Round Peg, Square Hole :: Our Journey to an Alternative ADHD Approach

Our almost-11-year-old, “Bob” (not his real name), has always done things the hard way. I’m the stepmom, so I can’t account for years 1-3, but this has certainly been true of years 4+. His dad tells me that this was always the case. He started climbing out of his crib at 18 months, used the kitchen drawers as steps to get onto the counters shortly thereafter, and has always been difficult to contain. Although challenging at times, he has the biggest heart I’ve ever seen (especially when it comes to animals), and loves more fiercely than anyone I’ve ever known. As you can imagine, though, he has had some real problems at school. Not only did he struggle to stay on task and following instructions, but he was distracting to the class–moving all the time, making strange noises, interrupting the teacher, and trying to be the class clown. We took him to a number of specialists and, ultimately, he was diagnosed with classic ADHD. (Bob is quite intelligent and, despite this diagnosis, has always absorbed material well and kept up with or surpassed his classmates academically.)

Initially, we were quite opposed to medication for Bob. I am not a huge fan of most long-term medications, and the list of potential side effects for ADHD meds is enough to give any parent anxiety. Beyond that, we were also concerned about stifling his fun-loving, creative, big-hearted personality. The last thing we wanted to do was take away what made Bob, Bob. So, we tried everything else we could think of–incentive/reward systems, altering his diets (reducing sugar, reducing gluten, reducing dyes, eating organic), regular therapy sessions, modifications in the school environment (busy toys, allowing him to go to a separate room to test, assigning him “buddies” to help keep him on task, etc.). We saw only mild progress at best, and his behavior at school was approaching a point where we knew we would soon have to have a conversation about Bob’s future at his school, which we all loved.

So, we caved. In the second semester of first grade, we put him on his first ADHD medication. After playing around with the dosage, things leveled off some. While he was not the exemplary student, he was “under control.” This was the start of our four-year roller coaster ride on ADHD medication.

Over the next several years, we learned that the human body does not respond the same way to these types of medications the same forever. Over time (in our experience, anywhere from 6 months to two years), the receptors in Bob’s brain would become desensitized to the medication, and we would have to try to find another one that worked for him, and the right dosage of the new medication. It was hard on us, hard on the teachers, and most importantly–it was hard on Bob. {You might be wondering if we gave up on all other treatment and just decided to medicate him–not so. We continued to try various therapies, diets, modifications at school, and approaches at home. The hope was always that he would be able to get off medication sooner than later.}

One of the side effects of these medications is appetite suppression, and for our picky eater, that was tremendously difficult. He lost nearly all interest in food (unless it was something like ice cream that he only wanted to eat because it tasted good). Bob has always been on the smaller side, but while he was on ADHD medication, he nearly wasted away. For three years straight, he did not gain weight–despite the fact that he was getting at least a little taller each year. Similarly, although he was never a great sleeper, the medication made him restless and he often roamed the house at night, waking up with bags under his eyes and looking generally unrested and gaunt. We did our best to deal with these side effects and made lifestyle changes to try to offset the side effects, such as offering lots of high-calorie, nutrient-rich food, giving him supplements, and giving melatonin to help him sleep. We hated it, but we tolerated it because it was what we felt like we had to do.

Until we couldn’t anymore.

When Bob was in 5th grade, we once again arrived at that dreaded time when Bob’s medication was no longer effective. We tried to increase his dosage, but he lost weight in a matter of weeks, and so we went back to his prior (now ineffective) dose. Overall, though, his behavior at home had been quite good. Rather than going down the rabbit hole of another medication, we decided to take him off of his medication and see how he would do. We were simply tired of the medication’s side effects, and we were even more worried that the medication might be seriously delaying his growth and development long-term. After taking him off of his medication, Bob gained 10 pounds in a month and looked more rested, healthy, and strong than he had in years. About the same time, we’d begun neurofeedback, which is a non-medicinal treatment for ADHD (read more about the practice we see here) that we were (and still are) hopeful would be an alternative treatment. While his behavior at home remained quite good off of medication, his behavior at school deteriorated. Unfortunately, the school environment and rigid schedules were just too overwhelming and oppressive to his personality.

Finally, it dawned on us–maybe, instead of trying to make Bob fit into the school’s mold, we should be looking at a different approach to school that is more suited to his personality. This idea gained even more traction with us when our doctor shared recent research with us that shows ADHD medication does not actually improve learning for most kids. It just keeps them “under control.” Studies have also confirmed that children who were on stimulants for ADHD were both shorter and at a lower weight than their counterparts who did not receive stimulant medication. This only confirmed our growing suspicion that the medication had been only helping Bob fit into the school environment–not only was it not helping him, it was probably hurting him.

Truly, we feel like we were just trying to fit a round peg into a square hole. This year, instead of trying to make Bob into a different kind of student, we decided to try a different kind of school. We enrolled Bob in an virtual school, where he will take self-paced online classes. We hope this will give him the flexibility and environment he needs both to succeed and to be happy (this was also a big factor in my decision to make a career change, which you can read more about here). I will write a follow-up post on how these changes have worked (or not worked) for our family in the coming year, because I know Bob is not the only square peg out there. For all you other parents out there with your own “square pegs,” please don’t give up on them. They might just need you to look at things a little differently to help them find where they can fit.

{I’m not a doctor, and I don’t pretend to have all the answers. This post isn’t anti-traditional school (we love our school and have other kids staying!), nor is it generally anti-ADHD meds. I am just sharing my attempt to encourage other to think outside of the box when it comes to how we deal with kids who don’t quite fit society’s mold.}