ADD Medications & Meds Management

College freshman has started taking Adderall

My son, ''Steve'' is a freshman in college and has started to take Adderall because he says it ''focuses'' him when he does his homework. Steve thinks he may have ADD because this medicaiton is so helpful to him, but I have not noticed any ADD symtoms when he was living at home. Also, Steve is a straight A student going to a very selective college and I don't believe he could preform at that high level of funtioning if he was ADD. I am concerned because I have heard that Adderall can be addictive and also because he is getting these medications from other students. Steve says lots of students at college use Adderall, but I am still very concerned. Any advice would be appreciated. Worried Mom

Need new Dr. for teenage boy with ADD

My 13 year old son recently started taking medicine for ADD with positive results. However, he really doesn't like the doctor - an older woman who doesn't connect with him at all. I would really like to find a doctor in Oakland/Berkeley who can prescribe the medication and is good at connecting with teenage boys. Any recommendations are greatly appreciated. Also, he is having a harder time falling asleep. If anyone has advice on this issue that would be great as well. concerned mom

With regards to not falling asleep easily, our son is on Ritalin and had the same problem. We were told to try Melatonin by another parent in the same shoes. After checking with our pediatrician and Berman, he took it. It was a miracle; 30 minutes after taking it, he was sound asleep. This works as long as he is in wind-down mode when he takes it. I get it at Trader Joe's under their brand. It comes as 500mg chewable tablets. My son only takes one, but we were told he could double it. Good Luck

Adderall and facial tics

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

My one caveat is that you do need a doctor who knows what they're doing and is going to be systematic, knowledgeable and objective about what is really a PROCESS. The MD shouldn't just throw the prescription at you and run. They've got to check in with you and follow up and keep tabs on your kid's growth. best wishes

1. Local resources: local CHADD chapters, support groups etc etc can be found at http://www.chaddnorcal.org. It's a great starting point and you will be welcomed at our meetings!

2. Information: there's a lot of misleading information and scare stories out there. I'm an engineer and like to understand how things really work under the hood. The best book I have read which has real, hard research-based information is by Paul Wender ADHD: Attention-Deficit Hyperactivity Disorder in Children and Adults. Oxford University Press, 2002. It goes into the neuro-chemistry, clinical case-studies etc.

3. Meds.

* I take meds every day and they're helpful.

* Delaying meds will not *harm* your son.

* Ritalin may or may not be the *right* medication - it did not work *for me*. If it makes a positive difference, great. I had BAD sides effects with Strattera which, anecdotally, are experienced by many males although denied by the pharma company. The only times I ever got driving tickets was when I was prescribed amphetamines.

* Meds ''the most effective treatment bar none''? This underestimates the significance of complementing with non-medical support. In my and my friends' experience, meds alone are NOT enough, and you may need to experiment with various organizing strategies and techniques. If you can get him into various habitual daily rituals (making lists and checking them) it will make a huge difference, especially when you and supportive adults are not around.

4. In my experience, many non-specialist educators and medical staff talk very knowledgeably about ADHD although (a) their knowledge comes from third-hand sources and (b) is several years out of date, typically gained through CE credit courses.

5. ADHD is a gift as well as a frustration. Find ways to exploit, develop and enjoy the positive and creative and fun sides of ADHD as well as 'fixing' the disadvantageous side-effects. This will help your son It is important to understand that your child does not have a problem, but a condition. Steve

How did you decide to try ADD meds?

Both of my kids, now 7 and 8 (20 months apart) have been little handfuls since birth- very active, very verbal, very intense, very creative and very bright. In fact, they were great babies, and we gave ourselves all the credit for raising them ''right''. Both of us parents were similar as kids and it was not thought to be more than a strong personality. We used to joke about ADD, but imposed as much structure as possible and learned to enjoy the chaos...then they started school. Both have problems there, primarily impulsiveness and emotional reactivity. One is gifted based on testing and off-the-charts active, the other distracted, dramatic and dreamy. After one too many discussions with schools, we started family therapy directed at behavioral modification (1-2-3 Magic, etc.) and have instituted every nonpharmacologic approach to ADD on the books. I am a researcher, but I have even done things that have no proven benefits based on research, such as limiting sugar.

