ADHD/ADD

The Pathology of Exuberance

by | Jul 29, 2011 |

George is a five and a half year old boy. He’s one of those types who’s quite bright, but hasn’t yet learned how to contain his exuberance or spontaneity. For example when George is in his pre-kindergarten class, he has a lot of trouble holding back whenever the teacher has a question.  George can’t contain his exuberance and enthusiasm. (Since George was the type of child who religiously watched shows on Animal Planet, he was a storehouse of knowledge that he couldn’t wait to share.)

 At home, his older siblings look at him like he is a little bit off. When they watch TV together or play on the Wii, George frequently starts jumping up and down during exciting parts, excitedly flapping his arms. It’s almost like every cell of his body becomes energized by what he watches. These behaviors bother his siblings.
 
George comes in to see me for an evaluation. 
 
I am charmed by George. He is fun, spontaneous, knowledgeable and exuberant. When I have George put blocks into different patterns, he exclaims, “Wow, Dr. Rich. I like doing these! This is fun!”
 
I know everyone is going to look at George like he is ADHD when George gets to kindergarten
 
You may not remember this era, but there was a time when kids like George weren’t considered “disordered.” 
 
They were just exuberant. 
 
Sure their exuberance might get on some people’s nerves and may be a bit hard to contain, but that’s the cost of doing business with children. There will always be Georges in the pack.
 
For now, George is not disordered in my book.  George is five and a half years old and loads of fun.
 
There will be time enough in life for George to “curb his enthusiasm.”
 

 

SHOULD CHILD BE ON MEDICATION WHILE BEING EVALUATED?

by | Jan 15, 2011 |

The followings question came to me regarding the pros and cons of having a child on medication while being tested:

“Please address whether a child should be on medication while assessing a child with executive function issues. Some of the specialists we refer to around the country say to lower the medication when testing so you see the real child. Others say give the meds so you can see the potential. What do you think?”

This question comes up a lot for me. Before bringing their child in for an assessment, parents will often ask, “Should I keep him/her on medication for the testing.”

Like most things in this business, there isn’t a clear-cut answer. (That’s why my hair turns progressively gray with each passing day.)

To me the question is answered by another question, “What’s your purpose of doing the assessment?”

For example, let’s say your child has had a year of tutoring (while on medication) and you want to know how the child is progressing. In that scenario I think having him on medication during the assessment makes sense.

In a different example, if your purpose is to get a second opinion as to whether the child still needs to be on medication, then it probably makes sense for the psychologist to see the child off of his medication, so he can get a better feel for the child. You child could also need medication for a number of other reasons, you may find yourself looking to an online pharmacy to assistance with permission from your doctor.

(Mind you, with this question I am only making reference to stimulant type medication here (e.g., Adderall, Concerta, etc.), as stimulants are very short-acting and are in and out of the system very quickly.)

Bottom line, get clear on your purpose for doing the assessment and this will help to resolve the question of medicating or not during the evaluation.

ADHD KRYPTONITE: THE LUNCHROOM & the PLAYGROUND

by | Dec 18, 2010 |

  Scene 1:  The Lunch Room – Jack’s Brain

“Gee, it’s so wild and noisy in here.  Everybody’s throwing stuff.  Haha.  Jake is so good at putting food in his nose.  Maybe I’ll try that too.”

“Why is that lunch lady getting mad at me?  Jake was putting food in his nose first.  How come she didn’t see it?  Jake never gets yelled at.  Now she wants me to sit off by myself until we go outside.  It’s not fair.  I was just having fun – just like Jake.”

Scene 2:  The Playground – Jack’s Brain

“Cool…we’re outside…great to be out….I’m so sick of being inside…oh man…I can’t wait to go over to the slide area and swing down…oh, man…There’s a line…oh, there’s Jake, maybe I can jump in front of him…wait there’s a cool stick that I can throw over the fence…wow, that went pretty far…better than yesterday’s stick.”

