I was a classic ADHD girl. I did not sleep at night because I was up obsessively reading a book. I did not pay attention in class because there was something else I'd rather do. I failed math every year of elementary and I can't believe I graduated except I did like my other classes and had no trouble with them. Luckily I was a smart-enough girl with ADHD. I could figure out a way around having to do things the "right" way. I never did laundry in college, I can't believe I wasn't some stinky pariah. Or maybe I was. Except I had a boyfriend. Oh whatever. I would have done so incredibly well in high school, socially and academically, and probably I would have had a goal for my life (before I turned 35), if I had simply had that little dose of Ritalin or whatever they had available back then.
Luckily with a lot of self-instruction I've learned it is possible to make myself do things that aren't so fun, like, oh, I dunno, housework. (I love laundry though, because you can do so much other stuff while the washer's washing.) I have taught myself to enjoy the feeling of having a clean house, and therefore I will clean in order to get to that point. It helps that J. is a great cleaner, because I will put forth the effort to clean so he doesn't have to. Not that you'd know it, because he will clean my apartment anyway. I have taught myself to develop some sort of perverse enjoyment in things I previously hated. Math. I made math friends in college (the second time around, for my teaching certification) and found things about math I could like, such as tessellations and, well. tessellations. Art and math can coincide. I just know it. So I will figure out how to make math art. But enough about me!
The little leftover ADHD streak also manifests itself in the way of being incredibly distracted in the classroom (I'm a substitute teacher until my dream job of Art Teacher (or maybe I'd rather be a Reading Teacher!? I really am more of a reader.) comes along) wait where was I? Oh, I'm distracted by any noise out in the hall or thru the walls, for example when another teacher is teaching loud. In my case, I do not and never have take medication for ADHD, however my two youngest sons do. My youngest is similarly distracted in the classroom, and takes a lower dose. The middle one has been on it the longest, and takes a higher dose of the same med his brother takes. His behavior is classic boy with ADHD. He's 11 years old though and in my opinion he is improving with his behavior as he gets older, and probably as I build up my own techniques to help him. I have quite a bit of experience in this area of child care, and frankly at age thirty-something I went back to school to become a teacher mainly so I could get another type of understanding of these boys of mine, and so I could be free when they're free.
Whether you choose to provide medication to your child to manage their ADHD is of course completely up to you and I will not argue one way or the other on that point. If children are receiving medication, if it works, it's going to work. If it doesn't work, obviously there is a need to adjust the dose or try some other medication or a behavior modification technique, or both. Dose adjustment is key. I think a lot of people feel like a kid should just take a pill and instantly behave better, but it is way more complex than that. We have been lucky, our first medication has been perfect for our situation. It is an extended release called Focalin. The guys take it in the morning after breakfast, they're awesome till about 5 PM. We don't do after-school activities because we can't handle that. I don't even like to go grocery shopping after school because it throws off the rest of our schedule. We are barely finishing our homework on time before the meds totally wear off, and they love to play outside. I know lots of other parents like to have extra things scheduled after school for their kids, but I don't know how we would make that work AND do homework, AND make dinner, AND do showers, AND have all our things picked out for the next day and get to bed at a decent time. Here is where I get to the point. Weight loss. Food. Schedules.
So many people talk about the weight loss aspect of having their kids on ADHD medication and every time I hear about it, I try to explain, well, there is a way to combat that weight loss. What I know is, both my boys lost weight at first and it was a little scary to have them in the tub scrubbing away and realize how skinny they were getting, and these boys were not chunky to begin with! It sort of sneaks up on you, too. You know "Some people's kids lose weight" but there isn't a lot of talk, or there wasn't from our doctor, about how to fix that problem. Doctors don't have a lot of time to spend anyway. They will warn you to expect the weight loss, I suppose. Other people will talk about it, or worry over it, or complain about it, but I have never seen anyone address what to do.
