Talking to Children about Medication for
Attention Deficit Disorder/ADHD



David Rabiner, Ph.D. Research Professor, Duke University


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David Rabiner, Ph.D.
Duke University

(Note: If you are looking for information on Attention Deficit  Disorder (ADD) please be aware that much of what is discussed below should also be relevant.  Technically, the term ADD is no longer used.  Instead, children who have the inattentive symptoms of ADHD but who do not show hyperactive/impulsive symptoms are now diagnosed with ADHD, Predominantly Inattentive Type rather than with ADD.  These terms mean pretty much the same thing but the latter is no longer technically correct.)



Talking to Children about Medication for
Attention Deficit Disorder/ADHD

A common question and concern that parents often have is whether and how to explain
the issue of taking medication to their child with Attention Deficit Hyperactivity Disorder/Attention Deficit Disorder.  This is a really important issue that I think warrants careful attention and concern.  I can not tell you how many times I
have encountered children who had been taking meds for years ever really understanding
why. In my opinion, this is a critical oversight.

Now, as far as what to say... First, a caveat. I do not know your child and thus can not
really provide specific suggestions about what would be best. Instead, I'll present a set of general guidelines that can be modified to be most appropriate to your child's specific
situation. I have found that even young children are generally receptive to a straight-forward explanation about why medication is being tried and what it can do.  If you have questions about what is and is not appropriate to say, please discuss this with your child's health care provider.

For grade school childwith ADHD/ADD, something like the following may be appropriate: (What follows is much more of a monologue than would generally occur and it is always important to give the child plenty of opportunity to ask questions.)
        

     "You know, kids your age differ in lots of ways. Some are short and some are tall.
      Some are really fast and others are not so fast. Some can read really well and
      some have a harder time learning to read. There are just lots of ways that kids
      differ.

      Kids can also differ in how energetic they are and in how their mind works. Some
      kids don't seem to have very much energy - they just like to sit around. Other kids
      have so much energy, though, that it is very hard for them to sit still. Having all this
      energy can be great for some things, but when you have to sit still and pay attention
    
to something - like you have to do at school - it can make things difficult. Some kids are
     also able to really concentrate and think about one thing for a long time. For
other kids,
     though, their mind sort-of jumps from one idea to the next.  Having all 
these different  
     ideas can be great, but when you have to focus on just one thing at a
time, it can make
     things hard.

Sometimes kids with so much energy and so many different ideas need some help sit still and focus on one thing at a time. One of the things that can help a lot with this is akind of medicine. What the medicine can do is make it easier for you to stay in your seat and pay attention when you need to at school. It can also make it easier to slow down a bit so that you can make good choices about the kinds of things you do.

Now, your doctor and I think it makes sense to see whether some medicine can make these things easier for you. That way, you will be able to use all your energy and ideas to get the things done that you need to and to make good choices about your behavior and the things you do. The medicine should make it easier for you to do these things, but we'll also need you to keep trying really hard as well.

 Now, there are several different medicines that kids can take to help with this. Not every medicine works for every child and we may have to try a few different ones to try and find one that is best for you. If we stick with it, though, there is a very good       chance that we will find a medicine that can help with some of the challenges you have been having at school."

(Note: This assumes that the child is aware of the difficulty they have been having and that this  has be discussed with them. Presumably, this would be the rational given for why they were  seeing the doctor in the first place.)

A few other things to mention. First, as hopefully comes through above, I try to convey to the  child that the medicine is not a "magic pill" and that the child has to also try to follow rules and make good choices. After all, if medication works, all it does is to help the child have more control over his or her behavior, but how the child chooses to exercise that control is still up to them. A child can make thoughtful decisions about not to comply just as easily as impulsive ones. What you want to convey is a sense that the child is responsible for his or her behavior and that if they do better it is just as much because of their efforts as the medication alone.

One other thing. I would be careful about presenting medication as something being tried to help a child "stop fighting." You don't want to convey a sense that aggressive behavior is  something that is outside of a child's control because this can make it more difficult to hold them accountable for their actions. Instead, I would say that the medicine may make it easier for them to stop and think about what they are doing, so that they will be able to make better choices about how they behave. This is a subtle difference, but I think it is an important one.

Anyway, I hope this is helpful and that you will be able take from the above what seems to fit for your child. Let me also mention that a number of good books have  been written on this topic. You can find them at the A.D.D. Warehouse site.


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