Yikes!!! Considering Meds for possible ADD

Laura,

There is a lot of research showing a likely connection between motor difficulties and ADHD, as well as between motor problems and LD. If you do a search for developmental coordination disorder and ADHD you will find many resources. Here is a summary of a very recent article on that very subject:

S. Sutton Hamilton, M.D. is the author of an excellent review article in the Oct. 15, 2002 issue of American Family Physician, a peer-reviewed journal of the American Academy of Family Physicians . It is titled, “The Evaluation of Clumsiness in Children”. (2002;66:1435-40)

The following summary preceeds the full text of the article:
“Parents and physicians often dismiss seemingly minor motor difficulties in children. Approximately 6 percent of school-aged children have coordination problems serious enough to interfere with academic performance and social integration. These problems often arise during the early school years and
manifest in difficulties with such simple motor tasks as running, buttoning, using scissors. Increasing evidence shows that rather than improving over time, these motor difficulties remain stable throughout adolescence and adulthood. While these chidlren are initially singled out for motor difficulties, their problems are rarely limited to poor motor coordination. Many of them have a range of associated deficits, such as attention-deficit/hyperactivity disorder, learning disabilites, poor handwriting and drawing skills, and emotional immaturity. Associated problems magnify with time, and as teenagers, these children have higher rates of educational, social, and emotional problems. Diagnosis is determined by taking a careful ihistory that includes a review of fine motor, visual, adaptive, and gross motor milestones, and performing a physical examintiation. Formal standardized testing may be indicated. Referral to occupational therapy that is appropriately individualized to the needs of each child appears to be effective. To aid in management, the familty physician must be aware of this condtion, as well as the associated coexisting deficits.”

Andrea

I too have heard this and I think this is why Interactive Metronome effectively improves attention. There is something about improving motor planning that works on attention as well.

We were planning a trial of medication this fall, following an ADD-inattentive diagnosis this summer by a neurologist. I canceled two appointments when the teacher assessments just did not justifiy it this fall.

Beth

I agree. I also think that meds could work. I have not given up trying to cure the motor problem so I don’t know if meds would get in the way because they treat the problem but are not a cure.

If I run out of other therapies to try and attention is still a problem I will go to meds.
IM improved his attention enough for me to believe that this is something we can cure.

I think it all depends on the severity of the situation and to what extent the attention problems are affecting the child’s life.

That’s a new one, but I like Linda’s explanation of why IM correlates with attention. Our journey began with motor planning at age 4. As you all know we just did a formal ADD-inattentive assessment and as usual ds did not meet the diagnostic criteria. So no meds even though I know in my gut they would help - it seems too scary for a borderline situation until we exaust all other options. But I do wonder if we are needlessly avoiding something that could make life easier for him.

But is that motor issue kids often have ADD, or that all these kids who are different in some way have motor issues?

I did just buy some flaxseed oil though - thinking about giving him some nutritional supplements to see if that has an effect.

dear beth,
i have a 12 yeard old who is in the 5th grade he has been in elem school for 7 years 2 years in k and 2 years in 4th and the way it is looking now we might be in the 5th again he is in ld classed and is add to but i dont think the med does any good he was on med in k but didnt nothing i dont have no probles out of him at home cause he knows that he cant push me but iam always at the school we just got a program called star and he goes to that on thur i dont see no diffent in him when he goes to it eight our school in midway ga. are bad i lived in fla and went to school there and also was in ld calsses and to me fla has a good school system here when they do something wrong they want to call u and to come and get your kid is there and way u can help me out on what to do i will try anything to help out my kid thanks alot for your time
barbara fletcherBeth from FL wrote:
>
> I too have heard this and I think this is why Interactive
> Metronome effectively improves attention. There is
> something about improving motor planning that works on
> attention as well.
>
> We were planning a trial of medication this fall, following
> an ADD-inattentive diagnosis this summer by a neurologist. I
> canceled two appointments when the teacher assessments just
> did not justifiy it this fall.
>
> Beth

Don’t do it ! Medications have side effects to them. Think carefully.

HOld him back again??? SOunds an awful lot like they are punishing HIM because they can’t teach him.

It’s one thing to retain a kiddo so he can mature, catch up…
It’s entirely different to have a kiddo on an “individualized” plan and put him THREE years behind. Unless he’s very small and immature I can’t picture it being good for anybody involved.

