In this ongoing series about my intervention with Christopher, a nephew on the autism spectrum, this post is about his attention struggles and whether medication is a good option for him. Christopher’s teachers have struggled with his distractibility and certainly want to recommend medication. Been there, done that, with some kids. Public schools cannot and should not require parents to put kids on medication, but very often, teachers are the ones who can see how attention problems affect daily learning.
Although kids on the spectrum can have attention disorders and are sometimes treated with medication, I don’t believe medication is the way to go for this youngster. First, Christopher did not receive early and effective intervention. We don’t know how far he can go with adequate support. He began kindergarten at six years old and finally received social skills support in second grade, for one 30 minute session a week. Parental denial was a primary factor in that delay, which stalled his progress and minimized and/or eliminated the potential benefits of school and family coordination.
Second, Christopher’s attention problems are reduced with positive behavior interventions and adequate academic support. He is an active learner in our sessions and is eager to please. I do provide times for him to act “silly,” which in his case means laughing and talking rapidly about his interests. Some of those interests, like getting a shot, reflect his anxiety about life. He worries about many things and given the tremendous upheaval in his life this year, those uncertainties are reasonable. We play through his worries, which seems to act like a pressure valve. Christopher will escalate into a wild thing if I don’t intervene at all, but I want him to see that he can “come back” with minimal support. Without other kids, it is easy for us to openly explore issues which affect his social standing, such as picking his nose and sucking his fingers.
Third, Christopher is at risk for losing weight on stimulant medications. He is already underweight and eats a very restricted diet by choice. He is gradually broadening his range of acceptable foods now that his environment has stabilized, but I don’t think he can afford to lose even 5 pounds.
Bottom line: We need to give Christopher the time to benefit from other interventions before considering medication.