Comments from the Neurologist,
John, a 9-year-old fourth grade boy, and his dad come into the office because the teacher asked the boy's parents to start ADHD stimulant medications ASAP.
The teacher said he blurts things out in class and sometimes interrupts other kids answering the teacher’s questions.
Dad remembers that in second and third grade, his teacher said he was constantly getting up from his seat and going to get something in back of the room. She would ask him to keep his seat and he would listen to her, but in 15 minutes, he would be up to get something again.
He is sometimes anxious and his dad points out that stimulants can increase anxiety. This is true for some patients. But he is starting to have negative comments on his report cards and we have to find a way to stop this before it worsens.
If the teacher wasn't writing negative comments, I would advise the ADHD testing now, but to hold off on medication and start with a non-medication, social skills program for John.
But, his dad said John is starting to notice all the negative comments from the teachers and feels bad about them. The teachers were very adamant in the parent-teacher meeting in October about recommending that stimulants be started.
Our options are either: We can fight this or we can start a very low dose of stimulant, so that if he has an increase in anxiety, we can monitor for this easily and change the medication.
Medication did make him anxious and he couldn’t fall asleep until 1 a.m. We used four other brands, but all worsened his anxiety.
I had to medicate with a non-stimulant (which takes weeks to work) and with an anti-anxiety medicine, and start behavior training and therapy with a nearby pediatric psychologist colleague, but none of these strategies would take effect as fast as his teacher wanted.
Comments from the Attorney,
The school district cannot require a child to take a controlled substance, such as a stimulant, as a condition of attending school or being evaluated for or receiving special education (8 NYCRR § 200.4(b)(9)). Medication is a question that is strictly between the parent and the child’s physician.
If the school is adamant and will not back off from this demand, the parent can file a due process complaint (8 NYCRR § 200.5(i)) which will result in a hearing before the local school district.
This can be frightening for a parent, but we spend a long time in the office going over what questions will be asked. This way, the parents feel confident when going into the due process hearing.
There is, however, one step prior to this hearing that might resolve the issue in favor of the parent. The local school district is required to have a meeting with the parent(s), referred to as a resolution session, where the issue is discussed and the educational agency has the opportunity to resolve the complaint.
When the parent or the parent's attorney shows the school representatives the clear language of the law, the school will likely agree with the parent and probably make suggestions as to how best to deal with John’s situation other than stimulant medication.
