Today I met with Katya's main teacher for our first conference. She showed me all of Katya's work thus far and the report that was jointly prepared by her, the school's neuropathologist (huh? perhaps it's more like a "counselor"?), and the speech pathologist. Katya's doing great so far and it was interesting to see her various assignments (I don't see most of her work at home since they try to have students complete their homework at school). They have no concerns about her ability to do well; she works very hard, pays close attention in class, asks thoughtful and thorough questions, and completes all assignments carefully. Her Russian isn't on the same level as that of the native speakers', but her teacher doesn't think it's an issue at all.
Yep, that music you are hearing in the background is the harp music accompanying this song: "Thank God we caught her ADD early on and she's getting great help!" (She was only diagnosed last month while we were in the USA).
I'm even more relieved about having proceeded with treating her ADD after hearing about how she's doing socially. Once she adjusted to being on medication, she began to play confidently with other kids. (ADD had mostly affected her socially up until now; she had difficulties staying focused in group conversations and games, often then just giving up and keeping to herself. She also had a hard time focusing on constructive problem solving whenever conflict arose). The teacher has seen very marked progress in this area, stating that although Katya was very happy to arrive at school each day from the very beginning, she clearly struggled emotionally in social situations.
Three weeks later, she is a different kid: mostly confident and social throughout the day. She is a rather serious child and will always need her "down time" to be alone, but she's happy and making choices about how to spend her time based on what she wants--and not based on her fears of how others might not like her. She still has room for improvement, but she's clearly on her way.
Having a kid with ADD opens up a whole new awareness about difficulties posed by being expat parents in Russia. While ADD is recognized as a condition in Russia, it isn't treated. The only reason any diagnosis is made is to simply pacify parents--that there's a reason for their child's behavior, so to be more patient. How tragic!!! There's no medication for it here, and Ritalin is illegal--it's classified as speed!
This causes many problems for expat parents--you have to always have enough of your child's prescription with you when you return from a trip to the USA. Then you encounter the problems with how Ritalin is prescribed in the USA: your prescription has to be received by the pharmacy as a hard copy, so you need to allow for necessary mail time. It's also hard to get more of the prescription than a one month's supply and insurance will only allow you to fill more than one month if you use their mail-order pharmacy. Given how outrageously expensive Ritilin is, it's quite an expensive ordeal!! (Yes, you can file a claim and get reimbursed, but who wants to front $1,800 or more?)
Having now been through this process, I've learned a few things:
- Get your prescriptions mailed in as early as possible!!!! Ask the child's doctor to mail in the scrips well in advance of your trip to the USA; even if a change in dosage needs to be made, at least you'll have a good percentage of what you'll need.
- Call the insurance company and plead your case if you don't have time for mail-order. They can do an override and you can fill up to six months under your insurance (Cigna International).
- Don't assume that any given pharmacy will have more than a month's supply of your child's medication. Call ahead; there was no pharmacy within an hour of my mom's house in CT that could have filled Katya's meds for three months. As a result, we won't have enough to get us to Christmas and Chis has to go the US and bring it back.
- You can't mail Ritalin; it is illegal and will be confiscated. If not legally seized, it will likely simply be stolen.
- If your Ritalin is stolen, you can file a claim with the insurance company and they will cover a supply to make up for the one that got lost.
- You can't ask anyone else to bring Ritalin into the country for you; they could get arrested for drug smuggling. When bringing in the medication, be absolutely certain to keep it in the pharmacy packaging labeled with your child's name. The US embassy has had to intervene in the past for people who were detained for bringing in Ritalin.
- The European drug companies are aware of this problem and are working hard to convince Russia to legalize medications which are standard elsewhere.
- Don't hide your child's ADD from his or her school; it's better to try to educate them. If they're not open to learning about it and working with you, your child would be better elsewhere...