"Bloopy" Feelings

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My daughter, Kim (9), is generally loving, happy, social and very active. As described in earlier posts, her ADHD presents itself in her talkativeness and her inability to stand still. She has been taking medication for her ADHD for a couple of years now.

Very often, especially in the evenings, she can break down into tears with little cause and little understanding. At bed time, she can have a bad case of "the blues", feeling choked up and sad without a clear reason why. We are not sure if these moments are early indications of depression, which have a high rate of coexistence or "comorbidty" with ADHD. Dawn, Kim's Mom, has been dealing with depression over the years. Alternatively, she may just be "crashing" as the effects of her ADHD medication(stimulants) wear off.

Lately she has put a label to these feelings - "Bloopy". My wife, Dawn, and Kim are putting together a children's book, where Kim can express how she feels, in a comfortable and creative environment. We will continue to encourage her to express herself through the book. If and when she completes it I will talk to Kim about sharing it here. Maybe another child is feeling bloopy and would be reassured knowing that he or she is not alone.

Until then...
- Peace

The Power of Choice

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We have changed direction a little lately. As mentioned in earlier posts, our son was having increasing difficulties with school. His ADHD was getting the best of him. PJ was reaching his limits with how many reprimands he could face each week. His spirit was at an all-time low.

Strict discipline was not working. It only seemed to shut down communication and showed itself as anger from all involved. After one particularly horrible night, I decided that the circus was over. We tried being more supportive, loving and encouraging. No more tug-of-wars over going to school each morning. We explained why it was important, offered rewards for going and explained restrictions if he didn’t.

In recent meetings with his school’s principal, vice-principal, psychologist and several of PJ’s teachers, I challenged them all to reach beyond their understanding of ADHD. We asked that they help PJ, through encouragement and support, rather than constant reprimands for his impulsivity. The principal made it clear that they were being understanding and that PJ had gotten off easy for his behaviors. For the second time, we suggested that maybe dealing with this was beyond reasonable expectations for the school and its staff. They insisted that they wanted PJ in the school and felt they could be of help.

In the following weeks, things got worse. PJ’s breaking point came when he told us through tears, that he just wants to be normal and that normal kids don’t get “written up” 5 times in one week. We assured PJ that he didn’t have to worry about Dawn and me getting upset over the school issues. We told him that he deserves to be happy and that he doesn’t have to worry about breaking the bad news of the day to us on top of everything else. We stopped pressuring him to go to school if he was having an anxiety moment getting ready in the morning. The school was clearly not helping.

Dawn was concerned. “He has to get to school! He’ll get left back!” I assured Dawn that right now, school was the least of our worries. PJ’s self-esteem and confidence were gone. He was in a depression-like state. There was more at risk for his mental health than was at risk for his academics.

Yesterday morning, PJ announced that he wasn’t going back to school. Considering what he had been going through, I could not blame him. I told him that it’s his choice and that was fine. (I know what you’re thinking – “who in their right mind would allow their 11 year old decide he wasn’t going to school?”. It needed to be done – read on!)

I continued to explain that it might be best for him to tough it out for the remaining three months of school. Then, PJ would be in a new school, entering 7th grade. I told him although it was OK that he did not want to go back, we would have to work out some other school or program, as he was legally required to stay in some form of education. I also warned him that, due to his numerous absences and time that would be lost transitioning into another school, he would likely have to repeat the 6th grade. I left the decision up to him. His choice. No tug-of-war. You can’t have a tug-of-war if no one is pulling on the other end.

PJ decided that he did not want to have to repeat the year. He chose to go back to school. This morning, I asked again what he decided and if he was sure. He confirmed that he wanted to go to school. Dawn called a little while ago – he went right in with no problems.

The power of choice can be an amazing thing. No one likes to have things forced upon them. We all like to feel that we are having some control over where we are going and what we do. I realize that this is not the end – just a great day.

- Peace

Many Shades of Gray

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Kim's ADHD is different than PJ's. As is the case with many girls, she presents her ADHD in excessive talking, constant movement to burn off her energy and difficulty in focusing.

With PJ, his ADHD presents itself most often with impulsivity and inappropriate behavior. As these kinds of behaviors tend to be more common with boys who have ADHD, they find themselves in trouble more. This, in part, explains why more boys were diagnosed with ADHD in the past. The girls flew under the radar and often went undiagnosed.

