You’d think I’m injecting my 5-year-old daughter with heroin, to hear some people talk.
“Drugs are just a Band-Aid solution,” they’ll say – these mothers of non-learning disabled children who believe all problems can be avoided by Good Parenting. (This is after I mention the ADHD and before I mention medication. After this quote, I never get around to mentioning medication, funny enough.)
“I can give you the number of a really great naturopath,” says one well-meaning acquaintance, who then tells me a 10-minute story about a former involving this wonderful “doctor” and some blood test (unavailable at the allergist’s office owing to that pesky thing called “a high rate of false positives”). The test proved the child in question was — as are all people who get their allergy tests at a vitamin store — sensitive to gluten, dairy, soybeans, carrots, anything yellow or beige, and oxygen. The child’s improvement was immediate and dramatic, of course. (Never mind any nutritional deficiencies or that giant bubble in which he now lives.)
Don’t get me wrong. I’m all for natural foods and positive reinforcement. We’ve done sticker charts and bribery positive reinforcement. Desserts are for holidays and chips are for computers. We use some natural supplements (like the newly-debunked fish oil chewables) while abstaining from others (marijuana as an ADHD cure? What are these people smoking? Er, never mind …). Chris and I both have ADHD ourselves, and after I did the quick mental Punnett squares any woman does when considering a potential mating partner, I realized I’d better research solutions for raising kids with ADHD, as any given offspring would have a 50/50 chance of being jittery, distractible spazmazoids like us.
My suspicions were confirmed when, sometime in the middle of my first pregnancy, I read about “kick counting.”
“Who the heck are these lucky women who have to count kicks?” I thought to myself as the world’s tiniest perpetual motion machine pummeled my ribcage.
The pregnancy book suggested drinking orange juice if one wasn’t feeling kicks. I wondered what one might drink in order to sleep for five consecutive minutes without the sensation of being attacked from within by a badger.
The experts said to worry if you didn’t feel 10 kicks in a two-hour period. I was never worried. A quiet spell for Maddux meant only 10 kicks in two minutes.
And one warm May day, the hyperactive fetus became a colicky, hyperactive newborn. The newborn turned into a bright, playful, and curious baby who was remarkably resistant to naps and bedtimes. Soon, the baby crawled, climbed, and beat up all the other babies in her playgroup, and her swimming class, and library storytime. (Did you know that a dainty blue-eyed 8-month-old girl can use another infant as a climbing apparatus? Neither did I. Neither did the mom of the other baby, who stared at my lovely daughter as if she had chewed her way out of my chest rather than spent 11 hours coming out the normal way.)
There was never a time, from the moment our fetal daughter began the never-ending gymnastics routine, that were anything less than certain she shared our disorder. And although Chris and I had both done wonderfully on ADHD medication, I was determined that we wouldn’t Drug Our Child until she was old enough to make the decision herself.
Books directed at parents of children with ADHD unfailingly mention the importance of establishing a predictable routine. Because we spazmazoids are predisposed to chaos and general spazmazoidery, structure and routine are not innate and must be taught from an early age. So, in what felt like a crime against my own nature, I made my first schedule ever – planning out meals, naps, exercise and quiet play down to within 15 minutes (to allow for all the diaper changes, as her bowels were hyperactive too).
Foods were introduced with great care and were organic and hand-mashed (Maddux being my first child and all — Thomas, being the third, eats a steady diet of dirty, expired Twinkies). Multiple books on pediatric allergies were consulted before I commenced Maddi’s initiation to solid food at 7 months with a bowl of shredded and gently steamed organic Gala apples. Any food sensitivities (broccoli and, oddly, rice) were caught and the foods eliminated.
I like to think it would have been worse had I not been controlling her diet, keeping her on a predictable routine, and implementing organizational aids and bribes positive reinforcement. But truth be told, there was a lot of coloring on furniture, assaulting of playdates, shampooing with glue, and bringing cups upon cups of water into her room at naptime and pouring them all over the carpet.
We won’t even mention Poo-casso’s Brown Period. (OK, we will. It lasted from 10 months of age to about 17 months, and it happened at least once per 24-hour period. There was one horrible day when she painted once upon waking in the morning, once at naptime, and then again for good measure that night after bedtime, and I had to put her back to bed with no sheets because all the others were still in the wash. The next week, noting that I had lost the will to rise in the morning, I began taking Prozac.)
