ADHD – Why Parents Shouldn’t Buy In at First

Eight-year-old Megan’s mother called me last week. The purpose of her call was to set up a consultation whereby I would offer medication options for Megan’s “ADHD.” I wasn’t asked to assess the child for ADHD – Julie, Megan’s mother, merely wanted to discuss the range of drug options and which one(s) would be most suitable for her daughter.

We set up an appointment. Megan arrived in her school uniform accompanied by Julie. The crux of the presenting problem according to Julie is that Megan is routinely falling asleep each evening when instead she should be actively engaged in her homework. Julie went on to say that Megan’s last evaluation report indicated that she had two C grades – not her customary straight A and occasional B performance. And because Megan’s grades had fallen off, her homeroom teacher thought the child should be placed on medication to “help her focus.”

I ask to see Megan for a few minutes alone. Julie adamantly refused, saying that Megan wouldn’t offer up all of the “facts” and that I should just tell her what medications are best. I refused to do that stating that if any recommendations from me were to be forthcoming, I’d want to assess the situation first.

So Megan and I met and here’s what I found out – information that was not volunteered by Julie. Three days per week, Julie picks Megan up from school and transports her to a gymnastics class, then to piano lessons and then to cheerleading back at school – all on the same afternoon, again,  three times weekly. The little girl has no interest in gymnastics and cheerleading but loves learning to play the piano. Megan told me, “Mr. Joe, I fall asleep doing my homework because I’m tired. Would you please tell my mother this is too much?”

I did just that; Julie was unaccepting of this and told Megan to come along because they were leaving. I made one more try at explaining the dynamics of Megan’s situation and why she wasn’t completing her homework; Julie refused to listen, away they went and that was that. I have not been contacted since.

Some children are increasingly being robbed of their childhood by those who are supposed to love them most. Kids’ lives are over-scheduled and sometimes insanely stressful. They’ve barely learned their ABC’s before they’re diagnosed with ADHD. And parents’ “more is more” approach often starts well before the child is born and follows them through their formative years.

Then there’s the issue of teachers acting as trained behavioral clinicians and indiscriminately recommending medication to potentially make their lives in the classroom easier – all at the expense of a child for whom there is no clear rationale for medication use in the first place. Drug administration can also be an easy out for parents who just won’t “parent,” are too tired, too busy or too self-absorbed to fully investigate their son or daughter’s circumstances.

Responsible parents should entertain the possibility of an ADHD diagnosis when either or both of the following are occurring:

  1. The child is failing in school and continues to do so without a hint of improvement. This means consistent Fs.
  2. The child has markedly poor social skills – an issue which is a harbinger of sub-optimal academic performance.

If the above two issues are the case, then medication with accompanying behavioral applications truly can make life less hard for these kids. Shouldn’t that be the goal of any responsible teacher or parent anyway – to make the path to success less rocky for our youth?

Joseph Wegmann, R.Ph., LCSW is a licensed clinical pharmacist and a clinical social worker with more than thirty years of experience in the field of psychopharmacology. His diverse professional background in psychopharmacology and counseling affords him a unique perspective on medication management issues. In addition to consulting with numerous psychiatric facilities, he has presented psychopharmacology seminars to thousands of clinicians in 46 states.

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