Finding Clarity: Navigating Life with ADHD

Previous episode: Why Occupational Therapy Matters

Surprisingly, after all the worries, thoughts, forms, and waits—the assessment itself was simple and easy. Mikhale and I arrived together to meet a kind, attentive, and professional doctor. He reviewed the forms carefully, asked Mikhale a few questions, and engaged her in some activities—repeating lists of numbers, storytelling, and more. It didn't take long before he turned to me and said: "Well, it's clear. She has evident characteristics of ADHD."

Ahhh. How wonderful it is to have a diagnosis. True, a diagnosis doesn't heal, but it's a start. It's understanding. It's a base to move forward from.

The next step was to question both of us about her daily routine, the times when the ADHD is most noticeable, and her personal needs. We quickly determined together that the best medication for her would be Ritalin LA, which lasts about 8 hours, allowing her to concentrate throughout school hours and in the after-school program where she does homework. The doctor instructed us to start with a very low dose and gradually increase it to the suitable amount, and he also left us a phone number so we could ask, consult, and request anything we might need.

We bought the first box of pills on the way home.

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A quick word on ADHD medications: the term "Ritalin" intimidates many parents, and there are different views on taking this medication. I don't want to delve into the principal debate in this column, though there's much to discuss. Ultimately—a child who needs medication, needs it. It helps them. It can prevent much larger challenges, both academic, emotional, and developmental. There are side effects and risks with all medications, so it’s important to discuss each case on its merits. Specifically, for Mikhale, the pill was salvation. Its side effects on her (and I emphasize, on her. Every child is affected differently) were minimal to unnoticeable, and the positive impact was amazing—you'll hear more about it.

* * *

I work full-time from home, and Mikhale stayed in school after hours for the after-school program. While my elder daughter used these hours for doing homework, Mikhale couldn't manage it. The learning gaps were too significant, and in hindsight, I understood she also struggled to organize everything required without my guidance. So, she only arrived home at 4 PM, when the medication had worn off, and only then sat down to do her homework, with my constant help.

The result: First-grade homework lasting between an hour to two hours!

Thus, within a few weeks, after consulting the doctor, we switched to Concerta, which lasts for 12 hours. Besides the longer effect, I noticed it caused even fewer side effects for her than the Ritalin, and so—with a little adjusting of the dose—this medication remains in use until today.

We quickly settled into a routine of school—after-care—homework, a routine that became more reasonable and manageable each day. Taking the medication became part of the routine, almost without noticing how significant its impact was.

One day, Mikhale wasn’t feeling well and stayed home. She slept in late and didn’t take her pill. In the afternoon, a friend came over to help her catch up on what she missed in class, and so we sat together to copy notes and do homework.

And suddenly...

"Mom, I can't! The letters are jumbling before my eyes!" It was painful to hear the despair in her voice. I saw her squirming in her chair, suffering. Trying, writing a letter, erasing, getting confused. Just yesterday, she did the same level of homework—easily! What happened suddenly?

Oh, right. She's without her medication.

Only then did I realize the massive difference, the strong effect of the medication. She wasn't the same child!

Many tears of gratitude were shed that day. So much suffering had been spared from Mikhale in those weeks! As the days progressed, the academic level rose, and without the medication—Mikhale would have been left far behind. With the medication, there was still difficulty, but it became manageable, something that could be addressed. Thank Hashem for the right medication at the right time.

Incidentally, Mikhale was very happy to take the medication. She was proud of herself for learning to swallow pills earlier than her older siblings, who still used syrup to reduce fever instead of pills, and above all, she was happy to feel the improvement in her studies. I explained to her back then that there’s a substance in the brain that she has at lower levels than expected, causing her to lose focus in her studies. The pill, I told her, will make up for that deficit. The fact that the effect was so significant helped her want to take the pill every morning, without arguments.

* * *

Looking back, one thing was missing from the doctor's visit: guidance and clarification that the medication isn’t a solution. It’s an important and significant aid, but not a remedy. ADHD inherently involves difficulties with regulation and high impulsivity, and while medications provide a certain stability that can be quite significant and even life-saving—they do not address all the challenges of children with ADHD. Guidance on the importance of complementary treatments, such as occupational therapy, emotional therapy, and more, could have helped me understand Mikhale’s needs sooner.

But in the meantime, the awaited phone call came: Mikhale has her first occupational therapy appointment.

Do you have ADHD in your house? Feel free to comment.