Waiting to treat ADHD

[Anonymous]

I have 3 kids, 2 have adhd. My oldest is in 8th grade and has thus far been ok without medication (his ADHD is mild, only rears his head in non-academic settings, and he has strong executive functioning that balances it out. We are keeping an eye on it, but he’s a late physical bloomer and I don’t think medication makes sense yet). We are keeping an eye on this, though, because it looks like he might be having more trouble controlling outbursts in class and we likely have to deal with this before high school.

My youngest is in 2nd and is doing really well socially and academically, but he just can’t sit still unless in a chair and working. His teacher is great and is ok with some movement and is working with him on coping mechanisms (figits, chair that doesn’t move, etc). He’s off the charts bright, and no inattentive issues, so he gets what he needs to get out of school. His report cards are pretty great. I’m sure medication would help him stop moving, but if he’s doing mostly ok, and the teacher is fine occasionally reminding him to stop moving during an assembly or when sitting on a rug, are we doing him a disservice by waiting to evaluate him? With our oldest, there were no symptoms until middle school, so we didn’t have to deal with it at this early of an age.

[Anonymous]

Have you had your younger son evaluated? That would be the place to start. Teachers, at least in public schools, are not going to tell you that medication is needed, or even that evaluation is needed. They hint at it, but sometimes pretty subtly in my experience.

Also, it’s pretty striking that you talked about only the academic outcomes, not any of the social effects of ADHD, which can be devastating and are also appropriate reasons to medicate or seek other help. There are social skills groups aimed mainly for kids with ADHD.

[Anonymous]

Have you thought about something like a wiggle seat? It helped my kids. I donate several each year to the classroom so my kids and others can use them.

https://www.amazon.com/Trideer-Inflated-Stability-Flexible-Classroom/dp/B07CTCBM2S/ref=sxin_26_pa_sp_phone_search_thematic_sspa?adgrpid=118091407878&content-id=amzn1.sym.51ad5f28-6bb2-4d3a-805c-658551f1e021%3Aamzn1.sym.51ad5f28-6bb2-4d3a-805c-658551f1e021&cv_ct_cx=wiggle+seat+adhd&hvadid=664609589035&hvdev=m&hvlocphy=9051985&hvnetw=g&hvqmt=e&hvrand=15606915072975005945&hvtargid=kwd-526096726992&hydadcr=1336_13626374&keywords=wiggle+seat+adhd&pd_rd_i=B07CTCBM2S&pd_rd_r=ff1676ce-0b4c-4e08-9b7a-8b17325d0b90&pd_rd_w=Er6bb&pd_rd_wg=Xed5d&pf_rd_p=51ad5f28-6bb2-4d3a-805c-658551f1e021&pf_rd_r=6BHYD7M9QAH2CJCS10ZA&qid=1703943014&sr=1-1-364cf978-ce2a-480a-9bb0-bdb96faa0f61-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9waG9uZV9zZWFyY2hfdGhlbWF0aWM&psc=1

[Anonymous]

My youngest was similar. He *could* meet classroom expectations, but it took a lot of work, both from the teacher (movement breaks, sending him to the hall to work with fewer distractions) and from him. But it was like a duck swimming -- we couldn't see his hard work just under the surface. He became much happier after diagnosis and meds so that he doesn't have to work as hard.

Also, while you have an understanding teacher now, that's no guarantee for the future. A diagnosis opens the door to a 504, to memorialize those accommodations.

[Anonymous]

Our younger one is in private school and we’ve discussed meds with both his teacher and his pediatrician- both think waiting on meds makes sense because he truly isn’t having social problems and isn’t having issues learning or doing work. It’s really physical movement and occasional redirection. I’ll note that in his class of 15, he’s the only one lying in the floor during a story, for example, but other kids are walking around, talking, etc. I think both pediatrician and teacher think it’s possible some of the movement issues will mellow over time. I’m just not sure.

[Anonymous]

I am a teacher and agree that some kids are so relieved to get meds and are able to stop working so very hard to control themselves socially and behaviorally at school and in other settings.

You can try meds, and stop if you don’t see a big benefit and your kid doesn’t, either. So many unmedicated kids feel like failures and they try so hard.

Imagine if you had poor vision. You could always try to sit up front and ask to have things read to you and double-check everything, or you could get glasses and just be a student like everyone else.

[Anonymous]

Anonymous wrote:I am a teacher and agree that some kids are so relieved to get meds and are able to stop working so very hard to control themselves socially and behaviorally at school and in other settings.

You can try meds, and stop if you don’t see a big benefit and your kid doesn’t, either. So many unmedicated kids feel like failures and they try so hard.

Imagine if you had poor vision. You could always try to sit up front and ask to have things read to you and double-check everything, or you could get glasses and just be a student like everyone else.

That is such a good analogy. Accommodations are great and often necessary, but no substitute for actual treatment, when available.

[Anonymous]

Please don't wait. ADHD is a life-long challenge that spikes in different areas as they mature. It only becomes harder. ADHD can be very alienating socially, which gets increasingly difficult through middle school and into high school. Also, the academic challenges may still show up, so best to address them early before grades matter in high-school.
I only wish we had a clue about our child's ADHD when he was young.

[Anonymous]

I have a child a lot like your younger one and we have worked closely with a psychiatrist to decide to do non-stimulant medication only right now. That is partly because of an unrelated medical condition that makes stimulants more problematic. My child has to work hard to stay still enough to not be disruptive and I do wish I could make it easier. But this is the compromise right now. My DC takes clonidine and it has no undesirable side effects- the only one we have noticed is drowsiness which is great because DC takes it at bedtime and it helps with sleep.

It took 5 months to get in with a pediatric psychiatrist and that was with us being willing to private pay. If you are considering medication I would start the process of finding someone now before you REALLY need it. I am so thankful if things start to deteriorate we have someone to help us figure out what to do next.

[Anonymous]

I have a child with ADHD (combined-type). Child was extremely hyperactive and impulsive and also has reduced attention to details and lost things easily when younger. This was my first child. I wasn't sure what was developmentally appropriate. Family, friends, and even the K and 1st Grade teacher told me it was "normal boy" and school wasn't worried because he got great grades and is advanced academically. We saw a clinical psychologist for some testing to get the ADHD diagnosis. We told school and got a 504 for accomodations. Our child was so relieved to know he had this condition. He was so frustrated and had lower self-esteem from getting in trouble for being "too silly" or "not safe." Medicating my child for ADHD was one of the best decisions of my entire life. At first we used pediatrician for medicatiohn. We tried the stimulants, which he didn't tolerate. We switched care to a developmental pediatrican and tried other medications (one anti-depressant- didn't work) and non-stimulants. We continue to see the developmental pediatrician and are considering trialing the stimulants again to see if they are more helpful, since the teen years are bringing on some new challenges with impulsivity.

I 100% recommend trialling medication. That doesn't mean it will be easy, but it is 100% worth it and your child deserves the best. It is wrong that parents and society are against medication for a neurologic condition.