ADHD Newsletter: April 1998

Wow! It's April already! Has Everyone Got their taxes done? I have lots of things to Share this month, so let's get right down to Business!!

**Publications, Listservs and Chat Rooms**

Being able to share our experiences with others As well as our feelings, our failures and our successes Helps to make us more knowledgable and better Prepared to make informed decisions for our Families. Here is some information on new as Well as familiar ways to communicate with Others.

Listservs: Email Discussion Groups

**Women and Learning Disabilities and/or ADHD This list is designed for professionals in the fields of education, psychology, or health services who are interested in topics relating to women and learning disablilities and /or attention deficit disorder. The focus is primarily on adult women with learning differences and higher education. College educators, researcher, counselors, disability support staff, writing center staff, admissions or health services staff, or psychologists and therapists in private practice who work with women with learning differences may be particularly interested in this list. Women educators or practitioners who have learning differences themselves are especially welcome! To subscribe, send e-mail to LISTSERV@HOME.EASE.LSOFT.COM with the command : subscribe wldadd

** Teaching Writing and Learning Disabilities/ADHD This list is for professionals engaged in the complex questions involved in teaching writing to persons with learning disabilities or attention disorders. The focus is on post-secondary students and the list is appropriate for educators, writing center staff/administrators, disability support personnel, educational consultants, and adult writers with learning disabilities, written output disorders, and/or attention deficits. To subscribe, send e-mail to LISTSERV@HOME.EASE.LSOFT.COM with the command: subscribe ldcomp

**Brain Wiring**

Rich Persaud has created a mailing list for discussion related to brain wiring. It is not ADD specific, but will address strategies for living with non-mainstream brain wiring. Rich will be writing articles and posting to this list regularly. To join, email , with the following text in the body of the message: subscribe education

It is less of a support group than a forum for the exchange of practical tips and strategies.

**ADDTalk : This listserv is open to all. To subscribe send email to addtalk-request@list.to with subscribe in the body of the message.

**NEWSLETTERS**

**ADHD RESEARCH UPDATE by Dr. Dave Rabiner: ADHD Research Update is an electronic newsletter designed to provide parents with extensive coverage of new research on Attention Deficit Disorder/ADHD and how new findings can be applied to help their child. The cost of a one year subscription is only $19.95, but you can sign up to receive a free trial subscription to ADHD RESEARCH UPDATE at no expense, risk or obligation. To sign up for the FREE trial subscription send email to addhelp@mindspring.com

**HyperNews by Rick Pierce is an interactive newsletter which allows readers to communicate their ideas and share their experiences. Subscribe to this newsletter by sending email to hyper@ns.net This newsletter is FREE.

**PUBLICATIONS**

** K & W Guide to Colleges for the Learning Disabled available from P.O. Box 187 Deerfield IL 60015-0187 for 31.50 U$. For more info Visit www.amazon.com/exec/obidos/quicksearch-query/002-7067983-3621221

**The booklet (21 pages in length) is titled "How Significant is "Significant"? A Personal Glimpse of Life with a Learning Disability" by Carolee Reiling. It costs $2.00 and can be ordered from the Association on Higher Education and Disability (AHEAD), PO Box 21192, Columbus, OH 43221 (614/488-4972). In the booklet, Carolee describes how she was diagnosed with LD as a freshman at Stanford. She documents how her LD effects her life over a ten day period, giving a unique look at her perspective of life. Carolee shows how her LD even effects how she takes a bus and where she parks her bike at school. I shared this booklet with the LD support group on our campus, and the students found it very helpful; they identified with all of Carolee's experiences and did not feel so alone.

**CHAT ROOMS**

Lena has just started an ADD Chat room on Pirch. If you are an IRC or PIRCH user, you can go to chatnet and type in /join #ADD_families If you do not know about Pirch or Irc, I would be happy to help anyone that is interested in this chat room. Her email is oliverjl@ghcc.net please email me. Or her icq # is 3389615 She has found over and over that chatting with people in real time can greatly reduce stress situations. She says " when my son gets out of hand, I will "escape" to my world of chatting. And no one would understand my problems with my son. And I could not find a chat room in Pirch on ADD. So I started my own. I would love for all of you to join me to discuss what ever happens to be on your mind or in your heart. Try it, it's a big frustration help when you feel like someone out there understands you."

Over the years the condition known as ADHD has been one of the most controversial diagnoses in child mental health. I came across an interesting article recently in a publication called "Point-Counterpoint: Controversial Issues Confronting the ADHD Specialist" that clearly indicates how aspects of this controversy continue to be alive and well.

The article featured interviews with two of the world's leading authorities on ADHD - Dr. William Pelham, a psychologist who teaches and conducts research on ADHD at the State University of New York in Buffalo, and Dr. Joseph Biederman, a Professor of Psychiatry at Harvard Medical School.

