. Ere you familiar with Dr. Daniel Amen and his clinic in Fairfield? He has worked with many types of ADHD kids (and adults) and uses different types of anti-depressants and/or stimulants to help his patients. His web-site is brainplace.com. He could also suggest someone closer to you that could help. I often have to go outside of our healthcare plan to work with specialists but it's worth it because I can't afford to waste time by not using the best. a concerned mom too
I don't recall your original question but I'd like to add my 2cents based on the other responses I've read. (As an aside, for what it's worth, here's a baby boomer who's horrified at the medicating of so many children, prompted by doctors, ''supported'' by pharmaceutical companies and completely agree with Dr. Fink and the respondant with the ''hard questions''). But I have another question. Have you paid attention to the timing of these rages? Is she menstruating? If so, are the rages in conjunction with her period? As someone who suffered from PMDD (a horribly exaggerated form of PMS), until recently when my periods finally ended, I would say a good 2.5 to 3 weeks of every month were given over to the hormones around my period, including deep sadness and rages. It wasn't until a couple of years ago (after 40+ years of suffering from this monthly and when it was basically too late to do anything significant about it) that I finally realized what was going on - in the meantime it impacted my entire life in many negative ways. Please check her out for severe PMS (or even PMDD symptoms) so that if this is what's affecting her, she doesn't have to suffer as well, though it may be difficult to distinguish if she's being negatively affected by her meds. Good luck Joan
I missed the original post, but read the responses with interest. My son (now grown) was diagnosed with ADHD when he was about ten. We had him on Ritalin for perhaps 2 weeks. The ''rebound'' effect when he got home from school was absolutely frightening. He was so angry and violent. We took him off the meds, went further with diagnosis, and eventually tried him on a variety of other things. The school was annoyed with us for ''giving up'' on Ritalin so quickly, but I told them we and he shouldn't have to pay the price we were paying for a calmer school day. Eventually what worked best for him was a boarding school for alternate learners (NAWA academy--he didn't get there until mid-year of 11th grade). He was still on some meds (but not stimulants) when he was there, but once he graduated, he chose to go off the meds, and as an adult is managing well without them at a college that accomodates alternative learning styles (Antioch). He is NOT bipolar, despite his huge mood swings on ritalin. He is intelligent, enthusiastic, and highly empathetic after all he has been through. The bottom line--whatever you decide about medication, if the current med is causing huge rages at home, you don't need it and she doesn't need it. There has to be a better way, with or without meds Hang in there--it's worth it

Rages in daughter who's been on Ritalin for 4 years

May 2005

Has anyone used or known anyone who has used a childs individual neurotransmitter and amino acid tests to manage ADHD. My child has been on ritalin and concerta for 4 years. For the past 8 weeks there have been progressively more intense angry rages and outbursts. She is 12 years old. I have lowered her dose and would like to wean her off the ritalin and concerta. I would like to begin to use an alternative approach. A reference to the use of neurotransmitters and amino acids was made in an ADHD parent support group web site. Any experience or information from any parent or guardian in this group would be greatly appreciated. I am also looking for a homeopath with experience with ADHD and children in Oakland or Berkeley. Thanks much Desperate and Anon


Randall Neustaedter, OMD CCH specializes in children and ADHD. He is a doctor of Oriental medicine and a classical homeopath. He is in Redwood City at the Classical Medicine Center and probably worth the drive. You may also find a homeopath or other practitioner who specializes in children and ADHD by searching the directory of the Holistic Pediatric Association at www.hpakids.org. Jane
I wonder if your daughter is getting more moody because she has began menstruating recently. Depression doubles in girls at the onset of menstruation, around age 12. Also, age 12 is a tough age for adolescents and girls at this age can get into clicks and become difficult to communicate with. I speak from experience remembering what a hard year my daughter had at age 12, and also as a psychiatrist I often find in women with depression that their first memory of feeling sad began about age 12. anon
I wanted to suggest to you that the rages you are seeing are as likely to be in response to reducing the Ritalin as they are a side-effect of taking it. I take Ritalin on a daily basis I can tell you that attempts to under medicate, or medicating only every 4 hours (unless that happens to be your metabolic rate) can lead to moments of rage and despair (as well as fuzzy thinking) as the meds wear off.

