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My eight-year-old, who was diagnosed with ADHD last summer, was having problems in school with a lack of consistency and a short attention span. He was never disruptive in the class and his grades were A's and B's. We sought the advice of an "expert" and he suggested PMS-Methylphenidate twice a day. After receiving his first report card, his grades decreased from what they were before the diagnosis. Also, he's getting the same negative comments that he's gotten for the past two years. So the doctor increased his medication. His teacher said that his concentration and task completion was not improving. We have just received his second report card. Now he's disruptive in the classroom, there are more negative comments, and his grades continue to go down.

I am very frustrated with his teacher and the doctor. I thought the medication was supposed to help with his attention and task completion, but it has only made it worse. Any advice?

Certainly the first place I would start is by getting a consult with another doctor who is well versed in the complexities of medication for ADHD. Your son may need a switch in medications. More of the same is not always better. Children and Adults with Attention Deficit Disorders (CHADD) can probably put you in touch with a professional in your area (1-800-233-4050).

In addition, however, I think it is critical to ask for a full psychoeducational evaluation for your son. You can either do this through school or privately. Medication alone is often not enough to treat ADHD. It often makes children more "available" to learn, but then someone needs to teach them new ways of coping and interacting with others directly. Many children have other learning issues that need to be addressed as well. These issues commonly arise when children enter third grade and the challenges for independent learning increase. An evaluation will tell you about the level your child is functioning at in all academic areas. If necessary, an individualized education plan can be written where goals are set and progress is monitored on a regular basis. Make sure that classroom observations are part of any evaluation that is done. You need an objective view of how your son is really doing in class so you can put appropriate supports in place for him.

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