Monday, September 1, 2014
Attention Deficit Hyperactivity Disorder
Normal Activity Level
Diary of Morning in May 10:15a
We have had breakfast and chores are done. We are on school vacation from year around school. The children (4 elementary school age and 1 baby) wanted to build a fort. They worked well together, but we will need dads help tonight.
I did not give my son his Ritalin this morning because I do not know how a normal boy of 9 acts. What is Hyper? What is normal boy. Maybe other parents can tell me. He has been on Ritalin for 5 years. It has been good medication for him. On medication he is still an active fellow, but not wild.
The following things never happen while he is on medication.
After the fort project began to loose its novelty the children began to use the card board struts for sword play of course. I knew it was coming. I even had told them not to even think about it :- } As I was telling him (and the other children) no more play swords, he stand on one leg, holding the other leg bent behind him. He began to fall and hit the baby. As I was telling him to stand with both feet on the ground, he fell back wards. I told him to get up, he fell again. I told him to stop it, he was going to hurt himself or his sisters. Is this just something boys do? Falling and being silly?
I left the room to go into the kitchen and sit at the table to finish some work. He comes running in (he runs everywhere not matter often reminded when not on medication) bumps into the kitchen chair and keeps running. Goes to the sink and turn on the water very hard, because of the breakfast dishes in the sink piled high, it splashes up on him, the counter and a bit on the floor. He grabbed a cup and puts it under the faucet. He fills the cup too full and it spills out and the same time he brings it to his mouth spilling it. The water is still on full blast splashing. I say to him not to turn on the water so hard, he lets the cup fall from his mouth to the sink. This all took about 15 seconds to occur and the whole time he is at the sink he is twisting and moving his legs and body. Is this what boys do?
He runs out again. The children play some more with the fort that does not look like a fort. My son finds a blue mesh plastic bag. It stretches and I have sometimes seen produce in bags like this. Some of the fort pieces came in it. He puts it over his head and face and begins to chase the girls. Now this seems typical of a boy. I tell them all to stop running through the house because someone WILL get hurt. Another child wants to get out a tabletop train set. I told her yes, but to play with it here in the kitchen (I want to supervise it because it is a new toy I do not want broke) he comes in and sits at the table in the chair. While trying to get into the chair he misses and starts to fall, he grabs for the tablecloth, the cloth starts to move making the train set begin to fall. Sister grabs it before it does fall. He is talking a mile a minute (he usually does while not on medication). I am typing this so my back is to them. Sister says he is drooling all over the train set. This is a common problem when he is not on medication. Does he forget to swallow? He realizes he is drooling and takes the bag off his head and wipes his mouth and chin with his the front of his t-shirt. This to me is a typical boy thing to use his shirt this way.
He sat there for about 5 minutes talking all the while. He jumps up abruptly says he is going to be the Masked Avenger, puts the net back over his head while running to the living room. The children are cleaning up the fort pieces and putting them away. He starts to help clean up too. I hear a sound and then my oldest says he hit the window (by accident). I call him into the kitchen and he says "No, I don`t want to get into trouble" I told him to "Come here, I need to talk to you about the window" He came running in, sits on the floor next to me and looks up. I told him to be very careful, we do not have money to fix broken windows. I can not even tell you how many windows he has broke over the years from silly non-sense. To some extent I think boys to tend to break windows, but usually it is a baseball thing. He run back out, hits the door way with his hand I guess, (could have been a knee) howls in pain, but keeps on running.
Now he is watching the Magic School Bus on PBS. This and a few other science shows are his favorite. He is not allowed to watch Power Rangers and the like (are they still on?) I have always said he needs no more ideas for jumping and running. While he is watching t.v. even though I am in the kitchen I know he is rolling across the carpet floor, getting up and down, opening and closing the cabinets doors on the entertainment center, all while watching t.v. He is not talking. It is quiet. He will probably come running in soon wanting to try something they showed on the Magic School Bus.
It is now 11:00a. The rest of the day will be much of the same with out his medication. Spills and thrills and injuries. Before he was put on medication (at 4 yrs. old) he had broken bones twice, stitches several times, numerous cuts and scrapes. One of the reasons he is on medication is because I think he is safer, happier and more welcome in social settings. Of course the doctors thought he needed it, what else would a doctor say? I now worry that it does not allow him to be a real boy though, that is just makes him what we want him to be, what we impose on him for Our behavior standard. What if our behavior standard is skewed? How should a boy behave?
It sounds like you may have answered your own question by describing your son`s very active behavior when he does not take his Ritalin. His behavior as you describe it sounds more active than the average 9 year old. Most 9 year olds are capable of having a good attention span of 30 minutes to an hour without rolling around. Although boys enjoy more gross motor activities than girls overall, they are able to sit still and enjoy watching a favorite TV show or read a book. Part of treating a child with ADHD with Ritalin is to help build the child`s self esteem. At age 9 years it is important he feels very competent about himself rather than inferior. It is equally important that you and he have a very positive relationship. Some physicians will allow a Ritalin holiday, meaning the child does not have to take his medication for a while. Often this holiday is recommended during the summer months. However, it is important that you speak to your doctor about this approach. In the meantime, focus on his positive behaviors and praise him for his accomplishments. Good Luck!
Marcia Hern, RN, EdD
College of Nursing
University of Cincinnati