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ADD: The Game Plan

Self-concept

ADD: The Game Plan As a former high school coach, I couldn't leave you without a game plan. Your opponent is attention deficit disorder. Because ADD can attack and impact on your child's life in a variety of ways, I've provided assessment tools to help you determine the best game plan (or plans) for your child. ADD affects children and adults in six areas, so I've designed defenses for each of them. Because each child's ADD symptoms are different, let's first assess how your child is affected within each of these six areas:

• self-concept
• behaviors
• home relationships and harmony
• social relationships
• spiritual life
• school life

I realize that each of these areas has been covered in previous chapters, and I would certainly hope that you will look back to those chapters for guidance and direction. But you cannot just follow one approach at a time. That creates confusion, and if there is not a major success with one approach, it might be thrown in the dump as unusable when it could be very powerful in conjunction with another. The message is that your child needs an integrated plan that includes a mixture of approaches. ADD is not a single problem and it cannot be helped with a single solution. That is the reason for this chapter, to start with the big picture.

For each category of assessment there will be a 1-to-10-point rating scale, with 1 meaning no impact of ADD in that area, and 10 meaning that the effects of ADD are having dysfunctional impact in that area of life. Each of the rating scales has different relevancies to determine how well your child is functioning; however, the underlying ratings are based on the general scale below.

Self-concept
In this category we'll look at how your child feels about himself by looking at his self-esteem, self-assurance, and self-sufficiency. There are many ways to determine a child's self-concept but I've found the best method is to simply ask the child basic straightforward questions: "How strong do you feel when you are facing tough problems?" or "How confident are you in your own abilities?" or "How well are you going to do on a test next week?" Have your child respond to those questions using the ten-point scale below.

Behaviors, relationships, spiritual lifeBehaviors
Behavioral areas include the ways parents and children cope and react. These reactions can be divided into reflexive reactions, which usually do not include any thought processes about consequences (impulsivity), and consequential responses, which include some processing before action. The assessment of forecasting and expecting the consequences of his or her behavior is a feature of self-control (impulsive behavior). The child with little awareness often creates more significant consequences out of the frustrated need for impact from external sources, such as teachers, parents, and law enforcement. The general dimension is not necessarily "good" behavior (accommodating to regimens), but appropriate and flexible behavior (behavioral adaptations to conflicts and demands). In the family meeting consider a variety of situations in which the child reacted without regard to the consequences (teacher responses, peer responses, and so forth).

Home Relationships and Harmony
ADD can affect a child's home relationships and family harmony by triggering rebellion by the ADD child toward parental authority or tension with siblings who resent all of the attention demanded by the ADD child.

Social Relationships
How does your ADD child get along with others? This includes friends and siblings, teachers, and other adult authority figures. Does your child make friends easily, or does he tend to be a loner? Does he welcome interaction and human contact, or shy away from it? Do others seek him out, or do they shun him?

Spiritual Life
A child's sense of spirituality may be limited to talk of guardian angels or fairy godmothers, or when faith is more a part of a family's life, it can be well defined in the context of organized religion. In many cases, children who feel disenfranchised because of ADD search for reasons that may lead them to question or refute their spiritual beliefs. Often this is merely an act of anger and frustration rather than a conscious rejection of their spiritual beliefs. They may lack sophisticated philosophies about a supreme being, but that will not stop them from asking questions about why they've been chosen to suffer. Some may embrace their faith and pray for help. Others may question their faith and ask how a loving God could allow them to suffer. Use the 1-10 scale to determine how much ADD has affected your child's spirituality, the sense of specialness and assurance.

School lifeSchool Life
Children with ADD are most often evaluated in this area because the symptoms are commonly first noted by teachers. Too often teachers assume that the child with ADD would learn in the same manner as other students if not for the symptoms. I strongly encourage parents to investigate how their children best learn and to make certain their difficulties in school are truly related to ADD rather than other factors. Parents have to serve as advocates for their children because teachers and school officials are more likely to focus on their own needs and the needs of a class or a school instead of the individual needs and circumstances of ADD children. Although the schools may have the responsibility to assess each student, especially those with learning difficulties, resources are limited. It is also true that in many school systems, ADD is poorly understood and the reflex response is to demand that children be medicated to control their symptoms in class. I urge parents to seek expert advice and counseling before they medicate their children, whether from a psychologist, psychiatrist, neurologist, or rehabilitation therapist.

The list below contains the major areas of challenges for children with ADD sypmtoms.

Auditory Memory (Immediate, Recent, and Remote).
This is an assessment of how well your child remembers items told to her, such as numbers or words.

Fine Motor and Pacing Coordination.
This area of learning relates to how well the child can perform skills such as writing, drawing, and producing appropriate outputs.

Visual Memory.
This assesses the areas in which the student is required to remember what she was taught in visual presentations such as reading, observing concepts on the chalkboard, and understanding spatial relationships.

Embedded Audio Acuity.
This skill is usually very difficult for children with ADD because it calls for a person to listen to a wide variety of signals and pick out the important ones, as in listening to a story and hearing the main points of relevance.

