Vagan Willer has one skinny arm stuck in the metal rabbit cage stroking 'BunBun.' She holds a black leather jacket in the other.
'I felt so bad when I found out about what leather was,' she says, scraping her bottom lip with her teeth, ''cause I felt bad for BunBun, you know.' She nods her head toward the white rabbit. 'But then someone at school told me I was wrong and that leather doesn't come from cute little bunnies, and I was, like, ‘Oh, well then, I don't care.' She giggles and pauses. Her eyes scan the room before stopping and staring at the cage with forced concentration.
She's trying to wrap her brain around something.
'But now I'm worried about the fur on the hoods of those big jackets that those rappers on TV wear a lot.' Her eyes remain fixated on the cage as she closes it and empties her backpack out onto the living room floor. 'That's gotta be bunny fur,' she said.
Vagan's 12 years old and in the sixth grade. It's a Friday afternoon, after school, and she's alone until her mom, Stacey Willer, gets home at 5 p.m. Vagan consults the chart on the fridge.
'Get self dressed,' she reads. 'Duh-that's morning; done with that. OK, do homework-nope, it's Friday.' Her large brown eyes dart around the room from BunBun to her school papers and chewed-on pencils on the floor, then back to the list. 'Feed BunBun and that's it,' she says. 'When I'm done with all that, I can go on online.'
Vagan claps her hands together, relieved the routine is finished.
Vagan was diagnosed with attention-deficit hyperactivity disorder when she was 6 years old. She had already struggled through kindergarten twice yet still couldn't recognize all the letters of the alphabet or count to 20. Her teacher suggested testing for learning disabilities and ADHD. It turned out that Vagan had both.
'After we knew what we were up against, I wanted to help Vagan in every way possible,' Stacy Willer said, 'but I didn't want to medicate her without trying other things first.'
It's tempting to boil the ADHD debate down to one hotly debated question: Medicate or not?
A Mayo Clinic study found that roughly 8 percent of school-age kids in the U.S. have been diagnosed with ADHD. Of those kids, a little more than half take prescription medication, according to the National Institute of Mental Health. Nobody, not even the drug companies, argues that pills alone are the best treatment plan. Most experts agree that a combination of medication and therapy is optimal, but there's no consensus on whether the risks medications pose outweigh the benefits for kids.
Anti-drug activists, like Dr. David Velkoff of the Drake Institute and the California Alliance Against the Psychiatric Drugging of Children, point out that the medications commonly prescribed to kids with ADHD are in the same Food and Drug Administration category as illicit recreational drugs such as crystal methamphetamine and cocaine. Though conclusive research is scant, immediate side effects include insomnia, weight loss and mood swings. Many experts also argue that ADHD is a neurological disorder, not a disease that can be 'cured,' so medications only ease the symptoms until the dose wears off.
Proponents of the drugs, like the National Institute on Mental Health and the American Medical Association, cite positive effects-increased focus, calmness and the ability to finish a page of math or sit through a movie. Prescription drugs are the most popular form of ADHD treatment, and most people reap some substantial benefits from them almost immediately. A UC Berkeley study reported recently that the use of prescription drugs for treating ADHD has more than tripled worldwide since 1993. For many ADHD child caregivers, the benefits simply outweigh the risks.
Vagan's mom wanted to try alternatives before medication. Hyperactivity, inattentiveness and heightened impulsivity make school tough for ADHD kids, but under federal guidelines, the disorder isn't a 'qualifying handicap' for special education. Vagan's learning disability, however, made her eligible for a private tutor.
After a few weeks, her grades improved a little, but Vagan couldn't sit still at her desk long enough for the tutor to make a real difference. No one at school was equipped to handle her constant jitters, nervous chatter or tendency to stare off into space. After a few frustrating months, it became obvious to Stacey that Vagan couldn't function and she started her on the medication.
Willer describes her daughter's life as like trying to watch 100 TV screens at once, only able to catch glimpses of scenes and bits of noise from each.
