If you have any inclination to be judgmental this is
probably a post you shouldn’t read, or maybe you should read it so that you can
get a glimpse of the other side of the fence in this case. I’m not looking for feedback on
what we have chosen to do. In fact, Josh didn’t want me to share this
information with anyone, but he doesn’t read the blog, only a hand full of
people do, so I thought I’d create a record of one of the major things that
have happened in our family over the last six month. Maybe it will clear up some misconceptions about ADHD, and I
think that someday I’ll wonder how this all went down and be glad that I made a
record. Maybe someone will read
this and be inspired to get help with their child so that he or she can reach
their full potential too.
To put it lightly, Caleb has not been an easy child to
parent. The academic in me has
studied a bookshelf full of parenting books. I have attended parenting classes offered by the church and
the community. I have enlisted the
help of caring friends and teachers, soliciting advice and help. All this felt like it was to no avail
because I continued to be at a loss for how to parent Caleb. When he got kicked out his after school
language class for repetitively asking what time it was I decided it was time
to get professional help.
I decided to go to a Psychologist who’s parenting classes
I’d attended, Dr. Bruce Johns. I
liked what I knew about Dr. Johns and when we had to wait about 6 weeks to get
in for the initial evaluation I felt validated that he was a sought after child
and adolescent psychologist. It
was June, after Caleb finished 3rd grade, that we got in. Honestly I didn’t even know who I was
making the appointment for. I knew
that I needed strategies for parenting Caleb. I needed ideas that I couldn’t find in any book. I wondered if Josh and I needed the
session more than Caleb so that we could better parent him. In fact, I honestly told Caleb that we
were going to figure out how we could be better parents and to learn how to get
along better. I was really looking
for a mediator between the three of us.
My idea was to push Caleb harder and give him tougher consequences and
rewards for compliance, and Josh felt like he just needed more attention. To my displeasure Josh would reward him
with attention for acting up.
Caleb was fighting with me about everything I asked him to do. I felt like we were going to be getting
professional help now or when he was 16 so I opted for NOW.
At the first session Josh and I describe the following, some
of which is taken from Dr. John’s initial evaluation report: Caleb is intelligent, but he has
problems at school because he lacks in follow through and self-motivation. For example, he reads a few books each
week (due to his inability to fall asleep), but he refuses to take the AR tests
because he would have to miss a few minutes of recess. He is relentless when he wants something. If he has one dollar he can’t wait to
spend it. He won’t stop talking
about going to the store until he goes.
He makes friends very easily, but he has difficulty maintain friendships. Many of the children he plays with are
significantly younger than him. He
is athletic, intelligent, and emotionally immature. Caleb is always looking forward to the next activity. We can be at an awesome party or event and
he begs to know what we are doing next.
On the way home from his last football game he was talking about
basketball and baseball. He is
obsessed with knowing what time it is and what is going to happen next. He cries extremely easily. His teacher has gotten after me for
reinforcing that behavior which makes me crazy because I don’t reinforce it at
all, but he still seems to cry when things don’t go his way. It appears to be a manipulation
strategy. Adjectives describing
him would be: talkative, adventurous, anxious, stubborn, distrustful,
impulsive, reckless, playful, aggressive, and easily bored.
Going into the session with the above description of Caleb, I
in no way anticipated what we heard, which was that this sounded like a classic
case of ADHD. My impression of
ADHD was children that were always bouncing off the wall. That they couldn’t concentrate on
anything or sit still, that they were behind in school or not as ”advanced” as
the other students. This is one of
those times as a parent I had the opportunity to eat my words and make some
decisions that seem so obvious to an onlooker, but to a parent who is living
with a child with ADHD the solutions seem much less clear.
To one looking on it is easy to think, “can’t they just
create more savior consequences, if it really mattered to the child he would
comply.”
“If they were more consistent in their parenting this
wouldn’t be a problem.”
“If they would just follow this program or that program . .
. “
“All kids are like that, they are just looking for an excuse
for their child.”
“They are just looking for a diagnosis so they don’t have to
parent.”
I admit thoughts like these have crossed my mind too.
I very specifically told Dr. Johns that we were looking for
parenting strategies, and that we did not come looking for a diagnosis. He did
not mix words in telling me that if Caleb indeed had ADHD then this was more
about a chemical imbalance then about how we have been parenting. He said that the best parenting
strategies in the world couldn’t compensate for the imbalance of chemicals in
ones brain, although good parenting helps, it will not solve the problem. On the one hand I felt relieved that it
wasn’t something I had done wrong, on the other hand I know that there would be
big decisions about how we would treat the chemical imbalance. Rather than talking stagey, Dr. Johns
wanted to spend time educating us on ADHD and begin some testing.