PJ’s focus component is hard to determine at times. PJ could be thoroughly engrossed in detailed drawing while his mother would read a book to him – something complex, like “Harry Potter”. It would frustrate her to feel that she was reading to him and he wasn’t even listening. Yet when she would check if he was getting the details, he never missed a point, a relationship or the finest details.

Hmm – I recall doodling my way all through high school – maybe a little needed extra stimulus to allow us to sit quietly and focus? (Note to Teachers: Maybe doodling is not the worst thing for your ADHD student to be doing, if it helps them. Some of PJ's teachers have gotten that and lived to tell!)

There are other moments when PJ would look you straight in the eye: “Yes please! I would like a bagel for breakfast!” – only to be heartbroken when you actually placed it in front of him. He talked the talk, but never heard a word.

Everyone is different. Things like ADD/ADHD, Autism and Asperger's Syndrome all come in many shades of gray. We have to be careful to treat the various presentations of these conditions individually, instead of pigeon-holing a person based on their label. Kim's needs and PJ's needs are drastically different and although difficult, we must address them differently.

Where did everyone go?

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When we first determined that our son had ADHD, we took an aggressive approach to the situation - denial wasn't our style. We sought the best medical advice we could get. We immersed ourselves in every book, magazine and web site having anything to do with ADHD and ADD.

Almost everyone has heard the debate on whether or not to use medication. Our doctor had advised that any side effects of the medication, such as weight loss, would be far outweighed by one critical concern. The doctor expressed concern that our sons impulsive behaviour would not only get him in trouble with his school teachers and administrators, but would also have the potential for him to be ostracized by his peers/friends.

We went the medication route and over time found the right meds, dosage and timing for our son. Having ADHD myself, I have taken medication also and can state, without hesitation, that my thoughts and actions are clearer, calmer, less distracted and less impulsive.

We have had times where our son has had to go without his meds. At those times, invariably, a new person comes out: completely out of control with bizarre interactions with others. At the end of those days, my son is generally remorseful and cannot wait to have his medication the next day.

Even with the benefit of the medication, school and relationships with friends have suffered.

Although school administrators have expressed patience and an understanding with the situation, that does not always make it all the way to the teaching staff. Teachers see an extremely bright boy who can behave at times and therefore see our son as choosing to behave or not. Reporting that the child is impulsive or ill-behaved is the equivalent of saying "the blind boy still refuses to see".

Close friendships never seem to last more than a couple of years. Our son's sense of humor is intelligent and above his age-level. Teachers and counselor's see some very clever attempts at humor that other kids see as just "weird".

It is a beautiful day today on Long Island - a nice warm break from a bitter winter. Other kids are running around outside in shorts and T-shirts. My son is sitting in front of the computer. His play is "safe" there. He won't offend anyone. No one will reprimand him for his impulsivity. It seems that it gets harder and harder for him to risk reaching out to others.

We still press on looking for opportunities for him to have positive social experiences. ADHD runs in cycles - good times of the day and bad; good days/months/years and bad. Better days will come again.

Lesson Learned

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I am currently traveling in the Midwest for a little more than a week. I checked in at home this morning to find that my son would not go to school today. He was "tired".

To bring you up to speed quickly, my son is a gifted 6th grader, with ADHD. He has been struggling with mornings of anxiety, which in turn becomes "not feeling well" enough to go to school. This has occurred on and off for about 3 years. So far this school year he has missed 8 days.

Before anyone jumps to the conclusion that this is a matter of a "lack of discipline" or poor parenting by enabling parents, I can assure you it is neither. It is so real to him that he has gone as far as jumping out of a moving car on the way to school.

Threats of punishment have no impact at the time of the event. He is in another world when it is happening. Positive reinforcements and rewards can be of limited help.

My wife was at the end of her rope. We talked about how he should spend his day. He has been lagging in Math. I suggested that my wife have my son spend his day working on Math exercises and work around the house, particularly cleaning bathrooms. I spoke with him and told him that it was fine that he was home, but that he was going to either learn to study or learn to work.

A call to my wife later brought good news. After cleaning the two bathrooms on his hands and knees and vacuuming the second floor of the house, he told my wife that he wanted to lay down. She reminded him that there was still a great deal of work to do. She also suggested that going to school was probably a bit easier then the work she had lined up for the day.

He made it to school in time for his Math class. Another day survived.