ADHD is a medical condition but the symptoms are often behavioral and medication is used to help increase focus and reduce impulsiveness and hyperactivity. Because medication is not used to control bodily functions, some parents wonder whether giving medication during the summer time is appropriate or if children should be given a "medication break." Parents wonder if this time without medication will help children that have slowed in growth will help them catch up or if the time should be used to help children learn to find non-medication ways to control symptoms.
To help parents, I went out an asked the "experts" what they thought, whether they recommend continuing medication or if they thought a break was better.
The following are the answers I received:
Dr. Ari Tuckman:
It depends. Some kids really need medication every day because their impulsive or hyperactive behavior is too problematic otherwise--they run across a busy parking lot, they play too rough with siblings, they can't sit still and are constantly getting into things, etc.
Generally, they are causing more family discord and provoking more yelling from parents. This isn't good for anyone. There are other kids (particularly those who are more inattentive and less hyperactive/impulsive) who may do pretty well at home without medication. Or there may be some days that medication might be more helpful (such as at camp or when all the cousins are coming over) whereas other days where it is less necessary (like a day at the beach).
Dr. Tuckman's website: http://adultADHDbook.com
The question of whether to continue ADHD medication over the summer can be more complex than parents envision. The best advice I could give is that this needs to be an individualized solution that "one size fits all" will probably not apply.
It can be a misconception that children and teens with ADHD need their full focusing abilities just for academic tasks.
Everyday life is full of decision-making, weighing risks and benefits, choosing activities instead of just going along for the ride, etc. The ability to filter out unnecessary distractions makes for better choices.
For children with impulsivity, using medication over the summer can reduce their chances of injury. When my son was young, children automatically stopped their ADHD medication when the school year ended. My son would have several minor accidents and injuries as he adjusted to the lack of helpful medication and he once had a very scary bike accident in June.
I've heard some experts compare this to only wearing eyeglasses during the school year, and disregarding that people need to see clearly in other aspects of their lives.
For those with concerns about proper weight gain, getting individualized advice from your pediatrician is key to striking the right balance.
Marie Paxson is the Immediate Past-President of CHADD: www.CHADD.org
I work part time in a pediatric medical office where this issue is frequently discussed. There are a few different thought processes about this issue.
First, some physicians believe that children would benefit from a summer break to avoid acclimating to the medication. The thinking is that a break will help the medication to be effective for a longer period of time.
The second belief is that several children or adolescents experience a loss of appetite while focus, impulsivity and restless improves. Here the thinking is that the child can regain weight during the summer months.
Yet, a final thought is that medication is not required during the summer with the absence of academic challenges unless they are attending summer school.
A summer med break is reasonable, assuming that the child's behavior will not be challenged by academic/focus issues, impulse behavior challenges such as at summer camp, sports, etc.
I find that some parents elect to continue medication during the summer to facilitate a sense of behavioral and mood continuity during the summer. There are advantages and disadvantages to discontinuing medication during the summer. Having said that, I make a strong recommendation that, if a parent elects to stop medication, it be resumed 2-4 weeks before school resumes to regain therapeutic levels BEFORE the first day of school.
I have all too frequently found children resume medication the night before school starts or worse yet, 2-4 weeks into school. Magical thinking parents often want to believe that the child's focus and behavior will improve without medication and delay medication until they hear concerns from the teachers in the new semester.
Rudy is a Certified Intrinsic Coach®. He can be found at: ADHD Center for Success Email: firstname.lastname@example.org
Always check first with your child's doctor to discuss possible changes in medication. Though some children may need ADHD meds only to help with school related activities, most children need to continue their meds throughout the summer. ADHD doesn't take a break starting in June; it stays with kids throughout their childhood and often into adulthood.
The benefits of using ADHD medications often go way beyond the class room; they can help children moderate and control their hyperactivity, impulsivity and more. These problems, when not under control, can be devastating to a child's self esteem because he/she may be excluded from social activities, have difficulty getting along with family members, and more.
One analogy would be the use of reading glasses. Glasses help children perform better in school because they can see the blackboard. But they also need to be able to see their world outside of school. Poor vision does not go away; nor does ADHD.
Terry Matlen, ACSW Director: www.ADDconsults.com and www.MomsWithADD.com_
Author: "Survival Tips for Women with ADHD"
No one takes a break from their prescription eyewear (sight-break) or wheelchair (mobility-break). So why 'Medication Break' -- Break from what? If it is break from being present to ones action, thinking, or life, then that's nothing I'd want a break from.
I would argue that all the expected changes from a proper medication are also the very things that would enhance one's summer experience. A parent once told me they wanted back the spontaneity from their "slightly zombie-like" child, to which I replied, "If the response to a medication is 'zombie-anything', then they are on the wrong medication or dosage".
When a diagnosis has been done properly and if it includes medication, I would certainly assume that the medication is intended for 365-days a year unless designed otherwise; and I would deviate only after consulting the doctor.
Steve Peer is the current President of CHADD: www.chadd.org
Of course medications are a personal choice. One that needs to be researched and explored as an alternative to comprehensive treatment of ADHD. With that said if a parent chooses to go down the medication path than I think medications are not just intended to manage academic issues during the school year but are also to support issues outside the realm of academics.
Impulsivity which can be exacerbated by boredom and pressure needs to be managed in a summer day camp setting or at home. If the child can't manage these issues, because their brain is not being given the chemical balance it needs to optimally function it can impair his/ her ability to make good choices and actions harmonious to connecting with new friends.
If children are not given the biological support, via the correct medications, to focus on controlling their anger, interrupting, boredom etc. they will act in inappropriate ways that can make it difficult for others to be around them. They can be rejected by others and become disconnected from a potential community of friends making them feel rejected and lonely.
In addition to the medications, I do think that it is very important for any child to integrate a physical exercise routine swimming, team/individual sports, kayaking, running etc. Taking the medications needs to be part of a regimented schedule where the child takes their medications at an established time each day and their summer activities also need an established schedule to provide daily structure.
Physical exercise will also improve the efficacy of any of the prescribed medications.
Bottom line is that the pill does not give your child the skill. If their diagnosis is accurate the ADHD medications (research shows with proper diagnosis and two or more trials of a medication 80% of the children will mitigate the challenges of ADHD) will help put your child on a level playing field with their ability to function and manage the challenges of inattention, hyper activity and impulsivity so that they can hopefully learn the skills through experience and support from their camp, home or activity individuals to help them identify what's going on.
The meds will help them to pause make them more aware of the situations but they will need to learn what to do in those situations by being able to observe what happens. This ability to inhibit their distractions and process what ahs happened I essential for them to learn the important life lessons that they can integrate into their lives.
Without the consistent use of medications their impulsiveness, hyperactivity and inattention will be more pronounced making it more difficult for the the child to optimally function.
This may also contribute to diminishing their self -esteem. By administering their medications in the summer months you provide them with an advantage for processing the world around them and learning the important lessons that will improve the quality of their life.
ADDCA website: www.ADDCA.com For more about David Giwerc