ADHD Newsletter January 1998

Dr. Dave's Advice
Helpful Information and Services
Exercising Control by Rick Pierce, The Hyperactive Teacher
To Each His Own
Urgent Request School Disctict Problems

As some of you may already have noticed, I changed the name of my website to reflect my mission and dreams for my site this year. "Taking Control Through Knowledge " means exactly what it says. It is my belief that through knowledge, we will have the power to take control of our own lives as well as those of our children and make their lives successful and more positive by being aware of our options, our rights and the services that our available to us. I hope that with this knowledge, it will give us the power to stop the horror stories that have become too familar to those with add/adhd children and ADDults.

With that in mind I'd also like to share with you some statistics from the website. My server told me that my readers are downloading over 4 gigs of data a month! Incredible! The graphs show that every single hour of every day, someone visits my site with peak hours being from 10 am - 10 pm.

Our Newsletter at this time has approximately 4200 subscribers and ADDtalk, our email discussion group has settled down and is steady at approximately 135 readers.

I am busy getting things put back together after my system crash. I'm a little behind in getting stuff done. I will be getting an faq posted on the website for the email discussion group so that there will be some guidelines other than the ones you get when you first sign up. Due to the crash, I lost some email so if you have written to me in the last 3-4 weeks and didn't receive a response, please contact me again.

New addition to the website is my new award "Heart of the Web". My plan is to collect quality sites dealing with ADD/ADHD and related issues and is based on content and place them together on one page on my site. Pages that promote products and services are not what I'm looking for and fancy graphics, frames and java are not important. I hope to create a "circle" of websites that will always be helpful and useful to my readers and keep handy for readers to use.

In my own practice, and in numerous e-mail messages I receive, parents often inquire about having their child "tested" for ADHD. Not surprisingly, many people believe that ADHD is something that a child can be "tested" for, and that there is an objective test that can determine whether or not a child has ADHD.

One attempt at developing such a test are computerized tests called Continuous Performance Tests (i.e. CPTs). Although several different CPTs are used in research and practice, they all the child to sit at a computer terminal, and to either press or not press certain keys in response to different stimuli that appear on the screen. This task is similar to a video game, although CPTs are purposely designed to be boring and repetitive. By examining the child's tendency to respond when he/she is not supposed to (i.e. errors of commission), as well as the child's failing to respond when required (i.e. errors of omission), information related to sustained attention and impulsivity is obtained.

When CPTs were developed there was great hope that they would provide an "objective" procedure for diagnosing ADHD. Thus, rather than relying on parent and teacher's judgements about a child's behavior, CPTs were intended to provide an objective measure of a child's ability to sustain attention and refrain from impulsive responding. Ideally, this would yield accurate, reliable, and valid decisions about whether a particular child had ADHD.

The only problem with these tests is that research has shown that they don't work very well. In general, if a child does poorly on a CPT test, there is a reasonably good chance that the child does in fact have ADHD. Many children with ADHD, however, achieve scores on these tests that fall well within normal limits. Thus, doing well on a CPT that does not enable an ADHD diagnosis to be ruled out.

Despite the current limitations of the CPT, which led the American Academy of Child and Adolescent psychiatry to decide that CPTs "...generally are not useful in diagnosis..." they are frequently used and parents often pay between $200-$300 to obtain information that may not be very useful. My own feeling is that a CPT can be a useful adjunct to other diagnostic procedures, it certainly is not the basis on which the diagnosis can be made or ruled out.

Although a reliable and objective test for ADHD may one day be developed, there is currently no substitute for a thorough diagnostic work-up. Elements of such a work up include a thorough medical exam, taking a good developmental history, and the systematic assessment of ADHD symptoms using standardized behavior ratings scales that are collected from parents and teachers. A broad evaluation of the child's behavioral, emotional, and social functioning is also required so that a comprehensive treatment plan can be developed. Academic testing will often be a necessary part of the evaluation process, but the results of such tests in themselves can not be used to make the diagnosis.

Ultimately, the diagnosis represents the best judgement of the clinician taking into account all the information gathered during the assessment. Although no judgement is infallible, the more parents understand about what the evaluation process entails the more confidence they can have in the results. For a more complete discussion of evaluation guidelines see

I wanted to let you know about two services I offer that may be useful to you. The first is a simple monitoring system will keep you informed of how well your child's ADHD symptoms are being managed, and how your child is doing behaviorally, socially, and academically. You'll know when things are going well, when they start to go poorly, and when adjustments/modifications to your child's treatment are necessary. If you'd like to receive this, send $5.00 and a self addressed, stamped envelope to ADHD Assessment Services 4711 Hope Valley Rd. - Suite 207 Durham, NC 27707. You'll receive a sample monitoring form that can be copied for use as often as you like, and detailed instructions about how to use the information it provides. I think you'll find this monitoring system to be extremely helpful.