If your child was accurately diagnosed, and medication previously has helped, it may be that what's needed is more of what she's taken in the past, or a different medication. Only an expert you trust can tell you whether reducing her meds, or changing her regimen is a good thing to do -- or even safe. Please, tell me that the changes you are proposing are being made under the care of an ADHD expert. Heather


Alternatives to Ritalin for 8-year-old

Sept 2004

I am trying to help a family member cope with her wonderful yet ''souped up'' 8 year old daughter, who is taking Ridalin to help her focus in school. She does not have the classic symptoms of ADHD, and the psychiatrist wonders if she could be manic. She took Ridalin for four months, and her reading improved 3 grade levels. Impressive, but she hates taking it (she cries every morning) and has no appetite. She literally did not gain one pound last year. While the drug does help her focus, her personality seems to be pulled back to the point where she doesn't quite have her usual spark. (In fact, she asked her class whether they liked her better with or without medication. The kids voted for without, while the teachers clearly saw better learning outcomes since she could concentrate.) Are there better alternatives? Someone mentioned the drug Straterra... Are there effective alternatives to drugs? I believe in a holistic approach but do not want to send the parents through a path of snake oils. I welcome your advice, which I will pass on. THANK YOU! Help Needed


I have seen great results in treating issues like these (bipolar disorder, ADHD, ADD, etc.) with nutrient therapy. See www.hriptc.org for an approach. This clinic, although located in the midwest, does outreach clinics around the country and will be in the Bay Area next month. Feel free to contact me for more details. Robin
I was diagnosed with adult ADHD and began taking Straterra about 8 months ago...it has been an incredible help to me. The advantage over Ritalin is that it is not a stimulant, and therefore not a controlled substance. The disadvantage is that it is patent-protected and therefore much more expensive. For me! the cost is very worth it. A holistic approach would include therapy but I don't have the time or patience. :-) Michael
Hi There is a great organization called Feingold (http://www.feingold.org/home.html) that every parent should know about. My son was displaying behaviour problems often associated with ADD. He also had problems concentrating and sitting still at school. On the other hand, he was able to sit still for a very long time at certain times. The Feingold organization has done ''numerous studies that show that certain synthetic food additives can have serious learning, behavior, and/or health effects for sensitive people.'' My son has become a different person with the help of this organization. It is well worth the effort. happy without medicine
Spending time in a leafy environment can reduce ADHD symptoms. http://cms.psychologytoday.com/articles/index.php?term=pto- 20040406-000015 Do you really have a proper diagnosis? Is it really ADHD? http://adhdparentssupportgroup.homestead.com/50conditionsmimicing ADHD.html Neurotoxins could be the problem: http://www.childenvironment.org/factsheets/neurotoxins.htm sunsol
If you are dealing with ADHD the best first treatment is with either a stimulant med or a non-stimulant med (Strattera). Improving diet and lifestyle are definitely helpful, too. (I liked the comment you got from Michael Bahn about not being patient enough for therapy -- ADHD humor, ha ha). If you are dealing with something ''like'' ADHD then Feingold or a nutritional approach may be all you need. A child who is sensitive to additives could appear to be ADHD, and benefit from intervention -- but whether that child has ADHD is a different question.

ADHD is not a nutritional failing or a character flaw, its a genetic neurochemical disorder for which there is a known successful treatment. If you trust your diagnosis and the doctor who recommends Ritalin, try it If you aren't sure -- find another doctor and get a second opinion. Just because Ritalin is over-prescribed in general doesn't mean your child's life can't be transformed by appropriate diagnosis and treatment. Heather


Do you tell friends & family your child is on meds?

Dec 2003

My child was recently diagnosed with ADHD and is now on medication (whoopee, it is really helping!) 1st question: do others of you tell family and friends your child is on a stimulant? Do you get unsolicited anti- med advice? How do you handle it?

2nd question: I have been diagnosed with ADHD too (no surprise) and have been prescribed a med. The psychiatrist I saw charges $15/month to process the triplicate. Is this typical? thanks!!


It has been my experience that people have some strong feelings about ADHD meds and are not hesitant to communicate their personal biases if you give them an opportunity. I would advise giving yourself time to assess your own response to medication before inviting confusion into your decision. Your child's teacher should know that your child is medicated because that relationship is impacted and the teacher can offer valuable feedback. Teachers are required to maintain the confidentiality of that information. I am a teacher and an ADHD coach, so I have heard a lot about this! Linda Lawton
My 8-year-old daughter was also diagnosed with ADHD (finally!). She is on Adderall, and is doing immensely better.

Yes, I tell family and friends, and if I got anti-meds flak from them (which I haven't so far), I woudl offer to let them watch my daughter for a week or 2 without meds. People who haven't been in the situation and know nothing about it shouldn't be judgemental!

