To be cross with this paediatrician?

[Thesunisoutagain]

Took my 14 year old who isn’t happy but has been taking his adhd medication for school, to his adhd check up.
The paediatrician had a ‘grown up’ chat with him and things been going well. She said to me it’s his choice now if he takes the medication or not as he is older.
This morning he woke up and said based what the Dr said, he won’t be taking the meds as we can’t make him.
24 hours ago he would not have done that.
Is 14 really an age where it’s reasonable to put the decision making into a child with ADHD??
I feel this Dr made me life so much more difficult.

Yeah 14 is definitely old enough to make medical decisions whether that is contraception, adhd medication or any treatment. Has he said why he doesn't want to take them.?

He has never thought he needed it. Despite of the fact he was close to exclusion, suspensions.
Home life is also very hard due to his impulsivity but we long given up medicating him for home time.
His view on himself is very different from how everyone else sees him

I think realistically it's reasonable for a 14 year old to be involved in decision making about his medical care. The paediatrician would hopefully talk through the pros and cons of continuing medication (side effects v reduction of ADHD symptoms) so that he can make an informed decision. I think all you can do is see how things go for him if he is stopping medication and ask for a follow up with the paediatrician if you feel things are slipping.

He's 14 not 4 listen to him and if things start getting out of control ask him again about taking the medication it doesn't mean he can't ever take it again it's just for now he wants to try without, have a little faith

Well ADHD medication isn’t without side effects so yes I think a 14 year old should have some say in whether they want to continue.

rather than getting into a battle of wills keep the conversation open about why he wants to stop. Probably not a good idea to tell him it makes your life harder (even though that is probably true) the focus needs to be on how it affects his life.

Maybe he would benefit from alternative supports such as therapy to help him manage his ADHD. It’s not a bad thing for him to start taking ownership of his condition.

I assumed that a parent was responsible for a child's medical treatment until they were 16. However having just googled this I see that if a child is considered intellectually competent before that age then they are responsible themselves for medical decisions.
I do sympathise with you OP. You are the one having to cope with any unwanted consequences of him not taking his medication.

The problem here isn’t the paed. You need to get him to take it. She’s right, he’s 14 and needs to start making his own choices

It is true that 14 year olds can be considered old enough to make their own decisions, but it depends on the child. Children with ADHD are developmentally a few years behind a neurotypical child with regards to emotional development so I'm not sure i would consider them old enough to make decisions in their own best interests.

I agree with you, OP. He is too young to understand the full implications of not taking the meds.

You could tell your son that it's up to him, but if he doesn’t take his meds you won’t be making any special allowances for his behaviour and won’t ask or expect his school to make any allowances for poor behaviour, non-completion of work etc. either. The medication was prescribed for a reason and if he chooses not to take it he must be prepared to deal with the consequences.

She might have considered him Gillick competent. If so he has the right to refuse his medication.

I remember there being quite a big thing about young teenagers getting pregnant as they could not access medical appointments for contraception and also terminations without their parents knowledge. So they changed the law which I think is now very reasonable. There were also a lot of children with anti vax parents desperate to be vaccinated who previously needed their parents permission. They can decide for themselves now.
Op of his behaviour is so severe off the medication, will he at some point not recognise this? There must be a lot of natural consequences if it’s constantly getting him into trouble

Do you have evidence to back up that claim? “A few years behind” is not what I’ve seen but I don’t claim to be an expert. That said, I’d imagine the paediatric consultant is an expert and could make the judgement on an individual basis.

As the mum if 2x14 year olds I would allow them to make the choice but with a conversation about their impact and the difference we see, but also listen to how they felt. Agree a trial period and reassess with them what’s been harder for them without the medication and whether that’s what they are okay with, whether they go back on meds, or whether you explore other meds.

Gillick competence . Child doesn't necessarily need to be over a certain age to make decisions about their medical care

We pre-empted this potentially happening and made it very clear to our child that at a point it would be their choice to take them or not. However, if they chose not to, then it would be our choice that they could NOT live at home. Basically they were/are a total fucking nightmare when not on their meds so not only did we not want to suffer this, but we also had to think of their siblings who would be adversely impacted. If there is one thing our kids knew, it was that we did not make idle threats/promises, so that was enough for them to make the ‘right’ choice. They still happily take them every day as an adult and they have no interest in attempting to go off them as they are sensible enough as adults to understand their life would go to absolute shit pronto.

