Q My son has a very mild case of ADHD combined. I say very mild because although he has all the symptoms (impulsivity, distractibility, irritability, speaking out of turn, difficulty with attention and concentration, etc.) he has not really had any academic or social difficulties because of it. I do worry that now that he is a fifth grader things may begin to change. He is a brilliant kid, but forgetfulness and disorganization at times prevent him from getting things done. We are working together on that, but I was wondering if I could give him a little more help with a cup of watered down coffee in the mornings. I don't want him to suffer because some of his absent-mindedness and daydreaming he really can't control. And I was hoping to avoid or delay having to talk to a psychiatrist about medication. Is caffeine a fair alternative?
I would recommend staying away from coffee as a first-line option to treat ADHD symptoms. If you’re trying to avoid giving a child medication, it’s important to note that giving him caffeine is already giving him a drug.
Both coffee and ADHD medications like Ritalin and Adderall are stimulants. The difference is that ADHD medications are much more targeted to the specific brain regions that are affected in a child with ADHD. That means that if you give your son enough coffee to get the positive effect on his attention and concentration you’re looking for, you’ll see more side effects like trouble sleeping, tremors, and appetite suppression than you would with ADHD medication. If you try to avoid these side effects by giving him small doses of caffeine, such as a little bit of watered-down coffee in the morning, it might not hurt him, but it’s not likely to have much impact on his behavior.
It’s good that you’re monitoring your son’s behavior carefully before he gets into major trouble at school. It’s very common that kids with high intelligence are able to mask ADHD symptoms until they get to the upper grades of elementary school. But if he lacks executive functioning, planning, and organizational skills, etc, it’s good thinking to get him some help strengthening them before it gets more impairing.
I’d recommend that you do see a psychiatrist to see if he meets the criteria for ADHD and, if so, to explore more appropriate medications than coffee. But I’d also recommend that you explore behavioral modification approaches to teach him skills to manage his inattention and compensate for his weaknesses on the planning and organizational front. For kids who are diagnosed with ADHD, what gets the best results are a combination of medication and behavioral intervention.