ADHD/ADD

“504 Realities (Part II) – Raising My ‘IQ'”

In last week’s post we talked about some of the basics involved with 504 Plans (504 Plans – The Reality : Part I ).

Remember, that a 504 does not offer any interventions,  but accommodations. It is intended to provide equal access to the mainstream to those identified as having a disability.  By far, ADHD is the disorder that receives the most 504 plans in school.

Of the things (among many) that raises my “IQ” (i.e., Irritation Quotient), are 504 accommodations that seem rubber-stamped or given by default.

A classic example is the provision of extra time, which is the top of the list of accommodations typically offered to ADHD children. (Not sure I’ve ever seen a 504 Plan that doesn’t give extra time as its top accommodation.)

To illustrate and expand upon my irritation, let’s look at Carl, an impulsive child who rushes through his work (and practically everything else he does).  Diagnosed by his pediatrician with ADHD, the parents took the physician’s prescription with a request for a 504 to the school.

The team met with the parents and set up a 504.  Among a few other accommodations at the top of the list was the provision of extra time (i.e., double time) on tests and classroom activities.

Given Carl’s characteristic impulsive style, the last thing Carl needs (or wants) is extra time.

As Carl blitzes through everything, it’s unclear how double-time helps Carl, as he is finishing a typical fifteen minute task in under three minutes (without checking any of his work).

Perhaps, rather than giving Carl extra time, which doesn’t help him at all, they can have the teacher’s assistant slowly go through his answers to help him to double check them, something he rarely to never does.

As you go into yo.ur 504 meetings  try and have an open and honest conversation (admittedly, not easy to do) regarding your child.

To guide the discussion there should be one central question.   That is, “What are the few things that can be done  to  help the child to function more effectively in the classroom?”  If time extension isn’t helpful, then don’t put it in the 504.

Takeaway Point

Be practical and realistic.  Come up with two or three things that you think would legitimately help your child

Keep it simple.  Keep asking the central question.


(***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: https://shutdownlearner.com.

504 Plans – The Reality: Part I

Parents will come to me loaded with terms only partially understood,  like referring to “504 Plans.”.

I will hear things such as the following:

“We just need to get him a 504.  so he can start reading better.”

“Yesterday, she had a meltdown in school and no one wants to play with her.  The 504 just isn’t working.”

Listen folks.  We need to get real.  Even if you are able to obtain a 504 Plan, that does not result in giving the child the help that may be needed.

It’s not the purpose of a 504 Plan.

Tack this on your office wall and repeat it as a mantra:  A 504 does not provide any service or intervention!!!  

This point is absolutely essential to keep in mind.

The notion of the 504 is that the child identified by an outside professional as having a disability necessitates developing reasonable accommodations so that the child can function as free as possible of any handicapping barriers  in the mainstream setting.

The word “reasonable is  open to a great deal of interpretation.

So is the word “adequate,” which comes up a lot in special education lingo.

Second mantra to post on your wall:

Schools are not required (by law) to provide the “best” education when it comes to special education, but an adequate one.

The Toyota – Lexus analogy has been used frequently to explain this.  While the Toyota may not have all of the features of a Lexus, it certainly is adequate to get you from here to there.

Takeaway Point

504 Plans do not offer services.

504 provides accommodations, not interventions.

More next week.


(***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: https://shutdownlearner.com.

“Hemming & Hawing”

OK… Among other disorders that I seem to have, readers of this blog know I have confessed to my  “PBD” or “Pushback Disorder.”

PBD usually manifests whenever parents tell me something that has a hypothesis (i.e., an opinion) as to why their child is doing or not doing something.

Usually, there is some type of disorder attached to the hypothesis.

Some examples include:

  • “My child is sensory seeking.”
  • “My mother’s uncle has clear ADHD and it runs in the family, so I see it coming out with our 7-year old when she refuses to do her homework.
  • “Emotional self-regulation is challenging for William – he always demands to be first in everything.”
  • “Her dyscalculia is running rampant – she just can’t do math word problems.”
  • “George hates reading so much – all he can focus on are video games. I think his dyslexia trips him up and he escapes to video games for safety.”

While all of these hypotheses may be true to a greater or lesser degree, ultimately they are opinions, guesses as to what’s going on.

Even with decent testing, there’s still guesswork involved with “the diagnosis,” which leads to another of my numerous disorders.

I haven’t seen it in the research literature, so I may be the first person to discover it – I am calling it “Hemming and Hawing Disorder” or “HHD.”

“HHD” manifests in my corner of the universe around questions of ADHD, Dyslexia, Anxiety and Asperger’s, among others, for example.

Recognizing that  there is no definitive test for any of these commonly raised concerns, I often find myself “hemming and hawing” after I’ve done a hefty dose of pushing back.

HBD is correlated highly with “Squeamish Disorder” (SD), which I freely own.

Not being a neurologist (who must have steelier nerve than I have with much more science behind them), I am uncomfortable saying that I child has a neurological disorder.

