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 ”
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 firstname.lastname@example.org.
i specialize in kids with AD/HD and ODD. I have seen over 8000 kids since 1997. The families that come to me are ALL loving devoted functional parents who have jobs and health insurance. These parents would do anything for their child. They often walk on eggshells to not set the child off. Invariably the child has AD/HD in my opinion as he is not learning these symptomatic behaviors at home or in his nice suburban school. These families often have siblings who act properly at home and in school so obviously the parents are not dysfunctional meaning they know how to parent with out abuse or neglect or harsh discipline.
Thanks for the comment, Steve.
I have had similar experience to what you describe. I agree that parenting, per se, is not the contributing factor. I tend to see things through the lens of temperaments. So, if there are two or three kids in the family and one is more challenging, they will need a different type of handling from the parent side of things than the ones with easier temperaments. I agree 100% that harsh discipline would not be encouraged.
What I have seen, and been taught through countless experts on ADHD and difficult behavior, is helping parents with the structure and boundary setting for the challenging kids are huge variables.
Would be interested in your thoughts.
As often seems to be the case, the wisdom of TV in the 1950’s and 1960’s is really all we need to guide us. All the layers of complexity that have accumulated through the years can make it hard to discern the core issues we so desperately want to identify.
Thanks!!!!!!! Glad you agree.
By the way, I’ve tried to reach you along the way. Let’s catch up soon. Hope all is well.