After having four boys diagnosed with ADD or ADHD, a pattern has emerged that no professional ever warned me about, and I wanted to share my experiences to give parents of teens on ADHD meds a heads-up and some pointers to stay ahead of the issue of medication adherence.
With each of my three older children, there came a time in their tween or teen years that they simply decided they didn’t want to take their ADHD meds anymore. None of them talked to me about it, and all of them pretended that they were still taking them. It started with them no longer taking the medication on their own, then when I put the meds in their hands and supervised them, they either pocketed them in their cheek then spit them out, or, in the case of one of my especially talented kids, he spit them up afterwards because, well, he could. Sometimes it was me that noticed the behavior changes when they started to refuse their meds, and other times, it was the school. Either way, each time it seemed to happen suddenly, and without any discussion between us about it.
My older children, once confronted with it, admitted that yes, they had been pocketing or spitting out their meds. They all gave the same reason for it – they all said that they felt their meds made them feel like they ‘weren’t themselves.’
After speaking with them, I followed up with a doctor’s appointment to discuss the issue, and possible alternatives. In some cases an alternative was accepted on a trial basis, but in all three cases, even after discussions with the doctor and their school, they just did not want to take their meds anymore.
Over the years, I’ve learned that it’s okay. At some point in their young lives, they start to become more self-aware, and notice side effects that make them uncomfortable. This is a step towards independence, and as long as your child is able to cope with life without meds without making everyone around them head for a sensory-depravation chamber, it’s probably okay. You will want to keep in touch with their teachers and guidance counsellors to see if they appear to be focused enough in class to get their work done and learn. If you find that you’re constantly over-stimulated by their hyperactive behavior, it’s probably a sign that they still need their meds, and the school is your best resource to find out if their behavior is having a negative impact on their learning. Most of the time, I was surprised to find that they were coping just fine without their meds at school. Sometimes I had to put myself in ‘time-out’ if they were too hyper and self-stimulating a lot at home with humming, whistling, clicking noises, spinning, and dancing around, but if I knew their school work and social lives weren’t being destroyed by their behavior, and they were absolutely refusing to take meds, I considered this to be my problem, not theirs.
Unfortunately, one of my four is definitely not ready to go off his meds (both ADHD and medication to control his tics), but he is trying to avoid taking them at all costs. He’s my little puker. He has a talent for bringing things up just by bending over thanks to his Gastroparesis (which causes food and liquids to hang around in his stomach unless he takes a medication to make it move through his digestive system). What’s a parent to do?
If your child stops taking their meds, and the school is calling to discuss behavioral issues, a meeting with your child’s teachers, WITH your child present, is warranted. Regardless of a child’s condition, they do have control over their behavior, and they are responsible for it. Instead of flipping a desk over in a fit during class, alternative, more acceptable coping mechanisms can be introduced. A thera-band wrapped around the legs of your child’s chair can help them to self-stimulate in an appropriate manner. Feelings of anger or frustration can be dealt with by allowing the child a time-out to go to the water fountain, down to the office to deliver something, or an opportunity to visit the stim room (if your school has one) are excellent alternative behaviors, but teachers need to be on board and attentive to your child’s needs. If your child is old enough to decide he doesn’t want to take the medication, then he/she is old enough to take responsibility for their behavior, and make use of these alternatives.
An appointment with your child’s pediatrician should be your next step. Having the doctor explain how his disruptive behaviour affects those around him may help. The doctor may also alternative medications that may have fewer side effects, or adjust the dose of the medication your child is currently on. If you have insurance, or your community has services for children and teens with ADHD and behavioral issues, engaging with a Behavioral Therapist may help you come up with better coping mechanisms, and by working with the therapist, your child may learn to substitute these behaviours more easily.
Keep in mind that while you are probably concerned and want your child to stay on their medications, once your child has begun to feel they don’t want it anymore, it will come to a point where getting – and keeping – their meds in will become impossible. Kids are smart and creative, and unless you want to be the parent that makes them show you that they’ve swallowed the pills by inspecting their mouth after giving them, it may be inevitable. Your child may come to resent you and it may cause a breakdown of your relationship if you are reinforcing that you don’t trust them by doing an embarrassing mouth-check every time they take their meds.
Each child truly is unique, and each child will have different needs if they decide to stop taking their meds. Knowing that you do have options, and exploring those options, is a much more positive way to allow your child to begin to express some autonomy than forcing the medication issue. Open communication, understanding, patience, and if/then scenarios are far more effective than battling daily with your child. (i.e. if you choose not to take your meds you have to explore ways to deal with noisy classmates/your need for stimulation). Keep in mind that it may not all be bad, though; children with ADHD usually do outgrow it as their forebrain develops, and if you’re lucky, they will cope with few, or no, issues. My motto is ‘Shalom in the Home’ – I try to avoid conflict with my children when possible, and it makes it easier to keep the lines of communication open if I’m not clashing with them daily. This one can definitely be a losing battle, so it’s one issue I try to address in a way that respects my children’s feelings.