ADHD/ADD

Over the last couple of decades ADHD (commonly referred to as “ADD”) is frequently diagnosed with struggling children.  Within the doctor’s office, the child’s history is reviewed along with the parent filling out a rating scale (typically the Vanderbilt Scale, which is not norm-referenced).

When it comes up positive for things like “overly distractible” and “inattentive” a diagnosis typically follows.

As a result of  the considerable numbers of children diagnosed with ADHD, parents stream into schools requesting 504 Plans for their child to provide the child with accommodations.

Let’s look at Liam, a  fourth grader I recently evaluated who was previously diagnosed with ADHD  based on the Vanderbilt Scales) and it was recommended that he be put on medication.

Once getting “diagnosed,”  the mom pushed the school to set up a 504 Plan and also came to came to me to get my perspective.  (They heard of my “Pushback Disorder.”)

While evaluating Liam,  he didn’t present as inattentive or distractible.  In fact, in many ways he was quite focused, particularly for hands-on tasks.    The mom rated him pretty high on the inattentive side of things.

I saw Liam, at best, as “quasi-ADHD” (a term I made up). In other words,  it wasn’t a “slam dunk” to label him as having ADHD.

What I did learn from Liam was he was overly caught up in a myriad of screen preoccupations (e.g., YouTube, Fortnight, etc.).  School and homework were just basic annoyances that he had to deal with primarily get his mom off of his back.

Liam’s mom complained that he never seemed to know what he had to do for school and her blood pressure rose daily over Liam’s obliviousness. Frustrated that Liam never wrote down any assignments (“Why should I,” says Liam.  “It’s online somewhere.”).

To lower her blood pressure,  mom has taken to downloading the Google Classroom App on her phone so that she can try and figure out what Liam has to do (while Liam plays Fortnite).

Liam thinks that it’s pretty cool his mom has the Google Classroom App, so she can keep track of what he’s supposed to do, rather than continually ask him.

It’s the mom’s view that the school should be relaxing the deadlines in a 504 Plan due to his “ADD.”

I pushed back some on the mom.  I wasn’t buying that Liam wasn’t handing in his work due to a disability.

It struck me that the purpose of 504 accommodations in school was essentially to “level the playing field” for children with handicapping conditions, not to be giving Liam the message that he can hand in homework when he chose to  or not at all because of his “diagnosis.”

It was my view that it wasn’t a 504 issue.  It was a lifestyle issue.  That is, Liam had a pretty cool lifestyle and he wasn’t about to compromise it.

Why stress when his mother was doing all the stressing.

(***Please note:  All blogs represent the opinion and perspective of Dr. Richard Selznick.  Comments and questions are welcomed, but are blocked by the hosting site.  Please email questions or comments: rselznick615@gmail.com)  

Copyright, Richard Selznick, Ph.D.  2022, www.shutdownlearner.com.

To Contact Dr. Richard Selznick for advice, consultation or other information, email rselznick615@gmail.com.

To receive future blog posts, register your email: http://www.shutdownlearner.com.

Brett, age 8, has difficulty behaving in his third grade class.  Frequently calling out, pushing on line and at times being rude to the teacher and other kids, his parents have been called in for the “meeting” to discuss Brett and his behavior.

They are told by the school, “We’re not doctors so we don’t know why he’s doing these things, but we think you should see a neurologist.”

The last statement is code language.

Here’s the translation – “We think Brett has ADHD and needs to be on medication.”

The parents come to consult with me about Brett, even though I am not the kind of doctor the school has in mind.

Brett’s mom says, “We just don’t know why he does these things.  If we only knew why, then it could be fixed.  Maybe it’s his anxiety or his sensory issues.”

I can’t help myself pushing back.  (It’s my own disorder – “Pushback Disorder,” I believe it’s called.)

“The problem with the “Why” question is it’s all speculation,” I say.  “Even the best neurologists are using subjective rating scales and history to determine things like ADHD.  So it becomes a “weight of the evidence” diagnosis.   Usually there are a number of variables interacting at the same time, not all of which are in the child’s head.”

“So how do we fix it?”  (A question I get all the time, but still wriggle around trying to answer it.)

“Well, they’re not car engines.  Nothing’s broken.  So there’s no fixing it. Rather than speculate, try and stay with the facts that are observed.  What happened first, second, third?  How did the adults respond?  What were the consequences?  Before starting on medication, which might be helpful for Brett, let’s get a sense of the basic facts of the behavior ”

Takeaway Point

Back in the day there was a popular TV Show, “Dragnet,” where the main detective would say, “Just the facts, Ma’m.”

Stay with the facts.  “Just the facts, Ma’m.”

Copyright, Richard Selznick, Ph.D.  2022, www.shutdownlearner.com.

To Contact Dr. Richard Selznick for advice, consultation or other information, email rselznick615@gmail.com.

Every week I hear an array of concerns regarding distractibility and inattentiveness.

Beyond the immediate assumption that the child has ADHD/ADD (in other words a neurological disorder), I do my best to broaden the narrative and review other factors to consider that may contribute to why a child is not consistently paying attention.