Despite all the challenges to my own well-being, I continued with the non-medicinal approach. Drugs are bad. Just say no.
“They” say to be sure you give your child with ADHD at least five praises for every criticism. Some of the praise came easily. The same genes that cause Maddux to feel like there’s a fire lit under her heinie every minute of the day also imbued her with insatiable curiosity and a remarkable hyperfocus. When other moms looked askance at Mads as she spoke (OK, yelled) out of turn at library storytime, I shamelessly boasted of her encyclopedic knowledge, at 3, of the human digestive system (while hoping she did not enlighten her playmates on the female reproductive system, as I was pregnant and she was very fond of telling people her new brother was going to be squeezed out of my birth canal, or be-gina). She also picked up preschool French easily, and was constantly singing made-up songs and telling imaginative stories. Her My Little Ponies had the most amazing dance parties ever (small consolation at 3 in the morning when most of them occurred, but fabulous nonetheless).
However, on days when she threw sand at preschool or used a contraband marker to decorate her very expensive dollhouse bed, five praises for each criticism seemed a tall order.
“Hey, Maddux,” the conversation might go. “I appreciate that you only hit your brother once and told the truth about putting all the hair elastics and barrettes in the toilet, but it makes Mommy and Daddy sad when you punch your classmates. But great work on remembering that we don’t undo the deadbolt and leave the house at night, and we’re very proud of you for helping clean up all the yogurt cups you opened this morning!”
The same types of people who now act as if I’m pouring chemicals into my daughter generally let me know back then, in no uncertain terms, that I Had No Control Over My Child.
Had I heard of “1-2-3 Magic?” I was asked. “The Happiest Baby on the Block”? “Raising Your Spirited Child”?
I had. Endlessly.
Just as I’d heard of and tried swaddling, babywearing, natural foods, positive reinforcement, sticker charts, schedules, and 5-praises-for-every-criticism. I’d doggedly followed all the “best practices” for ADHD offspring because the people who sell self-help books to harried mothers insist that if their techniques aren’t working, it’s the mother’s fault because she didn’t “stick with the program.”
So I stuck with the program, and Maddux still met the criteria for combined ADHD, her pediatrician told me this fall when we brought her in. Because unlike pop-psychology parenting books, genetics is based in actual science and your kids’ genes don’t particularly care whether the baby food is hand-mashed organic fare or whether you keep doing the sticker chart even if it doesn’t seem to be working. What I had was the best possible outcome for my little spazmazoid. And she was a happy, confident, hard-working (well, as hard-working as could be expected) little girl.
This year, Maddux entered kindergarten. She had been behind the other kids in preschool phonics, but this year, the teachers really piled on the work.Maddi had only just mastered the most basic phonetic reading, and now she was coming home with diphthongs and “sight words.”
Some people eat when they’re stressed out. Some smoke. Kids with ADHD get into mischief. Maddux threw sand on the playground. She hit classmates. She escaped from storytime and methodically locked all the stalls in the little girls’ room from the inside, offering a shrug and an embarrassed “I don’t know” as explanation for her prank. At home, my adorable blonde pixie continued to draw on walls and shred paper like a gerbil and empty six pots of glitter glue onto the shag carpeting in her room and wake her brothers up at 6 a.m. on weekends for spirited furniture-jumping sessions. In short, her behavioral issues eclipsed James’ autism in terms of parental worry. If only it were as easy as a spare set of clothes, extra planning and avoiding activities that involved jackets or strange footwear, we thought.
But those aren’t the reasons she started medication.
Every day at homework time, I quizzed her on her phonics. She did fine, as long as we sounded out one letter at a time. Putting the sounds together, however, required a level of concentration that kids with ADHD don’t have. At least not when the subject matter doesn’t interest them.
Maddux could proudly name the phonics sound for any letter you’d ask, but after a word or two, she’d lose interest. Her eyes would wander the room, searching for something more stimulating than a bunch of boring letters.
If you asked her to read the words on the clip that held our bag of Cheerios shut, she’d sound it out painstakingly. “Ch. Ee. R. Ee. Oh. Z.” Which would be great, if the clip said “Cheerios,” but it in fact said “Bag Clip.”