As far as your psychiatrist charging you to fill out the triplicate forms - mine doesn't, but I don't feel that it is unreasonable - since the meds are a controlled substance, there is probably a certain amount of extra paperwork/processing involved dealing with the triplicate forms and whatever regulations are involved.

feel free to contact me if you want a sympathetic ear! nkf


In reference to the question about meds for your child, my child is diagnosed with another disorder and has been on meds for almost a year to control his aggression. I do not tell everyone, only select family members that will need to know for his care. There are some people, including family and parents, that have never accepted his disability from the beginning so they definately wouldn't understand the fact that he has to be on meds. I am very careful about who knows and it's not discussed very often. Anonymous
Though I don't have enough experience to really answer your question, there is a great parent bulletin board/forum with a ton of parents who have dealt with this at www.schwablearning.org. Good luck! Anon.
Initially I was pretty circumspect about telling people that my child had ADHD and was on meds. Then I decided that I was role modelling that it was something to cover up. So I started treating it like I did my other child having an allergy. Yes, people do sometimes offer unsolicited advice. But if you present the information with a tone of confidence (this is how it is) rather than inquiry (what do you think?) they are much less likely to say anything. If they do, you can say something like, thanks for your concern, we're doing fine. BTW, I realized from the tests that I have mild ADD and have developed coping mechanisms over the years. So you and I can attempt to explain what it ''feels like'' but the truth is they may never understand. anon mom
The question isn't who to tell, but what to do with unsolicited advice? In this case I think I'd develop a stock and fairly harsh response for most people, along the lines of ''Thank you. I appreciate your insight, but of course you really know nothing about my child or our circumstances''.

Unsolicited advice is one of the more annoying by-products of life in Berkeley. PLEASE don't suffer it in silence...

But, if in fact the advice is from family who know and love you and your child --- I'd request that they withold judgement for six months and see how things are going. ...And, there's always the ''Stimulants for ADHD are like glasses for myopia'' argument. (Its not kind to withold them unless they aren't really needed).

p.s. My doctor charges $10 for writing the prescription. Heather


Diet, Sugar, and ADHD

March 1999

I have a 10 year son who has recently been diagnose with ADD. He is not on any medication(ridilin). His Doctors recommend the Feingold diet before starting the medication.


I would strongly suggest some research and a visit with a behavioral pediatrician. There are many useful techniques for dealing with ADHD that don't involve the use of medications. The Feingold diet is not one of them.

The Feingold diet removes foods containing additives and preservatives on the theory that these substances cause ADHD. This claim has not stood up under scientific testing.

Russell Barkley, Professor of Psychiatry and Neurology at University of Massachusetts Medical Center, is a leading ADHD researcher. In his book "Taking Charge of ADHD" he addressed Benjamin Feingold's claim:

"Most of the substantial research done over the next decade [after Feingold announced his theory] was simply unable to substantiate Feingold's claim. In fact, only a very small number (5% or less) of mainly preschoolers showed a slight increase in activity or inattentiveness when consuming these substances. No evidence has ever been provided that normal children develop ADHD or that ADHD children are made considerably worse by eating them."
Barkley also addresses another myth about diet--that sugar causes ADHD.
"Not a single scientific study has been provided by proponents to support these claims. Since 1987 a number of scientific studies of sugar have been conducted, and these have generally proven negative."
There are number of people who promote low-sugar diets for treatment of ADHD. The diets with the best self-reported success rates tend to be extremely structured. Researchers believe that the success of those diets comes not from lower sugar levels, but from the increased structure in the child's life and changed parental expectations.

A healthy diet can only help any child, but none of the diet-based theories about the cause of ADHD have panned out. Research has established that ADHD is linked strongly to heredity, and current research points to inherent chemical imbalances in the brain. In light of these findings, it seems unrealistic for parents to pin their hopes on diet as a solution to the problems associated with ADHD. Ken


With regard to info of interest re ADD, John Taylor, PhD has written several books on the subject and also speaks nationally about nutrition and ADHD. He also includes why nutritional blue green algae shows benefits in many cases across the country. MaryAnn

ADD diagnosis: How are you managing with Ritalin?

