The summer break is nearly here, along with the question of whether your child should also take a break from Attention Deficit Hyperactivity Disorder (ADHD) medications. The answer depends on many variables, and it is up to you to decide what’s best for your child and your family.
ADHD is the most common neurobehavioral diagnosis and one of the most prevalent chronic health conditions in school-aged children. It is characterized by persistent inattention and/or hyperactivity/impulsivity, resulting in impairment in daily functioning, including in social and academic settings. In the 2011-2012 National Survey of Children’s Health, parent reports revealed that 11 percent of school-aged children received an ADHD diagnosis by a healthcare provider and 6.1 percent of children ages 4 to 17 years were regularly prescribed medication for ADHD. This means you are not alone in wondering what to do about ADHD medication this summer.
Side effects of psychostimulants — which can be a big issue for some kids — include sleep problems, appetite suppression, weight loss, headaches, stomachaches, worsening of mood and rebound behaviors. The first consideration in deciding to continue or hold medications over the summer is to assess how much your child is impacted by the side effects.
If your child is underweight, withholding the medication during the summer may be a good idea to avoid ongoing appetite suppression and further weight loss. Summer days are often busier, making the need for a good appetite even more important. Sleep problems may include trouble falling asleep or trouble staying asleep. Since summer days are longer and nights are shorter, if your child is able to sleep later during the summer, staying up may not be a concern. However, if he needs to be up early for daycare or camp, having him fall asleep on time is an important issue. Balancing the benefits of medicating for ADHD with the frequent side effects can be tricky.
When kids need frequent redirection because they are off-task, spaced-out, moving around or even fidgeting, their self-esteem can be negatively impacted when adults and their peers become frustrated with these behaviors. The benefits of continuing ADHD medication over the break are possibly better behavior regulation, less negative social impact and more learning success at summer programs. The goal of psychostimulants is to improve attention and focus and, for some children, decrease hyperactivity and impulsivity. Assessing if your child feels more socially and academically successful is a helpful way to think about the benefits of ADHD medication.
Sometimes the answer to giving ADHD medication over the summer is not a straight yes or no. For example, perhaps your child is participating in a few weeks of day camp or going to an overnight camp for a week. With psychostimulants you can use the medication as needed since it does not need to be given seven days a week. For those three weeks of art camp, your child can take methylphenidate only on the days of camp. The good news is there are no harmful side effects to starting and stopping your child’s medication.
Shenoa Williams, CRNP, provided specialty care as a neurodevelopmental PNP in an outpatient practice for the last eight years. Recently she switched to a specialty practice focused on child maltreatment.