Parent Questions Use of Medication in Gifted and ADHD Kids

Medication should never be prescribed for a child without adequately examining the child and seeking to modify the environment.
I am trying to decide the right thing to do where my children are concerned. My 11-year-old is gifted and has been diagnosed as ADHD. He was on medication since the second grade and upon his constant request I took him off the medication last year. His grades have been horrible, but he is happier. He is starting Intermediate School this year and I hope he does well. His psychiatrist has gone with my wishes regarding the medicine. Am I doing the right thing in your opinion?

Child #2 is a seven-year-old boy. He has also been diagnosed as ADHD. He has not tested as gifted yet, but I believe him to be. He was on Ritalin® and then Adderal® for almost two years. The schools were the ones requesting this, as he is very active. But once I saw him at home on the medication, I did not like how it made him. He was zoned, missing everything around him (we were at a baseball game). He has been off medication all summer, and although active, he is retaining things that he learns at an amazing level. He is just high maintenance. My question is, is this so wrong? It seems that we are medicating children too readily, when they require more attention. I would really like your professional opinion on this.

I do think that we give medication too quickly and too often to children without adequately examining the child or modifying a child's environment. Gifted children, who often move quickly from idea to idea, and task to task (or who stick with a task for a very long time without seeming to be able to attend to anything else) are sometimes, misdiagnosed as having ADHD. It's important to have gifted and talented children evaluated by a professional who is very familiar with the characteristics of these children. Otherwise, they may be misdiagnosed and inappropriately medicated. Since pediatricians only see children for brief periods of time, they count on reports from teachers to help them make decisions about whether or not to medicate, and if the teachers are not seeing the child for who he is, then the data they provide is distorted.

The fact that your older son asked to be taken off the medication is significant; some kids have a good sense of whether or not they need to take medication, and although they can't make the final decision, we need to listen to them. It will be very important to monitor your son's performance very closely in the first few weeks of school to make sure his teachers understand (and can meet) his needs. If he's able to focus and attend outside of school, but has difficulty while there, then you and his teachers need to consider what aspects of school may be causing him difficulty. If he has difficulty in all settings, you can have more certainty about the ADHD diagnosis (and the need for medication).

Is your younger son's school the kind of place that can handle (or embrace) active, eager learners (or as you say, "high maintenance")? If teachers have a hard time accommodating exuberant, quick-witted kids, then a change of classroom (or perhaps school) may be indicated. On the other hand, in order to be successful in life, kids need to learn enough self-control to live and work with other people. If your little one has difficulty containing himself when he needs to, make sure that he's 1) being expected to settle and focus in school and at home, and 2) that he's being taught different ways to gain and maintain self-control and focus. These things need to be done before any thought is given to medication.

Jerome (Jerry) Schultz is the founding clinical director of the Learning Lab @ Lesley University, a program that provides assessment, tutoring, and case management services for children with learning challenges. Schultz holds a Ph.D. from Boston College, and has completed postdoctoral fellowships in both clinical psychology and pediatric neuropsychology.

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