• Better knowledge about ADHD
• Effective strategies to handle children with such problematic behaviors

To deal with ADHD, each school appoints a Special Educational Needs Coordinator (SENCO), who in coordination with the class teacher, will help your child to cope up with such disorder. SENCO is known as the Special Educational Needs Adviser (SENA) in Scotland.

Difficulties Due to ADHD at School

Problems actually start when your child is not diagnosed before its age is about to go to the school. The class teacher will ask you to meet him/her to discuss about the behavior. Due to the bad behavior, you might also happen to visit the head teacher and take your child from him/her. Some more problems could be:

• Teacher’s Approach/Awareness
  Your child can feel being ruled out or tortured if the teacher is unaware of ADHD or does not treat it as a medical condition.
• Medication at School
  If medication is to be given in the school, certain questions listed below do come to mind.
  • Where the medicines will be kept?
  • Will it be checked whether the child has taken the medicines properly?
  • In which manner will the school remind him/her to take medicines?

Appointment/Discussion with the School

Sometimes, the class teacher might call you or if you have queries or concerns, you would willingly take an appointment with the teacher. Based on the queries, you might need to meet the class teacher, the SENCO, and the head teacher.

The teacher or the secretary of the school will give you an appointment time once you tell them about the aim and agenda of such a meeting. This time can be either during the school time or after it. If you know that your child has ADHD when he/she is in primary, you might need to discuss with the head teacher and SENCO about the preparations that need to be done before going to the secondary section.

Preparation for the Appointment

Before going for the appointment, you need to prepare on following topics.

• The reason of meeting the teacher, one of them being the feeling of not being able to manage your child properly
• The areas of discussion along with examples wherever possible
• What you expect from the school
• What is your support in dealing with the medical condition of ADHD
• What will be the further steps once the meeting is over

It is recommended to show the school the reports of the therapy taken from a specialist, such as a speech or language therapist, if any. However, it is totally up to you if you do not want to give those reports to the school.

The best way to work on ADHD is to co-ordinate with the school. The school can help your child and can help you in changing his/her behavior. In the meeting, the concerned teacher, teacher, head teacher, or SENCO or all of them; might ask you whether there are any family problems or if the child is suffering from other problems that might have led to ADHD.

To aid your child in changing the behavior, the school maintains a record of different behaviors of the child, for instance, hurting another child in the playtime or break time.

Questions to the School

Listed are the questions you might feel like asking during the meeting or appointment.

• Are there stimulants present in the school, conditions where the child’s behavior is problematic or people or activities that mislead him/her? If yes, how are you tackling them?
• What strategies are you applying for my child to control his/her behavior? Is my child responding? If yes, what is the response of my child? If no, what is you next plan?
• What is the meaning and use of statementing process? What help can I provide in that matter?
• Can my child be shifted to some other class where the teacher is aware of ADHD and is capable of handling him/her? This is relevant only if you feel that the present teacher is not dealing with your child properly.

School in Treating ADHD

The school cannot wait until the child obtains a statement of special educational needs (record of needs in Scotland). It needs to start handling the child, as the statement might take 26 weeks, which is quite long enough to hold the issue. The school can start taking the following steps meanwhile.

• Financial Support
  There is always an emergency special needs budget that each school keeps. With this budget, the school can provide a helping hand to your child.
• Part-time Admission
  If the school does not have that much money for full-time help, it might opt for part-time school until sufficient money is available.
• Exclusion
  If the school feels that it cannot deal with the child’s behavior, elimination is the last option within the duration of two weeks. The reason of this exclusion needs to be given in writing.

The school can also suggest you to contact your local Parent Partnership that offers information and support.

Other Sources of Support besides School

Listed below are the other sources of support if the school is not providing the required support or is not willing to help.

• Parent Partnership Worker (www.parentpartnership.org.uk)
  Can provide good advice.
• Independent Panel for Special Education Advice (IPSEA – www.ipsea.org.uk)
  Helpline for England and Wales is 0800 0184016 and for Northern Ireland is 01232 705654. In Scotland, it is known as Independent Special Education Advice (ISEA) and its helpline number is 0131 454 0096 (www.isea.org.uk).