The focus of the interviews with each expert was how they felt the treatment of children with ADHD should best be managed. Dr. Pelham stated quite strongly that he believes behavioral interventions should be implemented first, and that medication be used as a secondary treatment if necessary. He based his position on research which suggests that medication does not alter the long term outcomes for children with ADHD. Because medication has not yet been shown to have long term positive effects, he believes it should not be the first treatment implemented.

According to Dr. Pelham, parent training should be an important part of treatment for EVERY child with ADHD. In his parent training program, which lasts from 8-16 sessions, parents are taught how to give effective commands, how to use appropriate punishment strategies, and how to use positive rewards to encourage good behavior.

Dr. Pelham also believes that every child with ADHD should get a daily report card at school, in which he or she receives grades from the teacher on how well important goals (e.g. completing work, following class rules) have been met. This report card is brought home each day, and depending on the marks received, the child is able to earn privileges at home. For example, for each goal with a satisfactory daily grade, the child might earn 15 minutes of TV time or computer time.

Dr. Biederman advocates a very different approach to managing the treatment of children with ADHD. He feels that because ADHD is a "brain disorder" with a strong biological basis, medication therapy should be started immediately. He believes it is difficult to know what other interventions will be necessary until one sees how effective medication can be for a particular child. This is because some children, if they are placed on the appropriate medication and have a good response, may have their behavior normalized to such a degree that additional interventions are not required. Making sure the child is deriving the optimum benefit from medication, and then carefully monitoring how the child does over time, are critically important to promoting the child's long term success. (For information on programs I offer that can assist you in doing this see www.svr.com/addhelp/medication.htm and www.svr.com/addhelp/monitor.htm.)

After the child's behavior has been stabilized as well as possible via medication, other treatments may then be necessary to target difficulties that still remain. For example, many children with ADHD will continue to have social difficulties and may require specific assistance in this area. Behavioral problems at home, and/or conduct problems at school may also need to be specifically targeted. Dr. Biederman also feels that some parents may benefit from supportive therapy to help them with their concerns about their child having a chronic illness. Children may also benefit from supportive therapy to verbalize the frustrations of dealing on a daily basis with difficulties with teachers and peers.

For whatever it's worth, my own personal feeling on this issue is more in keeping with Dr. Biederman. In my own work, I have seen many children who responded so well to medication that there really weren't any significant issues left to address. As long as the child continues to do well, it is not clear to me why any additional treatments are necessary. The ESSENTIAL thing, though, is to make sure that there are not difficulties that still remain to be addressed, and to carefully follow the child to be sure that such problems are addressed should they emerge. All too often, this kind of careful, ongoing monitoring is just not done, which may be one important reason for why the long term impact of medication on children with ADHD still needs to be clearly demonstrated.

It is also important to note that in today's era of managed care, there are often real world barriers to providing the kind of behavioral treatment that Dr. Pelham advocates. Many insurance companies will simply not authorize 8 sessions of behavioral parent training, let alone the 16 sessions that is sometimes required. I have cer- tainly felt the squeeze in recent years from the managed care industry, and it can be incredibly frustrating for providers not to be able to offer the appropriate level of care. I also know how difficult and frustrating this is for parents.

Finally, it needs to be stressed that given the disagreement on this matter by such experts, what approach parents feel most comfortable with is a VERY important consideration. Some parents I work with prefer to begin with behavioral interventions alone and see how things go. Others prefer to start medication right away. BOTH of these choices are quite reasonable alternatives. Just make sure that whatever you decide to do, there is a careful system in place so you know how effective the approach you decide on with your child's health care provider is being. If it is not working as well as it needs to be, make sure that you become aware of other options to try.

That's all for this month. If you haven't already received sample issues of ADHD RESEARCH UPDATE, the electronic news- letter I publish to keep parents informed about new research on ADHD and how new findings can be applied to help their child, please contact me so I can send them to you. Just addhelp@mindspring.com and type "Free Samples" in the subject line.

Have a good month.
Sincerely,
David Rabiner, PhD
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David Rabiner, PhD Licensed Psychologist

Visit www.svr.com/addhelpfor information and services designed to help parents promote the healthy development of children with ADHD.

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A brief note from Pete and Pam Wright states that A $600,000 jury verdict was awarded last Friday afternoon against a Florida school board for retaliating against parents of a child with disabilities. For more information visit their website at www.wrightslaw.com/

Do you ever wonder why ADD people act the way they do? or How a distraction issue can lead to unwanted behavior?

The following is an excerpt from my book "How to Help an ADD Child Succeed in Life." The explanations are meant to be more illustrative than scientific. Research continues to offer a variety of explanations for what we call Attention Deficit Disorder. The information I give is somewhat generic of a few of the theories. I only seek to help you understand a little better why we behave as we do.

