It’s a Wednesday afternoon and you’re patiently cajoling your middle schooler to start his homework. He’s avoiding it with every ounce of his being. You finally get him to agree that if he finishes his homework, he can have one hour of video games. He sits down ready and eager, but quickly realizes that he didn’t bring his math book home, can’t find his science sheet and has a social studies test tomorrow, but can’t remember which chapter to study.
If your child has been diagnosed with ADHD, this ongoing struggle may be familiar, and you’re probably feeling like something needs to change. It’s common to want to avoid the medication route and seek behavioral strategies that teach your child the skills needed to organize, prioritize, get the work done and hand it in. On the other hand, medication is helpful to lots of kids with ADHD.
MAKING YOUR DECISION
Medication has side effects, and those side effects can sometimes be scary for a growing child. It’s frustrating to watch and not easy for children with ADHD. They have true neurochemical deficits in the frontal lobe that aren’t all that different from a diabetic whose body doesn’t create sufficient insulin at the right times.
So, what’s the “right” thing to do? Is there a “right” thing? The answer is no. Here’s what to consider when deciding the appropriate course of treatment for your child:
- What’s the impact on your child’s daily functioning?
- How much is your child affected by poor focus, hyperactivity or impulsivity, anxiety, difficulty transitioning, going to school each day and daily routines?
- Is she able to establish and maintain friendships?
- Can he take in class lessons and learn?
- Does she distract herself or others in the classroom?
- Is he able to transition from home to school to activities?
- Is completing homework a struggle?
- Can she participate in leisure activities such as birthday parties or family gatherings?
You can begin to implement behavioral strategies, routines, boundaries and consistency from day to day. For example, create a space for your child to complete homework that’s not at the kitchen table, since your kitchen is likely the Grand Central Station of your home. It’s also helpful to implement a no devices rule while homework is being done. Create a visual schedule of morning, after-school and bedtime routines. You can also make a list of household rules and consequences and make sure to implement them consistently using a calm demeanor. You may want to start a nightly, tech-free quiet time before bed.
FINDING A BALANCE
Parents often find it helpful to work with a therapist to prioritize areas of need. By creating short-term goals as a family, you’ll experience success as a whole and work toward finding a balance between what your child needs to succeed and what your family needs to function.
Executive functioning coaching is another form of support where a therapist offers strategies to help with organization, prioritization, homework, scheduling and more. Work is done with the child and parent to identify learning style, natural tendencies and preferences in order to help the student develop self-awareness and ultimately internalize the strategies that work. The goal is to develop a sense of accountability and confidence for the student.
EXPLORING THE MEDICATION ROUTE
Do your research. Ask questions. If you’re interested in trying medication, start with a two- to three-month trial. Don’t rely on your observations alone. Ask others to help you see if there’s improvement. For example, get his Cub Scout leader, soccer coach and teacher to offer their feedback. Also, ask your child about his experience.
Consult with your pediatrician, a neurologist, a developmental pediatrician or psychiatrist about medication classes that’ll address symptoms interfering with functioning. Many physicians are using genetic testing to help identify medications in sync with your child’s unique neurochemistry.
Remember that medication is only one form of treatment, but it doesn’t teach your child the skills needed to succeed in life. Medication alone won’t help your child organize school materials, manage time or feel less stressed about schoolwork, the classroom or social interactions.
Whatever you decide, keep in mind that no decision is final. If you choose to try medication, you can come off of it if you feel it isn’t working. You can also take a “holiday” where you don’t give your child meds on weekends or during school breaks. You may also wish to pursue behavioral modification strategies with the help of a psychologist or ADHD coach, with or without meds.
Whichever course of treatment you choose, you’ll need to assess and re-assess as your child’s academic, social and physiological needs change. Don’t do this alone—work closely with a psychologist or ADHD coach to help you make decisions along the way.
—Dr. Liz Matheis is a mom of three and a licensed clinical psychologist and school psychologist with a practice in Livingston who specializes in children, adolescents, young adults and families with special needs.