You have legitimate concerns. Transitioning into middle school is one of the toughest times for a child and is often where a student who has gotten by will fall behind.

“He has a hard time figuring out what he just read and forgetting how to do math problems.” This sounds symptomatic of Visual Learning Disabilities–have you had him tested? He could easily have worked around a LD to get him to this point.

“Are there long term side effects I should worry about? ”
“Will this drug have immediate effects?”
“Will he retain and comprehend information on this drug?”
These questions your doctor must answer.

Public schools are required to provide whatever is needed for your son’s education, and that is good. However, they can be a quagmire. You will need to stay on top of the school to see that they are following their own recommendations!

Overall — don’t panic! Your son will still be able to graduate and live a normal life…ADD–with or without meds–is not a death sentence, and is sometimes misdiagnosed in place of a learning disability. Please note that there is no pill to sell you to treat a visual learning disability.

Here is my advice:
1. Interrogate your doctor about every little concern you have about the medications.
2. Have your son tested for learning disabilities to eliminate them as a possible cause.
3. Be in regular contact with his school to ensure that the accommodations he needs are being made.

Best wishes,
Allen Dobkin

My child is 13 years old, he has been challanged with schoolwork since the 4th grade. I recently had an appointment with a doctor who has advised us to try Methylphenidate Hydrochloride 5 mg oral tablets. He has been in a private school and we have paid for tutoring to try and keep him up to speed. This has been his worst year ever (7th grade). I have since pulled him out of private school and he is now in public school. The private school did not have any resources to help my son and the public school will. Do I give him a chance without medication? Do I try it for a month and see if there is any improvement? Are there long term side effects I should worry about? Will he retain and comprehend information on this drug? He has a hard time figuring out what he just read and forgetting how to do math problems. Will this drug have immediate effects? My husband and I are in disagreement in regards to the medication, I feel something needs to be done. This has been my son’s worst year (7th grade) and I am fearful he will only lose ground if something is not done to help him. He has been in a private school since the 3rd grade and has had tutoring outside of the school to keep him up to speed. I have removed him from private school, they could not and would not help him bring his grades up and I have put him in public school. Any information you can give me would help me.

Aloha a huihou,
Hassie Mae Zitnik

You are absolutely correct. There is a wide variety of severity in ADHD. Certainly in your son’s case, the medication was needed and helpful. It is interesting to note how a child with a strong hyperactivity component is quick to be diagnosed and prescribed, but the “space cadet” who is just quietly in dreamland is overlooked until much later.

I don’t think I suggested that chaotic family life is linked to the development of ADHD. It sure can make it worse, though. The last thing a child with ADHD needs is anxiety from home. They have enough to deal with, with or without medications.

As for the article’s suggestion that some parents are quick to give their children medications, that too varies from case to case. There are many instances where there is a clear need for medication, it is properly prescribed, and results in improvement. However, there can be problems when doctors do not agree on a diagnosis, or when doctors prescribe combinations of medication for children when there is no evidence that such combinations are helpful.

Diagnosis Disagreement:
http://www.nytimes.com/2006/11/11/health/psychology/11kids.html?ex=1171947600&en=8887028935214782&ei=5070
Pill Cocktails:
http://www.nytimes.com/2006/11/23/health/23kids.html?ei=5070&en=3bacd18b3c841c91&ex=1171947600&adxnnl=1&adxnnlx=1171812482-hExvScUEKNOzk0MEa65tOQ

Parents of course rely on the expertise of their doctor, but doctors are under a great deal of pressure from pharmaceutical companies to diagnose and prescribe. Not all chaotic behavior is cause by ADHD, but if the doctor recommends an alternative to pills for ADHD, then he may lose out on some perks. Here is an example:

http://www.mercola.com/2000/jan/23/drug_co_gifts_affect_doctor_practice.htm

So, yes, there are many cases where medication is a life-saver for children and families dealing with ADHD. There are, however, a myriad of reasons why a family might choose or wind up giving their child a dangerous or unhealthy combination of medications for which there is no evidence of efficacy. An alternative treatment to ADHD, whether diet, parenting, talk therapy or magic crystals must also provide evidence of effectiveness. The difference is that eating a healthier diet, seeing a counselor or even wearing a useless trinket may not be effective, but has no dangerous or potentially life threatening side effects.

Sue, please come back and give us your insight in the future. You have a great perspective and our readers will benefit from your input.

Sincerely,
Allen Dobkin

In severe cases of ADHD it is cruel to force the child against their will to struggle to achieve the impossible and fail repeatedly. Their brains can unscramble and focus if they are given a little help in doing so. The behavioural treatment is also necessary but ‘complementary’. Without first achieving the focus and receptivity to discipline, instruction, learning and completing tasks you won’t get far.

Prior to medication we also started a wholefood diet and cut additives and have continued to investigate potential allergens but that was never more helpful than just providing more healthy eating. Neither food nor fish oil never caused any noticeable change in behaviour.

Furthermore I take issue with the notion that the development of ADHD is in any way linked to ‘chaotic’ home life/family dynamics or poor parenting. However it is true that ADHD certainly contributes to and indeed can be a direct cause of chaos and stress in the home.