There Are More Things Than Medicine To Help Children With ADHD
Question: Our son is in grade 3. We have seen the paediatrician recently and he confirmed that our son has Attention Deficit Disorder (ADD). From what we have learned, we have to agree. He has a hard time learning in school, and constantly disrupts everyone. Homework is a nightmare for all of us. The doctor has suggested that we give him medicine. We are concerned because we heard there are side effects. He is not a big boy and we worry about his growth. What should we do?
Answer:
It looks like that your son has been properly assessed and found to have ADD, and you have accepted the diagnosis. The difficulties that you face are what to do, how can you help him, what will happen if you give or don’t give medicine, and is medicine harmful in the long run. These are the same questions many parents with ADD children have. I will try to answer them here.
Managing children with ADD involves much more than medicine. Some children with ADD are hyperactive, and this can be hard for parents. Others have difficulty settling to sleep at night, or wake up very early in the morning before everyone else does.
Many of these children are impulsive, doing things without thinking or saying inappropriate things at the wrong time. As a result, some are more prone to injuries or “get into things.” Others have difficulty making or keeping friends. As you can imagine, some ADD children do not shine in social circles.
The first step to help your son is to know him well, know his strengths as well as his weaknesses. Many children with ADD are very bright, although they may be so distractible that they cannot do well in school. As a result, some actually believe they are stupid, and this feeling is often reinforced by adults and other children. The low self-esteem can become a stumbling block for them. Quite often I have to do tests to show that they are actually very bright, and the results frequently surprise the children and their parents.
Due to distraction, many ADD children miss out a lot in their foundation years in elementary school. When they go to higher grades, they lack the skills that others have already learned. As a result, some are thought to have learning disability. Quite often, once their attention problem is dealt with and given time to catch up, many of them can become successful. I have quite a few patients that are studying in colleges and universities around the Maritimes who have ADD, and they are doing well.
The bottom line is to come to terms with the problem after proper diagnosis. All of them will benefit from strategies that improve concentration at home and in school. Teachers have to make sure that these students are paying attention when they teach, and parents have to give them a quiet place to do their homework and study. It is hard for them to focus too long, giving breaks from time to time is essential. Regular exercise has also been shown to improve attention span of children with ADD.
In addition to academics, social skills are often slower to develop. For some reason, many ADD children have difficulty picking up social queue from others. Their impulsiveness may make them too bossy or competitive. The end result is losing or difficulty making friends.
It is important for parents and other adults to be aware of this problem and to assist ADD children with their social skills. Many school counselors are specially trained to help these students. Co-operation and co-ordination between parents and schools will benefit these special children.
Medicine does have an important role in helping children with ADD. I often compare this condition with diabetes. Not everyone with diabetes needs insulin, and insulin alone is not the solution either. They need to pay attention to what they eat, as well as getting regular exercise. However, if the body needs insulin to keep diabetes under control, one should not avoid it because of possible side effects of insulin.
The same is true for ADD medications. They do not cure ADD, but many children can benefit from them if they are used carefully with slow adjustment of dosage to prevent side effects. However, ADD medications have to be combined with all other aspects that I have discussed earlier. Most of these medications are extremely safe, without long term side effects. They do not slow down the growth of children, although some can have reduced appetite at the beginning.
Some parents, because of their worry about medications, do not want their children to take anything until they fail in school. I would caution against this approach. Many children with ADD suffer from poor learning and self-esteem for years before they fail. By the time this happens, many of them have already given up learning altogether. Complications like behaviour problems and anger outbursts can develop.
[Notes to Readers: This column, although written more than 20 years ago, is still very relevant in explaining about this common medical condition; officially, it is called Attention Deficit Hyperactivity Disorder (ADHD) with different subtypes or presentations (inattentive, hyperactive/impulsive, and combined). The importance of healthy eating, exercise, and sleep has not changed, newer long-acting medications have much less side effects and are more effective than older medications.]