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Dr. Dave's ADDvice- ADD and Siblings BOO!! It's almost Halloween!! Is everyone looking forward to trick or treating? If you have any ideas to help make Halloween fun and exciting for our kids, please feel free to send them along to me at BrandiV@ns.net and I'll be sure to get them posted on the website in plenty of time for Halloween. Any ideas for fun games, recipies or saftey tips to help make this a safe and fun time would be appreciated.
Speaking of Holidays..... CHRISTMAS is right around the corner! If you have anything to share to help make this important holdiay a joyous one, please send them to me. At Christmas time, a lot of us are traveling, or have a house full of guests, lots of treats about and tons of activities and this can often mean over stimulation for our kids and headaches for us so if you have any tips or ideas to help make the holidays run smoother, please share!!
TONIGHT!!! Conference on Self Esteem online with Concerned Counseling! A quick reminder about tonight's online conference:
Wednesday, October 15th--- 8 p.m. CST, 9 p.m. ET, 6 p.m. Pacific (3 a.m. GMT-overseas)
Topic: "SELF-ESTEEM...what is it, is rating ourselves a positive thing and if we need more, how do we get it."
Guest: Robert F. Sarmiento, Ph.D. is a licensed psychologist in practice in Houston, Texas since 1976. He specializes in short term results using Rational-Emotive Therapy and has counseled over 1500 individuals and families. He is on the national Board of Directors of S.M.A.R.T. Recovery. Dr. Sarmiento also has extensive experience in psychological and career testing, having evaluated over 3500 people. He has consulted with over 50 organizations including law enforcement agencies, schools and businesses. A Harvard grad, he has taught at the University of Houston and the State University of New York.
Dr. Sarmiento will be answering your personal questions. Here's the link to our chatrooms. Once inside, just select "Conference Room" from the list of rooms. http://www.concernedcounseling.com/chat/index.htm
FANTASTIC NEWS!! and just in time for the holidays, Dr. Rabiner is lowering the price of subscriptions for his newsletter, ADHD Research Update for a limited time to only $18.00 a year for the electronic version. (contact Dr. Dave for info on rates for snail mail version) Dr. Dave sends this newsletter out on a monthly basis, and is full of current, up to date, information on ADD/ADHD. This is an invaluable tool for any parent wishing to stay abreast of the latest research, technology and treatment being done today concerning the diagnosis and treatment of Attention Deficit Disorder. For more information, contact Dr. Dave at addhelp@mindspring.com ** Dr. Dave's ADDvice**ADD and SiblingsOne of the difficulties that parents I work with frequently raise concerns how their other children are effected by having a sibling with ADHD. These concerns include problems with fighting and aggression that go beyond what could be considered "typical", finding adequate time for each child, and siblings teasing their brother or sister about "having ADHD". Although every family's situation is different, I'd like to try and provide some general ideas about handling these kinds of problems that may be helpful.
Because children with ADHD generally have problems with impulse control, conflict with their sibling(s) is often intense and can include frequent instances of fighting and aggression. When siblings fight, parents find themselves acting as a judge trying to decide who "started it", who is to blame, and who should be punished. In many instances, it is difficult or impossible to make these determinations. This can be true even if you were fortunate (or unfortunate) enough to witness the entire episode.
Several approaches may be useful in dealing with what can be an extremely difficult and frustrating problem. First, I think it is really important to be absolutely clear that physical aggression against a sibling is almost never appropriate. Regardless of how one has been provoked, children need to learn that hitting and kicking is not an appropriate response. (If a child truly needs to fight in order to defend him or herself, of course, that can be another matter.) Thus, telling the child that they will be punished if they aggress against their sibling, even if their brother or sister was being incredibly provocative and obnoxious, is an important step to take. This removes you from having to decide who "started things" by making clear that regardless of who initiated the conflict, physical aggression is not an appropriate response. Even if the child's sibling "hit first", instructing the child to remove him or herself from the situation and find a parent to help handle things should be stressed. Obviously, there will be times when this is not possible and a child may have to fight back in self-defense. In many cases, however, children will hit their sib simply because he or she says something they don't like. The child needs to know that this is never acceptable and will ALWAYS result in their getting punished. Instruct your child on more appropriate ways to handle such situations and be sure to praise and reinforce such behavior when it occurs. Learning to inhibit impulsive aggression is incredibly important, and often requires this type of firm and consistent stance from parents.
