Q: Our 7-year-old granddaughter, of whom we have custody because her parents are addicted to opiates, is going to start taking Ritalin soon. How do we explain the need for the pills to her? Somehow saying "to help you concentrate" seems too much like a panacea. Thanks. I appreciate your wisdom and ability to articulate it so well.

A: It is quite a challenge to raise a granddaughter when her own parents can't. I think your own words are excellent, because you have not said she can't concentrate and only that she requires some help. You can further reassure her by explaining that as she becomes better at concentration, it's possible she will eventually be able to focus without the medication.

This does happen for some children. Attention deficit hyperactivity disorder is on a spectrum and a matter of degree. If her inattention is not extreme, as she performs better in school, she's likely to become more motivated, and motivation trumps all when helping someone with attention issues. For example, if she becomes a very good reader, the intrinsic interest of the books will help her to concentrate. If she views her persona as one of a very good student, she will put forth more effort to keep that view of herself.

Try to encourage her as much as possible and continue to read to her. Practice those math flashcards by making the math facts into a game, so she can feel more capable, and so she can think of learning as fun. That, together with her prescribed Ritalin, could build her confidence and her motivation, and she'll begin thinking more about her love of learning than her Ritalin.

BOY MAY HAVE LARGER PROBLEM

Q: How do you deal with a child that refuses to accept help with schoolwork, even when he doesn't understand it? He will not take the initiative with schoolwork and communicate with his teacher about it. He takes hours to complete homework and often doesn't complete tests in the time given.

A: Sometimes, it's really hard to get kids to ask for help, because they assume that the teacher will then see them as "dumb." I usually tell children about the research that finds that students who successfully complete college are more likely to have asked for help when they needed it in high school. I also tell them that students who are planning to go into highly competitive careers, like medicine, veterinary science, law, etc., must earn high grades to be admitted. Often, they get tutors to help them with the challenging work so they can earn those high grades. Even if your son is very young, it can help him to understand that highly intelligent young people can actually find things difficult, thus encouraging him to also ask for assistance.

If your son is very young, it's logical for you to take the initiative to tell the teacher that he's struggling but hesitant to ask for help. Your last statement about the length of time that it takes him to do homework and the non-completion of tests suggests other potential problems. I expect that he is surely struggling with self-confidence, since children who don't finish their work often assume that the first one done is the smartest, and their slow speed proves that they're not very intelligent. While the slow speed could only be a symptom of lack of confidence, it could also be caused by a disability, processing speed or attention problems. Your son, whatever his age, would definitely benefit by a comprehensive evaluation by the school psychologist or a clinical psychologist.

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Dr. Sylvia B. Rimm is the director of the Family Achievement Clinic in Cleveland, Ohio, a clinical professor of psychiatry and pediatrics at the Case Western Reserve University School of Medicine, and the author of many books on parenting. More information on raising kids is available at www.sylviarimm.com. Please send questions to: Sylvia B. Rimm on Raising Kids, P.O. Box 32, Watertown, WI 53094 or srimm@sylviarimm.com. To read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.