ADHD continued. Three cases. (Jack, Gordon, and Sam)

Jack.

Jack was an adult student in my Child Growth and Development class. He was happily married and found a job where his hyperactivity was a huge benefit—the Chicago Stock Exchange. He worked on the trading floor where his naturally high level of energy allowed him to get through each action packed day with relative ease.

Jack had the best looking yard in his neighborhood. After a full day’s work and commute home to the northern suburbs, Jack spent a few hours, weather permitting, working on the yard. He did this in part to keep from driving his wife crazy.

When Jack was a child, his mother opted not to put him on medication for hyperactivity. As a nurse, she read studies that suggested at the time that the current medication, methylphenidate—also known as Ritalin, may cause a change in the motility of sperm. She wanted grandchildren and felt Ritalin might rob her of the chance to spoil her future grandbabies. She was also concerned for her son as methylphenidate was thought to be habit forming.

In the classroom, Jack was able to pay attention if part of his body was able to move. Frequently, he tapped a pen against his leg to keep any sound he made down so he wouldn’t disturb the other students. When necessary he’d walk back and forth in the back of the room. As long as he could move, Jack was able to concentrate. He was a superior student.

Gordon.

My friend Gordon asked questions by the billions, or at least that’s what his mother remembers. A high-energy child, he thrived while doing more than one activity at a time.

In elementary school his teachers often sent him to the office to deliver notes and gave him jobs requiring physical movement. Gordon remembers banging erasers together in the hallway during the days of chalk and blackboards.

Because Gordon’s family drank coffee throughout the day, it was not unusual for his mother to give Gordon coffee topped off with milk in the mornings before school. The caffeine in his coffee may have helped Gordon be a little less energetic in class. Stimulants in a hyperactive person have a calming effect on the body.

As an adult, Gordon holds a job that requires a high level of concentration. He does this by multitasking and drinking coffee. Even while working on a mind-bending, computer-related task, he listens to music and doodles on paper.

Sam.

Sam, born in the early 1990s, was one of my Pre-K students. His was a world of privilege and high expectations.
Sam was diagnosed by his pediatrician with attention deficit disorder with hyperactivity at age four. According to the American Academy of Pediatrics, it is possible to diagnose a child as early as age four with ADHD. Not so with ADD as inattention is harder to diagnose in preschool aged children. For more information on ADD see the previous blog, Attention Deficit Disorder with and without Hyperactivity – Part 1 Overview.

Sam was so active at home and at school that he was unable to stay still long enough to watch more than a commercial’s worth of television. He literally bounced off the walls everywhere he went.

Sam’s parents tried behavioral therapy for six months, first. The therapy was minimally beneficial. Although not recommended by the Federal Drug Administration until age six, Sam’s parents agreed with their family pediatrician to give Sam, just under age five, a prescription for Ritalin. This decision was taken due to the severity of Sam’s symptoms.

On Ritalin, in school, we saw a much different Sam. He was subdued. A sparkle of mischief no longer shone in his eyes. He was, however, able to sit in a chair and work with a teacher on an age appropriate task.

At home Sam’s parents noticed he was less interested in eating and had difficulty sleeping. Both are common side effects of Ritalin, as are delayed physical growth and anxiety. All these side effects disappear once the child no longer takes the medication. For this reason, some families take their kids off medication for ADHD on weekends and during the non-school months.

Several months went by before a good dosage of Ritalin was found for Sam. Each child responds differently to medications and doses must be carefully monitored.

Sam continued behavioral therapy as the family believed medication alone was not enough.

According to WebMD, recent research has documented a decrease in omega-3 fatty acids and zinc in the blood of children with ADHD. As a result, supplementation with omega-3 fatty acids and zinc may be recommended for children with ADHD. Parenting classes that focus on parenting skills, child safety, and understanding the child’s behavior have been found to decrease the symptoms of ADHD.

The decision to use medication for ADHD should be a last resort.

The information provided is not meant to diagnose or treat a medical problem. Please consult your own physician. References are provided for informational purposes only.

References:

http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/AAP-Expands-Ages-for-Diagnosis-and-Treatment-of-ADHD-in-Children.aspx
http://www.webmd.com/add-adhd/guide/vitamins-supplements-adhd
http://www.childmind.org/en/posts/articles/2011-10-17-pediatricians-lower-adhd-age-six-four
Join me for the next blog in the series, Diagnosing ADHD.

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