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Summer Check-Up Season

by Sue Hubbard, M.D.

As we hit the midsummer check-up season, I am seeing a lot of my adolescent patients as they are getting ready for their freshman year in college. I have realized for a long time how important this visit is in general as there are so many topics that should be covered before a “child” leaves for college. With that being said, make sure you have an appointment booked for your soon-to-be college freshman to see their pediatrician prior to their departure.

This is an especially important visit if your child has ADHD.  When I was a younger doctor it was thought that a child would “outgrow” ADHD. Over the last 20 years doctors, psychologists, neuropsychologists and all of the other specialties that have studied ADHD now understand that one does not “just outgrow” ADHD. So, ADHD doesn’t stop when a child leaves for college. But, the new college student will be managing their own ADHD, and often from far away. You need a plan to do this successfully.

Seeing that most college freshman are older than 18, I like to make sure that both the parents and child know that when need be,  I will now be talking to the student rather than the parents. I have usually spent some time during the high school years “weaning” the parent away from managing all of their child’s medication issues, or organizational issues etc. in preparation for college so that this is not an entirely new concept.  That is the lovely part about taking care of a child/family for many years.

The soon to be college freshman is a better source for information too especially if the conversation involves trying to change or tweak medications. First person information is always better than playing the “telephone game” where the story may change a bit.

There are several important areas that should be discussed before college:

Medication changes: many students who have been used to taking a long acting stimulant will have an entirely different class schedule in college. No more 8 hour days in a class room, followed by evening homework, so it is good to discuss and plan for using more short acting stimulants which allows some flexibility.  Know that it may take a few weeks into the semester to figure out the best combination of long acting and short acting medication, and plan on staying in touch either via email or voice mail when necessary to adjust medication dosages.

Medication use with alcohol: Although I know that college freshmen are under age, there isn’t a college campus that doesn’t have alcohol. Alcohol and stimulants don’t mix well. Stimulants also don’t mix well other illegal substances. Caffeine and stimulants can be problematic too.  This is a very important conversation!

Medication abuse: The stimulant drugs used for the treatment of ADHD have the potential for abuse. Typically this is not for the student that they were prescribed for, but rather for friends, roommates and anyone else that might want to take or steal the medications.  I warn my patients that they need to hide and lock up their medications and that NO ONE ELSE should ever use their medications. I also let them know that I record when and how much medication I prescribe, so repetitive requests for another refill because “I lost my medicine” or “someone broke into my room and stole it” will not allowed.

School resources: Almost every college that I know of has a program or programs to help aid the college student with ADHD. It may be a study skills program for entering students, or a counselor who can help with accommodations within the classroom. I recommend taking a copy of any testing, documentation etc (if not already provided) to orientation and meeting with the appropriate people before the semester begins. These services are often underutilized and being pro active is important.

By planning ahead the young “adult” child can have a successful transition to college and their ADHD can too.

That’s your daily dose for today.  We’ll chat again tomorrow.

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