A Practical Example (not ADD)

A group of children are playing basketball. Terry* is elbowed in the stomach. The senses of touch (from the rib area) and sight tell the brain that Jimmy elbowed him. The natural emotional impulse would be to punch Jimmy in the face. However the intelligence part discerns that Jimmy didn't really mean to, it was just a part of the game. His conscience reminds him that fighting is wrong, and besides, he could be suspended for fighting, but he could call a foul. Terry decides to call a foul and leave Jimmy alone.

*Terry represents the non-ADD person throughout this book

For most people the above example explains in simple terms how decisions are made in our brains. Our brains make decisions in the frontal lobe (the part of the brain just above the eyes) after gathering stored memory from various locations. Chemical messengers known as neurotransmitters carry the information. People with ADD have less neurotransmitters. But what happens when all the necessary information does not make it to the decision-making part of the brain? Answer: The brain acts on the available information.

A Practical Example Revisited (ADD)

A group of children are playing basketball. Bobby* is elbowed in the stomach. The senses of touch (from the rib area) and sight tell the brain that Jimmy elbowed him. The emotional impulse suggests punching Jimmy in the face. Intelligence and Conscience messages fail to make it to the decision-making part of the brain on time. Therefore Bobby responds immediately with a right hook to Jimmy's jaw. The basketball player is taken to the principal and is suspended for three days.

*Bobby represents the ADD person throughout this book.

Simply put, in the ADD person's frontal lobe there are not enough neurotransmitters to carry all the information necessary for a good decision. Therefore, they can be impulsive and easily distracted. Does the ADD person know what the right action is? Yes, the information is stored in the brain and is available for use. But does he or she do what is right? Not all the time. It depends on the severity of the ADD and what messages get to the decision part of the brain.

What is often frustrating about this behavior is that one time they will act properly and the very next moment do the wrong thing. Which message the neurotransmitters carries is not always the same. However, emotional and routine messages seem to appear more often than more thought oriented messages.

The 4 Examples
Look at the following examples and see if you can now understand why ADD children respond in the manner they do.
4 Examples

If a Parent tells student to put homework on table, get a snack, an begin working. Terry (Non ADD) will put backpack on table, get a snack from the refrigerator and then begin working. Bobby (ADD) will get a snack, forget the rest of the instructions so he watches TV
If a teacher asks a question, Terry (Non ADD) will raise his hand, wait for teacher to call on, and answer politely when appropriate. Bobby (ADD) will yell out answer.
If a teacher assigns book report, Terry (Non ADD) will write assignments in calendar, read a few pages a day, and begin report a few day before due. Bobby (ADD) will Try to read the whole book the night before, and does not finish report.
When students are to hand in homework. Terry will get finished work from subject indexed binder, put in basket on time with name on paper. Bobby (ADD) will dig through backpack clump, sort through desk, flip open books, but not hand in because he can't find.
The 4 Can’ts

The four examples are representative of four areas where ADD people have a difficult time being successful. Much of the negative ADD behavior we see is a result of inappropriate coping in one of these four areas. We are often asking them to do activities that they have a difficult time with which then leads to poor decision making much like the basketball example used earlier.

Can't 1: The ADD person can not do more than one thing at a time well Since there aren't enough neurotransmitters to carry and hold multiple messages, ADD people struggle to remember and perform multi-step tasks. When asked to put several actions together in sequence, they will often remember and do only one of those actions, usually the one that has the greatest pleasure attached to it. Parents and teachers are often frustrated when a few simple instructions are not followed or followed incorrectly.

Can't 2: The ADD person literally can not think and act at the same time. They just do. Again since there aren't enough neurotransmitters to think through an action or response, ADD people tend to move from response to response. What ever is the first or most important instruction in his or her mind is what gets done. Furthermore, you can not expect to teach, in a traditional sense, the ADD person to think and act at the same time. It is physiologically impossible since the source of the difficulty is a chemical imbalance in the brain.

Can't 3: The ADD person can not break complicated or long-term tasks into individual steps. Because the brain has difficulty storing multi-step tasks, the ADD person will tend to generalize tasks as one event. This is why tests can overwhelm them or why projects get put off until the last minute.

Can't 4: The ADD person can not maintain order. Since ADD people tend to move from task to task without much prior thought, finished or partially finished task often do not get put in the proper place. This leads to chaos, lost homework and the like.

Also the ADD person responds to instruction and stimuli one at a time. Let's look at a simple example in the classroom: Let's say a teacher asks a question. Of course the immediate reaction is to answer the question. But, the classroom rules say, “You need to raise your hand first and remain quiet.” And the expectation is, “You need to have that answer ready so when the teacher does call on you, you can give it.”

