Whether your child has been taking medication for AD/HD for a long time, or is just starting, here are a few tips for considering dosages. Always consult with your pediatrician and possibly a child psychologist and psychiatrist before starting or changing dosages.
- Give your child the single (or largest) dose in the morning when s/he wakes up. Medication is divided into two categories: Extended or Immediate Release. Most morning medication is extended release, meaning it will be on a controlled release throughout the day.
- If you or your child’s teacher(s) notice an increase in problematic behavior in the afternoon during the school day, consider a lower dose either extended or immediate release of medication at lunch time. You will need the appropriate school medication permission form to be completed by your pediatrician and give it to the school nurse. The nurse will need the prescription bottle with the child’s name, medication name and dosage, and time to give it on the prescription label. You and the nurse may need to count the number of pills in the bottle and the nurse will note that information in the school’s records. If your child needs pudding or a drink with which to take the medicine, provide it to the nurse.
- If you notice that the evenings are difficult, tantrums and difficulty concentrating on homework, take immediate action. Consult with your pediatrician to determine if:
- a) a stronger dose of medication earlier in the day would improve the situation, or
- b) a weaker dose of medication upon returning home will help.
- AD/HD is a chemical illness with a biological basis. With medication, the child’s chemicals are altered, “organizing” itself.
- Early on in the school year, establish the after-school routine, including snacks, time and place to do homework, having all school work in the backpack ready to go in the morning, bath time and what the child will do to get ready for bed. It may be important for your child to have a low dose of medication about two hours before bedtime. The brain needs to organize itself, including preparing itself to go to sleep.
- As the child grows taller and gains weight, the dosages may change, may need to increase to keep the behavior appropriate.
- As the child gains maturity, the dosage may be lowered.
- When you know that you are going to go through a particularly challenging day or time period, discuss with your pediatrician increasing the dosage.
- Attending a seemingly problem-free event, such as a birthday party at a noisy venue such as Chuck E. Cheese may bring on unanticipated fears and lead to embarassing tantrums. A small dose of medication shortly before the event may reduce such problems.
- The birth of a sibling, while very exciting, can also be a really difficult time. Particularly if the child with AD/HD was previously the only child, huge anxiety can result from no longer having the parent’s undivided attention. Discuss ways of dealing with this huge change with your doctors.
- The death of a loved family member can also cause changes in behavior, even if the routine is largely kept intact. Make sure you alert the child’s teacher(s) to the event and give your child lots of extra love.
Acknowledging the reality of the child’s day and evening behaviors and adjusting medication and schedules as soon as possible maximizes the child’s ability to be successful and – happy- throughout the day.