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Ritalin Isn't Helping

Pediatrics Expert Advice from Shari Nethersole, M.D.

Q: My son was diagnosed with ADHD and he's been taking Ritalin, but I don't think it's been helpful. His behavior has improved, but he still has trouble interacting with others and has difficulty in school. He sometimes will just break down and cry, or he will be angry and lose his temper very easily. Is it possible that my son was misdiagnosed and that he could suffer from some other problem?

A: Attention deficit hyperactivity disorder (ADHD) is a common problem, consisting of short attention span, impulsive behaviors, and hyperactivity. Many children with ADHD have trouble learning in school, though their intelligence is often average or even above average.

Because of their hyperactivity and impulsive actions, children with ADHD often have difficulty making and keeping friends. They can annoy other children because they often find it hard to follow normal social customs and interactions. The subsequent rejection they receive can lead to poor self-esteem and depression.

While Ritalin and other medications can be an important component of treating ADHD, it should not be the only treatment. It's essential that children with ADHD be managed on two other levels:

  • Educational therapy -- This should address weak areas and provide successful classroom strategies to make sure the child is learning appropriately.

  • Psychological therapy -- Counseling can help children sort through any issues about being rejected by their peers, or being different from other kids. There are even counseling groups available for children with ADHD to help them learn social skills and other techniques to improve their self-control.

Your description sounds rather serious; I recommend that you consult with a child psychologist or psychiatrist as soon as possible. While the symptoms you describe could certainly all be associated with ADHD, it's important to reassess your son's initial diagnosis. Problems such as learning disabilities, depression, anxiety disorders, and post-traumatic stress disorder can at times be misdiagnosed as ADHD. Also, it sounds as though the educational strategies that your son's school has tried have not been very successful. At this point, it's necessary to re-evaluate his educational plan.

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Shari Nethersole is a physician at Children's Hospital, Boston, and an instructor in Pediatrics at Harvard Medical School. She graduated from Yale University and Harvard Medical School, and did her internship and residency at Children's Hospital, Boston. As a pediatrician, she tries to work with parents to identify and address their concerns.

Please note: This "Expert Advice" area of should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.


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