The Dos and Don’ts

Each human is different and so its physical composition. So, if a medicine for treating ADHD is suggested for a child, it might not be appropriate to recommend it to other child having ADHD. In case of certain children having ADHD, only behavioral and other therapies work well, rather than medications. Keeping these points in mind, there are some dos and don’ts for this medication that needs to be taken care of.

The Dos

Use atomoxetine with utmost care when one or combination of the following has taken place.

• Liver disease (the victim will be given a low dose)
• Last-stage kidney disease
• High blood pressure
• Low blood pressure
• Depression (even in the past)
• A history of suicidal thoughts
• A past of manic symptoms such as, hallucinations or delusional thinking
• A past of fits (seizures)
• Fast beating heart pulses
• Abnormal heart rhythm called ‘prolonged QT interval’ or any family history regarding this disease
• Abnormality in the heart composition
• Diseases related to the heart and blood vessels
• Diseases connected with the blood vessels associated with the brain

The Don’ts

Atomoxetine should be avoided for:

• Children under six
• Victims with narrow angle glaucoma, a disorder in the eyes
• Victims who have allergy to items used in the capsules

Atomoxetine with Other Medications

Before using this medicine, always remember to inform your doctor about the medications that are already being taken by your child. Such medications include those that are taken without any prescription. Not only this, but you also need to speak to the doctor or pharmacist about taking any new medicine once the medication of atomoxetine is been started. Medicines with which you need to pay attention to take atomoxetine are:

• Monoamine Oxidase Inhibitors (MAOIs)
  These are antidepressants that are taken for treating depression and must never be given with atomoxetine. This is because MAOI includes phenelzine, tranylcypromine, and isocarboxacid that when given with atomoxetine leads to negative effects in the body. If atomoxetine needs to be given, it should be given only after 14 days from the last consumption of these antidepressants.
• Beta Agonists
  These medications are used to treat asthma such as salbutamol. If atomoxetine is taken with these medicines, it affects the manner in which the body reacts to these beta agonists. So, if salbutamol is taken through inhaler, orally (as tablets or syrup), or as an injection with atomoxetine, it might results in fast heart beating. However, it will not worsen the condition of asthma. If asthmatic children take atomoxetine with salbutamol as an inhaler, it will not create any problems. In short, you need to take the advice of the doctor.
• Medicines that Affect Noradrenaline
  Atomoxetine when given medicines that affect noradrenaline has a high probability of different side effects. Listed are these medicines.
  • Antidepressants such as imipramine, venlafaxine, mirtazapine, and reboxetine
  • Decongestants including pseudoephedrine and phenylephrine that are present in cough and cold medications, which are often consumed. Therefore, verify with the pharmacist prior to taking the decongestants with atomoxetine.

There are certain medicines whose dose should be adjusted when atomoxetine is also given along with any or combination of them because of the specific side effects caused because of their union. Table 1.1 lists the medicines along with the side effect.

Side Effects of Atomoxetine

Like all medicines, atomoxetine too has side effects. However, it is not mandatory that all people taking it will experience these side effects. There are many side effects of atomoxetine. Listed are the most common side effects of atomoxetine.

• Stomachache
• Vomiting
• Headache
• Decreased appetite
• Sleepiness
• Feeling sick

Some more side effects of atomoxetine are:

• Constipation
• Indigestion
• Dizziness
• Fatigue and tiredness
• Rash
• Irritation
• Mood changes
• High blood pressure
• Increased heart rate
• Weight loss
• Difficulty in sleeping or causing sleepiness (should avoid activities such as riding bikes, driving cars, and climbing trees due to sleepiness)

Atomoxetine is also responsible for the cause of psychiatric disorders and further worsening such conditions. These are:

• Depression
• Suicidal or self-harming thoughts
• Hostility
• Anxiety
• Agitation
• Psychosis
• Hallucinations
• Mania

This is not all. To be aware of all the possible side effects, go through the patient information leaflet that you get along with the medicine from a medical shop. If you observe any of these side effects, consult your doctor.

Initially, due to atomoxetine, your child might lose weight temporarily, as this medicine results in reduced appetite. Therefore, as a precautionary measure, your child’s height and weight needs to be monitored. However, if in the long run, the growth is improper or the weight is not satisfactory, it is advisable to stop the intake of this medicine to cope up with growth problems.

Regular monitoring of children and adolescents taking atomoxetine is a must due to such critical side effects. It is recommended to the stop the intake of this medicine slowly after consulting to your doctor.