For children on neurological or psychotropic medications, summer freedom, if not closely watched, can become summer upheaval. The American Academy of Child and Adolescent Psychiatry estimates that three to five percent of children in the United States have attention deficit disorder (ADD). Each year, 45,000 new patients under the age of 15 develop epilepsy, according to the Epilepsy Foundation. Most of these children are on medications and have routines established to minimize risk of seizure or hyperactivity/focus problems.

Extended hours of bright sunlight or video games can lead to seizures in those with photosensitivity. Camps and vacations can wreak havoc with medication schedules. Staying up late to watch movies, while fun, can compromise sleep quantity and increase probability of seizures or migraines. Studies indicate that lack of quality sleep increases behavioral symptoms of ADD, as was just published in the May 2009 issue of Pediatrics. Dehydration, overheating and overstimulation can make the most compliant patient experience breakthrough symptoms.

A 2004 survey conducted by Eli Lilly and Company showed half of parents of kids with ADHD said they planned to reduce or discontinue their child’s ADHD medication over the summer. This usually occurs when their child’s primary issues with ADHD are related to concentration and symptoms are mild. On the other hand, in a child who struggles daily with hyperactivity, impulsiveness, distractibility and social relationships, discontinuing medication may have a negative impact on the summer and ultimately on the child’s feelings of confidence.

Some questions for parents in adjusting a child’s summer dosages:

Will your child be enrolled in a summer camp or other summer activities? If your child has trouble staying on task, listening to directions, relating to peers and controlling movement, medication may help make this summer more productive.

Will your child will be supervised by adults who are not as familiar with ADHD and its impact on your child’s behavior? Familiarity with your child’s behavior patterns will not be as established in summer activities supervised by an outside adult instead of their regular teacher.

Would the medication help provide support to your child during family vacations? Would your child and your family’s time together be enhanced? It is something to consider.

For all neurological and behavioral conditions managed by medication, in the summer, the best strategy is balance and prevention. Make sure your children:

• Drink plenty of water

• Don’t get overheated

• Have some down time

• Get enough sleep

• Limit video games

• Discuss the medication routine with your doctor

and make informed decisions for changes in ADHD medicine schedules. Keeping seizure medicine schedules is paramount.

With just a little extra effort, your child can enjoy a balanced, refreshing summer full of fun.

J. T. Jabbour, M.D., is a founding physician of Memphis Neurology, formerly Pediatric Neurology, P.A. He is board-certified in pediatrics and board-eligible in neurology and psychiatry, specializing in epilepsy, migraine, developmental delays, autism and attention deficit. Since 1977, he has been a professor of pediatric neurology at the University of Tennessee.