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Feb 16, 2004 -- Nellie Ramos loves her grandson and knows that he loves her.
Sometimes, she marvels at his photographic memory, his mathematical skills, his loving, if mercurial, nature and his ability to quietly play video games for hours.
There are the good days. There are bad days, too. Days when he spins out of control in a shopping mall and starts screaming and kicking. Days when he throws himself on the floor at home, tearing up the house and hitting the walls, his grandmother said.
Since he was diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD), 11- year-old Jovani Ramos has struggled to function well, particularly at school. Complicating his fate is his deafness, almost complete by the time he was age two, and possible emotional disorders.
He still struggles with language but is learning sign language. Jovani was diagnosed with ADHD - a disorder afflicting 2 million children nationally - when he started school. He refused to sit still or pay attention. Often he threw temper tantrums. "Sometimes he would just run from one side of the room to another again and again," his grandmother said.
Even now, she's not sure ADHD is the correct diagnosis for the boy she and her husband have helped to raise since he was two.
Like many other parents, she worries that her grandchild's other problems, his deafness, learning disabilities and obsessive behavior, have thrown him into a catch-all category called ADHD. Critics contend the label -- and the psychotropic drugs prescribed such children - are creating a nation of drugged children whose behavior and emotional problems are masked by medications.
Since his diagnosis, the slim, brown-eyed child has been given a potpourri of drugs to control his behavior. Sometimes they work, sometimes they don't. Often they work for awhile, then fail.
Doctors first prescribed Ritalin to control Jovani's outbursts and impulsive behavior. He became more violent and out of control, said his grandmother. "At 4 a.m., he was jumping on the bed and screaming," she said. "I would cry and pray; I was afraid if I went to the emergency ward they would take him to the crazy house." "There's no way I would do that to a child like this," she added. "He needs us; he needs his family."
A medical center prescribed a nonstimulant drug, Strattera, which proved nearly as bad. The young boy went out of control again and into psychotic episodes.
For the past year, Jovani has taken Concerta, another stimulant drug, and has remained manageable most of the time. Most recently, a psychiatrist has prescribed an anti-depressant and an anti-hypertensive drug similar to those used to treat high blood pressure. Both are new treatments for ADHD kids, according to Russell Barkley, head of the Center for ADHD studies at the University of Massachusetts Medical Center.
Like other parents of ADHD children, the Ramos family faces a bewildering choice of treatments, medications and advice. Often, they must try one medication after another until they find the one that works.
Other parents reject psychotropic drugs altogether, and instead turn to nutrition, massage and other therapies.
Jovani shares many traits with other ADHD kids. He's a boy and the malady strikes boys three times as often as girls, research shows. He may have a genetic predisposition to his disability; two of his uncles showed ADHD symptoms as children and now are in constant trouble with the law.
Ramos and her husband struggle to improve Jovani's behavior, fearing it could lead to difficulty as he grows older, to institutionalization and even to jail. Now, they wait, worry and hope. "You have to have patience, motherly love and understanding," Ramos said. "There is lots of love in these children and you have to love them a lot. It's a full-time job taking care of Jovani."
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