To Adderall or Not to Adderall?

My two oldest children take Adderall.  I'm still not in a place where I'm thrilled about that fact or particularly like a lot people knowing that... there is such a stigma to it. But it is what it is.

My husband, who was diagnosed with ADHD at the same age our oldest son was, was staunchly anti-medication, as was I. Both of us can admit to having uttered the words, "We will NEVER put a child of ours on medication."  Well, we all know what happens when you utter those "We will NEVER" sentences as parents.

Anyway, so after lots of trial and error, mostly error, we reached the point with B where his schoolwork was suffering, his teachers were pulling their hair out, and we were frustrated because we knew how well he COULD do, if only he could focus. He was never a "behavior issue" per se, but he was, to put it quite frankly, super annoying when he was at his worst (ridiculously impulsive, fidgety... just EVERYWHERE). He also couldn't focus well enough to finish classwork.  Adderall turned out to be the answer.  It had exactly ZERO negative side effects and exactly 101 positive ones. His schoolwork turned around almost instantly. He nows gets As (with an occasional B) in GT classes without issue. Adderall didn't fix all of his organizational issues, but those have improved with time, maturity and good habits. The medication just allowed him to tune out the distractions and calm his thoughts. 

We reached the medication point quite quickly with S, after seeing how well it worked for B. He is not hyper like B, nor is he impulsive, but he does zone out and when he does, it's BAD and he can't accomplish a single thing.  The medication hasn't made QUITE as striking a difference, as S's issues are deeper than just not being able to focus. But it did help.... the ability to focus was enough to help him get caught up to a good place in school. 

There is no question that I would never send either one of them to school without at this point.  However, on the weekends, I usually don't give it, because I feel like a break from it is good and their ADHD-related issues do not really come into play all that much at home.  There is not much they really HAVE to focus on on the weekends and I really don't mind B's hyperactivity.  

But now... it's summer.  Last year, it was a no-brainer. B was the only one taking it and I didn't give it to him at all. This year, I have experimented with not giving it to either one and it is blowing up in my face.  

S is doing swim team this year, which requires daily practices. The kids have to listen to the coach's direction and just DO it. Without the medication (which I didn't give at all until today's practice), he bobs aimlessly around and just generally looks like is mentally somewhere else.... completely oblivious to what the other kids are doing and what he is supposed to be doing. It's REALLY hard to watch as a parent. He is frustrating the heck out of the coach too. I finally broke down this morning and gave him the medicine and he followed all directions and stayed mentally with the coach for the majority of the practice. Hard to argue with the efficacy there.

B, on the other hand, doesn't really need the medication to focus on practice. He loves swimming, so he naturally focuses reasonably well and the fact that it's constant movement anyway eliminates most of the focus issues.  However.... out of the pool is a different story. His impulsivity is off the charts. Today after swim practice, he led a near riot at the pancake bar. It was mortifying. He gets SO carried away and I have to get down on my knees and hold him by the shoulders to get him to calm down. He has been known to do completely insane things like dump cups of ice cream on his head or trash entire rooms when he gets really wound up. At his least destructive, he runs around in circles flapping his arms like a bird. This does NOT happen on the medication. 

SO I think for this summer, most days are going to be medication days for one or the other or both.... especially for the duration of swim team season.  

I didn't ever really foresee it being that way, but I try to remind myself it's like putting glasses on them.... just improves what they already have going for them. 

It's tough though. These decisions. Really tough. But in the end, you do what works, I guess.... right? 

Sigh.

Dear Swim Coach....

Dear Swim Team Coach,

I love that you don't run the swim team like the tiny, perpetually losing, mostly-just-for-fun country club swim team that it is. It's why we keep coming back. You took my fearful, anxious son and turned him into a swimmer and gave him the gift of a sport that, with the right encouragement, he just might do for the rest of his life.

However, it has been a full year since he last swam in a meet. So when he showed up yesterday for the first meet of the season, a mess of tears and anxiety, and I brought him to your office, I had really hoped you would give him a little more than just a dismissive, "You won't die." I just wanted you to listen to him for a minute. Give him a pep talk. I'm a little disappointed in you.