I had a student in my middle school class — they’d let him get three years behind. THen after that second year in fifth grade they decided to JUMP him to seventh grade, then to ninth — he had sorta grown big for the elementary school. Well, he was totally rebellious and noncompliant as well as being a non-reader. (The sped head shrugged and told us “well, you can’t expect to teach *all* of them, can you?”)
Frankly, dropping out in fifth grade might have been better for him.

Karen,
According to the Neuropsych, the area in the brain where dopamine is produced (the neurochemical necessary for attention) also affects motor skills. So the liklihood of these two being strongly related is extremely high.

Yes, the side effects are definitely something to be considered.

In addition to the link between motor problems and ADD, there’s also recent research indicating that children with ADHD (and this would probably include ADD) who do not take medication develop a smaller brain than children who take medication (the medicated children develop normal sized brains).

It would be interesting to know which category non-medicated ADD children receiving intensive intervention fall into. Obviously attention is extremely important to learning and normal brain development. Just how much intervention could accomplish this without stimulants would make a fascinating study.

With this to consider, the decision is not an easy one!

However the difference in brain volumes cannot be used to diagnose the disorder because the measures are based on group averages. The report was funded by the NIMH.The study addresses concerns that medications for the ADHD may be responisble for the children’s smaller brain volumes…but both medicated and unmedicated children with ADHD had smaller brain volumes.

If it helps you at all, I have students who just “turn around” when they start medication. INdeed, there are deficiencies of neurotransmitters in certain areas of the brain and I think newer and perhaps better medications are being developed.

I f you have the time and the inclination (the $$$$), consider reading the work of Dr. Daniel Amen. He has done extensive brain imaging in his private practice and he offers advice on nutrition and supplemental support for different subtypes of ADHD. He can be found on line and Broders carries some of his books.

My son has severe LD (dyslexic) and had very poor fine motor skills/motor planning in the early grades. We worked on these skills and his fine motor skills are now above average.

After homeschooling last year, I really noticed his inability to focus on his schoolwork. After having him tested for possible entry to an LD school, the teacher that tested him recommended medication.

My son is very well behaved and has good social skills. I had heard from many people that he didn’t need medication.

I took a chance and tried Concerta. It made a huge difference and you could see the difference right away — the very same day he took the medication. I noticed his expressive language skills were much better. He communicated better.

We’ve had no side effects with the Concerta. His appetite is fine and he goes to sleep just fine at night. This is a newer drug.

Maybe one day scientists will discover the answers. But for now I’m really happy I took the chance and tried the medication. It’s made a huge difference in his school work and his ability to communicate with others. It’s been very good for his self-esteem.

I read Dr. Amen’s book and have made sure since that my son takes a multi-vitamin and eats protein in the morning. I am not sure how much these changes have contributed to the much more attentive child at school but may be part of whole package. He also does suggest supplements but I haven’t tried them.

Beth

Its certainly an interesting piece of research, but if non-medical intervention produces the desired effect, does size really matter? ; )

Your son sounds similar to mine, but we aren’t doing a drug trial b/c of concern about stimulant meds increasing his anxiety (which is much better this year thanks to some therapy, acknowledgement of his issues, and maybe IM?)

Hi Laura,

I’ve been reading this thread for the last couple of days with interest. I, too, decided to medicate my son about a year ago. It was a hard decision to make - but my husband talked me into it by saying that we need to give him the opportunity to do what we all know he can do. Without the meds, he couldn’t get it together enough to even complete his schoolwork. With the meds he is a different child - much happier, learning, eager, etc. This year we added an anti-anxiety drug. My son had been diagnosed with an anxiety disorder, but my husband and I thought that with the better focus from the meds and auditory training a lot of the anxiety would go away - it didn’t. The combination of drugs is really doing wonderful things for my son - and these are things that would never have happened without them.

All that being said, we had to try 4 different stimulant meds to find the right one for my son, and we are still working on dosages a little bit. Not every drug works with every person the same way - and it is a trial and error process to find what will be right for your child, if you decide to medicate.

Best wishes with whatever you decide,
Lil

Yes, I think we should expect that *all* of “them” be effectively taught. I’d like to slap the L.D. teacher who said that! I want to say to him/her, “Go work at the post office or something where you can’t hurt people”, (and yes, these are people!)

And people wondered why my school-teacher husband and I already had so much cynicism when we started down this journey with our son. There are many great direct-service personnel place, and there are equally as many horrible ones. That’s why we always say to each other, “Trust - BUT VERIFY”.

Poor kid!

Welcome to the world of hard decisions.

My daughter was making great grades, but so slow and NEVER finished a writing assignment.

