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What can cure my hyperactive son?

 Yes I can suggest other ways to try to improve your son's situation, but there are a few points I'd want to check first.

When you say he has ADHD I presume that this has been diagnosed by a specialist such as a paediatrician or a child psychiatrist. They would describe him as having attention-deficit/ hyperactivity disorder (ADHD) if he has symptoms which fall into specific diagnostic criteria.

The problem is that the term ¿hyperactivity¿ is often used to describe excitable, naughty, restless or over-exuberant children. Needless to say, these are usually perfectly normal boys, whose behaviour and inattention come to light when challenged by the regime of school discipline and often overcrowded classrooms. Such children may end up being inappropriately labelled as having ADHD and it is no surprise that they do not respond to treatment.

I am concerned that he has been suspended from school for two months. Is this because of his behaviour and if so what kind of help in addition to Ritalin is he receiving? Usually the educational psychologist would be involved in assessing his needs and advising you and his school on ways to help his behaviour. Your son should also be receiving home tuition whilst he is not at school. Your school doctor or local community child health service can help you access these basic requirements.

It always helps if there is something you can do yourself ¿ you and his school can try the following:
1. Have realistic expectations - avoid situations which may be impossible to cope with eg long assemblies or church services, protracted meals, double sedentary lessons.
2. Try not to criticise or make negative comments - your son's self-esteem will suffer if there is a constant stream of adult complaints about him.
3. Encourage and praise him if he works at solitary activities which involve sitting still eg Lego, jigsaws, reading, homework, computer work.
4. Build on your son's relationships with yourself and others by sharing activities with him and by encouraging him in team sports.
5. Try to identify what are the main distractions in his environment both at home and at school in the hope of removing them.

Formal behavioural treatments working with a child psychiatrist or clinical psychologist can build on these measures. If your son is old enough he can be taught cognitive routines to help him think about his actions, how to act less impulsively and how to organise and complete a task.

Finally onto medication ¿ I have left this discussion until the end as medication is at the most only part of the treatment for ADHD. Your son is taking Ritalin (methylphenidate) which is an amphetamine-like stimulant drug. It calms down many children with ADHD and their learning may be improved. It can be less effective in children with ADHD and learning disabilities.

Side effects include stomach aches (these wear off after the first month), appetite suppression (growth needs to be monitored), insomnia (less so if the drug is given before mid afternoon), tics (rare) and a zombie like state or depressed mood at high doses. If the drug works the benefits may far outweigh the side effects.

A few hyperactive children seem totally unaffected by Ritalin even at higher doses. Dexamphetamine (Dexedrine) or pemoline may be used, each dose tends to be longer acting. Other drugs include imipramine, haloperidol, clonidine and sulthiame. However these all have many side effects and are often not very effective. They should only be used under the supervision of a child psychiatrist.

Even if your son does seem better on medication it is a good idea to stop it once each year as you may find he does just as well without it. Many hyperactive children no longer benefit from medication after the age of about 12 years.