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Q
When my eight-year-old was in first grade, he was in and out of the principal's office nearly every week. The school wanted him on Ritalin. I went through many appointments with our doctor, psychologists, and a few others. It was the most difficult and horrible experience of my life. Second grade was a delight for him. He had a wonderful teacher, made great grades, and just had a great year. Now that he's in third grade, he seems very depressed and sad. He says he has no friends -- it just breaks my heart. Am I hurting my son even more by not giving him the medication that is available to him? Should I go against my deep fear of giving him the medication so he has a better social life? I just don't know what to do.
A
I know how frustrating it is to go from professional to professional and still not get the answers you need to support your child. Diagnosis is critical for the kinds of behaviors you are speaking about. I am particularly concerned about your son's feelings of isolation and sadness. It is not unusual for a child who has an attention deficit disorder to also show symptoms of other problems, including depression. Call Children and Adults with Attention Deficit Disorders (1-800-233-4050) and find out if there is a parent support group in your community. You need to be able to speak with other parents who have already been through this process. You should also be able to get a referral for a professional who can tease out how much of your son's difficulties might stem from an attention deficit and how much might come from other sources. You need to know what's wrong before you can choose the best treatment or intervention.

If his primary problem is an attention deficit disorder, the most effective treatment is generally appropriate medication. It is critical, however, that if you do decide to go the medication route, that someone reviews his response to medication on a regular basis (monthly, at least at the beginning). Your family pediatrician is usually not the best person to do this. You need to consult with someone who has comprehensive knowledge of the range of medications that are available today -- someone who can help you to weigh the pluses and minuses of each possibility for treatment. A consult with a pediatric psychiatrist or psychopharmacologist can be helpful. Your local hospital may also be helpful in helping you to find a good referral.

Behavior therapy can also be a useful part of treatment. You might also want to read Betty Osman's book, Learning Disabilities and ADHD: A Family Guide to Living and Learning Together. I know this is a difficult road for you, but I hope you can take comfort that you are on the right track. Good luck!

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