Ritalin only one part of the solution when a child keeps getting into trouble at school
My 8-year-old son's teacher says he has ADHD and wants me to get the doctor to give him Ritalin. I am worried that he is getting into trouble at school and may fall behind. It feels terrible that he has something wrong with him. But I'm not sure I want to give him powerful medicine. What do you advise?
It's very hard to have someone describe your child negatively and even worse to worry if your child’s struggles are your fault. Over the past 30 years, ADHD seems to have become an epidemic in our society, with one in 10 of all 10-year-old boys being medicated for these symptoms. Teachers are often at the forefront of dealing with classroom difficulties, so it's not surprising that they sometimes turn with relief to the idea that a pill can change a child's school behavior.
The complication is that medications like Ritalin, Adderall and other stimulants can change everyone's behavior. They increase concentration and ability to focus for anyone who takes them, at any age, whether they show "ADHD symptoms" or not.
So it's a big challenge to assess what's right for your child, when you know he is a whole complex person, with all sorts of strengths, as well as the vulnerable areas he is still grappling with. Any child is a work in progress, and we don't expect their behavior always to proceed smoothly. It's unlikely that one solution can fix multiple issues or be the best for every child.
In addition, sophisticated research is increasingly showing that these drugs may not do all that parents and teachers hope they will, and there are serious potential long-term disadvantages.
Last week an eminent developmental researcher, L. Alan Sroufe, wrote in the NY Times about his growing doubts about the impact and usefulness of drugs to address these problems. You can read his article, "Ritalin Gone Wrong," at the New York Times website.
Unfortunately he didn't go on to address the important issue you raise in your letter. If your child is struggling, you want to do everything you can to help him. If the drugs don't really work over time or are bad for children long-term, what can a parent do? This is the sentiment expressed on many parenting sites since Dr. Sroufe’s article. You can see one example on the pages of the New York Times' parenting blog.
Most of us make parenting decisions based on what we think is the top priority. Sometimes that's an immediate crisis, in which case we reach for a short-term solution. You know then that you will have to deal both with the current fallout and eventually find longer-term answers. Since medication does have an effect right away, it might tide you and your child over the current upset and concern, with the idea that it's temporary.
In the meantime, you would work with his teacher, the school psychologist, and maybe other professionals to create a team to support lasting growth in his capacity for self-control, concentration, persistence and managing his feelings — some of the emotional muscles parents and children work on together throughout development.
One problem with that idea is the impact it can have on your son's self-image. Many doctors, with good intentions, explain to children that their brain chemistry isn't working right and the pills will correct it. First, that isn't true — there is no research evidence to support that idea. Second, children are sensitive to the idea that there is something wrong with them; their self-image and self-esteem start to include the idea of being defective in some mysterious way. Thirdly, kids then feel discouraged from taking responsibility — why try to change if it's hopeless?
But it isn't hopeless. With effort, love and goodwill, parents can be strong enough to make the demand that their child learn to regulate himself better. Together you can devise coping mechanisms that spring from his own personality and makeup. Building on his strengths not only equips him with the emotional muscles he needs for life. It gives him a powerful message of your love and respect.
Kerry Kelly Novick is a local child, adolescent and adult psychoanalyst, and author, with Jack Novick, of "Emotional Muscle: Strong Parents, Strong Children," available at amazon.com or through
Tue, Feb 7, 2012 : 9:38 p.m.
I am very skeptical of teacher's abilities to diagnose neurological diseases and demanding treatments is outside of their scope. Not everyone who exhibits poor self discipline (problems sitting still or interrupting class) has ADHD. It is appropriate to report performance and symptoms, but leave the diagnosis to doctors, and treatment decisions to parents with their physician's consult.