ADD: should we medicate our child?
When the teacher identified a problem, this parent faced a difficult decision.
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It started in Grade R. The first time my son’s teacher sat me down and suggested that my son might have issues with his concentration and that there might be an underlying issue, I was quick to dismiss the possibility. I reasoned that he was simply younger than all his classmates (he was 5 going on 6, instead of 6 going on 7 like his peers) and that his apparent inability to concentrate and keep up with the skills being learned in class was age-appropriate.

Denying the disorder

There were other complicating factors. He’s left-handed, which according to his teacher put him at an immediate disadvantage and he battled with things like cutting, colouring and spatial development. He struggled to complete tasks, couldn’t stay focused and was always interested in something else – anything else but school and work.

His teacher brought up the possibility of medicating our 5 year old, and my husband and I both baulked at the idea. We decided to delay making the decision for as long as possible, by trying occupational therapy and dietary changes. We were advised that Omega oils could help, and we tried all the things everyone else (family, friends, doctors) suggested.

Our son scraped through Grade R and we didn’t make a big deal about it. His teacher was extra-vigilant and extra-attentive of our son, and would call me in to discuss any concerns she had about performance issues in the classroom. We worked on extra skills at home, together, in the hopes that he would outgrow this phase.

The first time we saw a psychiatrist specialising in ADD/ADHD disorders, I sat in his office with tears streaming silently down my face as he explained to us that it made no difference how much Omega oil we gave our child, or how much extra cutting practice we did – ADD is a condition that’s bigger than that. It’s the brain’s physical inability to concentrate.

Defining the disorder

Our son, he said, was not ADHD. He had none of the hyperactive tendencies that warrant the “H” in the diagnosis. Rather, he had Attention Deficit Disorder. Since its official definition in 1980, sub-types of the condition have been identified and these are classified according to the main features associated with the disorder: inattentiveness, impulsivity, and hyperactivity. The three subtypes are:

•     AD/HD [ A.D.D. OR ADHD ] Predominantly Combined Type,
•     AD/HD [ A.D.D. OR ADHD ] Predominantly Inattentive Type, and
•     AD/HD [ A.D.D. OR ADHD ] Predominantly Hyperactive-Impulsive Type.

This takes into consideration that some kids might not have trouble sitting still, or inhibiting disruptive behaviour, but that they might be predominantly inattentive and will thus find it difficult to focus on a task or activity. Other kids might be able to pay attention to a task, but will lose focus because they could be predominantly hyperactive-impulsive and thus unable to control the impulse to get distracted. The most common sub-set is, of course, Predominantly Combined Type, wherein the child displays strong features of all three elements.

The cause for ADD/ADHD, the doctor said, was still unknown to the medical profession. What they did know was that it is a neuro-biologically-based developmental disability estimated to affect between 3-5% of school children, and that there was evidence to suggest that the disorder is genetically transmitted in many cases and results from a chemical imbalance or deficiency in certain neurotransmitters, which are chemicals that help the brain regulate behaviour.

If the child has ADD, the doctor explained, there’s a good chance that the parent has it as well and if one parent has it, there’s an even better chance that both parents have it, too. Why? Because ADD/ADHD people attract each other, apparently. They’re more likely to be unconsciously tolerant of each other’s deficits, because they recognise the same deficits in themselves, is my theory.

 Co-incidentally I have since been diagnosed with adult ADD, and have been on medication myself for almost six months. My husband displays (and has always displayed) various tell-tale signs of the disorder, but has managed to develop coping mechanisms that do not require medication.

Deciding to medicate

As our doctor explained, there is a deficiency in our child’s brain that prevents him from producing the right quantity and quality of neurotransmitters to enable the brain to control behaviour. He reasoned that if our son had crooked teeth, we would get braces to correct this. If he had trouble with his vision, we wouldn’t think twice about getting glasses to help him.

ADD is a condition that puts our child at a disadvantage in the classroom. It affects his ability to learn, to grow and to develop the skills he needs for life as an adult. We can either leave it untreated and leave him to develop his own coping mechanisms and hope that these will be sufficient to see him through to adulthood, or we can help him.

The doctor explained our options for medication, thoroughly. We started out on a low dose of Ritalin, having chosen it because it has a shorter active lifespan in the body and was not a medication that needed to be taken every day, in order to build up effectiveness. We noticed an improvement, but it was not as significant as we’d hoped. We monitored the side effects, and decided that because our son was bigger than most boys and had a bit more weight on him than was expected from a height/age perspective, that loss of appetite while on the medication was not enough reason to discontinue. There were no changes in his personality, little sleep disruption and he seemed to be healthy, overall.

His dosage was increased and the conversations I was having with his Grade 1 teacher were all positive. He sat still in class, didn’t talk excessively, was much neater and more consistent in the execution of his tasks and was better able to contribute to the classroom environment.

The change

The reality of it all sunk in for me, not when I’d given my child his first Ritalin tablet, but when I saw physical proof of the difference it made. It was almost immediate, the improvement in his handwriting. He’d gone from a chicken scrawl to perfectly formed letters, almost overnight.

That was enough for me. Proof that I’d made the right decision. It’s been less than a year, and we’re still experimenting with timing and dosage, and trying to get the routine thing right but we’re taking steps in the right direction, every day.

There are many positive aspects to ADD (imagination, the ability to see the bigger picture, to think up creative solutions, the ability to hyper-focus) that we would be doing our son a disservice to ignore his condition. Our son is bright. He might not be genius-bright, but he’s smart enough that he’ll make other people feel uncomfortable one day, and we want him to be able to make the most of what he has. Without needing to find ways to “cope” with who he is and what he has.

If that means he needs to be medicated, I’m fine with that. After all, you need a prescription for glasses too, don’t you?

Disclaimer: The views of columnists published on Parent24 are their own and therefore do not necessarily represent the views of Parent24.

How would you respond if told your child may have ADD/ADHD?

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