“Oh, no, that lunch lady is coming over to me again and she’s got that look."

“I didn’t mean to throw the stick,” I tell her.

“Phew.  She lets me go this time. Back to the swing…cool there’s Jake.  We can jump down together….oh, man it’s line up time already…how come the line teacher is yelling at me? I didn’t push on line, did I?  Everyone else is doing it too.”

Scene 3:  The Classroom- Jack’s Brain

“Oh, man.  The teacher is filling out that “daily report card” thing…that stinks… I got another frowny face on the report card for lunch and playground.  I’m going to get yelled at and punished again when I get home.”

“I didn’t do anything…How come Jake never gets in trouble?”

Does Your Child Have Curriculum ADHD?

by | May 13, 2010 |

A mom came in the other day to talk about her struggling eight year old daughter, Hayley, a third grader.  She presented with many of the common concerns  – difficulty with decoding, reading  fluency, spelling and writing,

“What has the school done for her,” I asked.

The mom answered, “Well, in kindergarten she got Wilson Fundations.”   “Then in first grade she got Reading Recovery,” she continued.  “The Reading Recovery Teacher went out on maternity leave in April and they gave Hayley support with Harcourt Trophies in her regular class.  Now they are talking about SRA for next year or  Read 180.  I really can’t keep up with it.  Why do they jump around so much?”

“Sounds like she may have a case of Curriculum ADHD,” I responded.  “Curriculum ADHD is characterized by  jumping from method to method without every really giving any one a chance to take hold.  There’s a lot of that going on these days.”

Response to Intervention (RTI) is the prominent new buzz term in education.  (Every 10 years there seems to be a new one.)

My question is this. If a child is not given a sufficient enough time with a particular method, how do we know if he/she is responding to the intervention? 

Could curriculum ADHD be contributing to the child’s difficulty?
 

Clogged Fuel Lines and ADHD

by | Jan 14, 2010 | ,

By its nature, school places a certain demand on the child throughout the day. Most children throughout their day typically face a number of tasks that they find challenging and difficult to manage. When faced with such challenges many will work through their difficulty to arrive at solutions and complete the tasks before them.

What about the kids who are the concerns of these blogs – the shut-down learner types who have ADHD tendencies?

 They aren’t working through their challenges so readily!

One of the biggest issues facing these kids is the issue of “sustained mental effort.”  Put another way, these kids have clogged fuel lines for  completing difficult tasks!  They simply don’t have enough “juice’ to get them through their difficulty.

Take Hannah, age 9.  By description, Hannah is a very affectionate, loving child who tries to be helpful. At the same time, she is quite impulsive and unable to manage tasks that require sustained mental effort.

When I start to work with Hannah, I see very quickly that she has a “clogged fuel line” for task difficulty. After two minutes into a task she’s start whining, “Do we have to do the whole page…I have to go the bathroom.”   Rolling around on the desk, dropping her pencil on the floor repeatedly whenever she faced the slightest difficulty, Hannah had virtually no capacity to manage frustration. 

There are no easy solutions for “clogged fuel lines.”  Medication can be helpful, but many parents are reluctant to go that route.  Trying to provide enough structure and incentive may also be helpful.  Joining the kid and acknowledging her feelings about the task can also reduce the building emotional resistance building.  At home, you might try something like, “Hannah.  I know you hate this activity, but I’d like you to give it a shot.  I’ll set this clock. We won’t do more than 15 minutes.”

Ultimately, a certain amount of realism is required.  Knowing the nature of your kid and understanding that this issue of “clogged fuel lines” is part of the child’s make-up is better than getting upset with her.  Try working in small steps, increasing a little at a time.  Keep the teacher in the loop as to what you are trying to accomplish so the teacher knows what you are trying to accomplish.

Any ideas are welcome.  I will be sure and post them if you respond.

Tag:  ADHD,  Learning Disabilties,  Shut-Down Learners
 

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