Why Medicate? Reflections on the Vanderbilt Questionnaire

We are in the process of deciding whether DD should get on medication at this time, or wait for a bit longer.

The AAP recommends against treating with medication if the child's ADHD is mild, or if the child is in preschool (unless other methods have failed).

Well, DD's ADHD is probably more than mild, but there aren't any universally recognized criteria for grading severity of ADHD, so the judgment is probably subjective.  I definitely think medication would be worthwhile if she were failing school or having problems making and keeping friends.  That is not the case.  She is very bright.  Once I get her going doing schoolwork, she can usually do it (although I have to hang over her to keep her going).

When I look at the Vanderbilt Questionnaire, the questions seem to target behaviors that we see but are not really the problem.  So why are we considering medication again?  Well, I think more than anything, I am tired of correcting her, tired of nagging her, just plain tired....  But parental tiredness isn't something you treat by medicating a child.  So what do I want?

I want her to be able to start school without several reminders and threats.

I want her to be able to get dressed in the morning without being nagged.

I want her to be able to face math problems and piano practice without becoming a lump of jelly on the floor.

I want her to not impulsively hit or scream at her brother (or anyone else) because she's mad.

I want her to be able to eat her food without getting half of it on the table and the floor.

I want her to be able to sit for an entire meal without getting up to see what is going on elsewhere in the house.

I want her to sit for evening Bible reading.

I want her to be able to bathe herself.  

I want her to be able to put on her pajamas without being threatened or nagged.

Of those things, it is very possible that medication will not treat morning or evening symptoms (stimulants usually wear off after 4-12 hours to enable the patient to sleep and eat).  So then, what I will get is that she'll be a bit better at meals and not be a lump of jelly.   There might be less conflict with her brother.   This would be an improvement, but is it worth the risk of taking meds?  Not so sure.    I think what I need to do is make a list of the problem behaviors and do a little report card to see how frequent they are before we talk with the doctor.

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