More parents than ever before are considering using medication to treat their child's emotional or behavioral difficulties. (See Who's Drugging the Children?) If your physician or your child's teacher recommends medication for your child, consider this option, but carefully weigh the pros and cons of your decision before taking action.
With few exceptions, using psychotropic medication with young children should always be a last resort after all alternate methods of treatment are shown to be ineffective or inappropriate.
Here are some basic guidelines and issues to consider as you make your decision.
MAKE SURE YOUR CHILD HAS A FULL MEDICAL CHECK-UP BEFORE STARTING TO TAKE ANY FORM OF MEDICATION
This check-up should include:
1. A full blood work-up
2. Blood pressure check
3. EKG
4. An evaluation of your child's height and weight. Many psychotropic medications can affect your child's growth. It is therefore important to consider where your child's growth stands before starting treatment and have his growth rate checked regularly if he is taking any form of psychotropic medication.
TAKE YOUR CHILD FOR BOTH A VISION AND HEARING EVALUATION
There are symptoms caused by vision or hearing difficulties that are similar to those found in children with attention difficulties. These include short attention span, difficulty focusing and behavioral difficulties. Make sure that any attention problems are not due to other medical factors.
TAKE YOUR CHILD FOR A FULL PSYCHO-SOCIAL EVALUATION
Before starting any kind of medication, a psychologist or a psychiatrist should give your child a full evaluation to determine his emotional and developmental strengths and weaknesses. An evaluation by a psychologist or psychiatrist is important to help you decide if your child could be helped by behavioral therapy or if he needs treatment with medication.
EVALUATE YOUR CHILD'S DAYCARE OR PRE-SCHOOL SITUATION
The same behavior problems that are manageable in a private home are sometimes a nightmare in a daycare center. In fact, some experts suggest, that the rise in medication use with young children may be connected to the fact that more children are now in daycare.
Consult with your physician and child-care worker to decide if a change might help. If it is within your means, consider placing your child in an educational setting with fewer children or with more adult caretakers per child.
EVALUATE WHETHER YOUR CHILD'S BEHAVIORAL OR EMOTIONAL DIFFICULTIES ARE AFFECTING HIS ABILITY TO LEARN
How urgently does your child need treatment for his difficulties? Behavioral therapy can often have the same effect as medication. The drawback of therapy is that it takes times until it is effective. Medication usually works more quickly, but with medication there is the risk of side effects.
How is your child being affected by his difficulties? If the primary problem is difficulty in dealing with his behavior, behavioral therapy should probably be your first step. If, on the other hand, your child is starting to lag behind significantly in his developmental skills and his behavior or emotional state is preventing him from learning, then the "quick fix" that medication often provides might be more urgent.
CONSULT WITH YOUR DOCTOR ABOUT POSSIBLE SIDE EFFECTS
Discuss with your physician potential side effects of the drug treatment you are considering for your child. Side effects vary according to each drug. Possible effects commonly include altering a young child's growth patterns, headaches and loss of appetite. Each drug has different side effects. Find out the possible side effects of the treatment you are considering.
IF YOU DECIDE THAT MEDICATION IS NECESSARY FOR YOUR YOUNG CHILD'S DIFFICULTIES, KEEP THE FOLLOWING ISSUES IN MIND:
* Children receiving any kind of medication on a regular basis, including psychotropic medication, require constant medical follow-up and supervision.
Ask your doctor how often you should be bringing your child in to check on his progress. Make sure to let your doctor know about any side effects as a result of the medication your child is taking. If your child's doctor says your child does not require follow-up supervision, look for a new physician.
* Ideally, treatment with medication should be combined with behavioral therapy.
While when appropriately prescribed, psychotropic drugs can be extremely effective, drug treatment should also be combined with behavioral therapy. Studies show, says Dr. Israel Strous, a psychiatrist involved in researching psychotropic medications, that the combined effect of medication and therapy is generally more effective than using medication alone. In addition, since your goal should always be to stop using medication as soon as possible, a child should also work on other ways of resolving his difficulties.
YOUR CHILD'S BEST INTERESTS ARE WHAT COUNT
"When a physician prescribes medication unnecessarily," states Dr. Strous, "he is being negligent. When, however, a child needs the required medication and his parents or physician are not willing to consider the option, then denying the child this medication is equally negligent."
Do not eliminate any option that may help your child. On the other hand, do not jump into drug treatment without giving all the factors listed above careful consideration.
For more information about the use of psychotropic drugs with young children and the effects that they can have, go to Who's Drugging the Children?
