The Two-Week Notebook: Jotting Down the Small Stuff When ADHD Medication Begins

Starting ADHD medication can feel like standing at the edge of a very long spreadsheet. There are doses to remember, review appointments to book, questions from relatives and a small voice in your head asking whether every sigh or skipped lunch is a side effect. The first two weeks of titration are not a clinical trial you are running at home. They are a short stretch of information gathering, and the information should serve your child, not the other way round.

A simple notebook, a shared phone note or a page on the fridge is enough. The aim is not perfect data. It is a picture your paediatrician or specialist nurse can actually use at the next appointment.

Begin with four ordinary questions

Instead of building a colour-coded tracker, start with four prompts for each day:

• What did we notice?
• What did our child say about how they felt?
• Was there anything different about the day — a test, a PE lesson, a late night, a big noise?
• Did anything help?

That is it. You do not need to score every hour. A few honest lines are more useful than a page of ticks that nobody reads. If your child wants to add a drawing, a sticker or a one-word mood note, let them. The diary belongs to the family, not to the filing cabinet.

Appetite: note the practical bits, not the plate

Appetite changes are one of the most common things families notice. Rather than counting calories or turning mealtimes into a battle, jot down the shape of the day. Did breakfast happen before the dose? Did lunch get eaten at school? Was there a after-school snack that made dinner possible? Did your child complain of a headache or tummy ache before eating?

In the UK, school lunches and packed lunches can be a useful marker. If your child is leaving most of a packed lunch, note it without judgement. If they are ravenous at 5pm and dinner has moved later, note that too. The clinician may want to talk about timing, breakfast, or a planned snack. Your job is not to fix it in week one. It is to notice it.

Sleep: record the pattern, not the verdict

Sleep can shift when medication starts. Some children settle differently; others take longer to fall asleep or wake earlier. Keep it simple: what time did they go to bed, roughly how long until they fell asleep, did they wake in the night, and how was the morning?

Try not to decide whether the medication is ‘causing’ a sleep problem on day three. A late night might be excitement, a growth spurt, a noisy neighbour or the fact that Wednesday is always chaos. Context matters. Write down the context alongside the sleep. That is what helps a specialist nurse work out whether a pattern is real.

Mood and your child’s own view

Ask your child, in whatever way works for them, whether anything feels different. Some children will say ‘I don’t know’ and mean it. Others will offer a detailed review. Both are fine. You might use a simple face scale, a feelings sheet from school, or just a conversation in the car.

Note irritability, tears, flatness or anxiety — but also note what was happening around them. A meltdown after a fire drill is not the same as a meltdown after a quiet morning. And ordinary bad days still exist. Not every difficult afternoon needs to be entered as evidence. The goal is to spot patterns, not to pathologise childhood.

School feedback: one named person, one short message

It is easy to overwhelm school with daily requests for updates. Instead, agree one named contact — perhaps the SENCO, form tutor or pastoral lead — and ask for a brief note twice a week. A short template helps everyone:

• Any changes in focus or getting started?
• Any friendship or mood observations?
• Any physical complaints, such as headache or tummy ache?
• Anything the family should know?

Keep it to a few lines. Make sure the school knows what the medication is called, when it is taken and who to contact if they are worried. Check that information-sharing consent is in place. A calm, consistent link with school is worth more than a flurry of messages in the first week.

Physical observations: what to note without becoming a nurse

You do not need to buy a blood pressure monitor unless your clinic has asked you to. Do note headaches, tummy aches, dizziness, a racing heartbeat, new tics, skin rashes or anything that feels physically different. Write down the time and what was happening. If your child has a temperature or a bug, say so — it is easy to attribute every symptom to medication when actually it is a cold from school.

If the clinic has asked for home readings of height, weight, blood pressure or pulse, follow their instructions and bring the numbers to the review. If you are unsure how to take a reading, ask the specialist nurse to show you. Guessing is not a plan.

Missed doses and the wobble that follows

It happens. A lie-in, a forgotten dose at a relative’s house, a vomiting bug. Do not double up to catch up. Note the time of the missed dose and anything you noticed afterwards. If you are unsure what to do, contact the clinic or your GP rather than adjusting the dose yourself.

Weekends, school holidays and sleepovers may need a different plan. Ask the prescriber early so you are not making it up on a Saturday morning. A missed dose is usually a note in the diary, not a disaster — but it is worth recording so the pattern is clear.

What counts as urgent

Most side effects are manageable and worth a routine call. But some things need urgent help. Seek emergency advice if your child has chest pain, faints, has a severe headache that will not settle, develops a rash with fever, has a severe allergic reaction, or shows signs of severe agitation, hallucinations or thoughts of self-harm. Call 999 or go to A&E if it is an emergency. For urgent but less severe concerns, NHS 111 or your out-of-hours GP service can advise.

Write the clinic’s number and your GP’s number on the first page of the notebook. It saves a panicked search later.

Let the notebook be small

After two weeks, take the notebook to the review. Read it yourself first. What stands out? What was probably just a normal run of bad Wednesdays? If keeping the diary has become a chore, cut it back. One line a day is enough. The clinician wants patterns, not perfection. Your child wants a family that still feels like a family, not a research site.

The first fortnight is a beginning, not a verdict. Keep it kind, keep it brief, and keep asking your child what they think. That is the information that matters most.