I know you were busy getting things set up for the swim meet, and I know you don't pander to crying kids...  it's part of what made this all work for B last year.  He needs to be pushed and he needs people to not play into his tears and his fears. I love that you made him swim butterfly last year as a new swimmer and didn't let him back out. I love that when he said he didn't want to to relays, you said "Oh well. You're doing relays!"

But what he really needed yesterday was to be reminded by someone whose opinion means something (a.k.a. not mom and dad) that he could DO this. That he already DID do this. That you needed him to get it together and play his part on the team because he's important.  It would have taken you all of two minutes and would have made a world of difference.

I keep reminding myself that you are young... that you don't have your own kids and definitely don't at ALL understand kids like mine.  I just wish I could make you understand just how much it has taken to get him where he is now....  how much he overcame just to get in that water last year, much less race. To you, I know he looks like a kid who needs to "man up" and be less crybaby about the whole thing. You just see he's a good swimmer with a ton of potential and you don't get why he'd have so much anxiety about it. Nope. You don't get it at all.

I'm not going to waste my time trying to make you get it either.  That in itself will be a life lesson for B. Not everyone he encounters in life will understand where he is coming from or the battles he fights with his own mind. Mom can't always follow behind him explaining to people that he has sensory issues, an anxiety disorder, and ADHD. Unlike school, life doesn't give out IEPs and 504 plans.

You are a good coach, I just wish you would take a little time to get in the heads of some of the kids more. It's not just B, they all could use a little more individual attention and encouragement.  These aren't the college swimmers you coach the rest of the year. Just a few well-timed encouraging words here and there could make the difference whether or not they stick with this sport you love so much.

Sincerely,
The Mom With the Crying 10-year-old

A Year of Difference....

When my middle son started first grade this year, he could barely form letters. At a conference just after the beginning of school, his teacher put a paper in front of me, a math test, it contained pages of scribbles with some random legible numbers scattered throughout. She gently said, "I'm just.... not even sure how to grade this."

This conference was  no surprise at all. In fact, it was a HUGE relief that his teacher saw everything I had been seeing. I had been saying for a year to anyone who would listen that there was a problem-- That my son couldn't make letters well or in some cases, at ALL.  That he wasn't producing any real work.... that his skills had stagnated during the kindergarten year. 

In kindergarten though, (in my experience, anyway) unless your child comes in with an IEP or shows a very, VERY obvious MAJOR issue, it's so much a "wait and see" game because the kids come in at so many different levels anyway and some kids are just late bloomers. So we waited and saw.... and things didn't get any better.  In hindsight, I should have been a squeakier wheel that year... insisted on more OT consults, requested a team, gotten him evaluated back then on my own. I knew there were problems and my gut has never been wrong any of my boys' issues. When will I learn to just go with it?

So I sent him off to first grade in August and quietly waited for the other shoe to drop, which it did about three weeks into school with that first conference.  After that and a subsequent evaluation in which we learned he has processing deficits that affect his writing, we basically started from scratch. He got pull-out help with the resource teacher to help him learn to write out whole words and eventually sentences and longer sentences. We worked tirelessly at home on his homework working on correctly forming letters and developing strategies to keep him on task and not get too frustrated at this skill which does NOT come easily for him. We erased, we started over... we practiced, practiced, practiced. His teacher had him redo things when they weren't his best work... she pushed him, which is what he very much needed.  

I am happy to say that writing is finally something that doesn't completely overwhelm him. He doesn't have to think through every stroke of every letter. The amount of progress S made this year is amazing.  I had a conference with his teacher last week and he is caught up to where he needs to be and ready for second grade.  Interestingly, now that he is writing more, we have learned he he is a pretty great speller, which I didn't really expect!

As I was leaving, his teacher said to me, "I really want you bring him back to visit in ten years or so because I just can't wait to see what he ends up doing because I know it's going to be something really interesting and amazing!" Isn't it wonderful that a teacher can start out a year with a student who produces the kind of work you see in the top picture and still manages to see the kind of potential that those deficits are masking?  I love that.

