To Ritalin or not to Ritalin
Posted August 17th, 2010 by Joe NewmanAs a toddler I was the kid who repeatedly stuck his fingers in the electric sockets. My mother tells of my father slapping my hand for doing this and with tears streaming down my face I looked him in the eye and did it again, then another hand slap, then again, and another slap, over and over until my father gave up and carried me away. By age three I’d learned how to use the screwdriver and began taking everything in the house apart (like the reclining chair I removed all the screws from, then watched from the closet to see what would happen – it collapsed into pieces when our neighbor sat in it.) I was aggressive with other children, knocking them over and taking their toys. When my mother brought me to the playground the other mothers would gather their children and leave.
By first grade I was getting into fights every day at school. And in the second grade they diagnosed me as A.D.H.D. and put me on Ritalin. Although the Ritalin made me a bit easier to manage, I still spent a lot of time in the principal’s office. I made explosives out of model rocket engines in the basement and tested everything to see how well it would burn or what it looked like when I blew it up.
I was unfocused in school and found it difficult to sit down to read or write for more than a few minutes. My teachers described me as “not working up to my potential,” or “a good student if he would just try.” When you’re a child who can’t focus or control his impulses, most teachers treat you as if you either don’t understand what’s expected of you, or you simply don’t care. You spend your school years annoying and/or disappointing everyone and most teachers’ feeling for you is one of either condescension or chagrin.
I don’t know if I would have graduated high school at all if it hadn’t been for my success on the wrestling team and the fact that my mother was willing to take my dictation. Once a month she would type my papers for me while I’d pace between the kitchen and the living room calling them out to her.
Although school often left me feeling humiliated and angry, I made it through and was even admitted to the state university (at the time they would admit you based solely on a decent SAT score). But university looked like more of the same. Sit still, be quiet and regurgitate what we say. The only thing it seemed to offer was an education in competitive drinking, and since I’d already mastered that in high school, I didn’t see the point in staying. So after seven weeks at college I shaved my hair into a Mohawk, dropped out, and went surfing.
Ten years later I still carried the shame of being A.D.H.D. It had been a secret no one but me, the doctors and my parents knew. Ritalin was the disguise I needed to survive behind enemy lines. Every time I took that pill, I also swallowed the belief that I was broken, disordered and not like everyone else. But the last ten years had begun to teach me something else.
Instead of being the one who couldn’t sit still, I was the one who kept moving and got a lot done. Instead of being unable to focus on one thing, I was able to do several things at once and adapt quickly. Instead of being too impulsive and aggressive, I was spontaneous and driven. Instead of asking too many questions, I was a good problem solver. Instead of being unable to follow the rules, I was creative and unafraid to take risks. The flip side of those characteristics that had been called a disorder, and needed fixing with medication, were actually my strengths.
So after all this what do I think about putting children on Ritalin? First, every parent should know that Ritalin is a two-edged sword and not a silver bullet. The truth is that while Ritalin did some serious damage to my self-identity it also prevented untold damage that might have occurred had I not been medicated. While it postponed my learning to master and find the gifts in the mind I was born with, it also allowed me to fit into and survive the culture of public school.
The second thing parents should know is that behavior and neurology are malleable. A well thought out behavior plan and effective boundaries can make a big difference in how much self-regulation, impulse control and respect for others your child develops. The more a child is out-of-control the more the mind practices this and the better at out-of-control it gets. When adults effectively motivate respectful, in-control behavior in their child the child’s mind practices and gets better at this. Creating consequences that effectively motivate self-control is the key.
For instance if self-regulation were measured on a scale from one to ten, one being the least self-regulation, effective boundaries and a behavior plan could shift your child from a one to a four (or two to five etc…). While rating a four in self-regulation might not be perfect, it could mean the difference between being able to succeed in public school without medication or not. And that four in self-regulation combined with strong problem solving skills, creativity and enthusiasm could make for a very successful student.
When my parents decided to put me on Ritalin, like most parents, they did so not because it was an easy answer, but because it was the only answer they had. This is why I’ve worked as a Behavior Specialist with behavior problem children for the last 19 years, so that today’s parents will have other answers.
For more from Joe Newman you can go to youtube.com/RaisingLions or RaisingLions.com
6 Comments
August 27, 2010 at 4:29 pm by Joe NewmanI am encouraged that so many thoughts and feelings are raised because of a two-page blog. But this subject is so explosive is because the stakes are so high. We are dealing with the development of the next generation and all opinions are strong because the people involved care deeply about the outcome. I deeply respect the people who explore this topic every day. I am also a person exploring the many paths we are on and, perhaps, could be on with regard to raising the next generation.
Ms. Pera speaks as if looking at your dynamic with your child makes you a bad parent, or that suggesting parents look more closely at this dynamic is blaming the parent. I would suggest looking at parenting in another way; as a relationship that needs work all the time. If a person was to run into trouble with their husband or wife and decided to seek counseling, on every occasion the counselor would encourage the person to look at their own dynamic in the relationship – is there something they could do different? Are their expectations realistic? Do they need to say what they mean more? How are their boundaries? As we would respect a person who could take a good look at themselves when they were unhappy with a mate, let’s respect, and encourage, the parent who can look at their dynamics with their children and try to facilitate a more healthy relationship that nurtures the child’s growth. After all isn’t the relationship between a parent and a child at least as complex and important as between husband and wife?
