Hyper Campers

Sunscreen and stamps are a must, and granola bars are always appreciated. But when it comes to packing up their kids for camp, many parents are leaving the prescription drugs at home. For the 2.5 million kids medicated for attention deficit hyperactivity disorder (ADHD), physicians recommend an occasional break from the meds. The freewheeling days of summer are in some ways the perfect time. But when sleepaway camp is in the cards, drug holidays can present a problem—not just to the counselors having to handle kids who can be off-the-wall, but often also to the campers themselves.

Health professionals do recommend a drug holiday at least once a year to see if the medication is still needed and as a break from possible side effects, the most common of which are decreased appetite and trouble sleeping. The time off can also affect a child's physical development. Josephine Elia, an attending psychiatrist at Children's Hospital of Philadelphia, says that while studies have shown that in the long-term, ADHD drugs don't have an effect on height, they can delay growth. "By taking kids off during summers, you do allow some room so that a growth spurt can occur," she says.

With the stimulants usually prescribed for ADHD, like Ritalin and Aderall, there's no physical harm to going on and off. The drugs start working quickly and do not have to be built up in the body before having an effect, the way antidepressants do; they are metabolized, leaving the patient's system, quickly too. According to experts like Elia, it's no more dangerous to stop taking ADHD drugs when you don't need to treat hyperactivity symptoms than it is to stop taking aspirin when your headache goes away.

But camp might not be the right place for a meds break. Sue Scheff, a parent advocate who has blogged about her son Scott's ADHD, tried for years to send him to camp unmedicated. Every year it was the same: "Within a week's time I'd get a call saying the claws are coming out, he's misbehaving, and I'd have to send the medication up to get him on track." So why keep trying? In part it was to give him relief from the side effects. But the bigger motivating factor, she says, was avoiding the stigma of the ADHD label—both for Scott, who was teased when he had to leave the lunchroom to take his pills, and for herself. "Maybe it was a selfish decision," Scheff says. "I just wanted to take him off so I didn't have to explain to everybody why he was on the medication."

The fear of a stigma even drives some parents to keep their kids' drug holidays under wraps, deciding not only to stop drug treatment over the summer but to leave the diagnosis off camp health forms entirely. Although their intention may be to avoid sticking their child with a "problem" label at camp, the effect is often just the opposite; counselors and camp directors, who review all campers' health forms before a session begins, are more likely to misread a camper's disobedience as insubordination or a discipline issue if they don't understand the disorder behind it. Jeff Freedman, the director of Camp Winaukee, an all-boys' sports camp in New Hampshire, says that's the case for a handful of his campers each summer: a boy is having a hard time following directions, Freedman calls the parents, and the parents say they forgot to mention that the child is typically medicated for ADHD.

"If the medications are helping at school and helping at home, we really think they will help at camp," says Edward Walton, an assistant professor of pediatrics at the University of Michigan. Walton was the lead author of the camp guidelines of the American Academy of Pediatrics, which state that "elective interruption in medications (drug holidays) should be avoided in campers on long-term psychotropic therapy," which includes medication for ADHD.