Noah is a second grader who you recently diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) combined type. His parents are involved and concerned about their son’s diagnosis. They have questions about behavioral and medication treatment options, but they worry about the short-term and long-term side effects of medications. In addition, they wonder what resources are available for behavioral strategies and support.
How would you as the provider caring for this child answer their questions?
Making the diagnosis of ADHD to the caregivers is the starting point to many conversations about management. In my experience, parents have evolving questions about management and need resources beyond their child’s health care provider to help give the child the best treatment at home.
I highly recommend parents read the book “Taking charge of ADHD” by Russell Barkley. This resource is the Bible of parenting an ADHD child. I explain to caregivers that parenting an ADHD child is a challenge and that takes an added skillset that is not needed in a non-ADHD child. I encourage the parents to seek out parenting skills classes, which can often be found at a local child guidance center. If neither of the earlier options are helpful, I recommend the family seeks the professional services of a behavioral therapist or a licensed therapist.
It’s common for parents to have anxiety about starting stimulant medication. Prior to the initiation of medication, I explain the difference between stimulant and non-stimulant medication. I discuss the known common short-term and long-term side effects of stimulant medications, and I write or draw important concepts on the back of my prescription pad or table paper to help their understanding. I also explain that it may take trying a few different medications to find the right fit. I often use the analogy of Goldilocks and the three bears and finding the porridge “just right.” I encourage parents to start the medication on a weekend so they can observe how their child responds. And, I discuss whether “a medication holiday” is something to consider.
After all that initial conversation and education, many parents still want additional resources. I usually recommend CHADD (www.chadd.org), which is a support organization for families affected by ADHD. They offer parent support groups, news on the latest ADHD research and educational conferences.
Even though an ADHD diagnosis is not life-threatening, it can be traumatic and emotional for parents. As health care providers, we can help parents navigate the journey by recommending helpful resources and providing sound guidance.