When I am deciding which pieces of my boys' schoolwork to save, I try to only keep work that shows measurable progress or mastery of some new skill (well, and anything sentimental or that starts "Dear Mommy...." ;)   Needless to say, his "keep" pile this year is pretty big. :o) I am so proud of him!

Here's work that came home yesterday....

What a difference a school year makes! 

I thought swim team practice started TOMORROW. I learned last night that it actually starts today. I was dreading telling B. He was (mostly) mentally prepared for tomorrow and the unexpected news was NOT going to over well, though I hoped to be pleasantly surprised.

A little background -- B LOVES swimming these days. Up until about two years ago though, he actually could barely do anything but doggie paddle and only in shallow water, and he most definitely would not go under water... couldn't stand any water on his face. Sensory issues and anxiety just got the better of him and we tried swim lessons three different times in the past with no success. Two years ago, deciding that an 8-year-old that couldn't swim was just getting a bit ridiculous, we found a wonderfully patient teacher who was a natural with kids like him and he made steady progress and breakthrough after breakthrough. Within months he was swimming free-style across the entire pool like he had been doing it for years.

Knowing our pool's swim team is pretty low-stress, but also that the daily practices and coaching were known to really move kids along, we suggested he give it a try last summer. It had to be his decision, and we had to move very slowly.... he did want to do it, but it took two weeks to get him to finish a whole practice, he cried and cried, but eventually he mustered the courage (once Tom gave the coach permission to just put him in the pool), and then he even competed in the last four meets of the season. The big surprise though was that once we got over the hump of his anxiety about deep water/cold water/swimming the length of the pool/practicing with kids his own age/this list goes on forever.... he turned out to be a natural!

By the end of the season, he had the basics of all four strokes down and was lightning fast in backstroke and freestyle. He even developed his own signature pre-race move when they would call his name, which was kind of hilarious. I don't think he ever swam a race without DQ'ing, but we never told him that. The progress alone was just amazing!

He got a whole fistful of ribbons (that he proudly displayed on his bulletin board over his desk) as well as the season's "Most Improved Swimmer" trophy. He still says the day he got that was the best day of his life.

The boost to his confidence that came from finding something he was REALLY good at was truly amazing. He had had a rocky school year with his anxiety, social stuff and learning to manage the ADHD -- we did multiple interventions including medication, and cognitive behavioral therapy; but I honestly credit swimming with really finishing the job of turning things around for him. Emotionally and socially he grew SO much over last summer. He has continued swimming lessons and fine-tuning his strokes all fall, winter, and spring in anticipation of this year's swim season. He works SO hard.

Still, his mind is his own worst enemy. He is already anxious about competing again, getting in the cold water, not being able to swim the length of the pool. I have to tiptoe around his anxieties, so as not to feed into them too much. It's a careful balance of letting him verbalize what he's worried about and not discounting those worries, but still convincing him to take a step back and remember that he LIKES swimming, and that he's pretty good at it!

So this morning, when I sprung on him that practice was tonight, he immediately burst into tears and said I had ruined his day. He started in on his list of why he was worried. I pointed to his big award from last year. "How did it make you feel to get this?"  "Really great...." he answered between sniffles. "But I can't swim the length of the pool anymore!"

"It's the first practice, most kids probably can't. No one is going to make fun of you for grabbing the lane line if you need it."

He is SO afraid of failing, of being made fun of, and of course, all the sensory stuff that still bothers him -- cold water, not being able to see the other side of the pool.

I am hoping he is okay with I pick him up from school, but I'm bracing myself for a battle on the way to the pool. I just wish he wouldn't regress like this! All that work we did last year and it ended on such a wonderful note and now I feel like we're back at square one, at least temporarily....

Anxiety never goes away. You learn to cope and to hide it (sometimes); but it never goes away. I feel so sorry for him. I totally get it because I'm the same way.  I wouldn't have wished it on him for anything.... but I guess it's a good thing that he has a parent who can totally understand his thought process. The bad news for him is that because I understand, I know he just needs to be pushed and not allowed to quit. I was often allowed to quit things that made me anxious... it makes things better in the moment, but not in the long run.   Poor kid... his mom knows too much. ;)

So here we go. Wish us luck! I'm hoping for another great season! :)