A second useful approach for dealing with sibling conflict is to provide incentives that encourage siblings to co-exist more peacefully. For example, setting up a behavior plan where siblings are rewarded for going through the day without fighting can be very helpful. This provides siblings with the shared goal of getting along better along with a tangible reason for doing so. Be sure to combine any tangible reward with lots of praise and appreciation for the better behavior. When this is not sufficient, removing privileges from both children for fights which escalate beyond a certain predetermined point can be added to the mix. Although this type of system does not always work, I can recall many times in my own practice when it has been quite effective.
Another common problem in families with a child who has ADHD is that this child can take up so much of parents time, that there isn't much left to give to the other children. Siblings can become quite resentful of all the time and attention devoted to their brother or sister, and logically conclude that the best way to get any parental attention in the family is by acting up. Sometimes, a sibling feels resentful and is also experiences guilt for feeling this way because they understand that their brother or sister really does have special needs.
If one of your children has ADHD, think for a moment about the way that parental time and attention gets distributed in your family. If this seems too out of balance, finding a way to make extra time for your other children is very important. I realize I'm restating the obvious here, but this can be easy to forget and difficult to act on. This should not be interpreted to mean that an "equal" amount of time needs to be devoted to each child. The reality is that a child with ADHD often requires more of a parent's time and assistance. Siblings are often able to understand and accept this when it is thoughtfully explained to them, and when it is clear that their parents are making a concerted effort to put aside and spend special time with them as well.
The final issue I'll touch on, which is closely related to the preceding discussion, concerns children teasing their brother or sister about having ADHD. In many situations, this can be a child's way of getting back at a brother or sister who seems to complicate life in the family and who requires so much of parents time. Just like it is important, I believe, for children with ADHD to understand what this is and what it means, siblings also need to be educated about this. A child will often be better able to accept and understand their siblings problematic behavior, and the amount of time parents need to devote to helping their sib, when they have a clear understanding about what ADHD is. Because ADHD is not a disability that can be seen, providing this type of explanation can be very important. Although I am not aware of any books that have been written specifically for the siblings of children with ADHD, books that explain ADHD to children can be useful for this purpose. You can find several excellent choices for this purpose at
The American Academy of Child and Adolescent Psychiatry recently published a set of guidelines for the evaluation and treatment of ADHD. Although I may discuss these in more detail next month, I did not want to leave you finish without mentioning a very important recommendation contained in these guidelines. In regards to medication, the guidelines note the importance of frequently monitoring medication effectiveness. The suggestion, in fact, is that weekly ratings of ADHD symptoms and academic performance be obtained from teachers using short and easy to complete rating scales. This information should be used by the child's physician to monitor the effectiveness of the child's medication on an ongoing basis with adjustments made as necessary. Weekly ratings from parents are also suggested. In addition to this type of feedback, it is also recommended that if "...school behavior and academic performance are stable, a carefully monitored trial off medication during the school year will provide data on whether medication is still needed."
My guess is that this recommendation is in sharp contrast to typical practice, where often no systematic, ongoing feedback is obtained by a child's physician. Obtaining this type of feedback can be very important, however, because response to medication can change over time and carefully monitoring the ongoing effects of medication is the best - and only - way to ensure that your child is getting the maximum benefit possible. I'm not sure that gathering this data each week is really necessary, but certainly monthly feedback from teachers using rating forms specific to this purpose would be easy and important to do. An annual trial to reassess the need for medication is also an important recommendation. The Medication Monitoring Program described on my web site provides one way to do this.
My guess is that this recommendation is in sharp contrast to typical practice, where often no systematic, ongoing feedback is obtained by a child's physician. Obtaining this type of feedback can be very important, however, because response to medication can change over time and carefully monitoring the ongoing effects of medication is the best - and only - way to ensure that your child is getting the maximum benefit possible. I'm not sure that gathering this data each week is really necessary, but certainly monthly feedback from teachers using rating forms specific to this purpose would be easy and important to do. An annual trial to reassess the need for medication is also an important recommendation. The Medication Monitoring Program described on my web site provides one way to do this.