When I googled this I saw that this ruling was calked Gillick Competence but not until I read your post connecting it' s origins to contraception did it jog my memory about Victoria Gillick and her campaigning.

My DS gave up his ADHD medication at the same age as he didn't like how it was making him feel. He found other outlets to deal with his symptoms and is doing well.

If he is that bad without them, then he might just realise he needs them himself

Bit harsh you also need to remember kids do grow up and change so a 5 year old pre meds won't be the same as a 14 year old. Also drugging kids isn't the only options there are more options. Yes they may take more effort but they can find other outlets.

It’s his choice. Just make sure he has all the information he needs to make an informed choice.

I was forcefully medicated aged 14-16 after a MH misdiagnosis and as a consequence have no relationship with my mother and I don’t trust medical professionals. It’s much better if teenagers can be informed and be part of the process with their care

@HoppingPavlova exactly. The only thing we ask him is to take a short acting (lasting 4 hours) so he has a good start/ focus before lunch. No meds afternoon or weekends, holidays so we clearly know what he is like on and off meds.
He has 3 other siblings and home life could be a nightmare with his constant verbal ticks and swearing and jumping on his siblings. He is not this bad out of the house but his swearing can get him into big trouble and school doesn’t care if it’s adhd or not.
He is highly intelligent and smart but his decision making at times gets him into big trouble.

I don't know anything about ADHD so unsure what impact that might have on decision making capacity but my DS made a major decision about his medical care when he was 12 and was deemed competent to do so. His consultant spent a long time talking through the pros and cons of his refusal to have a particular procedure and decided that he had fully understood and was capable of making his own decision. As it happens I didn't oppose his decision, but if I had done I couldn't have over ridden his wishes.
I think all you can do is check your son is fully informed, watch for any negative effects and go back to the doctor if things deteriorate OP. Hopefully if stopping the medication does prove problematic your son will be able to see that and be willing to go back on them if needed.

Can you agree with him a trial period of say 2/3 months off meds and see if it causes problems? If he gets into trouble at school or falls behind on work, or falls out with friends etc then he needs to accept that the meds help him.

I think he’s at an age where he needs to test things out for himself rather than just accept what parents say. It would be better to have an agreed trial period like this, where it is all being discussed openly and he has agency, than him feeling his arm has been twisted and then refusing point blank at some stage.

Thanks all yes agreed on a deal that when the first detention comes through he’s back on it. Day 2 and he was given a detention so tomorrow he is back on his meds again. I don’t know how will he will be but hopefully will keep to his side of the deal

At that age you can't exactly force them down his throat. So if he doesn't like them he could easily just stop or take less regardless of what the doctor said.

It's correct the doctor spoke to him in that way. Rather than not listening to him and saying it's compulsory you take this medication because your mum says so.

@youalright Bit harsh you also need to remember kids do grow up and change so a 5 year old pre meds won't be the same as a 14 year old. Also drugging kids isn't the only options there are more options. Yes they may take more effort but they can find other outlets.

Not harsh at all. Someone has to be able to live under the same roof as others. Without medication my child makes everyone else’s life hell. It was not right to sacrifice their siblings rights for this. Or, the other option was their siblings would have had to go live elsewhere with one parent, who, for their own sanity, would then need to have swapped out with the other parent. Now that’s harsh on everyone!

I’m also well aware of both organic changes in medical conditions and disorders over time and the necessity of reviews of medication for all conditions, not just this, but thanks for the 101 medical instruction. My child was a nightmare off medication at 7yo, 14yo, 21yo and indeed would be today. Just in case you are wondering, they are not a zombie, but medication has allowed them to obtain a difficult, sought after degree, gain and keep a good professional position, have friendships, play sports, and enjoy a good life. Without it, they literally can’t put a pair of socks on.

Drugging is an interesting word. I believe the word you should have used was ‘medicating’ as that’s what one does with medicines prescribed correctly by a licensed practitioner. I think you are confused with people who run meth labs possibly?

Also, if you can describe how the outlets you refer to will completely take the place of medicine it would be good. While medication is not the sole ‘therapy’, for instance, my child runs every day and also plays sports/trains most nights, which also assists in addressing the excess hyperactivity, what else will ‘fix’ their disordered and scattered mind in place of medication.