A recent report which came across the news this last week discussing the possible relationship between ADHD drugs and premature deaths in adolescents quickly caught my attention. Having raised several boys over the past 30-some years with the condition; and then being introduced to even more once we got into foster care in the State of Texas; I obviously had an interest in any possible linkage. The report I read on CNN stated that this relationship has been suspected for some time now, but no conclusive evidence has been established as of yet by the medical community. There are others though, albeit non-medical, who take a more hard-line stance against the use of these medications; for example, the ‘National Alliance’ against mandating drugs for the treatment of ADHD in children – you can get their view at www.ritalindeath.com.
So where does this put foster parents who are charged with the responsibility of looking after the best interests of the children who have been placed into their care? On the one hand, from our experience, there seems to often be an 'overeager’ rush to label the vast majority of kids brought into care as having some form of hyperactive disorder. I recall distinctly that one time as Nancy and I were at the local CPS office on SW Military Drive in San Antonio reviewing case files of possible foster and/or adoptive placements, that almost every-other child was being tagged as ADHD and prescribed Ritalin or Concerta or Adderall. Of course, we thought that was a fairly high percentage – and also questioned that couldn’t some of the so-called ‘hyperactivity’ and acting out just be the result of the trauma they were experiencing by being separated from their families and thrust into an unknown – even though in most cases safer – environment? Or how much was a result of their inherent ‘fight or flight’ mode which causes a constant check of their surroundings and resultant lack of attention to parents, teachers, or others? To us, it often seemed that the ADHD drugs were being used to help the adults deal with the hyperactive child, rather than as an effective way to help the hyperactive child deal with his or her issues.
Certainly our bias is shaded largely by our own personal experience in raising children who actually had ADHD. In fact, 3 of our 5 biological sons had this condition, often compounded with dyslexia. Yet in spite of the constant urging from family, friends, neighbors, and doctors to “do something to control those unruly boys!” we never put them on the medication. And yes, we have seen the questions and concerns such as: “Can a child with ADHD who goes 'untreated' ever become a productive adult?”
Here are a few ideas on how we dealt with the situation:
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1. Patience – anyone who knows Nancy knows that she is the model of patience. When I was pulling my hair out or at my wits end trying to deal with the boys, she would always have that loving patience, lots of hugs, and belief in their inherent good and potential.
2. View the ADHD child as someone with a ‘quick mind’ rather than someone who is trying to cause trouble. We soon came to realize that the mind of an ADHD child can process information much faster than a more ‘normal’ person. Something like comparing a duo-pentium processor to an old-time standard 486. Since they can multi-task and process more information and at faster rates than the rest of us – keep their minds busy and occupied – have you ever seen one of these guys work the controls on a video game during a high-speed chase? Absolutely beyond my comprehension.
3. Reason with the child. These kids are generally really intelligent. Offer them trade-offs as part of an overall behavior-intervention approach; for example: as long as you control your body and hands in school or in public, you can release all your energy at home – in the pool, or the football field, or on the basketball court.
4. Always believe in your kids and their potential. Eric, our oldest, was not only ADHD but also had dyslexia and as a result struggled with school. Fortunately, his Mom continued to encourage him and urged him to do his best. As a result, following a tour of duty in the Army, he put himself through college and med-school and is now a successful ER doctor at the Hershey Medical Center in Pennsylvania.
All that said, realize that we do not advocate a “no drugs ever, under no condition” policy; but rather a sensible approach to the use of medication as a part of an overall treatment program. Eric, as an adult with medical training, opted to use Ritalin on occasion during med-school, especially at test time, to help focus when he needed to be stationary for extended periods. His wife, Stacy, now tells us that many of the ER doctors they know have the same condition; which we suppose makes them effective in dealing with the high-impact, high-activity, multi-tasking environment.
For foster parents, these are serious issues of concern. But remember, you are the primary, and sometimes only, advocate for that child which has been entrusted to your care. When our daughter Natasha first came to us at the age of 11, she was prescribed a number of psychotropic and other medications including Ritalin for ADHD. Nancy, after interacting with Natasha for a few days, and as the foster parent, went back to CPS and stated that she felt Natasha really did not need the Ritalin and recommended a change. After consultation, the prescription was changed to Stratera, a milder non-stimulant drug used to treat ADHD. Natasha then continued with this medication for some time until she was able to come off it entirely. The point is, there are options; and foster parents do have a right to advocate on behalf of their children.
For those dealing with ADHD children, we would suggest you check out the CDC WebSite dedicated to ADHD issues at www.cdc.gov/ncbddd/adhd/index.html which provides a wealth of information on this condition and possible treatments, including medication where deemed appropriate along with behavior intervention techniques and – don’t forget this one – parent training. And for those looking for a non-medicated approach, we could suggest taking a look at the Handle Institute www.handle.org where we have found some of their techniques to be quite interesting and effective.
For us, the general assessment is that as appropriate, medications can play in role in the treatment of these disorders, but we have also had success with the ‘hugs’ vs. ‘drugs’ approach to helping kids deal with their issues.
If you have comments you would like to share with us about your own experiences or questions about fostering; feel free to contact us at fostering@gvtc.com
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