Nothing is working for school and whenever we go out to public events (BD parties, etc get them overexcited) although their behavior is markedly better at home. I have tried to think of their ADD as a personality type that can be adaptive in many ways. I work with alot of successful adults who were hyper kids. I cannot seem them as ''diseased'' or having a brain disorder.

But we now are beginning to understand why people medicate their children like ours- the reaction of teachers and other kids and their parents to them causes us and the kids alot of anguish. People are quick to assign blame. It's assumed we do not discipline our kids (and yes, we don't hit them but there are very clear consequences when they misbehave, but impulsive kids still lose control of themselves at times) or spend enough time with them (both parents work), etc. I am tired of yelling at them and dampening their exhuberence, which I have been advised I must do to get them to be able to behave at school and in public. They never were allowed to run around screaming, but you have to shout to keep them in line and impose consequences daily. I am NOT setting expectations too high- as if!- I'm sure half the parents we come in contact with assume I'm too lax. But they also think it's unseemly that when one of the kids get revved up, I have to speak firmly to them in public.

They have friends because they are creative and funny, but if a kid wants to be mean, they choose one of mine. When my kids get upset, they often cry or ''take a swing'' back- very rewarding to tease with low risk of retribution. They both do well in school, but are felt to be underperforming by teachers- one's messy handwriting is said to be a sign of insufficient pride in work product, the gifted one can't sit still for reading aloud. It's one month into the school year and I have been to 2 ''conferences'' about my problem children. I am in tears and stressed out daily- trying to hold the line on their behavior and bear up under criticism, snide remarks and ''advice''.

Here's the dilemma- do we give them medication? We promised ourselves we'd give the other path a full year to work and if anything, things are worse as one year later. I just can't yell anymore at kids who really are trying their best. I know they will gain self-esteem if their schoolwork begins to show their potential (I myself am less concerned about ''grades'' at this age but they both are very invested in school despite daily negativity there). Our medical advice is that it's time to give it a try. One kids is getting too dispirited from all the criticism and the bouncier one is starting to lose his temper from the same. I know I will likely be judged negatively for medicating the kids too, but I am concerned that they used to be hyper and happy, and now they are hyper and anxious.

I am asking for support in general from parents of kids like mine. If you gave your kids medication, what tipped you over into that decision? Did the ''shame and blame'' from outside the family play a role? Did it just wear you down to deal with their behaviors constantly? Did the meds make them into zombies? Some days, I really just want a quick fix, but my real concern is their happiness and future well-being- and it's starting to seem one or both might be happier on meds. not quite super-mom

Use your skills as a researcher and do a lit. search--look at what works, look at what people do in other countries, look at the risks and side effects of ritalin.

Honestly from your letter I couldn't figure out a reason why you wouln't want to try medication. Because people are going to judge you?

Keep in mind if your kids are zombies from the meds. then it isn't that they shouldn't be on them, it may be that they're taking too much.

Get a good doctor who knows about this and then go for it. What do you have to lose?

Also, your kids sound almost old enough and together enough to have an opinion about it themselves. Ask them whether they like it. Sometimes kids like it and feel so much better on medication and ask for their medicine when it is stopped. extremely thankful my child is on medication

If you have not yet seen this site, visit: http://millermom.proboards23.com/

It is a huge source of support on all these issues and includes a large section on complementary & alternative treatments, which work well fro some kids. There is also a large section on conventional medication.

