Using Medications to Address Difficulties in Concentration

Q: Our 10-year­-old son is a sweet boy but has a stubborn nature. He is the youngest of five, ka”h,… Previous years showed that he needed to be on Ritalin to concentrate more in class. It took one complete year to persuade him to take it. He was almost expelled from school for misbehaving, chutzpah and disturbance. Now he realizes that the pills are helping him concentrate…

He would benefit from taking an extra dose of medication after school, as then he would do his homework and probably do what he needs to do… For example, I have to remind him to clear his room, put away dirty laundry, take a shower, etc… He complains a lot and takes his time with everything… I can go insane asking him the same thing again and again…

On Shabbos afternoon, my husband tries to learn with him. But since my son’s concentration is low, it is difficult to spend more than 10 minutes without my husband losing patience with him….I have not known how to deal with him and who to ask until someone told me to write to you…

A: Your letter is an excellent illustration of the frustration parents go through on a daily basis with a child who suffers from A.D.D. (Attention Deficit Disorder). I can just imagine all of those parents nodding their heads knowingly as they read your description of your 10-year-old.

We hear much more about A.D.D. today than we ever did years ago. I do not believe that it is because it is more prevalent. Rather, we are more aware of it now and, consequently, better able to detect and treat it. Many children, for example, who grew up a generation ago and were convinced they were behavioral misfits or learning disabled, may have been suffering from undiagnosed A.D.D.

As your letter also illustrates, medication can lead to a dramatic improvement. Suddenly, as if by magic, an unruly, easily distracted child is able to concentrate and focus on learning and school work. Sometimes, the medication itself can confirm the diagnosis. In other words, a child who does have A.D.D. will experience a drastic reduction in his symptoms almost as soon as he takes the medication. A child who does not have A.D.D., however, will become overly stimulated if he takes the same pills.

While the benefits of these medications are seen in minutes, not weeks or months, these benefits wear off quickly. As a result, a child, such as your son, who takes his pill in the morning to concentrate in school, loses his ability to focus by the time he gets home. If your child refuses to take another dose after school, there is a simple solution. Ask your pediatrician to prescribe one of the new class of time-delayed-release medications that can be taken in the morning and that last throughout the day.

In case these newer medications are not available in your country, and assuming your pediatrician agrees to this plan, you may need to convince your son that his life at home will be greatly enhanced if he were to take another dose after school. First sit down with your son and review with him how much better off he is in school since he has been taking the medication. Remind him what things were like before the medication enabled him to focus and concentrate. Then ask him what his objections are to taking more medication.

When he tells you, be sure to hear him out. Do not dismiss or minimize his concerns. Validate his feelings and demonstrate that you are really listening to him. Only after doing that should you attempt to answer his questions and challenge his misconceptions. Finally, if all else fails, you may need to use the time-honored technique of “bribery.”

When a child resists doing that which is in his own best interests, it is legitimate for parents to gain the child’s cooperation through the judicial use of incentives. The Torah forbids a judge to accept a bribe (Shemos 23:8, Devarim 16:19). There is no prohibition, however, against a child accepting a bribe from his parents.

I recall, for example, when I was about four years old, I had some childhood illness for which a very foul-tasting medication was prescribed. That was in the days before sweetened medications for children were invented. I refused to cooperate after the first dose, until my aunt came over and offered to buy me “anything I wanted” if I would just take the medicine. I asked for a car. “One I can sit in,” I stipulated. She agreed. I took my medicine. And to her credit, a week later, she kept her promise and arrived with a toy car which took my uncle all day to assemble.


 

The opinions expressed in this article reflect the view of the author. In all matters of halachah and hashkafah, readers should consult their Rav.