Ritalin Decision Agonizing
Second of three parts
By Lisa Popyk, Post contributor
Originally published in The Cincinnati Post, April 15, 2000
Tyler Malicoat calls them his "be-good" pills.
Small white tablets that turn him into the nicer, smarter, more agreeable little boy everyone wants him to be.
He hates them.
The taste. How they make him feel. The way everyone always asks if he's taken his daily dosage.
But, the 6-year-old says, he knows that people like him more when he's medicated so he always takes his Ritalin.
For his Mount Washington parents, the situation is agonizing. John and Andrea Malicoat aren't sure if the stimulants are really helping their child through a tough mental disorder, or if they're making their own lives easier by drugging their son into compliance.
Without the Ritalin, Tyler is a high-strung, troublesome child who doesn't listen and seems bent on trouble. Discipline, punishments, rewards - nothing else seems to have an impact.
On the medication, he's a different little boy: attentive, obedient, calm, even polite.
But which child is really the Malicoat's son?
"It's hard to know what to do, what's right for him," said Mrs. Malicoat. "My mother won't watch him if he hasn't taken his Ritalin. And when I tried to take him off, his teachers complained.
"But it hurts me to think that my son needs to be medicated to be a normal 6-year-old," Mrs. Malicoat said as she turned to watch her son in the next room. "And I hate seeing him like this."
Tyler sat cross-legged on the floor, playing silently with his baby sister. He looked angelic, his red hair combed forward and his light blue polo shirt buttoned neatly at the collar. He smiled and responded to questions politely.
But Tyler's movements and answers were deliberate, dull and slow. His eyes glassy and unfocused. Everything he did was almost slow motion.
"He's stoned," Mrs. Malicoat said, as if the words themselves broke her. She shook her head, her eyes starting to tear. "Whenever he takes his medicine, he just looks stoned. I have him on the lowest dosage, and still, he's just out of it."
Most days, Mrs. Malicoat blames herself. When Tyler was born, she was a 17-year-old single mom, working and going to school. Tyler was usually with his grandparents, and while loved, was rarely disciplined. He was a handful from the start.
"I look back and think about how I could have done things differently, and I wonder how much that has to do with how Tyler is now," she said.
In preschool, Tyler's teacher cautioned Mrs. Malicoat against Ritalin. She said that although he was high-strung and active, Tyler was one of her brightest pupils. Other teachers, she said, likely would recommend Ritalin in the future to calm him down.
"She told me not to listen to them, that Tyler was just fine," said Mrs. Malicoat.
But before the start of kindergarten, another teacher was already calling for medication. She said Tyler was "out of control." He was too imaginative, undisciplined and unfocused.
At home, he was hitting the family dog and even lashing out at family members.
Tyler, listening to his mother talk about how he used to be, just shrugs, his blue eyes opened wide.
"I don't know why I hit the dog," is all he'll say.
"You could just see the frustration in him. I was getting so tired of yelling, and I don't think he even understood that what he was doing was wrong," said Mrs. Malicoat.
The family doctor diagnosed 4-year-old Tyler with attention deficit hyperactivity disorder and recommended a daily regime of stimulants to help Tyler focus and restrain impulsive behavior.
The doctor told Tyler that the pills would make him more like the rest of the kids in his preschool class.
The Malicoats resisted at first. They didn't want other people to think they'd "drugged up" their child.
But ultimately, they gave in and put Tyler on Ritalin.
The change in his behavior over the two years has been remarkable, but the side effects undeniable.
As with many children on Ritalin, Tyler is smaller than he should be for his age. Doctors say that's a side effect of the medication; Tyler says he doesn't want to eat because "the pills make my belly hurt."
In addition to being "detached," he's now also frightened of the shadows and empty rooms. He no longer goes upstairs or to the basement alone, usually insisting that a family member come along.
"Somedays, I think Tyler wouldn't need the medication if he had constant attention. But who has the time?" asks Mrs. Malicoat.
She and her husband both work, are renovating their home and have two other children, Morgan, 21 months, and Madison, 5 months.
Every day is a juggling act of responsibilities.
"I think this is the only way he's going to make it, that any of us are," said Mrs. Malicoat.