We did a trial of medication when our daughter was your kids' age and the side effects were just too tough to deal with, due to her metabolism, I guess. A few years later we tried again, and it has been really, really good. The side effects have been tolerable, and most importantly, she feels like it is really helpful. It helps her with attention and also with impulsivity in her social interactions. I'm fairly certain that without the meds, her life would be much more stressful and home life would be much more bitter. She's not zombie-ish at all. It seems the key is a willingness to work through the trial-and-error period to find the right medication and dosage-- and that can be trying.

Best of luck on this journey, Sympathetic Parent

Medication is not a miracle although we saw a difference in our child within the first few weeks of starting. What it has done for our child is help him focus and control his behavior just enough that he can engage and learn in his school environment and start experiencing some of the success that is rightfully due to him because he is smart and bright and can be a pleasant guy. We use the lowest dosage that we are comfortable with and that appears to make a difference. We use his more balanced personality as teaching opportunities to empower him to take responsibility for himself. Now, I'm convinced we did the right thing and could kick myself that we waited 10 years before getting help for our child. Because he has had some real success, I hope that as he grows older and his maturity and physiological system catches up OR he learns about better behavior and can more control his actions he may be able to eventually be med free. But I would also support him staying on the med as long as he benefitted from it. We'll just have to see what the future holds. Happy to have a happy kid

I wanted to write to tell you that trying meds was the best thing we could have done. My kid is still his same wonderful smart weird energetic (and occasionally very trying) self, but it is just much easier for him to focus and control his impulsivity. He handled what could have been a very difficult transition to middle school this fall beautifully. He likes school and is doing very well there, both academically and in terms of behavior. He would tell you himself that it helps him to take the medication. One initial issue was getting the right drug. He started on Concerta, which kept him up all night, but after switching to Ritalin, that was much better. The other, ongoing, issue is that he doesn't have much appetite in the middle of the day - we've had to be pretty vigilant about making sure he eats.

I would encourage you to get a second medical opinion if that would help, and then just to give it a trial of a month or two. You can always take them off medication if you feel the harm outweighs the benefits. I still cannot necessarily say I'm thrilled at the idea of medication, and I just have to tune out those who want to be judgmental about it, but our experience has been very positive. Good luck with your choice. Been there, doing that

It is all a very painful process -- for both your children and for you. It never ceases to amaze me how other people make such negative assumptions about your parenting skills when your children ''act out.'' In our case, we had to battle not only other parents, but the school, where the principal was very unsupportive and, despite a public pronouncement of ''community,'' took a hands-off approach to creating a community for our son. We, like you, have clear rules and clear consequences and discipline at home, but suffer others' assumptions and implicit criticism when our child acts in a way that is contrary to their expectations.

Good luck in your decision. anonymous

Do you know that your kids have ADD/ADHD? Have they been diagnosed? If they havent, you need to do that. If they have you need a really supportive doctor. I use Brad Berman who is WONDERFUL. He really likes my kid! He really cares. Hes told my son to call him anytime. They have one-to-one talks. Brad tells my son how terrific he is and is frank about the issues hes dealing with. My son too is gifted, cares about school, has friends. But the ability to control himself is not all there yet. We decided to put him on meds when he expressed his concern about how things were at school. He is very clear that having meds helps him focus on school and on his homework. It has helped with his cooperation as well. He was already a very self aware person not that he sat down and talked a lot about it, but at times he certainly does. It has made life much easier for everyone and school is much better. We also decided in middle school to put him in a private school with whole-child approach - that is they care about his mental and emotional state as well as his academic performance.

By the way, I got the recommendation for Dr. Berman a few years ago from this list. His office is in Walnut Creek and his phone number is 925-279-3480. There was a waiting list for new patients when we signed up. But I left a very frank message about how hard things were and they got me in earlier.

Good luck! Don't be afraid of meds.
a mom who has been there

I am also a volunteer facilitator for an adult support group and a certified parent trainer for CHADD. I hear a lot there from people who have experienced AD/HD from both sides, medicated and non-medicated. chadd.org has a national clearinghouse and it is a place to get information about medication and support groups for parents. Schwab Foundation has a parent message board.