Arithmetic Sequencing.
Although simple arithmetic problems usually represent no obvious challenges, they do require the student to remember to sequence the operations correctly, such as adding the columns in proper order or maintaining the numbers in proper arrangement.

Listening Concentration.
Probably one of the most difficult for children with ADD, this assessment requires the student to grasp the theme of a story and maintain the memories of characters and circumstances imparted by auditory presentation.

Reading Concentration.
This learning skill enables the student to remember the facts, characters, and themes of stories imparted by visual presentation.

Auditory Abstraction and Logic.
This skill enables a person to organize facts and questions in her head by receiving auditory information.

Visual Learning Capacity. These tasks measure how quickly a student can remember important visual information and reproduce the information in appropriate ways.

Abstract Tolerance.
This is the measure of the level of tolerance and endurance a student has in pursuing a solution to a problem that requires long-term commitment (the answer requires some long-term processing, similar to a mystery).

Assessment; action plans for self-conceptSummary Audit for Action
It might be useful to use a summary form in order to formulate an action plan. I have listed the areas mentioned above for an overview of the areas that need to be addressed.

 

Assessment Area Rating Self-concept 1 2 3 4 5 6 7 8 9 10 Behaviors 1 2 3 4 5 6 7 8 9 10 Home Harmony 1 2 3 4 5 6 7 8 9 10 Social Relationships 1 2 3 4 5 6 7 8 9 10 Spiritual Life 1 2 3 4 5 6 7 8 9 10 School Life                       Auditory Memory 1 2 3 4 5 6 7 8 9 10   Fine Motor Control 1 2 3 4 5 6 7 8 9 10   Visual Memory 1 2 3 4 5 6 7 8 9 10   Embedded Audio Acuity 1 2 3 4 5 6 7 8 9 10   Arithmetic Sequencing 1 2 3 4 5 6 7 8 9 10   Listening Concentration 1 2 3 4 5 6 7 8 9 10   Reading Concentration 1 2 3 4 5 6 7 8 9 10   Auditory Abstraction 1 2 3 4 5 6 7 8 9 10   Visual Learning 1 2 3 4 5 6 7 8 9 10   Abstract Tolerance 1 2 3 4 5 6 7 8 9 10 Overall Impact 1 2 3 4 5 6 7 8 9 10

Game Plans
From the assessments you make in the areas listed above and from the ones from the preceding chapters, you can formulate a game plan for treating your child's symptoms. Remember to work with the child's strengths, but find ways to build up her more limited areas. Any area in which your child scores above a 6 suggests a need that should be addressed. Attention deficit disorder just doesn't go away. Your child will need treatment and counseling, perhaps for many years. I know of fifty-year-old adults still using therapies they learned more than thirty years ago.

Based on your findings with the evaluations, make a priority list, with the most severe issues at the top. Get your entire family involved in the process. Enlist the help of siblings in looking for resources as suggested throughoutthis book. The following are basic approaches you might want to take in specified areas:

Self-concept Issues
Action Plan #1: Daily Positive Hits.
ADD children get so much negative feedback that it needs to be actively countered by positive hits of encouragement and support. Parents and family members get so wrapped up in treating the problem they sometimes lose sight of the individual, his needs and feelings. Too often parents forget to tell their ADD children that they are loved and appreciated. Children need to hear that just as adults do. Make a point to say something positive every day to your child. Let your child know that you appreciate him regardless of the trouble he has caused.

In my hospital programs I have always insisted that each patient be given a positive stroke every day. It is part of any healing process. I believe the body responds, sometimes in miraculous ways, when patients feel they are in a supportive and positive environment.

Action Plan #2: Counseling.
Often ADD children develop negative inner conversations. They take on the labels others affix to them, calling themselves stupid or worthless. It is difficult for an ADD child to break free of that negative thinking, especially if it has been reinforced by teachers, friends, parents, or other family members. Parents sometimes slip up when they become frustrated with a child. If it happens often, however, the child may take disparaging words to heart. Once such comments have been made repeatedly, it can be difficult for the parent to rebuild a child's wounded psyche. This is where the extended family can be of enormous value. Grandparents, aunts, and uncles can be great healers. Their kinship gives them a bond that can open the door to healing with an ADD child. On a different level, professional counselors and psychologists are exceptionally helpful in reshaping a kid's self-concept into constructive modes.

Action plans for behaviors and relationshipsBehaviors
Action Plan #1: Behavior Modification.
Often children misbehave because they are getting payoffs from it. They want attention, even if it comes in the form of punishment--a payoff they can easily earn. Mostly, I see ADD children act out because they are confused. These children, with their slowed brain functioning, usually cannot prioritize their activities very well. Since they have difficulty doing one thing at a time, they go into hyperactive mode as they attempt to do everything at once. It actually makes sense when you understand what is going on in their heads, but that doesn't always make it any easier for the child or the parents to deal with.

By reinforcing positive behaviors in very concrete terms and developing better methods for expressing their frustrations, ADD children can learn more acceptable behaviors. Too often I have observed that a parent or teacher will tell a child what to do once, and then become frustrated when the child does not immediately respond. It takes more time to get that message into the mind of an ADD child.