As many of you know, I also publish an electronic newsletter - ADHD RESEARCH UPDATE - to keep parents informed about new research on ADHD and how the findings can be applied to help their child. I'd be delighted to send you several sample issues to review so you can decide whether you would like to subscribe. To receive the samples, e-mail your request to "mailto:addhelp@mindspring.com" and write Free Trial in the subject line.

Have a good month.
**********************

Often when ADD people are forced to think fast on their feet, make multiple decisions or are backed into a corner, they will try to self medicate through confrontation. By causing a situation to escalate, they are boosting their adrenaline in an attempt to gain control. It is common for ADD children to push buttons and create classroom disturbances in order to gain a sense of control and stability. This can get them into much trouble and can become a self-destructive coping technique. Soft, controlled responses and time outs work well to de-escalate when they are becoming confrontational.

Athletic coaches and military drill sergeants have known for years that one of the best ways to get someone to be more receptive to training is to have them run a few laps or drop and give them twenty.

Physical exertion is a very positive way to increase the adrenaline and therefore the dopamine levels in the brain. Many of our best athletes have ADD. They have used activity to self-medicate. Not only does the ADD athlete gain from the increased dopamine, but the fitness also aids in a more efficient use of the body's resources.

However, when an ADD person is having difficulty in school or with behavior, one of the first ways both schools and parents try to deal with the problem is to take away athletics. I would suggest more physical activity as a method of helping the student, not less. However, I know that some sports can be so demanding on time and energy, that this may be the only reasonable solution. Be careful, because that sport might be the only way this child gets success and might be the only reason to keep trying in school.

I know a teacher who gets permission from parents to use physical exercises like push ups for disciplinary purposes. The students respond well to this method.

I had an ADD student who had such a difficult time sitting still during an assembly that I had him and me run around the school twice before we went back in and sat down. This type of immediate approach also allows the student time away from the stimulus that caused the problem, thus reducing the need for the additional neurotransmitters.

In Modesto, California, a physical education teacher came to me during a break at an in-service I was giving at his school. He said that he has had problems with certain students who purposely confronted him, the other coaches and players. He had heard me say that the best thing to do when a student is becoming confrontational is to find ways to de-escalate by backing off, softening your voice, and providing space to calm down. He expressed concern that if he backed down from the student, that the student would use confrontation to manipulate every situation. I impressed on him that it would be wrong to back down, but letting the situation cool before administering discipline will help the student learn from the situation and learn that confrontation does not work. Eventually, confrontations should decrease because he is not achieving the goal of boosting the neurotransmitters and thus he does not gain control using this method.

Time outs are definitely one of the best ways to achieve calm in a classroom. The best discipline for an ADD person is one that is immediate, does not allow for increase of tension and allows the emotions of all involved to subside. However, time outs should not be long in duration. Five minutes is usually enough. The real correction occurs at the moment of being separated from the rest of the class.

One time one of my students refused to go outside for time out. I sent the rest of the students outside for a five minute time out. He did not like the isolation and tried to come out with the class. He never tried that again!

Another approach to de-escalating a situation involves providing specific options or choices. Since ADD people have a difficult time thinking and acting especially in stressful moments, providing limited choices helps them think while allowing them to keep a sense of control. For example, if a child is not doing his work properly, a teacher could give her the option to work right or take a time out. The choices do not have to be equally good. In fact, it is best to make the right choice obvious and the wrong choice distasteful. However, be willing to let the child choose the wrong one. Otherwise, it would not be a choice at all.

By keeping in mind that ADD people are seeking balance and control, we can learn to respond positively and provide options which can help them achieve balance without self-destructing. It is my greatest hope that no person give up on success.

Rick Pierce will be having seminars in Elk Grove, CA on Jan 24; Prineville, OR on Feb 7; and Colby, KS on Feb 27. If you would like more information about these trainings or would like to find out how to bring Rick Pierce, The Hyperactive Teacher(TM) to your school at no charge, please email hyper@ns.net. You may order his book "How to Help an ADD Child Succeed in Life" from http://www.hyperactiveteacher.com

I wanted to share this idea that was brought up in ADDtalk. I think it's great and I want To thank Carylin for giving me permission to share this:

On cleaning their rooms- what I mean by 'visual pics' is this: I cut out actual pictures from ads or magazines of a neatly made bed, dresser with closed drawers, books on shelves, shoes in a row etc. and stick them on index cards (so I can add or change them when needed).

When room cleaning time comes instead of a long list or one at a time verbal instructions that I continually have to repeat or check up on I just select the cards I need and stick them on the wall or a poster board for them to refer to. Then they can bring each card or all of them to me to check if they are done and how they compare to the picture.

This works for the bathroom too. They especially like the cards I've made with the big NOT sign on them- you know, the circle with the slash in it. Like the no smoking signs. Since on of mine is dyslexic and can't read he really grabs on to these. We have one with the cap off the toothpaste and the stuff all smooshed out &NOT. And even one with chewing gum on the bedpost &Not These actully make it fun-more like a detective game to figure out. (the last is really a reminder to wear his orthodontic headgear at night!)

