Can ritalin (or other stimulant meds) be given on an as needed basis)

[ilovemyboys2]

My 6 year old son was given a diagnosis of ADD - inattentive type.  He does very well academically because he is in a small private school that deals with these types of issues.  The teachers say that at this time, as far as school goes, medication is not needed. They are able top handle his inattentiveness.  The problem is outside of school.  We handle him at home ok, it is in the community.  For example, he plays on a soccer team and I am finding that his behavior is really making him stand out of the crowd and the other kids are really starting to notice him.  For example, he will make loud noises and wave his arms around.  He will say silly things to the other children.  He just does things, which in a 4 year old might be acceptable, but not in a 6.5 year old.  We have him in social skills camps this summer and are trying to help him by pointing out what is not appropriate, etc.  It is not really bad behavior, it's like his brain is all jumbled up with different signals and he is trying to respond to all the stimuli around him.
My question is:  I have heard from other parents of ADD children, that ritalin, etc (not antidepressants), can assist in reducing the 'silly' behaviors that these kids have.  It makes the kids 'fit in' abit better.  Can these medications be used on a 'part-time' basis?  'as needed' basis?  Just for certain situations?  We would not use it for school at this time, but for out of school activities so that he does not stick out so much.  The kids are also starting to whisper about him and avoid him.  Parents/coaches are also noticing and commenting on the behaviors.  It seems to be getting worse as he gets older or maybe just more noticable.

Thank you for your time.

[Kevin Kennedy, Ph.D.]

Yes, Ritalin can be used to assist children in particular circumstances (e.g., homework, music lessons, sports activities) which [pose problems for them in terms of focus/attentiveness. To the extent that your son focuses more on the activity, his extraneous behaviors might be reduced. There's no way to know without trying it out. I wouldn't necessarily encourage you to think that stimulant medication will help with this particular social problem, but it's not irresponsible to try it. The social skills group approach is a sensible plan.

[PRW]

I am sympathetic to situation in that my daugther has displayed similar socially uncacceptable behaviors from time to time of the kind you describe. While I am no clinician, I'd suggest you get a second opinion on the ADHD diagnosis. Your comment about your son's brain seeming "all jumbled up" is quite like what many parents report in kids with Sensory Integration Dysfunction (which my daughter was diagnosed with). SID can look a lot like ADHD if a careful differential diagnosis is not made.

There is very good reason to suspect that ADHD is overdiagnosed and/or not managed properly when other common disorders are also present.

I'd also suggest getting your son's eyes examined by an optometrist with experience in dealing with functional vision issues in children. This is often overlooked.  In my daugther's case it made a huge difference.