Using Medication for a Child with FASD

June 20

The cereal box T created for his media literacy class is called "Growing Stronger."

I like that they teach Grade 3 students media literary, as well as nutrition, in a hands on way.

Just as diet influences health of kids with fetal alcohol spectrum disorder, our parenting journey has demonstrated that medication can be an effective part of our toolkit to help our son.

It was four summers ago, when T was 5, that we started T on methylphenidate to help with his ADHD symptoms.

As with any medication, one's tolerance changes over time and we've made adjustments, one to two times a year, in close consultation with his developmental pediatrician.

In the last four years, we've also tried Biphentin and Guanfacine in different doses and combinations.

Most recently, we added Citolapram, an SSRI drug commonly used to treat depression, to help with T's mood, and it has greatly helped with his anger, irritability and anxiety.

This is on top of Adderall and Guanfacine, now a total of three daily medications.

If you're reading and thinking, "Oh my God!" Yes, it is so very heavy.

The hubby has always been all-in with medication and always the first to say, "We need to talk to the doctor about adjusting his meds."

I was very hesitant to start T on medication, because I worry about adverse side effects and the stigma that comes with it.

The decision to start your neurodiverse child on medication is a very personal one and there are several things a caregiver should consider:

Always consult with a pediatrician, ideally one with expertise on your child's diagnosis. They can consult with other resources, such as the FASD medication algorithm (think of it like a decision tree), which was helpful with our recent change.
Monitor and adjust, because your child's symptoms may change over time and their tolerance to the type of medication and/or dosage will change as they grow.
Have an open conversation with your child about why they are taking the medication.
Plan for a transition period to start medication or change. We start T on any new med or change on weekends or an extended break, like summer, in a calmer environment in case there are any transition effects.
Be transparent with your child's community, including family, school and child care staff.
You are the expert on your child and will make the best decision for them based on the information you have. Be informed. Read up. Ask questions. Ask for second, third, fourth… opinions, until you feel best informed.

Three years in, despite my initial hesitation, I think starting T on medication has been a good decision for him and our family.

We see more benefits than added challenges - and we feel it on those rare and comically disregulated days when we forget to give him his meds.

But it's not a magic bullet. It's doesn't fix everything.

To me, medication is a part of a larger toolkit to help improve outcomes. Other tools include advocacy, accommodations, therapy services and most importantly, fundamentally adjusting your approach to and expectations of parenting.

The FASD parenting journey is hard, but being T's Papa is the most rewarding job in the world.

You can say that thanks to my child, I, too, am growing stronger each day.