I evaluated a middle school kid recently who was recently “diagnosed” with ADHD.  You know the drill.  The school told parents that, “We’re not doctors and can’t diagnose, but we think you should see your child’s doctor.”

(Translation:  “Go to your doctor now and get your child on medication.”)

The parents went to their doctor, filled out some rating scales along with other forms and left with a “diagnosed” child, prescription in hand.

The parents were not ready to jump on that diagnosis, feeling that there were other issues that were not being addressed with the medication approach

Upon evaluating their daughter, what struck me was the tempo with which she completed so many of the tasks given to her.

For example, on a spatial task that had a two minute upper end time limit, Jenna concentrated hard  while trying to figure out the solution to the problem, it took her over eight minutes – quadruple the upper end limit of the test.

While reading, Jenna struggled with some of the larger words, but the biggest issue was the slow, labored manner in which she read out loud, again at a rate probably four times longer than average.

Even when Jenna was asked a question such as, “How many states are there in the United States,” Jenna was noted to take up to 60 seconds to come up with a vague answer

From my perspective, Jenna’s internal “clock speed” relative to her characteristic approach to solving problems, answering questions, or reading or was significantly slower than average.  I conveyed this imagery to Jenna’s parents to help them understand what was going on with her.

Along with using the image of “clock speed,” I like to explain these issues akin to “RPM”s (i.e., revolutions per minute in terms of a car’s engine, as in, “Your child has very slow RPMs”)

There is no legitimate fix (there are lots of illegitimate ones) that can alter sluggish clock speed or “slow RPMs.”

Keeping this in mind, here are some pointers that may help:

  1. We tend to get irritated with these children. We want them to hurry up and when they don’t they get yelled at a lot.  Really, it’s  like yelling at someone with a heel spur to run faster – no can do.
  1. Hard as it may be, try and keep an honest and open dialogue with your child.  You might even try referring to images such as “clock speed” or “RPMs.”  “Jenna, you have a very slow clock speed, and we need to find other ways of getting things done.  Let’s break the assignment down into smaller parts.”
  1. Get the teacher on board. Stay away from clinical terminology and use plain language. (“Jenna works at three to four times slower on average on most tasks.”)
  1. If you try medication, fine, perhaps it will help. However, recognize that things are rarely as simplistic as the “we got the diagnosis” mentality would suggest.

Takeaway Point

Children with slow internal clock speed or RPMs are often misunderstood and frequently punished or yelled at because of their characteristic way of interacting with academic tasks, as well as in “real life.”  Reminding yourself and sensitizing others that your child is not working slowly on purpose would be very supportive.


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