In Which I Was Afraid to Have My Son Evaluated for ADHD

As I've shared before, we began to suspect that Squirrelboy might have ADHD when he was fairly young. I actually didn't think about it when behavior expectations in school became overwhelming to him, but Mr. Engineer shared later that he began to suspect ADHD when Squirrelboy was a preschooler. However, we didn't actually pursue an evaluation until the spring of his 6th grade year, when Squirrelboy was 12.

This was partly due to the fact that Squirrelboy's teachers dismissed the idea of him having ADHD throughout elementary school. However, we could have pursued a private evaluation despite that. The main things holding us back were the facts that we weren't sure we wanted to put a label on him, and we were afraid he would automatically be medicated, which might be detrimental to him.

Things came to a head during my first year homeschooling Squirrelboy. All the excuses were gone. Squirrelboy was alone in the house with me. There were no other kids distracting him. He could get up and move around as often as he needed to. I could change my teaching tactics if one style wasn't working for him. However, his constant distraction was still driving me up the wall. There were days that I couldn't get through a paragraph in our history book without him interrupting me ten times.

Despite all this, Mr. Engineer was still leery about pursuing an official diagnosis for Squirrelboy. He had heard horror stories about ADHD medication turning kids into zombies. Squirrelboy is a great kid, with a quirky sense of humor and a sweet spirit. Mr. Engineer didn't want to lose any part of him by pursuing a medical remedy for his unique brain.

Eventually, Mr. Engineer agreed to let me bring up the possibility of ADHD at Squirrelboy's 12 year well check in March of his 6th grade year. Our family doctor, who is amazing in so many ways, asked a few questions and had me fill out a survey. Based on that information, he referred us to a behavioral health practice for further evaluation.

Amazingly, the practice had an appointment for an initial interview the very next day. As soon as the psychologist started asking us questions about why our doctor referred us there, I felt validated for pushing to pursue this route. She affirmed my thought that Squirrelboy exhibited symptoms of ADHD and might be helped by having an official diagnosis. We then made an appointment for a series of psychological tests over the next month.

When we met with the psychologist to go over the results of the tests I was a bit nervous. I was both afraid that she would say it was all in our heads and Squirrelboy was just a normal, active boy who needed some time to mature (the line all of his elementary school teachers gave us) and afraid she'd say he definitely had ADHD and medication was the only possible route to follow.

She confirmed a diagnosis of moderate ADHD, combined type. She then shared with us several possible routes for treatment including counseling, medication, or a combination of the two. Squirrelboy is not a fan of sharing his feelings with strangers, and therefore wasn't keen on the idea of counseling. We decided to try the medication route first, and pursue other avenues if that failed or if it partially succeeded but we felt we needed additional tools to help Squirrelboy be his best self.

We were referred to a psychiatric nurse practitioner to begin a trial of stimulant medications for ADHD. It was a long journey. The good news is, in contrast to many, Squirrelboy did not experience side effects from any of the medications he was put on, even at the highest doses. The bad news was, even at the highest doses, the first three medications had no discernible affect on his ADHD symptoms. He reported that he felt no different, and I noticed no difference in his behavior.

Because of this lack of response, his nurse had him take a genetic test called Genesight, which is supposed to show your likely response to a variety of types of medications based on your genetic profile. We filed the information away in case Squirrelboy ever has another chronic condition in need of treatment, but it was no help whatsoever regarding ADHD medication because, according to his genetic profile, Squirrelboy should have responded normally to every medication we had tried.

Finally his nurse prescribed extended release Concerta, and a light appeared at the end of the tunnel. About half an hour after taking one pill of the smallest dose the first day, Squirrelboy noted, "I feel different. My brain is a little less noisy." It didn't make a huge difference in his school performance, but it was a great sign.

Squirrelboy's nurse continued to increase his dose until we reached a point where there was a definite change in his ability to concentrate and do his schoolwork. At that point, we decided he was stable on that dose. We eventually added a small, short acting dose of Ritalin in the afternoon as the Concerta was starting to wear off. Mr. Engineer had started teaching math, usually in the evening, and Squirrelboy had lost his ability to concentrate by then.

Our fears that medication would change Squirrelboy's personality turned out to be completely unfounded in his case. His medication instead allows him to be the best version of himself. Unlike the vast majority of kids on stimulant medications for ADHD, his appetite is not even affected.

Our experience is not universal, of course. In some cases, medication for ADHD is not the right choice. In other cases, it's somewhat helpful but the side effects are so severe parents have to make the decision to stop the medication in the interest of the child's overall health. However, from my very limited perspective, it seems that the negative medication stories often happen because a doctor, sometimes just a pediatrician or other general practitioner, just prescribes a common medication (most often Adderall), and leaves it at that. They might increase the dosage, but they blow off side effects and say that that's just a sacrifice that has to be made.

I wish we had pursued a diagnosis sooner. Having a label has not hurt Squirrelboy. It's given a name for why his brain works differently from the brains of most of his friends. His medication allows him to be his best self in school and other endeavors that require serious concentration and not be hampered by his brain going a million miles an hour. I wish everyone with ADHD could experience both a timely and a thorough, thoughtful diagnosis, resulting in a treatment that allows them to be their best selves.