Action Plan #2: Get Professional Help.
There is no shame in getting a professional consultant to help you and your child. There are wonderful counselors, psychologist, psychiatrists, and support parents, and even a network of online counselors. They don't have all the answers, but they've probably heard nearly all the problems.

Home Harmony
Action Plan #1: Have a Huddle with the Family and Make Some Joint Decisions.
Try some of the tools in this book and together develop a plan that calls for family participation. Agree to meet regularly to assess how this is working for each family member. Remember the steps in Chapter Fourteen as you approach each issue. Openly discuss each topic and reveal your feeling and desires; listen to the others; work out contracts on how all of you can help one another to bring about what you want to happen (not what you don't want), and make a plan.

Action Plan #2: Family Counseling.
This is the stuff that marriage and family counselors are so good for. Get some help, even if it is for a one-shot consultation, because, unlike psychotherapy, you don't have to dig up your whole past and wallow in the bad stuff. You can just deal with the current problem, get some creative solutions, and move on. See the counselor down the street or one on the Internet at www.mytherapynet.com.

Social Relationships
Action Plan #1: Groups.
Support and therapy groups help children with ADD heal. They offer a positive path to understanding and acceptance. I've never heard of an ADD child solving his problems or developing a workable plan by himself. It just doesn't happen. Isolation and seclusion only foster depression. As a family you cannot allow this to happen. Find a group that has a common interest, such as chess, dancing, sports, or even helping build a house or car. Boy Scouts and athletic clubs can be great resources for children with ADD. Children with ADD need organizations that foster teamwork and harmony.

Action Plan #2: Develop a Class.
We humans are social animals who have developed advanced societies because we come together to solve problems. The modern manifestations of this are therapy groups or classes. These come in all forms and address all problems. If your ADD child is having trouble with social skills, there are all sorts of classes available through schools, colleges, churches, social service agencies, and private counseling services. If your child balks at attending them with a parent, have a favorite sibling, aunt, or uncle take him.

Action plans for spiritual life, school lifeSpiritual Life
Action Plan #1: Talk to Your Child About How Special He Is Spiritually.
We are spiritual beings too. Whatever your faith or beliefs, find a way to talk to your child about his spirituality and let him know that he is valued on that level too. The first step for your child is to discuss his special and unique place in the universe. Aside from focusing on the negatives of sin and retribution, emphasize for the child that each soul is different and precious. Songs and poems have special impact at this age.

Action Plan #2: Stories.
I just reread The Little Prince (by Antoine de Saint-Exupéry) and was reminded of the strong messages told to us through metaphor. This is a story of a child who comes from another dimension and discovers that love is what makes each of us unique and special, worthy of attention. There are many stories we can read to our children that convey how important love is and the inherent protection from isolation and fear it supplies. It is your responsibility to find these and read them to your kids. Excellent resources can be found at your library, school, or religious center, and from friends.

School Life
Action Plan #1: Become the World's Leading Expert on Your Child.
No one knows more about your child than you. Educate yourself on his needs in every area so that you can be his champion in dealing with doctors, teachers, counselors, and psychologists. Take your child in for a thorough physical examination and insist that the physician look for hormonal imbalances, toxins, vitamin deficiencies, and all the possible factors that could possibly affect learning. Consider the use of medications carefully, and allow their use only as part of a holistic treatment program rather than as a total solution.

Invest in a thorough neurological assessment for cognitive issues with a professional neuropsychologist, rehabilitation psychologist, clinical or counseling psychologist, neurologist, or an educational assessment specialist. Ask that person to prepare a written report and make sure you understand everything in it and what it means for your child's educational needs. The areas below can serve as a base for your requests from the evaluators:

auditory memory fine motor control visual memory embedded acuity arithmetic sequencing listening concentration reading concentration auditory abstraction visual learning rate abstract tolerance

Action Plan #2: Become an Advocate for Your Child to the School.
These action steps take courage and enormous energy, but remember, your child's future depends on your being his champion. Become a pest if that is what it takes. Some of the greatest people in history were pests who did the right thing when no one else would. The old adage that the squeaky wheel gets the grease should be your motto. Remember that most schools do have programs for attention deficit disorder, but sometimes they haven't been implemented. Stir the pot. Be the burr under the saddle.

Be a presence in your child's school. Volunteer for school activities so you'll know what is going on. Sit down with counselors and teachers regularly to let them know you are involved. Tell them what works, to make their jobs easier. Write out recommendations. Give the teachers literature, review your child's work, and above all, reinforce the teachers' efforts positively. They work hard and put forth tremendous effort for all their children, so you can be their best friend and colleague by telling them when they are doing a good job. Write letters to their principals or superintendents when they bring about progress in your child.

You absolutely do not want teachers to lower standards for your kid. That would be a disaster. But make the learning experience as positive as possible. I must warn you: this is a very tough assignment. Most parents tell me that they would probably do homeschooling if they had to do it over.

Persistence is the key. Do everything you can to make this a family effort. Family unity will get you and your child through this, and the bonds that form will be dividends for many years to come, for all of you.