'But with the medication, it was like all those screens fed into one big screen that she could focus on without being distracted by the other ones,' she said. 'We gave her the smallest possible dose, and within one week Vagan was reading fluently. She knew how to read the whole time; she just couldn't focus long enough to say it or something.'
These days, Vagan takes Focalin, one of the stimulant drugs critics worry about, and attends a full-day special-education class st Sunnyside Elementary in Bonita.
The drugs have such an impact on Vagan that some people prefer her company only when she's on them.
'My dad uses figures of speech all the time, like ‘Stop bouncing off the walls,'' Vagan says. 'And whenever my mom drops me off with him, he always asks her if I've had my meds today. A lot of times I get hyper and my friends don't like it and they tell me I'm annoying when I get hyper. I talk a lot so I won't just start getting all crazy when I'm hyper-I'll talk on and on and-but if I can't talk, like at school or something, then I'll just smile a lot.' Her eyes widen and she smiles a huge, almost frantic smile. 'I smile to get the energy out, but it's better than acting up,' she says.
The grin, for Vagan, is a self-taught, non-drug, coping mechanism for dealing with her ADHD.
Six-year old Sam will spend the next six minutes crouching in the corner of his principal's office at Balboa City School, hugging his legs just below his knees, rocking back and forth and missing a chunk of hair. Sam had told his teacher he needed to use the bathroom. Moments later, he returned to class with his bangs chopped off into a 'do that only dull school scissors can create.
Sam's a student with ADHD at this private school for kids with learning disabilities and ADHD. Situated across the street from Balboa Park, the school exudes a certain urban serenity. There's lots of lush shrubbery, plenty of potted plants and even a small rock-climbing wall in the quad area. Inside, the classrooms are small.
Dr. Stephen Parker, the school principal, argues that kids with ADHD can learn how to stay in control of their symptoms and be successful without high doses of medications.
'For example, Sam's learned that he can bend over and grab his knees like that when he needs to calm himself down and regain focus,' Parker says, nodding toward Sam in the corner.
He keeps talking but sneaks frequent peeks at his wristwatch while Sam serves his sentence. Time's up.
'Sam, come here and sit down in this chair here and relax. You know what, Sam's a good boy.' Parker says, looking at but never locking his eyes on the small boy balled up on the large chair. That would be too threatening.
Instead, Parker's voice is light and soothing and offers Sam a clean slate-no lectures, no ominous phone call home and no critiques of the haircut.
'You just have to understand what kids with ADHD need and help them understand how to meet their own needs,' Parker says as Sam returns to class.
It sounds complicated, but the techniques Parker and his colleagues use to help the kids are simple, if pricey.
For example, every classroom at the school is equipped with surround sound and teachers wear wireless microphones. Kids who can hear clearly, Parker said, can pay attention better. Students are encouraged to stop and hug themselves, roll their neck around or breathe deeply whenever and wherever they realize they need to regain control. The classrooms have charts on the walls that illustrate ways to calm down and participate appropriately in class. They get 'sensory buckets' filled with trinkets and cheap plastic toys to 'fidget with' while they work.
Every case is unique, but Parker says most of his ADHD students quit taking their medications after several months at the school. Others cut their dose in half.
'Look, it's that simple,' Parker says. 'But people would rather pay $5 a pill than 29 cents for a plastic toy because no one's pushing 29 cent toys.'
Parker contends that huge revenues for drug companies discourage some people from exploring alternative treatments like the ones he uses at his school. A UC Berkeley study put American ADHD drug spending at $2.4 billion, the most in the world.
The toys Parker uses with his students may be cheap, but the school isn't. Attending Balboa City School costs $13,000 a year, far more than Vagan's prescription costs Stacey Willer.
'My insurance covers her meds,' Stacey said. 'I'd love for Vagan to have a chance to go to a private school, but I'm doing the best I can.'
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