Wednesday, January 26, 2011

Just when you think things are going along well...

The week between Christmas and New Year's was more or less a nightmare.  With two grandmas staying with us, a complete lack of schedule, and a drastic change in sleeping arrangements to accommodate our visitors, Dylan was not exactly at his best, with frequent outbursts.  Even that first week back to school was not stellar.  Major difficulties sleeping that had begun when he was camping out on his bedroom floor did not go away when he was back in his bed even after school restarted.  An increase in medication, from a 15mg Daytrana patch to a 20mg patch probably didn't help.  I think he was up past 10:00pm at least three nights that first week back at school.  Instead of the 9-10 hours of sleep he should get, it was more like 7 or 8 much of that week, a big difference for an 8-year old.  By the end of the week his distraction level had gone through the roof. He was so off track his teacher even asked if he was off of his medication. 

We were determined to get a handle on his schedule.  We started by not giving him medication that weekend so he would sleep more easily.  And sleep he did, demonstrating just how tired he was.  On Monday, a week after school had restarted, he was back on the 20 mg patch and we were ready to get our schedule straightened out.

Stimulant medication is well known for causing sleep disturbances and we had already been giving him 5mg of melatonin to help him sleep, at his pediatrician's advice.  But the full dose all at once was not cutting it.  Somehow, I don't even know how, I got the bright idea to give him a portion of that dose - 2 mg - early and give him the rest right before bedtime.  And that second Monday, a week back at school, that's just what we did - and it worked.

Even better, that same day when Dylan came home from school, he had finished all of his homework.  I don't think that had ever happened in his entire history of having homework.  As a result, I could get dinner started as soon as we were home.  I even allowed Dylan to go on the computer, even though screen time of any kind is generally forbidden.  But I was so pleased and proud of him, I felt he deserved some sort of reward.

With dinner occurring earlier, bedtime also came along at an earlier hour.  By 7:30pm, Dylan was brushed and in bed and we were having "interactive" - reading together, each taking a page or maybe even switching off sentence by sentence.  We talk about the book, and the usual bedtime rules - Be Quiet, Be Still, No Talking - aren't in effect.

At 8:00pm, the earliest he had been getting in bed previously, Dylan snuggled down and I read a chapter book to him.  He fell asleep easily and comfortably.  The combination of "layering" the melatonin and an earlier schedule combined to send him off easily to dreamland.

The latest he got to bed that week was 9:00pm.  With adequate sleep, he was generally more pleasant in the morning and he was continuing to come home with his homework finished.  I really thought we had turned some sort of magical corner.

Then I was asked to come in to school.

There was nothing markedly different really.  The meeting was in response to Dylan's last report card conference, which had occurred in the throes of that first bad week.  I still though that things were improving.  But when I got to that meeting, it was obvious that the school didn't agree.

While I was seeing big changes in completion of his homework and even in his approach to homework (coming in and sitting right down to it) the teachers reported little to no change in class.  He was still needing a lot of direct assistance and attention to get his classwork done.  If they sat with him and coached him along, tests got done and done well.  If not, work was not done or not done properly and not finished, and his grades suffered. 

I still thought we were on the right track...until I mentioned how the increase to 20mg of Daytrana was working.  Three of the four teachers and facilitators gathered (all but his homeroom teacher) suddenly saw the only possible solution was increasing or changing his medication.  That was it, they said.  He just needed to be properly drugged.

I was stunned.  I should have said more.  I just was so taken aback.  It just didn't seem possible that educators were telling me I should medicate my 8 year old even more.  Considering that I had only been asked to attend the meeting two business days prior and didn't get the written notification until the day after, I couldn't help but wonder what solutions they might have considered had I not been there and had they not suddenly latched onto the medication.  ADHD has been around for a long long time and that is the best we can do?  It's really no wonder that some consider stimulant medication to be as big an epidemic as attention deficit itself.

The medication is a good thing, don't get me wrong.  It helps kids like Dylan get through the school day.  It helps curtail their impulsive responses.  It gives them a few seconds of control that they wouldn't necessarily have.  But should it be the only thing?  If ADHD is as widespread as it seems, shouldn't we have more options, more methods for helping them in class?

I'm sad.  I'm sad that the big improvement I thought we were seeing maybe isn't the turn for the better we thought.  I'm sad that two weeks after homework was completely done when we got home, it was far from completely done when we got home today.  I'm sad that it's 9:56pm and I can still here him rattling around in his room.

What are the solutions?  And why don't we have better methods? According to the CDC Mortality and Morbidity Week, Louisiana is among the top areas for ADHD diagnoses.  Why don't we have an ADHD center or a university-sponsored ADHD program?  Why is there no CHADD support group here?  Everyone agrees this is a problem affecting more and more kids.  Yet there seems to be no urgency to addressing it.  The idea that it's caused by poor parenting lingers. I can't believe that this is the very best we can do.

1 comment:

  1. Ugh, I feel your pain. It seems that pharmaceutical companies have edged out all other options. I can't help but wonder whether there would be more options if those companies didn't have billions of dollars to throw at everything (including doctors and lobbyists).

    We do medication combined with therapy and a regular routine that includes exercise and outdoor time. I wish there was A Solution.