My Son Takes Ritalin

As a pharmacy technician (for twenty years), I have judged parents for “dosing their kids up” on hardcore ADD/ADHD drugs like Ritalin, Dexedrine, Adderall, you name it. I just never understood how a parent could do that. I wondered why they didn’t try other things, like changing diet, therapy, tough-love, quit their jobs and stay home and raise the child, give him/her more attention. Once again, I have been shown that it is wrong for me to judge…

Once again, something I judged others for has come full circle and impacted my own life.

My oldest son, Nathan, has been challenging from the beginning. The poor little guy had reflux and lactose intolerance as a baby. He was always miserable, unable to sleep or sit still, unable to play with a toy for more than 5 seconds. He could only focus on TV for any length of time, so Baby Einstein and Sesame Street became my go-to relief when I needed a shower or time to clean. (That’s another story, right?…”Terrible parents who let their kids watch too much TV!”) Anyway, I felt so guilty taking him to daycare Three days a week so I could work part time, but also so I could have some sanity. He was not a fun child to be around. I could not please him. He hated me. Fast forward a few years to: an exhausted mommy, with a child nobody else could/would handle. I divorced his dad when Nathan was three. This helped a little. It meant I got to have some time off and I could pursue some happiness. But I soon realized that Nathan was getting even more difficult, because now we were dealing with transition time between dad and me, different house rules (mine having many, dad’s having few).

A year of therapy helped me realize that I’m not a crazy person, and my son is, well, um… He’s normal.

At 5 years old he was still not potty trained. He was angry, loud, non-compliant, and very disrespectful to me. He would bite, hit and kick children at daycare. Run away from teachers. Scream profanities at me. Apparently his father never has any of these problems with him. I blamed myself for creating this mess of a child. I blamed myself because I wanted the divorce, because I wasn’t happy, because I couldn’t take it anymore, you name it. A year of therapy made me realize that I’m not a crazy person, and my son is, well, um… he’s normal. He’s just a bit more difficult. The therapist explained it like this: most kids are Parenting 101, Nathan is Parenting 501. She recommended Love and Logic Parenting. I loved it. I loved the idea of how it would work. Primarily it helped me have empathy for my son. This helped take some of the blame off me, and helped him learn how to make good choices, based on the consequence he desired. But, the story doesn’t end there. Some of the scenarios I was dealing with could not be handled with Love and Logic. There was the issue of preschool, interacting with others, and two different household on two different planets. Ugh…

Have you heard of PCIT? Parent Child Interactive Therapy. I hadn’t either. It was recommended by Nathans therapist for learning how to help his behavior. There was alot to learn with PCIT but after seeing some results I was eager to continue. Hope was my middle name. We’ve been doing the therapy for 6 months now. Honestly, some things are better. Some things are not. Dad got on board, until it came time to do the hard part, called PDI (i’ll explain PDI in a minute). Our therapist (a different one now) has an answer to every scenario, it seems. (Honestly, can I just ask for an answer to “how do i not lose my freaking mind when he absolutely will not stop screaming, or kicking or cussing at me?”). Don’t get me wrong, I love Amber, our therapist. She knows her stuff and has helped us tremendously. But she’s young and doesn’t have kids yet. I’d like to be a fly on the wall at her place when she’s losing her mind. Just saying.

I’ll explain PCIT in a nutshell. A PCIT trained therapist teaches the parent some special skills for CDI, Child Directed Interaction. This means the child decides what the play will be, and will make all the choices in how the interaction will go. The parent asks no questions, only complies with the child. If there is negative behavior, it is ignored. If the negative behavior escalates to a physical level, where the child hits, etc then CDI is stopped. The parent is to use the P.R.I.D.E. skills. (Praise. Reflect. Imitate. Describe. Enjoy.) during CDI. The therapist goes into the next room where there is a window and camera and she watches the parent interact with the child, using these skills. The parent wears a earbud and gets coaching from the therapist. After practicing in sessions and at home, there was a very obvious change in behavior during our CDI. Nathan blossomed into a loving, confident, imaginative little boy. I was actually able to enjoy playing with him. Then came the PDI, Parent Directed Interaction. This is where CDI skills are used, but there is the added element of the parent directing the child to do certain various tasks, like trading toys, putting toys away and starting a new game. When the child complies he is praised for listening and following directions. Commands eventually get more complex and intentionally aggravating for the child. When the child doesn’t comply, a time-out routine is implemented. The first session where we ended CDI and went into PDI, there was a huge battle, throwing of clothing, cussing, etc, just like at home when I ask him to do something. It was an emotional time for me, because I felt evil for provoking my child. In reality, its to help him deal with, well, reality, and that all his choices have consequences. We worked on this for months. By the end of our PCIT, he would quickly and enthusiastically do what I asked and did it with pride, knowing he would be praised for it. This was a huge breakthrough! Even Nathan’s teachers got involved and came to our sessions (secretly) and watched from the window. They learned the skills and observed how they work. They are excited to use them with all their students.

So, now you may be wondering where this ends up with Ritalin. We all used our skills, we had better days, we enjoyed Nathan more. But he was still an angry and frustrated little boy. He cannot handle criticism, no matter how small or who gives it. He cannot sit still or stop talking, unless he’s watching TV (and even then, he’s wiggly). He still withholds pooping and often doesn’t make it to the toilet when he can’t hold it anymore. He still has horrible tantrums for a very long time, when he is told “no” or for various odd reasons. While we’ve had improvement, the trouble lies with how Nathan feels about himself. He’s so smart its scares me sometimes. He’s a handsome, charismatic, charming, articulate little boy. I had him evaluated by Early Childhood Intervention and was told he has above average intelligence. His pediatrician says he’s very healthy, not autistic, and has no sight or hearing issues. We give him Miralax to help (make) him poop. He takes melatonin to help him wind down and go to sleep. We changed how we eat at my house to a mostly vegan diet, organic, low sugar, no artificial sweeteners/colors/flavors/preservatives, etc. He eats lots of fruit, nuts, carrots, broccoli and occasional spinach. He takes Juice Plus chewable a for kids. I gave him Zevia several times (a stevia sweetened caffeinated soda) and noticed a significant difference in his behavior, at home and school. The effects only lasted about an hour and it was a rough protocol for Dad to follow at his house, so consistency was an issue.

The behavior physician, recommended by Amber, saw Nathan for 1 minute (walking in the hall, before we got to her office) and with a smile, she said “He’s got some energy, you have your hands full, don’t you?” At that moment, I knew. I knew my kid was going to be “one of those kids who takes drugs”. She did a thorough evaluation on Nathan, asked me a million questions, and suggested medication. He has ADHD and SPD. As much as I figured this was going to be the outcome, it still freaks me out. I only hope I can help him make it to his full potential and live a happy life. When Nathan takes Ritalin he is the boy he wants to be. He’s happier. He is more confident and willing to please. He is not angry. He doesn’t scream or growl at me. He listens to his teachers and sits still for story time. We get smiles and thumbs up when I pick him up from school. Why would I NOT want to give him medication? Now I understand.

 

With the PRIDE skills, I always had hesitation with “Enjoy”. I was on edge, constantly waiting for the blow up, unable to take my sons affection and sweetness at face value. Have I ever really allowed myself to enjoy him? I feel like I can enjoy him now. I can only imagine how it makes him feel. I no longer judge parents who give their kids drugs. I’m sure there are some who do it for the wrong reasons, but it’s not my place to determine that. I’m not the perfect mom. I’m just doing the best I can with my own situation.

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