In my private educational therapy practice I see people who have had both good and poor results with medication. It's not for everyone and it's a very personal choice. Medication works best with education - of kids, teachers, parents, family, friends.

The practical considerations you mention are the reality of life with ADHD in this time and place. It's not easy, but it doesn't have to be awful! Good luck to you. linda lawton

Rages in 13 y/o on Concerta/Ritalin

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

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

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

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

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

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?

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!!

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

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 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

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

ADD Treatment without Medication

Fish oil for ADHD?

Not asking for medical advice here, but personal experience only. I've read the Australian study that said around 40% of 7-12 year olds they tested had the same improvements with their ADD/ADHD symptoms (focusing, impulsivity control, etc.)after using a certain amount of fish oil, than as if they had taken medications. Has anyone had luck with the fish oil? How much did you use? I'm seeing alot of different info on dosing amounts. I'm also wondering how long the fish oil takes before being effective. We gave my diagnosed child the smallest amount of Concerta possible for 1 day. It was amazing to see how it effected him just for one day, but then he stayed up ALL NIGHT LONG. I know we can go back to the dr. and get new meds, but I ran across the fish oil thing and thought I'd try it. anon

However I do have a 9-year-old on meds for ADD and I do know exactly the problem of the ''big improvement, but now he's up all night.'' I just wanted to tell you not to give up on the meds yet. We found that at Kaiser, they start everybody out on Concerta, but it does not work well for every single kid. It didn't work well for our kid - it kept him awake. But there are a LOT of different ''delivery systems'' for ritalin and you don't have to use Concerta. Talk to your doctor. We ended up consulting with a meds specialist to sort out the options (child psychiatrist at Kaiser). It turned out that our kid has a slow metabolism, so the timed-release meds like Concerta were just sitting there in his gut too long and then kicking in too late. Thus the all-nighters. We found something that works, and everything is smooth sailing now. But it took us several months of trying different things mainly because we didn't understand enough about what to look for, what the side-effects are. With ritalin (unlike SSRIs), you can see immediately whether it works, and immediately see the side-effects. When they stop taking it, it immediately leaves their system. So that makes it easier to find out what works for your kid.

Ritalin has made such a dramatic difference for our son. Without it, he can't function in a classroom at all, on any level. Not only that but his social interactions suffer because he can't hear what other kids are saying. (He has Inattentive Type ADD). I wish we had tried it sooner than 3rd grade. I'd be happy to answer any questions about our experience.

In any case, on so many levels my decision to try medication for her was one of the best I've ever made. Her grades sky-rocketed, her social interactions and friendships improved dramatically, and home life got less chaotic, particularly around homework and chores. In fact, she thanked me for having her take them. I now wish I hadn't waited as long as I did (5th grade).

There are many options in terms of meds and forms of delivery. The time-release options did not work (they ''ran out'' early rather than keeping her up) and others gave her stomach upset. I did not want her to have the stigma of going to the school nurse to take a pill at lunch, her doctor suggested the daily patch (Daytrana). It is fabulous, but very expensive, so it is usually not a first choice (particularly for Kaiser, I would assume). She takes it off around 5 p.m. and has no problems getting to sleep.

In retrospect, I realize there is no reason not to use medication. She is not ''drugged'' any more than a kid with Type 1 Diabetes is ''drugged'' when they use insulin. Mom of happier child

Since your son responded well to Concerta except the sleep problem, I suggest you try the short-acting Ritilin or generic equiv. methelphenedate. Same stuff without the candy coating. Although we give our child Concerta most days, I prefer the short-acting which has no candy coating to introduce digestive variables. We also must ignore instructions to give the drug on an empty stomach since it suppresses our child's appetite.