3rd grade we tried Concerta OH MY GOSH. She started on Saturday. On Monday, she wrote her first handwritten paragraph (she previously had never gotten past the prompt sentence) and actually typed 12 questions and answered them all in Science that day. I could not believe it.

She says “it makes all the noise in the room go away so I can read better”. She can tell the difference herself. She is not hyperactive, but is able to focus and attend in class now. Doesn’t take it on weekends, unless she is going to the beach, riding bikes or doing some other “safety concern” activity. She had severe motor planning as a preschooler and has been in private OT for approxiately 18+ months.

Additionally, no side effects. In fact she gained 4 lbs. in the last few months, which made me feel even better. Doctor calls it her “brain vitamin”.

Good luck with your decision. and remember: You will have people who disagree with you regardless of the path you decide to take. You love your child and only you can make the decisions your gut tells you to make. Make your decision and make no apologies for it.

I agree with the “welcome to the world of hard decisions’. Won’t be easier if someone jumps into the thread with an hysterical message regarding drug use.
We, too, were faced with this decision. Some facts to think about:
1. Stimulants clear the system rapidly. Ritalin clears in a few hours, others slightly longer (they are formulated to be longer lasting).

2. As in the above posts, you will likely know within a couple of days whether or not the drugs are for your child. In many cases, you will know within hours. If the meds work for your child, it is amazing what they can do. If you don’t see the desired effect within a short time period, you can simply stop.

3. Getting the right med (and getting a doctor who really knows) is a process of trial and error. Think of it as a refining process. It is likely you will get an effect immediately but then need to refine it-hours of application, better match for child, etc.

I have read some horrible posts here by hysterics particularly about ‘kiddie cocaine’. I no longer open any posts by Ball, in particular. It is important to realize that a true ADHD/ADD uses stimulants in a very different way to ‘normal’ people. Addiction to Ritalin or Adderall is not a problem for true ADD/ADHD’ers. Addiction to stimulants would be a problem for the rest us who could use stimulants for the ‘rush’. Our kids use stimulants to slow down the constant bombardment of stimulus- an anti-rush. Don’t listen to the hard sell of the hysterics. Get some facts.

When we were faced with our decision, we were in a place without sophisticated medical options. Apparently, the ‘try-the-meds-and-if-it-works-its-ADD’ was a fairly common diagnosis tool in the past. Our child is ADD-inattentive so is without the external manifestations of the ADHD that are easier to pick up. We didn’t realize that she really had no control over her attention.

In the end, you must do what you think best for your child. Good luck

Absolutely right about everything you said. We must sometimes put aside our own biases to do what’s right for THE CHILD, despite what others who are uninformed about the issue say. Only the best interest of the child matters, and while I agree that may often be difficult to determine, that must be the ONLY THING that drives and motivates us as the parents.

My husband is a teacher and has seen a number of children make dramatic improvements, both academically and self-esteem-wise, shortly after beginning medication (not drugs!).

Good luck!

The article I read was in a science journal I came across at the library (I think it’s called “Science Weekly”). It was a recent issue (within the last 2-3 weeks). I’ll look through it the next time I’m at the library and see if I misread it or if this might be a different study.

Now I’m curious!

Thanks for sharing your thoughts and experiences. Sometimes being a parent is one of the hardest jobs imaginable. Most of us love and care about our children so deeply that we agonize tremendously over making “the right” decision.

Fortunately, this is one of those decisions that can be made and then “unmade” if it’s not working or improvement hasn’t been made. Although I’m wondering if assessment over effectiveness may be easier when a child does not have hyperactivity or behavioral difficulties. It seems to me that it would be.

For example, since I’m not trying to change any “behavior” but trying to determine if attention is the cause for some of my childs difficulties with memory and awareness, it seems to me that gauging any improvements might be more simple than if there were other issues.

One more question…who prescribes these meds? Is it a general physician or a psychologist? My husband is hesitant to do a med trial, but I think it may be worth trying.

And yet, I hate giving my kid pills!!! I had one child on high levels of prednisone (a horrible medication!) for two years and that was a complete nightmare!

Of course, a very different situation with a much stronger medication. Also, we had no choise.

I would suggest that you consult with a child psychiatrist, preferably one with experience at medicating for attentional issues. It needs to be a MD, and since you may need to tweak the dose, brand etc even if its working you want someone with alot of experience.

Do keep us posted!! Even tho our psychiatrist is against meds at this time I also wonder if the right prescription would make some of the other issues easier to deal with.