Out Of Control: Imperfect Solutions

Wendy Snider and Paul Kirchmeyer asked counselors for help with their son Alex. Dr. William Pelham, who works with Alex and other ADHD children, helped them take Alex off the medication patch and start him on a pill: Adderall, another ADHD medication. They tested him on different doses.

"Now, what we're doing is trying different doses of Adderall on different days to find out what the best combination of medication is with the behavioral treatment," says Pelham.

"It's very tough," says Alex's father. "We don't want to overmedicate him. We want to give him as little as possible, but at the same time we want to make it as easy as possible for him to succeed.

Dr. Pelham also intensified Alex's behavior program. Camp counselors rewarded Alex more frequently, but only if he behaved. After he worked for a certain period of time, he earned three minutes' worth of computer game time, which is his chosen reward. Counselors kept track of his behavior minute to minute.

"It's tough," says one counselor. "Alex just needs more immediate feedback to know exactly how he's behaving."

Meanwhile, the Taylors spent years trying to modify and medicate their son Ryan's behavior. "I don't pay attention in school. That's pretty much why I take the Ritalin," says Ryan. Ryan's most serious problems happen at home, where he has a strong sibling rivalry with his brother, Cameron. He also competes for his parents' attention with three adopted sisters.

"He's taking 80 percent of everything that we do," says his father. "And that's not fair to anybody else. It's beginning to consume the whole family."

"Why are we medicating this child?" asks Shara Taylor. "He's never been responsive to any of the medications that he's been placed on."

Dr. Mary Block, his pediatrician, thinks Ryan's problems may be caused by low blood sugar. Ryan was also tested for anemia, thyroid problems, allergies to various foods, including wheat, corn, milk, beef, chicken, eggs, baker's yeast, apple, banana, grape, and allergies to dust mites, cats, dogs, trees, weeds, grass and mold.

Dr. Block believes that attention and behavior problems could be the body's reaction to the environment, and physical conditions and foods. In fact, during testing, Ryan's behavior appeared to get worse as he was exposed to some of these elements. At the end of a particularly tough day, Shara admitted that she was having trouble holding herself together.

Dr. Block had a new plan: "We're not going to give Ryan choices, we're going to give him instructions, tell him exactly what he's going to do," she told the Taylors. "And we're going to expect him to do exactly what we've told him."

In Buffalo, Alex's parents felt that he had made progress by summer's end.

"I guess we were looking for the cure-all," says Kirchmeyer. "And we didn't get it. But we did get some good things. Me and Wendy learned a lot. They seem to have a lot more self-confidence now."

After a rough start, things started to look up for Alex, who began to respond when counselors rewarded him more often for paying attention and behaving.

"He's much more focused," says teacher Greg Fabio. "Lots more positive feedback. He's getting the same amount of attention, but now it's for doing things the right way and for following the rules instead of getting into trouble."

Dr. Pelham had just about settled on how much medication to give Alex and his step-brother Zack. Now it would be up to his parents to keep up the work.

Zack was doing even better than Alex. "I can behave," says Zack. "I'm not always bad. I can be really good, I can be the best."

Ryan and the Taylors, however, were no closer to a solution.

Dr. Block found that Ryan had allergies, low blood sugar, and nutritional deficiencies. She says this is causing his behavior problems. She wants him to change his diet, which is not so easy for boy his age.

She also recommends a counselor: "They need some help from the type of counselor that can put the parents back in charge of the house. Right now, Ryan...is in charge. And that's a very scary place for him to be."

But while Ryan hadn't gotten better, he also hadn't gotten worse. And that's was remarkable since he was no longer taking all the medications he once did.

For these parents, and even for their doctors, dealing with a child's attention and behavior problems is a journey that never really ends.

"Being a parent is hard work," says Dr. Pelham. "Any parent who says it's easy to raise their children is not doing something right."

"We'll try anything," says Alex's mother, Wendy. "I'll do whatever I can to make these children's lives easier. I mean, whatever it takes. I'd feel like a failure if we didn't try everything."

Go back to Part 1.