BTW, we decided we'll feel guiltier depriving our son of the drugs than we will giving him the drugs. One mom said, ''If I could get a drug to help my child, I would crawl across burning coals to get it.'' Either way, we'll feel guilty. And we cannot get our son to sleep on time with or without drugs, so you are better parents than we are in that respect. - Hope this helps -

Neurofeedback training for ADD

I would love to hear from anyone who has any experience with neurofeedback training for children with learning difficulties. My son is a 4th grader with inattentive type ADD. Searching online, I found the Attention & Achievement Center (4 bay area locations) as well as a handful of independent practictioners. Please share any experiences you may have as to the efficacy of the therapy itself as well as any reviews of local practitioners. I also would like to find out how much it costs (and do costs vary much among providers). Heidi

I'm not saying that neurofeedback does not work. It does but it's finding the right practitioner. Susan Snyder, PhD does neurofeedback but I don't know if she works with children. Her contact number is 925-388-2001.

There is no easy answer. It takes a lot of work and any one who makes outrageous promises - beware! Anon

Feedback about Attention and Achievement Center

I am considering testing myself and would like to know if you have any feedback about this place. I would love to hear any positive or negative feedback you may have experienced or heard. Since the treatment is very expensive I want to make sure it'll be worth the money. http://drugfreeadd.com/ Thank you!! Ann

''... While Ali Hashemian and other providers of complementary and alternative services hold private certification from independent credentialing bodies, such services are not regulated by the government and no licensing is offered. As such, providers of alternative or complementary services, including Ali Hashemian, are not, and are not required to be, physicians, surgeons, psychologists, or mental health providers and are not licensed by the State of California as healing arts practitioners.''

Yes, treatment was performed by his administrative staff. TM

I am thinking about using the Attention and Achievement Center in Walnut Creek(also Pleasanton, San Mateo and Fremont) to assess and treat my son for ADD. Has anyone used them and how do you feel about the results? Thank You

Their team of professionals are independent contractors which mean they refer to one another. There is very little coordination with the work that they do except take your money. I was certainly disappointed with Attention & Achievement Center. The neurofeedback my son received did not make a measurable difference with his ADHD, if any at all. Be sure to read their LEGAL DISCLAIMER carefully. A Wiser Mom

Dr. Stein's book about parenting ADHD no drugs

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

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

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

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

Non-medical remedies for 9-year-old's ADD?

I would like some advice on hermal remedies for a 9 year old diagnosed with add. We have evaluated her, and a very conservative doctor diagnosed her add and wants to medicate her. I have battled with the thought and have finally come to the conclusion we need to do something. We are tutoring and helping at home all the time. I just can't bring myself to do the drugs. When she was little she was harrassed by my husband for not eating well(he's greek) and since we've had her tonsils removed, she eats great now, but is now calling herself stupid. The biggest side-effect to all the add drugs is loss of appetite. Other than the fact that I don't like the idea of my child on a narcotic, even if I could do that, I don't think she or I can deal with her not eating again and the negative effects on the household. Hopefully, being from the Walnut Creek area, all you great Berkeley-ites could recommend some herbal remedies? At my whits end

If she is concerned about being ''stupid'', stimulant medication is much more likely to help her to change this self-perception than any herbal remedies are. And please remember that herbal remedies have psychotropic effects too (which is why they would have any impact at all), but they are generally untested in terms of their effectiveness and side effects. Also, FYI, ADHD is never treated with narcotics. It is typically treated with a stimulant. Stimulants are very short acting and are not addictive. That means within a matter of hours you should see a positive effect on your daughter's behavior and there is little risk to a short-term trial (e.g., a few days). If stimulants aren't effective or if the side effects are intolerable, you'll find out very quickly and can discontinue medication. Good luck! I know you have a difficult decision to make. Liz O.

