Reply to ADHD - medicate or not medicate?

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[quote=Anonymous]OP, my child was first diagnosed in K by a very thorough neuropsych. We knew he had anxiety and I was pretty much expecting the ADHD diagnosis, but no one else was, as his activity level was certainly within the normal range and he was very advanced academically. Later we started to see a wonderful developmental pediatrician as well. No one has ever pressured us in any way to put him on medication.

We work extremely hard to create a very structured environment for my son at home, making expectations very clear and consistent, making sure he gets tons of exercise, eats well, takes fish oil and vitamin D. My son  got an IEP in first grade because of serious writing issues even though his grades (except in editing his own writing) were all very high. The IEP included a lot of organization/executive function type help and, as far as I can tell, was very solid.

Anyway, where I am going with this is that children and their situation evolve. My son is very bright and academically oriented and could easily handle academics in early elementary years. Honestly, without excellent testing, we might have thought he was just a stubborn kid with poor fine motor skills. By the time second and third grade rolled around, despite being in advanced classes, his self-esteem really took a hit at school.  Turns out he has Dysgraphia, too.  The older he is the more obvious his attention issues are to me, to teachers, to anyone who knows him well. He can't get by on just smarts anymore.

To me, the medication decision is about whether your child is 1) open to learning and able to learn 2) able to make and keep friends and 3) emotionally strong and happy/able to enjoy childhood. For us, as it seems for you, we could entirely manage the behavior part with other techniques. When, on an emotional level,  our situation became insurmountable (child wouldn't leave the house, panic attacks, therapy wasn't working) we used anxiety medication and it was incredibly helpful--life-changing really. I wish we hadn't waited so long. We stopped after a while because son was in a much better place.

We also ended up taking him out of public and it was a very good decision for us. At this point (child is 11), I am much more open to trying ADHD meds, though it is especially complicated for us to try a stimulant because he is so prone to anxiety. Basically, I see the effect of attention issues on school work (not reaching potential, very hard to sustain attention for any length of time on writing tasks) and extracurriculars but since he is still okay in all of these and, importantly, happy and has friends, I am in wait and see mode.
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