It has been five months, so I don’t remember a lot of
details about what he taught us, but there were a few things that stood out to
me. First, ADHD is due to a lack
of dopamine. It is dopamine that
creates the sense of satisfaction.
That is why Caleb is always anxious to know what is next. He isn’t satisfied with the
moment. That is also why he is
obsessed with the time. (Hence
asking his Chinese teacher what time it was when he didn’t have access to a
clock.) Next, ADHD is almost
always genetic and ADD runs in my family.
They are related. This
chemical imbalance more often shows up in boys as ADHD and in girls as
ADD. Josh was also tested for ADHD
in his early 20’s but not diagnosed.
He insists that he doesn’t have it, but I still wonder. Either way, genetically it is coming at
least from my side of the family.
I have two sisters that were diagnosed and treated for ADD when they
were in college.
There are many more indicators for ADHD than what I have
always thought of, the inability to concentrate or sit still. Caleb’s third grade teacher and I both
completed a questionnaire, of nearly 100 questions, about Caleb’s behavior. The
test called the Behavior Rating Inventory of Executive Function, looked at his
behavior in three categories and his metacognition in five arias. He had a clinically significant score
in seven of the eight categories making his diagnosis of ADHD quite clear. His test results were as follows:
Behavior Regulation 76* 68*
Inhibit 78* 62*
Shift 53 52
Emotional
Control 71* 88*
Metacognition 72* 73*
Initiate 72* 66*
Working
Memory 65* 74*
Plan/Organize 77* 66*
Organize
Materials 58 73*
Monitor 78* 76*
Composite 77* 72*
*= Clinically Significant Score
If I remember correctly an average child his age would score
50 on any given section so his scores indicate a significant deviation from
what would be expected.
Behaviorally he can move from one activity to another like would be
expected, but he is struggling emotionally, especially at school, as compared
to his peers and with his ability to exhibit self-control. Cognitively I don’t notice a problem
with organization of his materials at home, but it might be because I
micromanage him and insist on organization. He is struggling with initiating responsibilities,
remembering what he needs to get done, seeing the future and planning for
anything that is not immediate, and self-monitoring. I had no idea that these were all indicators of ADHD. I would consider myself an educated
person, but I was clueless on the reality of ADHD.
One sad thing is that ADHD has a reputation for being over
diagnosed. That is part of the reason Josh didn’t want to share Caleb’s
diagnosis with anyone. It is hard
to understand if you don’t live with someone who is struggling with it. We also didn’t want Caleb to be judged
negatively because of his diagnosis. He is a wonderful person, he will be
successful in life. He has so much
potential and now we will know better how to help him reach that
potential.
The first month of school this year has been a huge
success. I wanted to do a happy
dance after parent teachers conference when he received all “excellent” on the
behavior portion of his report card.
In the past he always received mostly “needs improvement”. Each Friday his teacher gives a
behavior score for the week. The
first week of school he got a 10/10.
I almost wanted to cry. He
was not capable of receiving that score in the past. I am so grateful we got help so that we could move in this
positive direction.
After prayerful consideration we decided that we would
create a benchmark of “the best it can get” using a combination of modern and
alternative medicine. We did
decide to put him on Ritalin. The
side affects pale in comparison to the chemical imbalance he has been
experiencing. We have noticed no
negative side affects. He is still
his persistent and busy self. I
have not noticed a “personality change.”
What I have noticed is that he doesn’t cry nearly as easily. He can hold a little more still, for
example, he seems better at keeping his hands to himself and not pestering
others during church. Prior to using the Ritalin we would barley survive sacrament meeting. I would prefer sitting with the three younger kids than just Caleb alone with his constant talking and pestering. (There is a
major difference between when he takes his medicine and when he doesn’t.) He seems to have a better comprehension
of consequences and more self-control.
It is hard to describe, but he is just doing better. It feels great!!
We are using some essential oils. We use a blend to help with focus. He is also drawn to Wild Orange and
Lavender to calm his nerves and to assist him with his ongoing battle with
falling to sleep. I’d like to get
him taking my company's amazing supplements, but I have yet to convince him that
he can take capsules that big. We
will experiment with going to straight alternative medicine in the summer, but
for now we are having success using both.
If that is what it takes for us to happily live together and for him to
reach his full potential then it is worth the exchange of potential side effects
and cost. I am so grateful that we
acted on the promptings to get professional help and for the options we have to
assist us on this journey of life.
As parents there is always something to humble us and this is just
another one of those things.
