By the time he was 4 years old, my son had already been through seven child care programs. We left a couple voluntarily – one because the facilities weren’t kept clean and another because my son went missing and was found wandering down the street. But in most cases, the day care centers either asked us or forced us to leave. When my son was 2, his day care said he demanded too much attention from the teacher, grabbing her legs during reading time and refusing to sit still. When he was 4, another one called him an “insurance liability.” I hoped kindergarten would offer a new start. But just 18 days into the school year, I received the much-feared request for a parent-teacher conference.
I will be the first to admit that my son is different. He is extremely active and my own patience with him falters on a regular basis. He takes more effort than your average 5 year old. I’ve made efforts to address the problem. When one day care teacher said he was biting other children because of a speech delay that prevented him from verbalizing his frustration, we sought help from three intervention programs. That problem has improved. Conner is not violent and he doesn’t target other students. But he still struggles to sit still and follow certain directions.
Take a look at the picture above. I bet you can tell which kid is mine. Conner has always stood out, and not in the way I felt I could brag about during lunch. He stands out in the sense that the rest of the world sees something wrong with him. My perfect baby isn’t perfect to the rest of the world. And now they want me to medicate him.
Since school started, I’ve looked forward to opening his school folder, hoping to see a star. A star means your child had a fabulous day. A smiley face means he had a good day. A note is bad.
Conner never got a star. There was the occasional smiley face. But the notes came daily:
“Conner interrupted during my lesson today.”
“Conner had two time outs today, following multiple warnings.”
“Conner ran around the cafeteria – please discuss.”
“Conner swung his weighted snake today and hit a friend in the face.”
“Conner and I would like to have a meeting to discuss how we can help him be successful in school.”
There it was, that awful note that I knew was coming.
On the day of our parent-teacher conference, within minutes, Conner’s teacher was tiptoeing around an extremely sensitive question that I knew was coming.
“What has his pediatrician said? Have they given you any recommendations?”
I knew what she was hinting towards, and I finally brought it up: “Medication? Are you going down the road of, have we considered medication?”
“I’m not going to say that word,” she hesitated, “but…”
My initial thoughts came in the form of expletives. The meeting request had come less than a month into his first year of elementary school. Was that all the time a child is given before being pathologized? How do I medicate a 5 year old who can’t even swallow a pill? The meeting did force me to consider that Conner has attention deficit hyperactivity disorder, an idea that we had already discussed in our family, but I vowed to look into all available options. Adults should not view medication as the default option for a kindergartener.
The use of medication to treat ADHD in children under 6 years old is fiercely debated, even in the medical world. Methylphenidate, the active drug in Ritalin, is the most common medication used to treat ADHD, but it is not FDA-approved for children under 6. A 2006 study by the National Institutes of Mental Health found that children between 3 and 5 years old experienced more side effects than older children, and the drugs were less effective for them. Should I choose to medicate, Conner faces losing his appetite, losing weight and having stunted growth. Young children who take ADHD medication also have reported mood disruptions, tics and insomnia. I run the risk of all of these negative side effects to prescribe a drug to my child that may not be FDA-approved for his age and might not even work. I’m not alone in my skepticism. In an article from the American Psychological Association about ADHD treatment for preschoolers, University of Pittsburgh psychology professor Susan Campbell says “I’m very opposed to the use of medication with young children, because we don’t really know the implications for brain development.”
I started looking into alternatives and found that there is anecdotal evidence that children who exhibit behavioral issues related to ADHD symptoms sometimes show intensified behaviors when their diet contains food dyes and artificial flavors. The Monday following our parent-teacher conference, I started Conner on a dye- and artificial flavor-free diet. I also cut back his sugar intake quite a bit. For breakfast we replaced sugary cereals with eggs and gluten-free pancakes, with the occasional bowl of Cheerios topped with a banana. In his lunchbox, we swapped out goldfish crackers and fruit snacks, and replaced them with Triscuits and real fruit. We call the old snacks “dead food” and Conner adjusted pretty quickly. He’s even discovered a love for broccoli. The first week on the new diet, he came home with smiley faces and stars four out of five school days.
Many medical professionals and psychologists suggest behavioral therapy as the first method of ADHD treatment for children under 6 years old, not medication. On the same day I changed Conner’s diet, I also made an appointment with a behavioral therapist. Our appointment is set for November, and I am excited to add new techniques to our daily routines. There are many alternatives to medication, so why is the first thought in so many people’s minds “Why aren’t you medicating?” More than one in 10 children ages 4 to 17 in the United States has been diagnosed with ADHD, according to the Centers for Disease Control and Prevention. More than half of them are taking medication, a 28 percent jump between 2008 and 2012.
For young children, medication should not be the first response to hyperactivity. Parents and teachers should work as a team to reinforce the same structures, routines, and positive and negative reinforcements at home and at school. Given how common this diagnosis is in students, teachers and school psychologists should be equipped with a plan of action to address the behavioral issues, before resorting to parent-teacher conferences arranged purely to push medication.
When Conner is older, we might decide that medication is the right path. But if we do, it will be our decision as a family, not society’s push to make him more normal. My Conner is different, as you can see from his picture on the school wall. He might be the only kid in class who drew outside of the lines, but he was also the only kid that wrote “I love you mom” on my Back to School Night picture. He stands out, and I should feel proud to brag about him.
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