It didn’t bother me that James was well ahead of where she’d been at his age. It seems only fair that the universe should balance his difficulty adjusting to new clothes with the ability to sound out words he saw upside-down (not surprisingly, both autism and ADHD appear to be caused by large copy number variants on the 16th chromosome). But when Thomas – who is completely typical as far as we can tell – could rattle off as many phonics sounds at 25 months as Maddux did in her second year of preschool, I began to worry.
And then it came to me.
I’d had the same problems with numbers. To this day, if I’m not on medication, it takes me a good month before I can confidently tell you my latest telephone number. To me, 867-5309 might as well be 908-3567 or 866-3355. As a child, I’d wanted to become either a neurologist or a craniofacial surgeon, but I majored in journalism instead because I knew my sloppiness with numbers would bode ill for a future in medicine.
After realizing in my mid-twenties that journalism was incredibly unfulfilling, I rescheduled the follow-up appointment I’d forgotten about after my ADHD diagnosis in college (yes, you read that right) and availed myself of a bottle of Strattera. Suddenly, I was multiplying matrices without absentmindedly ignoring the order of operations. I was also cleaning my long-neglected kitchen and waiting for people to finish talking before I cut in with my own hilarious but completely unrelated anecdotes. ADHD medication enabled me to be me, but better.
As I reminisced, I realized that while medication shouldn’t be the first resort, I’d been foolish to write it off altogether for Maddux just because she was a child. Here we were, doing everything “right,” and Maddux still came home weeping because all her classmates were in a higher phonics reader than she was. We could praise her endlessly for her great science and French skills and her generous heart, but surely having to reprimand her 20 times a day for hurting playmates and damaging property was going to have some sort of effect on her self-image.
And for us, taking ADHD drugs had made a profound difference. My failure to follow a dream because of my math troubles paled in comparison, I realized, with the struggles my daughter faced if her ADHD gave her similar misgivings about something as fundamental as literacy.
Of course, we had reservations about pharmaceuticals. The children in the articles I’d read on medication always seemed to have complaints about stomachaches and feeling “fuzzy” and losing their creative spark. These were things the helpful moms of children with perfectly-calibrated dopamine receptors were certain I needed to know before I began poisoning my kindergartener with drugs.
Nevertheless, I couldn’t bear allowing my daughter to develop a lifelong hatred for reading when one 10 mg pill per day could make all the difference for her.
Amazingly, within the first few days of beginning her daily 10 mg dose of Biphentin, a drug that one might compare with an extended-release form of Ritalin, Maddux was experiencing approximately zero of these side effects. Instead, she has listened to lessons and participated eagerly in class instead of tearing up pieces of paper and antagonizing whoever happens to be in the vicinity. Her reading has improved to the point that, three weeks after her poisoning by Big Pharma commenced, she was able to navigate, with little incident, a book titled “The Headache.” Not one pot of glitter glue or Sharpie has been abused in her room (although she and James did empty a third of a tube of AquaFresh into the toilet tank last weekend). And she is once again allowed to use the school bathroom on her own rather than suffering the ignominy of an adult escort.
When the other moms and the well-meaning naturopathy adherents tell me solicitously about the benefits of fish oil (she’s been taking it since she was tiny, thanks very much, and JAMA debunked the fish oil mythology this month anyhow) or how Supernanny does this wonderful star chart, I smile and nod.
Then I go home to drug my kid — my natural-foods eating, fish-oil-supplemented, oft-bribed positively reinforced kid — so she doesn’t cry over her schoolwork and endure dirty looks and cruel whispers from the same people who are telling me I’m poisoning her with pharmaceuticals. (And, yes, also so I don’t feel the urge to throttle her for disobeying the no-toothpaste-in-the-bedroom rule yet again.)
Maddux doesn’t get stomachaches. She doesn’t feel “fuzzy.” She’s not a dull-eyed zombie, but a sparkling, cheerful girl who invents delightful games for her playmates. She still makes up wonderful songs and stories, but no longer suffers from the impulsive and destructive behavior that made her a kindergarten pariah. Shortly after beginning her prescription, Maddux told Chris, “I never want to stop taking my medicine. It makes me so smart.”
Naturally, there are days when her mind still wanders during phonics lessons or she gives her brother a green foam-soap beard while the rest of the house is sleeping. And she misbehaved outrageously for an entire week following Halloween (thank you, chocolate). But so do “normal” kids, and that’s what pharmaceuticals have enabled her to be.
If drugs are a Band-Aid solution, I’m pretty sure people aren’t giving bandages enough credit.