One thing that happens with some ADHD medication is, the appetite goes away once they take the pill. I have seriously had the boys tell me, as soon as they swallow it, no they're not hungry. Logically, this isn't possible, but there's that placebo effect, I believe. They know they aren't hungry because they take it, so in their head, they just took it and now they're not hungry. Just my guess. As the day progresses, they aren't interested in food at all. In the evening, at least with mine, they get very hungry, we do not take a second dose during the day. I keep a lot of healthy food around in case they want to eat more at night. Apples, cheese sticks, milk, crackers, granola bars, yogurts. I do not limit them to eating just the evening meal I prepare, and frankly they don't always want what I fix, and frankly I don't always stay coordinated enough to actually fix something like a meal that was planned (yes I know how to plan, no it does not always happen.) But there is always food they like in the kitchen for them to eat in the evening. I try to always feed them a vegetable, how are we supposed to feed them 5 servings of vegetables per day? I am just not sure but we are supposed to try. Anyway, the other food, this is easy, the evening part, they will eat what they want, plus usually whatever I fix, they will eat it. There are some things you can do to increase the likelihood they will eat what you fix for dinner, but I also worry about their relationship with food. I had one of those "Eat everything on your plate" families. In my opinion I have a really strange relationship with food because of that. Clearly I do not want to teach my children to also have emotional eating issues, but I guess I can only do my best.
Us, eating our breakfast!
The trick, then, to getting them to gain back their weight, or hopefully to avoid that weight loss, is meal planning. If you are starting out on ADHD meds for the first time, insist they eat breakfast, while you are standing there, before the pill crosses their lips. I usually talk about portion sizes with my boys, but I don't deny anyone a second helping of food. It is safe to say a kid on ADHD meds is not going to eat too much if they aren't hungry. Cereal is okay, but really it is not a star of the breakfast menu. Everybody eats cereal thinking its actually good for you. In most cases, cereal is not that great, just read the label. If you can find something with a good protein/fiber/calorie ratio, go with that one. If you see one with a huge number of carbs and no fiber or protein, just skip it. I think a breakfast should include a protein. Eggs are amazing, but a cheese stick (string cheese?) is a good option. A fruit is nice too. Applesauce, a banana. On the run, it is a good idea to bring cheese sticks, cereal bars. At home, I would say until they are about 12, be there to supervise breakfast before school and on the weekends let them eat what they want (My boys don't always take their meds at home on the weekends unless we need to go out somewhere that they really need to concentrate on their behavior!)
The rule is, enough needs to be in their stomach in the morning to get them through to lunch. They may or may not eat their lunch at school, and how would you know?
Here I think, we might get arguments about "Oh well at our house we don't eat breakfast, we don't like to eat breakfast in the morning." So if your kids give you that argument, you need to be the parent. We all do things we don't like. If they don't want a shower, do they get to skip that? If they don't want to brush teeth, do you let them skip it?
The simple fact, which any doctor will tell you, is the calorie burn in the morning when the body is getting revved up to face the day is impressive. Between 6AM and 10AM I burn 232 calories just laying in bed. Little kids burn a ton of calories, because they're always moving around. I can see not being hungry immediately when they wake up. But once we at our house are dressed and basically ready for school, we eat something, and in order to avoid losing weight, this is how it is. Sit them down, tell them something like this: "Once kids turn 7 and a half, they sit down and have something for breakfast." or "I was reading about how breakfast is important, so our family is going to start having breakfast." It's a good habit to get into as children anyway, most people who are able to maintain a healthy weight are breakfast eaters, that's a well known fact.
If they are really skinny there's no reason why they should need skim milk, 1% tastes a little better in many kids' opinions and that extra little bit of fat is going to help. Potato chips are not good. Junk food is not good, especially with little kids. Everyone knows that. Parents are responsible for what goes in their child's mouth, and we are building these little bodies at an incredibly fast rate, so the food needs to be good, quality food. Oh and no caffeine for little kids. Caffeine is going to speed up their calorie burn and mess with their minds, so just avoid it in all situations.
Getting good food in their stomach before they ever take their meds in the morning is an absolute must if they are currently losing or have lost a lot of weight. I like the Carnation Instant Breakfast mix in some milk for the boys in addition to a breakfast, and even for a snack. Lunch is just about a lost cause, unless you are a super lunch packer. My kids eat school lunch so I just hope they nibble on something. After school snacks can be duplicates of breakfast, a protein, a fruit, any carb, especially if the kid is really skinny. Dinner, hopefully by dinner they will have gained their appetites back. In all cases be sure to give them the highest quality food you have available.
Then you start again each morning.
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