However, when a teacher asks the classroom a question, our ADD child is going to do what? Speak right out and tell you the answer, because that's the only message his frontal lobe received.

Our goal is to get the ADD person to choose the one right response to a given situation.

For example, what would the one proper response be when a teacher asks a question?

Raise a hand.

If the teacher calls on the ADD person who raises a hand, will that person know the answer? Probably not. If the teacher calls on the ADD person who raises a hand, will that person even know the question? Probably not.

What response should the teacher have? Since the ADD person can not think and act at the same time, the teacher will need to break the process into smaller parts. Once an ADD person raises a hand, and the teacher calls on that person, the teacher should restate the question and then wait a sufficient time for an answer.

Since ADD children act without thinking, the solution to helping ADD children is to reduce change, decision making, and idle time to an absolute minimum. Certainly these items can not be completely eliminated and shouldn't be, but to the degree you can reduce change, decision-making and idle time in their lives is to the degree that they will not hyper or hypo activate. In other words, much of the behavior associated with these people is due to the stress created by asking them to do something they cannot do.

Therefore, reduce the stress, reduce the decisions, reduce the stakes of failure, reduce the change, and you will reduce much of the negative behavior of the ADD person.

You may order "How to Help an ADD Child Succeed in Life" or sign up for a FREE newsletter subscription by visiting Rick Pierce's web site at www.hyperactiveteacher.com

**Mothers of Handicapped Children**

I posted this on my site a few days ago and have had A lot of requests to repeat it. To the best of my knowledge, This was written by Erma Bombeck.

Most women become mothers by accident, some by choice, a few by social pressures and a couple by habit. This year, nearly 100,000 women will become mothers of handicapped children. Did you ever wonder how mothers of handicapped children are chosen?

Somehow I visualize God hovering over Earth selecting his instruments for propagation with great care and deliberation. As he observes, he instructs his angels to make notes in a giant ledger. "Armstrong, Beth; son; patron saint, Matthew. "Forrest, Marjorie; daughter; patron saint, Cecelia. "Rudledge, Carrie; twins; patron saint......... give her Gerard. He's used to profanity." Finally, he passes a name to an angel and smiles, "Give her a handicapped child." The angel is curious. "Why this one, God? She's so happy." "Exactly," smiles God. "Could I give a handicapped child a mother who does not know laughter? That would be cruel."

"But has she patience?" asks the angel.
"I don't want her to have too much patience or she will drown in a sea of self-pity and despair. Once the shock and resentment wear off, she'll handle it.
"I watched her today. She has that feeling of self and independence that is so rare and so necessary in a mother. You see, the child I am giving her has his own world. She has to make it live in her world and that's not going to be easy."
"But, Lord, I don't think she even believes in you."
God smiles. "No matter. I can fix that. This one is perfect. She has just enough selfishness."
The angel gasps, "Selfishness? Is that a virtue?"
God nods. "If she can't separate herself from the child occasionally, she'll never survive. Yes, there is a woman whom I will bless with a child less than perfect. She doesn't realize it yet, but she is to be envied. She will never take for granted a 'spoken word.' She will never consider a 'step' ordinary. When her child says 'Mama' for the first time, she will be present at a miracle and know it! When she describes a tree or a sunset to her blind child, she will see it as few people ever see my creations.
"I will permit her to see clearly the things I see---- ignorance, cruelty, prejudice--- and allow her to rise above them. She will never be alone. I will be at her side every minute of every day of her life because she is doing my work as surely as she is here by my side."
"And what about her patron saint?" asks the angel, his pen poised in mid-air.
"God smiles. "A mirror will suffice."

That’s it for this issue of ADDed Attractions. I hope you find the information Useful and helpful.

I’d like to thank my sponsors for making this newsletter, as well As my site possible.

NATURAL AND ALTERNATIVE THERAPIES FOR ADHD: www.naturaladd.com
GRANDMA'S PET WILDEBEAST ATE MY HOMEWORK: A practical guide for teaching and parenting adhd kids: www.adhdcounselorguy.com
LIVING WITH AN ADHD CHILD: www.adhdbook.com
ADDwarehouse: www.addwarehouse.com/indexbv.htm
DR. DAVE RABINER: Home of ADHD Research Update
BOB SEAY: add.miningco.com
DR. STEVEN RICHFIELD: www.parentcoachcards.com
MICHELLE DAVIS: www.freeyellow.com/members4/michelledavis/index.html
POWER ORGANIZER SUCCESS SYSTEM: www.powerorganize.com/

Copyright 1998 Brandi Valentine. All rights reserved. This Newsletter is copyrighted by the authors and/or publisher. ADDed Attractions may be used for non-commercial purposes only and may not be redistributed for commercial purposes without the express written consent of Brandi Valentine.

Appropriate credit should be given to this resource and it's authors if It is reproduced in any form. Brandi Valentine