My blog encouraged parents to look first at behavior intervention strategies because of the success I’ve had using them with all types of children. Most of the children I’ve seen during the last 20 years had behavior intervention plans that were deeply flawed, based on incorrect assumptions about the root causes of many of the behaviors, and were poorly or inconsistently administered.
When these children were given behavior intervention plans that weren’t flawed, were based on a correct understanding, and were applied properly and consistently – outstanding progress was achieved. In most cases when this is done the need for medication to control behavior is mitigated. In some cases the need for medication is eliminated.
I find it frustrating that most parents don’t yet have access to, or knowledge of, behavior intervention strategies that are effective and comprehensive but his will not be remedied by discouraging them from exhaustively seeking options to medication.
Lastly, as to Ms. Pera’s assertion that my ““medication regiment” was no doubt sub-sub-optimal. As evidenced by your challenges, including abusing alcohol” and that I clearly lacked any “psycho-education”. My doctor between 1971 and 1977 was Larry Silver, MD perhaps the preeminent doctor in the field at that time. Dr. Silver is the author of more than 150 publications on learning disabilities in children and remains one of the great minds in the field. I met with him every other month during those years for “psycho-education”. And the drinking I refer to in my blog occurred two years after the discontinuation of my medication regime.
While I appreciate Ms. Pera’s vigorous efforts to educate parents about the effectiveness of proper medication for children with ADHD I work toward the day when medicating our children becomes the alternative and effective behavior intervention becomes the first step in addressing their difficulties.
Joe Newman
RaisingLions.com
[Reply]
August 18, 2010 at 8:37 pm by Gina PeraHi Joe,
There’s a difference between effective parenting and behavioral interventions that are specifically geared for ADHD.
I know it’s a common myth that parents rush to medicate first, but in my 10 years of ADHD advocacy, I have not seen that.
Instead, I have seen parents try every possible alternative (many of them not only wastes of time and money but equally wasteful of a child’s and parents’ hope or optimism that the child’s functioning can improve).
At any rate, it’s important to not conflate “bad parenting” with valid diagnoses of ADHD. It’s also important to screen parents of children with ADHD to see if the parents’ own ADHD is interfering with effecting parenting skills.
thanks,
g
[Reply]
August 18, 2010 at 1:08 pm by Gina PeraI also think it wise for you to point out that your “medication regiment” was no doubt sub-sub-optimal. As evidenced by your challenges, including abusing alcohol.
Today, we have better choices of medications and better behavioral strategies to go along. Still, too many physicians are haphazard. Parents must educate themselves on the medication protocols and best practices in order to choose a clinician wisely and work with that physician.
[Reply]
August 18, 2010 at 1:06 pm by Gina PeraYou wrote:
“:The truth is that while Ritalin did some serious damage to my self-identity it also prevented untold damage that might have occurred had I not been medicated. ”
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Actually, it seems to me that what caused the damage was the way in which the medication was given to you — without, it seems, benefit of psycho-education.
Perhaps if the physician and your parents had been able to explain to you why the medication would be helpful and helped you to develop a more balanced view of your abilities, you wouldn’t have what seems to me a clear anti-medication bias.
As for “self-identity,” this is indeed a challenge for many people with unrecognized ADHD, and it doesn’t just come from the predictably negative feedback. Consider that, in many ways, the seat of the self is in the frontal cortex. That means that people with ADHD might have an even harder time of developing a strong self-identity, much less strong self-esteem.
“Alternatives” to medication are all well and good if they work. Every child is different, and must be assessed as an individual. Primarily, it must be determined that the valid diagnosis is ADHD and not something else. Moreover, many parents of children with ADHD have this highly heritable condition, too. If their own ADHD is not addressed, that can often compound a child’s problems.
I can’t help but think that your dad slapping your hand, seemingly showing little empathy for your inability to control yourself, was exhibiting the same behavior you were: Continuing to do the same thing that wasn’t working. Perhaps your dad had ADHD as well. I know just as many people who were scarred by the poor impulsive control around anger from a parent with unaddressed ADHD symptoms as from the medication.
Please know that what seems to work for a child with ADHD at the time might not be what gives that child the best foundation for the long-term. Many behavioral strategies simply manage the child’s symptoms from an external source. What happens when the child grows up and lacks the internal structure? That is something to be considered very seriously.
Gina Pera, author
Is It You, Me, or Adult A.D.D.?
[Reply]
Joe Newman Reply:
August 18th, 2010 at 8:05 pm
@Gina Pera,
Gina,
Thank you for your thoughtful response.
One sentence in your reply to me stood out. You said, ““Alternatives” to medication are all well and good if they work.”
I would like to suggest that changing the way we interact with children, speak to them and give them consequences (behavior interventions) be considered as the proper first and primary response to behavior problems and that medication be considered the “alternative” when these approaches have been exhausted.
More and more I hear behavior intervention referred to as “alternative” and medication considered the first and normal response. I believe this paradigm must be reversed.
Joe Newman
RaisingLions.com
[Reply]
It sounds like you are doing fantastic work! I strongly believe in alternatives to medication. Go Joe!
[Reply]
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