I am neither for, nor against, medication for a child with ADHD, whether primarily Inattentive type (ADD), or Active type (ADHD), but an exploration of alternatives is warranted. I think this is an agonizing decision for most parents who are faced with the question, with deep concerns. Knowing what is best for your own child is most difficult-- since the outcome isn't known until you've already started down the path. No matter which path you decide upon, I think it helps ease the burden to know, you may always change your mind later.
Factors you should consider:
- What behaviors
- How critical
- What are
- Can the main
- If the goal(s) can be met in other ways, are you willing and able to provide the
A common concern for parents of children with ADHD is fear of the long-term ramifications of using medication. Many parents don't want their children to be dependent upon a brain stimulant. There are alternatives for raising the level of chemicals in a child's brain without medication. One way of meeting the need for additional brain chemical stimlation for a child is through intense daily exercise. (continued below..)
If you choose not to use medication, insuring your child gets a good 30--45 minutes of intensive physical activity EACH day can be critical. The intense exercise helps an child with ADHD burn some energy, helps raise the level of serotonin and dopamines in the brain (which is what the medication does). Raising the brain chemicals helps the child focus longer on school work, improves memory, and helps the child be less impulsive. Exercising can vary from day to day, and can be accomplished through physical activities that interest your child. The activity level may be a bit much for you, but it is a sacrificial decision you'd make to make coping with ADHD feasible for your child.
As an example, your child could do karate two days a week, tennis two days per week, go for a walk at the park two days per week, and sometimes do other things--like wash the cars, or vacuum the whole house, etc. Although the active schedule might be difficult on you or seem like it will break the pocketbook, you can find inexpensive community-based classes, engage in activities that have no associated cost, and you will eventually adjust to your new routines.
There is a lot of neuroscience behind brain development and the treatment of ADD/ADHD. Programs such as Brain Gym or Balametrics, or treatments at the Dore Centers can help stimulate your child's cerebellum, thereby alleviating ADD/ADHD symptoms. Some people report excellent results with cerebellar stimulation exercise programs, but there aren't a lot of controlled scientific studies proving its effectiveness.
Another way of dealing with ADHD is through ongoing family counseling. Couseling
helps you deal with ADHD issues and to help your child learn more appropriate
behaviors and reactions. Sometimes the child may go in to work with
the psychologist one-on-one, sometimes the psychologist will see each
of person one-on-one, and sometimes will see everyone as a family. You
can get a psychological referral from your pediatrician. Ask specifically for someone who 'specializes' in
working with children who have ADHD, learning disability issues, or or specializes in neuropsychology.
I think many psychologists who specialize in ADHD, learning disabilities, and family counseling approach the situation differently than typical medical doctors (who may see medication as a quick cure all). A good doctor will be willing to work with you either way you want to go. Whether you choose no medication, knowing you have more work cut out for you, or choose medication, your family will need good advice and a professional who is willing to accept your family's individual decision. Whatever you decide, you will likely need ongoing support for your family and child.Counseling for ADHD issues doesn't have to occur weekly. Counseling can take place once or twice per month, depending upon how intense the situation around the house is.. Not a lot, but enough to help deal with issues that have surfaced since the last visit. The counselor can help come up with ideas for you to help your child understand he MUST do school work, and for helping him stay focused. The counselor will listen to you vent when you're exasperated. For our child, the counselor helps him reflect on appropriate or inappropriate behaviors and expectations, and helps him with ideas for dealing with frustration or tasks he's disinterested in completing.
With regular counseling, your household can run smoother, and everyone will cope better. Family counseling helps everyone be a lot less frustrated, and there is less chaos. I think the regular counseling, combined with other non-medicated solutions, makes a difference similar to what you'd see with medication, it just takes a bit longer to get settled down (about six months). I understand medication makes a relatively immediate difference, but takes a few weeks to determine the correct dose, and can take six months to find 'the right' medication and dosage. (continued below)...
Another means of addressing ADHD without medication is through diet. There are several experts who have written books about ADHD and its correlation with artificial chemicals in our foods. Probably the most widely known expert source of diet related information is the Feingold Association. This is a non-profit organization dedicated to helping children and adults apply proven dietary techniques for better behavior, learning and health. At the very least, eliminating "junk" food can help. However, eliminating junk food is seldom sufficient for eliminating ADHD behaviors. MOST of the packaged foods contain some sort of food dye or perservative which can have pervasive effects. If you are not going to choose the medical, medicated route for your child, making some dietary changes will be beneficial. Please check out the Feingold Association for specifics on making significant dietary changes that may benefit your child.
You still may not know whether you want to medicate your child or not. If it helps at all, one teacher-parent said she'd medicate her child if the child were in school, but not if she were homeschooled. In public school, it is difficult to control the environment sufficiently to address the needs of the child on an ongoing basis, so it is often better to 'make' the child fit the environment. home schooling parents can modify the environment and school situation sufficiently, so the child doesn't have to be 'modified'. Whether you choose medication, or not, could very well be dependent upon the bigger picture of your child's daily routine and needs.
While it may be difficult to think of modifying your child through medication, if your child is in public school, that may be the best decision for your child in the long-term. If you do decide to medicate your child, it will help you to find a doctor who specializes in ADHD issues. A specialist will be able to direct you in more of the aspects of dealing with ADHD than a general practioner, who may have insufficient knowledge of the specific problems and issues your child will be facing with ADHD.
Benefits of medication may include more immediate control of a child's behavior, immediate improvement in a child's ability to concentrate, and more 'availability' for learning based tasks. The level of improvement and immediacy of it will depend totally on the appropriateness of the selected medication and dose for your individual child. If the doctor happens to select a perfect match, you are set immediately. Most often, some modifications to medicines or dosages are required through an adjustment period.During the period when your doctor is trying to determine the best medication and dosage for your child, you may go through periods when your child has behavioral changes, changes in appetite, disrupted sleep patterns, etc. Talk with your doctor about any symptoms that are of concern, particularly those having any significant impact on your child.
Parents who have chosen medication give mixed testimony. Some have had dramatic, and outstanding results. Others have had a difficult road with many modifications in the child's medication with few definitive results. Some parents mourn the loss of a 'spark' their child once had, whereas others say they noticed no personality changes in their child. Likewise, some people who initially decided against medication had poor results and realized a tremendous turn-around once they decided to medicate. The outcome with medication will be very individualized for your child, and the outcome cannot be accurately guessed without trying medication to see how it affects your child.
What ever your decision may be, always remember you can change it if you need to. In all likelihood, it will take a period of adjustment, no matter which route you choose. If nothing else, I hope this page has given you some ideas about ways to help your child. Maybe it will even have cleared "to medicate, or not" question.
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