So I absolutely, positively know where you are coming from and you were totally right to try behavioral modification first (and as well as anything else). BUT... your daughter is coming up on the age when start falling off rapidly in school if the situation is not corrected. I also have an adult friend with ADD who says, ''Even with their side effects, finding a good drug -the right drug- was heaven and made my life so much easier.'' Since you say your doctor is conservative --by which I hope you mean she doesn't prescribe at the drop of a hat-- I really urge you to send your husband to the doctor with your daughter to be educated on the issues... and then try the drugs. They are not forever, they are not all the time, and if they don't help you can stop.

It always bothers me that folks are willing to try herbal remedies that have not been tested and are often not administered by a licensed practitioner. We are, after all, talking about a herb that will affect brain chemistry! Why should it necessarily be better or safer than taking a known quantity in a pill?

As for my own daughter... she's in high school now and found her own solution in a strenuous sport plus the maturity to stay on fixed, regular schedules. But it required a LOT of parental committment and I still think we were awfully, awfully lucky that we were able to keep her on the educational bandwagon until that happened. ADD Mom

''Stupid.'' It is very easy to absorb the messages coming from doctors and schools that there is Something Wrong with you. Your girl seems to have learned some of these lessons already. Then comes that cycle where, the more you tell her she's not stupid, the worse it gets. I don't think there is anything Wrong with your daughter. I feel it is key that you create an atmosphere which lets your daughter be smart, and for that to happen, you and your husband need to believe it first. So she learns differently from other kids. So what? I'm sorry that it's hard for all of you right now, but ADD is not so bad. The real danger is that she hears ''there's something wrong with you'' and ''take this pill, it will all be better". I think that's a very dangerous lesson. Instead, what helped me was: ''of course you're smart and capable. Now let's figure out a way so you can show everyone else.''

I think it is great that you recognize the need to help her, but I would try a lot of other things before the drugs:

* More structure - having blocks of time assigned on a chart for different homework was helpful.

* Move! Get up, jump, chew stuff, walk around the room, whatever; it really helped me focus. My parents fixed it so that I was allowed to do this in class, too - great!

* Rewards for increased independence. My parents helped me a lot, but weaned me by letting me know (gradually) that I was smart enough to work on my own. Then they just became the homework checkers.

Maybe you could try to find some physical outlet for her, like a sensory gym where they allow kids to race around and pillowfight, and such. Those are great.

Best of luck to you, and may you never lose patience with your bright, beautiful girl! Fine Then, Better Now

One dose of appropriately prescribed stimulant medication will do more to eradicate your daughter's sense of being ''stupid'' than almost anything. My daughter's life was changed with the first 15 mg dose of ADD meds... when she was 15. Within an hour she knew her ADD was real, and could be harnessed --- and for the first time she really believed she wasn't stupid... even though we'd been telling her for years that she was smart. She has taken meds continuously since then, but not every day or all the time. As her study skill improve and her impulsivity declines I predict she will not take them anymore...maybe 2 more years.

If we'd known about the ADD when she was 9, we would have done the same thing then, instead of 6 years later...

For me meds for ADD are like eyeglasses for myopia -- I would be cautious about getting the safest glasses I could and the ones with just the right prescription -- but wouldn't deprive my child of glasses because they might have unwanted side effects.

I understand your concern, but weight loss or loss of appetite aren't always side effects, and there are ways of dealing with either one if it happens. ADD mom of a (smart!) ADD daughter

7-y-o with ADD diagnosis: did you try meds?

My 7 yr old first grader has been given a definite diagnosis of ADD Inattentive. My son is a highly compassionate, fun loving, creative ''space-cadet'' type, who gets along with all his peers. All the adults he interacts with think he is a delightful child, including his teachers. I would not call him hyperactive, although in a classroom setting he fidgets and seems unable to stay focused on classwork. The only challenges we have encountered with him are in the classroom, where he seems unable to stay on task.