We use this at the grocery store too. It beats list making to take coupons with and send them on a"special mission" to find and identify such and such a cereal. Although we don't always use the exact coupon item- it always helps us not to forget the spaghetti sauce or peanut butter!

This poem also came by way of ADDtalk and is something I also wanted To share. The author is "unknown".

A reader who has been embroiled in a battle with their son's school district that almost cost him his son's life, needs our help. Here is what he needs: A Psychiatrist whom this family was instructed to see, and who testified against the family on behalf of the school district has been asked to present his findings and notes that he based his testimony on for a new investigation. This Psychiatrist has stated that he destroyed all materials relevant to this case. Does anyone have any knowledge as to any laws that deal with how long a doctor must keep paitient files in the state of New Jersey? Any information would be appreciated. Please contact Steve Metz at TEACHER007@aol.com

** Humor ** All of us have been pestered by Telemarketers at one time or another and thought this might Amuse some of you. My thanks to John for sending this my way.

1. If they want to loan you money, tell them you just filed for bankruptcy and you could sure use some money. Ask, "How long can I keep it? Do I have to ever pay it back, or is it like the other money I borrowed before my bankruptcy?"

2. If you get one of those pushy people who won't shut up, just listen to their sales pitch. When they try to close the sale, tell them that you'll need to go get your credit card. Then, just set the phone down and go do laundry, shopping or whatever. See how long that commission based scum waits for you to get your credit card.

3. If they start out with, "How are you today?" say, "Why do you want to know?" Or you can say, "I'm so glad you asked, because no one seems to care these days and I have all these problems, my sciatica is acting up, my eyelashes are sore, my dog just died...." When they try to get back to the sales process, just continue on with telling about your problems.

4. If the person says he's Joe Doe from the ABC Company, ask him to spell his name, then ask him to spell the company name, then ask where it is located. Continue asking personal questions or questions about the company for as long as necessary.

5. This one works better if you are male: Telemarketer: "Hi, my name is Julie and I'm with Dodger & Peck Services.... You: "Hang on a second." (few seconds pause) "Okay, (in a really husky voice) what are you wearing?"

6. Crying out, in well-simulated tones of pleasure and surprise, "Julie!! Is this really you? I can't believe it! Julie, how have you BEEN?" Hopefully, this will give Julie a few brief moments of terror as she tries to figure out where the heck she could know you from.

7. Say, "No," over and over. Be sure to vary the sound of each no, and keep an even tempo even as they're trying to speak. This is the most fun if you can keep going until they hang up.

8. If MCI calls trying to get you to sign up with their Family and Friends plan, reply, in as sinister a voice as you can muster, "I don't have any friends...would you be my friend?"

9. If they clean rugs: "Can you get blood out, you can? Well, how about goat blood or HUMAN blood - chicken blood too?"

10. Let the person go through their spiel, providing minimal but necessary feedback in the form of an occasional "Uh-huh, really, or, "That's fascinating." Finally, when they ask you to buy, ask them to marry you. They get all flustered, but just tell them you couldn't give your credit card number to someone who's a complete stranger.

11. Tell them you work for the same company they work for. Example: Telemarketer: "This is Bill from Widget & Associates." You: "Widget & Associates!! Hey I work for them too. Where are you calling from?" Telemarketer: "Uh, Dallas, Texas." You: "Great, they have a group there too? How's business/the weather? Too bad the company has a policy against selling to employees! Oh well, see ya."

12. Tell the Telemarketer you are busy and if they will give you their phone number you will call them back. If they say they are not allowed to give out their number, then ask them for their home number and tell them you will call them at home (this is usually the most effective method of getting rid of Telemarketers). If the person says, "Well, I don't really want to get a call at home," say, "Ya! Now you know how I feel." (smiling, of course...)

13. My personal favorite way to Make a Telemarketer Go Away involves the help of my 3 year old son. When they call & ask to speak with Mr. Stevens, I explain they want the "other Mr. Stevens". As I hand the phone to my son, I tell him to explain all the fun things he did that day, from the detailed slimey booger he picked & where he wiped it, to his favorite & most proud stories about "pooping in the toilet." He is so proud of the shapes he can make. Usually after a few minutes of running around on the cordless phone explaining How proud he was with the details of his day, he comes back & says" they Hung up". Imagine the rudenes of some people.....Go figure....

That's it for this edition of ADDed Attractions! If you wish to contribute To this newsletter please email me at <a href="http://www.adhdnews.com/contact_us.htm">Contact Us</a>. If you wish to be Removed from this newsletter, send email to remove@ns.net.

I also want to take a minute to thank those who make this site possible. Without Their help and support I would not have been able to make the necessary repairs to my Computer and I would not have been able to recover as quickly as I did.

EZ-POCKET
DR. DAVID RABINER
RICK PIERCE, THE HYPERACTIVE TEACHER


BRANDI VALENTINE
<a href="http://www.adhdnews.com/contact_us.htm">Contact Us</a>
Fax: 530-743-4015
P.O. BOX 473
Browns Valley, Calif 95918