What’s happening with Ritalin? (Week One)

Dominic’s been on a very low dose of Ritalin for ten days now. 5mg, one time, in the morning. I give it to him about 6:45, and it’s probably all out of his system by about 11:30am.

The very first day he took it, the head of primary called me at 10:30 in the morning.

“Hello?” I said, when the phone rang while I was standing in the pasta aisle of the grocery store.

“I just wanted to let you know,” she said, “that Dominic is having a fantastic morning. I just went and observed in grade one for a while and he was sitting quietly on the mat, paying attention to what the teacher was saying, and not trying to touch anyone or anything.”

“Wow,” I said, dizzy with relief. “That is so great to hear. Thank you so much for letting me know.”

Since then, the feedback that I’ve continued to get about Ritalin’s influence on Dominic in the morning is good.

We’re all giving it time before drawing any firm conclusions, but he seems to be focusing much better in class, and there’s been a big improvement in his willingness to do his work.

Yesterday, his teacher remarked that she could see where he was making consistent errors while he was trying to read for her.

“Normally,” she said, “he spends so much time resisting and avoiding doing the work that I can’t actually tell what he can do and what he can’t. But yesterday he just sat down and did the reading.”

Dominic’s own reports back this up.

Before we started Ritalin, I told Dominic I needed his help to be a detective.

“We need you to tell us how the medicine makes you feel,” I told him. “We’re trying to figure out if the medicine is the right medicine for you, and we need you to help us understand how it makes you feel.”

I didn’t have high hopes for this gambit, I admit, because trying to get Dominic to talk about his inner world is like trying to coax blood out of that proverbial stone. So I was very surprised when, on day 2 of taking Ritalin, I asked him after dinner to report back on his morning at school… and he actually did.

“The medicine helped me block out all the noise outside my head and inside my head,” Dominic said from where he was lying at the time, flat on his back, underneath the dinner table. “It helped me write a looooong story, with lots of sentences, straight from my brain. But then when my teacher told me to copy the story out again onto pink paper, it didn’t work. It took me about one whole year to write one word. So either the medicine doesn’t work for copying, or it was all gone by then.”

Mike and I looked at each other across the table and I flashed a thumbs up sign. Dominic had just provided a great description of what we hope Ritalin can help him with—blocking out distractions, focusing, organizing his thoughts, and holding onto them long enough to communicate them.

The trouble he had with copying? Well, hello, #dyslexia and #dysgraphia. Ritalin can’t really help him as much there.

So it’s been all good on the Ritalin front, right?

Weeeellllll… the jury’s still out on that.

Ritalin seems to be doing really good things for him in the classroom. But… Dominic has also been in trouble at school twice in the past week for getting into physical fights with other boys. Both incidents happened as the Ritalin was wearing off (or afterwards). On Friday, it was serious enough that the principal asked me to come and pick him up from school at lunchtime.

And he’s been having more trouble falling asleep at night.

Dominic rarely falls asleep easily or quickly, but the difficulties he has winding down at the end of the day have been even more apparent this week. Several times he’s still been wiggling around, eyes open, well after 8pm.

We’ve been trying different strategies to help him with sleep for months. Sometimes we’ll do a “blanket roll”—where I roll him up tightly in a blanket and squeeze him up and down his body to give him that deep pressure that helps him calm down. Sometimes I see him seek out that sort of pressure himself—pulling on a heavy quilt—even as it’s getting hotter and hotter here in the tropics. But, this week, those strategies haven’t worked as well, or as quickly. And I can’t help but wonder whether it’s the Ritalin—which supposedly leaves his system more than seven hours before he tries to go to sleep—that’s  triggering this extra restlessness.

Dominic and I talked about Ritalin again this morning, as he was taking his morning dose.

“Why do you cut them in half?” he asked, as he watched me prepare the dose.

I showed him the packet.

“This box has 10mg tablets in it,” I explained. “But we’re only giving you 5mg at the moment, so I need to cut them in half. If we decide this medicine is a good thing for you, then we’re going to start giving you 10mg and see what happens.”

“So I’m taking Ritalin 5,” Dominic said, thoughtfully.

“Yep,” I said. “Do you think it’s a good thing for you right now? Do you think it’s helping you in a good way?”

“It is helping me do lots of work at school,” Dominic said.

There was a long pause, and then he appeared to make up his mind. “I think I should have Ritalin 500,” Dominic said definitively.

“Hmmm,” I said, making a mental note to hide the box from now on, and taking another stab at eliciting more information. “So, you think this medicine is doing good things for you right now?”

Dominic shot me a look of scorn, jumped off the bench, and ran away.

For now, I’ll take that as a yes.