When we started the conversation about medication for Kay’s ADHD symptoms, I had a lot of mixed emotions. On one hand, I was hopeful that maybe this could help her show more of her true potential, especially with kindergarten right around the corner. On the other hand, I knew this was a big decision and wanted to make sure we approached it carefully.
After completing evaluations and working with her doctor, we decided to try a medication trial. Getting to that point was its own journey because we had to work through insurance and prior authorization issues, which unfortunately delayed the start. By the time we finally had everything approved, we had a very short window before school started to see how Kay would respond.
We decided to use this time wisely and collect as much information as possible. One thing that was really helpful was that Kay’s ABA team knows her so well. They know her personality, her typical behaviors, her communication style, and what her normal baseline looks like. That meant they were able to notice even small changes.
The first day actually gave us a lot of hope. Kay seemed calmer, more compliant, and her RBT noticed that she did really well during structured activities. She was able to sit and focus better than usual. The only concern was that the positive effects seemed to fade fairly quickly, and later in the day she became louder and less compliant again.
The next day, we tried adjusting the timing to see if we could better align the medication with her schedule. Unfortunately, that day looked very different. Her RBT did not notice the same positive effects and instead noticed more noncompliance, increased loudness, impulsive behaviors, and agitation. She was also having a harder time with transitions and needed more redirection than usual.
The following day, we continued monitoring closely. Kay had occupational therapy that morning, and during that session she was extremely dysregulated. She had difficulty participating, needed constant redirection, and required several regulation strategies that typically help her calm down. Later during ABA, her RBT reached out and asked if Kay had taken her medication because she noticed Kay seemed much more irritable and angry than her usual self. She described Kay as having more yelling, frustration, and noncompliance throughout the day.
At that point, I reached out to her doctor with all of our notes and observations. I wanted to make sure he had the full picture, especially because kindergarten was approaching quickly and we were trying to make informed decisions before she entered a brand-new environment.
After reviewing everything, her doctor recommended that we hold the medication for now. The plan is for Kay to remain off medication and allow her to get older before considering other options that are more appropriate for her age.
While this was not the outcome I originally hoped for, I actually feel at peace with this plan. If waiting is the safest option for Kay, then that is what matters most.
I also think there is a positive side to this decision. Kay will start kindergarten as herself. Her new teacher and school team will get the chance to learn who Kay is at her baseline. They will see her personality, her strengths, her challenges, and what makes her unique. Then, if medication is something we revisit in the future, they will have a true understanding of what changes they see and whether something is helping or not.
This experience also reminded me how important it is to have a team that knows your child. The observations from her ABA team and OT were incredibly valuable because they were not just looking at a single moment. They know Kay, and they could tell when something felt different.
Was this medication trial exactly what I hoped it would be? No. But it was still incredibly valuable. We learned more about Kay, we gathered important information, and we made a decision based on real observations instead of guessing.
As always, we will keep advocating for Kay, keep learning, and keep finding the best ways to help her thrive.