May 2002

My son has recently been diagnosed with ADD. In many ways it explains some of the difficulties he has been having in school.He does not have the emotional or behavioral difficulties that often complicate this condition but has great difficulty with focus, concentration, impulsive behavior etc... He is repeating 2nd grade and not doing much better than before. As I look back it makes sense to me that his father (we are now divorced) also likely shares this condition although it was never diagnosed or treated. It is also likely that his father ''self medicated'' (ie: drug use) to deal with the challenges this condition brings. The doctor has suggested Ritalin and I have many questions. Will it turn my son into a zombie? What are the long term effects? I would like to hear from parents who have had to make this difficult decision. I would like to know about the good, the bad and the ugly. I want what is best for my son. I want him to have a chance to be successful.I have been doing some reading but I would love to hear from other parents about how you and your child are managing. Thanks. a mom


There is a great book that I used for the Cody's Parenting book group called ''Smart Moves: Why Learning is Not All in your Head.'' The author, Carla Hannaford, offers a less typical approach for dealing with ADD that you may find helpful. She advocates for something called 'brain gym' which she believes has helped children with all different types of learning difficulties. Good luck! Ilona
My now 14-year-old daughter had problems with organization and attention starting in 2nd grade. I felt that she might have ADD, but none of her care providers or teachers would acknowledge that ADD existed. I had her evaluated for all sorts of learning problems, put her in counseling, etc. Four years later, when she was ending 6th, I still was reading the same comments on the report card since 2nd grade: ''Talks too much in class, can't finish assignments--too distracted. Trouble paying attention.'' My daughter also felt like her impulsivity was irritating to her friends sometimes. Her self-esteem started really suffering. So I finally found a specialist who instantly agreed she had ADD. She has been on Concerta (timed-release ritalin) for almost 2 years. She is much happier. Her grades have improved significantly (Now As and Bs). I feel our family relationship is much better because there is less stress. Nightly homework used to be a nightmare. The main problem now is that some core academic skills (reading, spelling, vocabulary) were not instilled during elementary school and, now, in middle school, she has some problems in those areas. My suggestion is to try the ritalin and see what you think! It's not a lifetime commitment. You'll know pretty quickly if it works or if it doesn't. Hope this is helpful for you and good luck. PS--don't be surprised if you run into very strong anti-medication opinions. Read the studies in the clinical journals. Ritalin is one of the most tested drugs available. Anonymous
My son also had trouble with focusing and getting things done and he had some really hellish years in school. No teacher ever suggested that I have him tested, they said he was smart and needed to pay better attention. He told me at age 10 that he wished he had ADD so people wouldn't blame him when he couldn't focus. He was VERY ARTICULATE. I talked to his pediatrician who talked to my son. They decided to have a diagnosis. The doctor found that he has ADD and we started on Concerta (later switched to Metadate because he didn't sleep well with the Concerta) but there were results right away. It was easier for him to complete a task from homework to chores. If you don't see a benefit right away then you can just stop the medication. It has really helped my son's confident. It hasn't changed his personality -- as he says ''I wish it made me want to do homework.'' But now he knows he can do it and he gets a lot of positive feedback in the classroom instead of constant reprimands to sit down, stop talking and not call out the answers. He feels like he's more under his own control. I really angsted about giving my child a drug for his brain but he is so much happier. I do keep reading about it and I subscribe to an e-mail newsletter about the lastest research findings. You can sign up to receive the newsletter at http://www.attention.com. Good luck I know it's a really hard decision and you know your child best. anon
I've learned a lot about AD/HD lately as I recently made a career change and became a teacher -- a teacher of special needs kids with AD/HD and other Learning Differences. I also found out that I have AD/HD myself!

It is important to know that there are three potential causes for AD/HD in the brain, and that the medication that can work for your son must be targeted to the specific cause. What this means is that your pediatrician needs to try different medications, carefully monitoring the effects, and see which one works the best. Don't get discouraged if Ritalin doesn't seem to do the trick. You may just need to keep trying. Make sure that your doctor is willing to take this approach and doesn't just write you a prescription and not follow up.

Meanwhile, there are many things you can do to help. One of the most important is making sure that your son gets LOTS of vigorous aerobic excercise, every day! This has been clinically shown to have a therapeutic effect for people with AD/HD.

There are lots of other, simple ways that you and your teachers can help him cope. More information is available at a great educational outreach organization in Campbell (San Jose) called Bright Solutions. Their Web site is www.dys-add.com. The head of the company, Susan Barton, conducts workshops on dyslexia and AD/HD on a regular basis, and she puts aside a chair or two for parents, for FREE, at each seminar. Please contact her -- she is a great source of help and inspiration.