The doctor who evaluated him did not observe any learning disabilities, and seemed very convinced that a 5mg dose of Ritalin would greatly help him during those morning hours in school. His learning would improve and we were not likely to experience any negative side effects. We obviously want the best for our child, and it seems to us that if this is the case, if medication will give our child an immediate benefit, that we should start treatment now.

I should note that the teachers and administrators at my child's school have been very helpful and supportive, and they have already taken (and will continue taking) all kinds of remedial measures to help our child in the classroom. However, there is only so much that they can do, and they have expressed concern that in later grades, when the learning is more challenging, and the workload is greater, our child will become frustrated and his self-esteem is likely to suffer.

My question is to parents who have a child with similar characteristics diagnosed with ADD: Did you try medication? Did it help? What were the negatives? I am especially interested in hearing from parents who decided to wait a couple of years: Do you see the benefits of having waited?

I know there are a lot of horror stories circulating about Ritalin, and I am not interested in hearing about this, unless you have had direct experience with your child. Also, please understand that we are not parents at the end of the rope who are desperate to fix some behavior problems, this is not the case. We have been told that the most effective treatment bar none for our child's problems is medication, and we are wondering if there are any reasons why we should delay it.

Thank you! Anon

At your son's age organizational or occupational therapy might be great -- but I would not hesitate to give a 7 year-old the ability to be ''like everyone else,'' and that's what Ritalin has done for us.

I tell people that stimulant meds for ADD are like glasses for myopia... some folks do fine without them...if they're only slightly out-of-focus to begin, and can develop coping skills to deal with their challenges. No questions here!

Although his teachers have consistently remarked on his attention issues, I resisted having him tested for ADD, in part because I was/am dubious about pathologizing what seems to be a common and benign characteristic -- i.e. dreaminess. Because S was basically mastering all of the skills he needed to until this year, I hoped that he'd learn to pay attention better as he grew up.

Fourth grade was a tough transition. As he is in public school, his class went from 19 students to 27. Assignments, both in class and homework, became more demanding, requiring more sustained effort. For the first time, S became conscious and bothered that he was not performing on some assignments as well as his friends. His self-esteem was plummeting during the first semester, especially as his teacher was big on timed arithmetic tests, which he found excruciating. He broke down on several occasions, telling me that he was going to flunk 4th grade.

So, we had him tested and diagnosed in November. His teacher made a bunch of accommodations, which have helped, but she says that he's shown marked improvements on math and writing since we began the Ritalin in February (confirmed by my own ''blind'' test - a series of math quizzes on and off the meds).

I'm not crazy about my kid being on a stimulant, and I am comfortable that we waited until the attention issue became a self-esteem issue for him. If we could afford to send him to an arts-oriented school with very small classes geared towards dealing w/ kids w/ ADD, I'd probably do it. Reality being what it is, I've accept him being on the meds because his attitude about school has improved dramatically, and he is now keeping up or excelling in each subject. (BTW, he started on 10 mg, which did nothing. He is now taking 15, which works fine.) Another mom of a space cadet

Just remember it is called a drug TRIAL. You TRY the dosage and drug on your child to OBSERVE if it makes a difference. You get your child's teachers to fill out an ADHD questionnaire (like the SNAP) before medication has begun and then at the end of the 1-2 week drug trial so you have an objective measure (although it may be obvious that it helps or does not help). Your son sounds pretty insightful so you can also ask him how it makes him feel. Ritalin is a short acting drug that will leave your child's body FOREVER after about 8 hours. Giving your child a few pills is NOT like deciding to do some type of irreversible surgery. If you do not like the drugs, you will have the power to STOP or try a different dosage/type. If you decide to stay on the medication then every year or so you will see what happens if you stop the drugs and in order to decide if your child still needs them.

I am sorry if I seem impatient, but I have seen this question so many

Helping child with ADHD, not on medication

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?

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

Diet, Sugar, and ADHD

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.

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."

"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."

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

ADD diagnosis: How are you managing with Ritalin?

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