That's all for this month. I'll be sending out the next issue of ADHD RESEARCH UPDATE later this week. The issue contains summaries of recent studies on the use of Wellbutrin for treating ADHD, genetic factors in ADHD, the use of social skills training to improve the peer relations of children with ADHD, the effectiveness of medication over an extended period, and preliminary results on a large scale study of ADHD treatments. If you'd like to receive this issue, along with subscription information, let me know via e-mail. My address is addhelp@mindspring.com.
Please visit my web site when you have the time
If you have ideas for issues or questions you'd like to see discussed in next month's newsletter, please let Brandi know.
David Rabiner, PhD Many of us have had to fight for the services and the medical caret that our children receive and for some, the fight is an ongoing battle that encompasses the wellbeing and welfare of all children and not just our own. For some of us, being a "warrior" has become a way of life and Steve Metz is one of them. He sent me this poem and I wanted to share it with all of you.
Millions of children long to hear each day those wonderful words Class dismissed. However, different children respond to those words differently. Most students learn fairly quickly that when the teacher dismisses them that they need to check their homework, put the right books in their backpack, make sure they have the materials they need, straighten up the desk and possibly put up their chair and then leave. But the ADD child responds to Class dismissed by bolting out the door leaving homework, books, materials, jacket, backpack, etc. behind.
Our pleadings, scoldings, groundings, and bribings fail to create a long term solution. What can we do to help our child be successful?
This is only one example of a much larger pattern common to ADD. The reason for this behavior is not to avoid homework, it is not to make us mad, it not deliberate. ADD people struggle with thinking and acting at the same time. They just do. They just do the one response that comes to their mind and usually the one that brings the most immediate pleasure. This also explains why when you tell your little angel to hang up her jacket, get out her homework, get a snack from the refridgerator, and settle down to do homework, she will get a snack and not do the rest. You will probably find her in front of the TV enjoying her treat.
What can we do to help our child be successful?
One important principle for training successful habits for ADD children is:
Separate the Thinking from the Doing. Often at the moment of action, ADD people have a hard time thinking in steps; therefore, steps are often missed. I suffer still from this problem as an ADDult. I compensate by a process I call Plan, Do and Review.
When I need to do something, and since I don’t think and act at the same time; the best thing for me to do is sit down and write out the steps ahead of time. Then I have follow the list. By following the list, I get it done and if I am distracted, I know where to go to find out what to do next. Before I finish, I check the list to make sure I did all of the steps.
The same process can be followed when helping your child be successful. By sitting down ahead of time, prompting them to write out the necessary steps, and impressing on them to follow the list; you reduce the multi-step activity to one action.
As an example, when the teacher says Class dismissed, your child will open up their binder to find the list posted on the inside cover.
1. Do you have your homework written down into your calendar? If they follow the list, they succeed.
I know, how in the world are we going to make sure the list is followed?
ADD people lose concentration by definition, they need ways to remind themselves what they should do next. Plan, do and review can be a very powerful tool.
By separating the thinking from the doing, especially for routine tasks, you can help your ADD child succeed in life.
Rick Pierce, The Hyperactive Teacher, is the author of How to Help an ADDChild Succeed in Life and speaks nationally to parents, teachers and others emphasizing the hope of success for fellow ADDers. You may visit his website at http://www.hyperactiveteacher.com or send any comments to hyper@ns.net. Please take the time check out his book, It's great!
I spoke to a local Air Force Recruiter last week who told me that the military isn't concerned so much with the add/adhd diagnosis as they are with the medication involved. He checked his manual and told me that even with meds such as tetracycline for acne and even some allergy meds they require the one year med free before being considered for acceptance. He did say that each applicant goes through a medical exam and a pyschaitric one if indicated so if add/adhd is a problem it would be caught then. He also added that with an add/adhd diagnosis on the application they will look at how add/adhd affected the applicants ability to learn, how he performs on the entrance exam and why the meds were needed. When I asked him about our responsibility to admit to any prior diagnosis or disorder, I was simply told that at this time a computer base to check such information does not exist at this time. He also went on to assure me that they do not hold a diagnosis of add/adhd against an applicant if the med issue is resovled. Do I beleive this? I don't know, but I do encourage you to speak to your local recruiter and get the information straight from the government.
Steve has a wonderful site for addults so take the time to check it out!!!! http://www.azstarnet.com/~ask
That's if for this issue! If you have anything you'd like to share with our readers please send it to me and I'll be sure to include it in the next newsletter. Also, if you have any information on Depression you'd like to see made available, please send that along too!
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