Finally, you should be aware that AD/HD, for all it's difficulties, is a gift. It is strongly associated with higher IQs and brilliantly creative minds. Tap into that, and your son will find that he has an incredible asset in his ''different'' ways of thinking. Colleen


I don't know a lot about Ritalin or ADD, but I listened to an interview on NPR on the subject a week or so ago. A book was recommended which advocates against being too quick to label a child with ADD, when any of a number of attention deficits may be to blame for their behaviors. The author believes that many children are diagnosed with ADD who don't actually have it, and while Ritalin may be helpful in making their behaviors more manageable, it's not the best thing for them, because it's a drug ... for life ... which doesn't actually address their true problem. If you're interested, the name of the book is A Mind at a Time, by Mel Levine (sp?). Susan
I just noticed postings about ADHD so I thought I would let people know about the free 4 week ADHD series for parents or teachers. On Thursday June 13th at 6:30Pm till 8:30Pm Dr. Mel Burman and I will discuss medication issues. We'll cover the pro's and con's of using medication. The classes are interactive with a focus on answering parents questions. Anyone is welcome to attend...no pre-registration is necessary and no childcare is provided. This will be class #2 . Weeks 3 and 4 will cover parenting and school issues. The classes are at Kaiser Permanente, Richmond Medical Center, 901 Nevin Ave in Richmond (off of Harbor Way) You take elevator ''C'' to the 3rd floor. Rona Renner

Had any luck with alternative treatments?

March 2002

My seven year old son has been diagnosed with ADHD. It's pretty obvious, and I know he needs help. Although stimulants are recommended I am curious to know if there are parents who have had luck with any alternative treatments: homeopathy, behavioral mod. etc. I would also be interested in any success stories from anyone using the medications. I'm just concerned about long term medication on a still delveloping brain. Are my fears unfounded? Worried Mom


I tried everything possible to avoid medication. We waited till he was almost 7 yrs. I tried the OPC-3, a health food drink with documented improvement with many kids with ADHD. I tried for about 4 months, with a teenie bit of relief. With school progressing, and his situation getting more demanding, we finally conceded to Ritalin. The result is remarkable. He is now on a time released all day medication.. It has made an amazing change in his life, and the rest of our family. Getting him to eat is the only , but large problem. That is my constant challenge to get him to eat, let alone foods that are high in calories, but healthy. I choose not to share this with the school. He still is a wonderful, but very tough child. anonymous
I can completely relate to your concerns regarding longterm affects of medicine on a growing body. And I think they are valid concerns. When my (then) 5 year old was diagnosed 2 weeks before the start of Kindergarten, I resisted medication for the same reason. I spent a year and a half trying alternatives including several different homeopathists, and a food allergy theory that basically eliminated wheat, sugar and milk products (this was really hard!). Although I believe we gave all approaches a fair amount of time, sadly, they did absolutely nothing for our daughter. As a result, she had a miserable Kindergarten experience, and only a somewhat better First Grade experience (mostly because of a great teacher who was willing to go way out her way to help her). Mid-way through First Grade, I caved and decided to try traditional medicine. As much as I hate to say it, I now believe this is the right road and only wish I had done it sooner. My daughter, now in second grade, can actually sit and listen and take turns and cultivate friendships, etc. The key, I think, is to have a doctor that is well-versed in the condition as well as the available meds and their possible side-effects - a doctor that has the sense to start small and is willing to closely moniter your child's health. For instance, the medicine my daughter is on has been known to cause heart problems in a very small number of cases. Some doctors' approach is to say just that and assume your child statistically will fall in the category of no harm done. Instead, my daughter's doctor requests regular EKG's at Children's where an expert can look for the slightest anomaly. These are powerful drugs and it is very scary to put your child on them. But I think if it's done with care and intelligence, it's worth it. You have to weigh that against the emotional damage and lowered self-esteem that occurs when they are constantly getting into trouble at school and when noone wants to be your child's friend. Best of luck to you as you make this difficult decision. Anonymous

Tics brought on by Ritalin?

March 2002

My 7-year old son developed a vocal tic while on Ritalin. Has anyone had a similar experience? Does anyone know the prognosis for remission of the tic? Does anyone know any effective treatments to make the tic go away? e.g. acupunture, osteopathy, homeopathy treatments?


Obsessive Compulsive Disorder (OCD) has been known to occur in my family. Consequently, I know that sometimes vocal tics are related to OCD. Doing a quick search of the web for this, I found a fascinating link to an article about strep infections sometimes causing tics: http://www.findarticles.com/cf_dls/m1200/10_158/65913260/p1/article.jhtml Any chance his tic could have been associated with strep rather than the Ritalin? Either way, it sounds like further investigation into OCD and related things might be in order. Here's a link to start with: http://www.anxieties.com/5OCD/OCD_summary1.htm There are various treatments for OCD and related disorders, some of them ''allopathic western medicine'' approaches, and some of them more holistic. Not all treatments will be listed on all pages (some of the pages, for instance, are actually sponsored by the company that makes the drug they recommend--so be aware of any potential bias in this regard). I hope you are able to find a treatment regimen that works for your family. Good luck!
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