Ritalin and ADHD

When my son, Nicholas was four years old, he threatened his preschool classmates with a pair of scissors. Because of this and other behavior problems, his teachers handed me a list of symptoms and asked me identify those that Nicholas had. The teachers and two co-directors at his preschool were convinced Nicholas had Attention Deficit Disorder (ADHD).

I read through the list of symptoms. Nicholas had some but not all of them. At four-and-a-half, Nicholas had left his full-time daycare for a half-day preschool. For the first time, Nicholas was expected to quietly sit in a chair as soon as he entered the classroom. Trying to get him to comply with the routine of hanging up his coat, walking into his room, and staying there took five to ten minutes every morning. He wanted to see what everyone else was doing in the other classrooms.

At preschool, Nicholas had enormous difficulty making a successful transition from one activity to the next. He hated to stop playing with something he loved. In his frustration, he sometimes hit, kicked, or ran away from his teachers. When I came to pick him up, I often had to chase him around the school, and sometimes even had to carry him to the car.

Although he had always been an active child, his fourth year was our hardest. I felt worn down by battles with Nicholas. Once after repeated warnings not to stand on the edge of the grocery cart, he did just that. The weight from his extra-tall, four-year-old body caused the cart to topple over, with Nicholas’ baby brother still strapped in the baby seat. All three of us cried when that happened, but the next time we went to the store, Nicholas had to be repeatedly warned not to stand on the cart.

Trying to carry the baby and propel Nicholas into and out of the doctor’s office often occasioned many stares from other patients. Once I even had to enlist the help of another patient in guiding Nicholas out of the lobby. I couldn’t carry his writhing, fighting body and the baby at the same time.

Yet, despite these struggles, I also knew that Nicholas could sit and play quietly with small animals, dinosaurs, or toy cars for an hour at a time. His imaginary games and role plays were often carried out in a whisper. He loved to be read to and enjoyed listening to books written for much older children on topics such as oxygen exchange. While his teachers complained that his fine motor skills weren’t strong, Nicholas built elaborate structures with tiny Lego’s. Of course, what counted in kindergarten was whether he could write with a pencil, not whether he could design and build his own creation with Lego’s.

On the advice of Nicholas’ preschool directors, we took him to a neuropsychologist. Nicholas balked at the testing. On the basis of two visits, neuropsychologist said that Nicholas would not be able to function in a mainstream kindergarten. She said she could not complete her evaluation unless Nicholas was placed on a trial of Ritalin.