What I am not squeamish about, however, are stating facts that emerge in an assessment: .

For example:

“The fact is your child rushes through tasks.”

“Your child has a significant reading, spelling and writing problem and is well below the norm on these skills.

“Your child has superior visual intelligence, but is much weaker with verbal skills which are likely to impact things like reading comprehension or understanding lectures.”

“Following directions is very difficult for your child which came out in many of the portions of the testing.”

“Clear deficits with reading rate, accuracy and fluency were seen on all of the tests.

Takeaway Point

I clearly need help with all of my numerous disorders, such as PBD, HHD and SD, among others, however, stating the facts clearly keeps these disorders at bay.

For statements like these, I don’t show any HBD or SD.


***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: https://shutdownlearner.com.

Why Ask ‘Why?'” (Part II)

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Frequently, I hear from parents that they just want to know “why” something  is taking place (e.g., a behavior or a learning problem) .  As I hear their question, I understand they are seeking a “diagnosis,” such as ADHD or dyslexia.

For many parents when they get the diagnosis, they find comfort in it, believing that they have gotten to the root of the problem.

As we discussed last week, (“Why Ask ‘Why'”) the concern of of “why” is that the answer is highly speculative.

Related to this, I would like to offer a couple of quotes from Dr. William Carey, the late, renowned pediatric researcher from CHOP.

“‘I think the current diagnosis of ADHD is a mess and has been wildly overdone.  It blames a variety of symptoms entirely on the child’s brain, and ignores the child’s environment and the interaction with it.’”

The assumptions that the ADHD symptoms arise from cerebral malfunction has not been supported even after extensive investigations.  The current diagnostic system ignores the probable contributory role of the environment, presuming  the problem is supposedly all in the child.” 

“The questionnaires most commonly used to diagnose ADHD are highly subjective and impressionistic”

“The label of ADHD, which is widely thought of as being beneficial, has little practical specificity and may become harmful.”

Parents may feel a degree of comfort relative to getting a “why,” but I can’t shake Dr. Carey from ringing in my ears.


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

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

 

 

 

“Why Ask ”Why?” (Part I)

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.

 

 

 

“My Kid Can’t Pay Attention – Must Be ADHD” (Not So Fast)

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.

“‘When I Was Born There Something Wrong With My Brain, So I Took This Pill…”’

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

Feeling the Twinge

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:

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.

“My Child Doesn’t Pay Attention – Do You Think He Has ADHD?”

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

There’s always the question of, “Does my child have ADHD/ADD.”   In the discussion with parents a lot of  territory is covered and  I do my best to broaden the narrative and review other factors that may be contributing to why a child is not consistently paying attention.

Here are some factors to consider before presuming your child has a neurological disorder:

  • Perhaps the work is too hard.  If it is, it will lead to inattention
  • Perhaps the child is playing video games far too late in the evening and not getting enough sleep.  Maybe the child is addicted to video games leaving little in the tank for sustained mental effort, something that I am seeing much more.
  • Maybe there’s been a lot of tension and fighting in the family that is unsettling to the child,  which will lead to distractibility.
  • Perhaps the teacher is not motivating.  Not to blame the teacher, but a boring teacher can certainly produce a lot of off-task behavior.
  • Perhaps the child  has “W.B.D.” (i.e., “Worksheet Burnout Disorder.”) and 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 comprehend.  This is an extremely important consideration.
  • Perhaps there is a lot of distraction in the environment (whether it be the  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 does not feel included, leaving a sense of her upset and distractibility.
  • Maybe the child has been made fun of or ridiculed, but no one really knows of it other than the child.

Oh, yeah.  I almost forgot.

Maybe the child has ADD/ADHD.


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.

 

 

“Got My Kid On Medication”

Once parents have gotten the “diagnosis” of ADHD, typically medication is offered as the next step.   Parents will think the medication will do more than it can do in reality.

The goal of the medication is to help the child pay attention and focus better.

That’s it!

A 20% or so improvement in paying attention would be significant.

With ADHD there are  common deficits that cluster together including:

  • Poor problem solving.
  • Low frustration tolerance.
  • Weakness “reading” cause and effect (in actual reading and in social interactions)
  • Weak reading comprehension.
  • Poor reading accuracy and fluency.
  • Pervasive writing deficits.
  • Social misjudgment.
  • Low motivation.
  • Difficulty getting started on tasks.
  • Overcoming sense of boredom.
  • Poor time management.

While medication can improve focusing, it has little impact on these variables of concern.

However, there is much that can be done with these deficits.  For example, by putting the phrase, “The skill of…” before a deficit of concern,   helps you realize that the skill can be targeted and improved.

If you say your child lacks, “The skill of frustration tolerance,” then you can start thinking about how to teach and practice this skill.

Takeaway Point

Even if the medication is working, don’t be lulled into thinking that the skill areas are improving.

The skills need to be taught and practiced in order to be internalized over time.

 


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.

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