There are multiple reasons why a child could be struggling to pay attention, which is not always ADHD.

Some others to consider that are commonly in the “soup pot” include:

• Perhaps the child is obsessed (addicted?) to playing video games, leaving little in the “mental tank” for sustained mental effort.
• Perhaps the child is also playing video games far too late in the evening and not getting enough sleep.
• Perhaps the school work is too hard.
• Maybe there’s been a lot of tension and fighting in the family that is unsettling to the child, contributing to a sense of distractibility.
• Perhaps the teacher is not that motivating and the work has become overly boring
• Perhaps the child is being flooded by too many worksheets (or its on-line equivalent), leaving the child feeling disconnected and unmotivated.
• Perhaps the child has significant reading problems, making it difficult to pay attention and to comprehend.
• Perhaps there is a lot of distraction in the environment (whether it be an actual classroom or at home), and the atmosphere does not lend itself to paying attention.
• .Maybe the child is struggling with anxiety and the excessive worrying looks like inattention.
• Perhaps the child is feeling like she may have social issues as she goes on TikTok and Instagram and sees her friends and she’s not included.
• Maybe the child has been made fun of or ridiculed, but no one really knows of it other than the child.

Takeaway Point

There are many more such as these, but these are some of the ones that readily come to mind when considering why a child may not be paying attention.

Sure,  the child may ADHD/ADD, but make sure you go through a checklist to see what else may be contributing to the inattention.

Copyright, 2022 www.shutdownlearner.com
Questions or topics email Dr. Selznick email: rselznick615@gmail.com.

Jacob is an endearing,  extremely verbal 7-year-old.

Whenever asked a question, Jacob talks with great enthusiasm taking you on  a verbal roller coaster ride.

In psychology jargon, Jacob also has a problem with “self-regulation.” (Don’t you love all the terms out there?)

I ask Jacob, “So Jacob, how are you doing at camp…how’s your behavior going?  Are you following the rules?”

With bursting enthusiasm, Jacob says, “Great!!!  You see, when I was born there was something wrong with my brain, so I take this pill and now it’s better.”  (Jacob has recently been put on medication for ADHD.)

To no avail, I try and counter his view. “Jacob, your brain is fine,” I say.  “The pill may help you to focus a little better, but there’s nothing wrong with your brain.”

“Right,” Jacob exclaims, “but, when I was born…”  as he continues with his neurological explanations.

It may be my issue, but for a long time my mission has been to normalize things for children and families.

I do my best to move them away from “disorder” or “disability” language  to skill-thinking, framing paying attention as a skill that can be improved like any other skill.

Takeaway Point

Try and watch for kids like Jacob who show their cards when they say something is “wrong with their brain.” While you don’t have to go over the top with tell them “you’re amazing,” (another overused word), calmly explain to them that their brain is fine and the pill is a tool to help with the “skill of focusing.”

Copyright, 2022 www.shutdownlearner.com

Questions or comments email Dr. Selznick:  rselznick615@gmail.com

Sometimes I can feel the twinge coming on.  It usually occurs when I hear the misinformation parents are given from schools or have heard through the grapevine.

Here’s a small sampling of what parents are frequently told regarding dyslexia:

• “Well, we really don’t know what dyslexia is?” (Ugh, yes we do.)
• “Only medical doctors can diagnose dyslexia.” (Really? So a neurologist will give a broad array of measures that assesses word identification, reading accuracy and oral reading fluency along with spelling and writing, all of which are necessary to diagnose dyslexia.  I don’t know too many medical doctors doing these tests.)
• “The only thing in reading that matters is comprehension.” (So, if the child reads “medichan” for “mechanic,” that’s ok as long as they can answer some questions and somehow gets the gist of the story?)
• “It’s probably all attention – maybe you should see a doctor since we can’t diagnose.” (The unspoken, but clearly delivered message is, “Your child should be on medication and that will take care of it.”  Not sure how that will help the child just mentioned who couldn’t read “mechanic?”)
• “How can it be dyslexia? He’s not reversing when he reads.?” ( Reversals – Mythology #1)

To cut through a lot of the misinformation and mythologies I would recommend that you visit a few website to help keep you on the “straight and narrow.”

These include:

• International Dyslexia Association (dyslexiaida.org)
• Learning Disabilities Association (ldaamerica.org)
• Children & Adults with Attention Deficit Disorder (chadd.org)

Then, there is my all-time favorite, www.shutdownlearner.com, where there are over 500 blog posts, interviews and other such stuff.  (OK, a little self-promotion isn’t going to hurt anyone!)

Takeaway Point

There’s a lot of buzz on the street when it comes to children and their issues.  Be careful with what you are being told as much of it does not hold up with the research and the reality.

Copyright, 2021 www.shutdownlearner.com
Questions or topics email Dr. Selznick.  Not in the South Jersey area? For a free 15 Minute Consultation, contact Dr. Selznick: email – rselznick615@gmail.com.