ADHD Children's Issues

School's Out!

And many of us will be thinking about allowing our children a holiday from medication as well as from school. Each year we discuss this and again I want to stress how important it is that you discuss with your child's Dr. any changes you'd like to make BEFORE you make them. Some medications require that a certain level be maintained in the blood stream and altering the dosage may interfere with the medications ability to work properly.

I truly and personally believe that any day that I can get by without giving my son medication or can reduce the amount I give him, is a benefit to him. During the summer when he's not in school and lengthy holidays such as Christmas and Easter holiday, the demands on him to focus, concentrate, follow directions, etc are much lower. The medication he takes is not dependant on maintaining a specific level of medication in his system so on holidays where demands on him are low, I allow him to skip some doses medication.

Each child is special and faces different challenges. Each day is different and brings with it, it's own set of circumstances which I take into consideration before allowing my son to reduce his normal dose of medication. Some of these things are:

1. Is he a danger to himself or others when not on his medication?
2. Will he be going out with family or friends and need the benefit of his medication to focus and follow directions?
3. Will he be participating in any activities that require that he be alert and focused?
4. Is he involved in any school studies such as summer school?

And most importantly, to me, will he be interacting with family members or friends who are not tolerable/understanding of AD/HD characteristics that may cause negative interactions and circumstances that are harmful to his self esteem? Even now, after all that I've been through with my son, my family just doesn't seem to understand the ADHD child. There was a period of time after his initial diagnosis where it seemed as though we had reached an understanding but now that my son is in his teens, for some reason, they connect his age to the ability to over come the ADHD issues and insist that as a teen, he should somehow magically be able to control and overcome those difficulties. They are back to parenting skills being the problem and feel that harsher punishments and more severe discipline techniques being the answer.

Statistics say that our children encounter more negative interactions with others during the course of a day then they do positive ones and because of this, our children become susceptible to other disorders such as depression and other self esteem issues. In my opinion….It is not worth subjecting our children to situations that can be harmful to their wellbeing in order to save them a dose of medication, so please use good judgement when making the decision to give your child a holiday from his/her medication.

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The Parent Coach: Dealing With Your Children's Issues

Dr. Steven Richfield

A parent writes, I can't figure out my son. He's so unpredictable; sometimes when things don't go his way, he takes it in stride. Other times he falls apart over the same situation. I try to talk to him about it later but that leads nowhere. What's going on and what can I do about it? Situations that trigger strong emotional reactions in children sometimes serve to uncork accumulated feelings. To an observer, the intensity of these feelings appears very disproportionate to the event. To a parent, their child's reactions are confusing and bothersome. These release valve reactions occur when outside conditions, internal states, and foundation issues make for a combustible combination.

Foundation issues are to children as hot buttons are to adults. They represent the underlying reasons for the bottleneck of feelings, although it may be difficult to pinpoint the linkage between the issue and the event. A child's acute awareness of criticism, interpretation of events through the lens of jealousy, or the arbitrary assignment of self-blame are examples of such bedrock issues that contain anger, upset, or other painful feelings. Children are more susceptible to acting out these feelings when they are at home, since this serves as their safety zone where they don't fear embarrassment. Consider the following coaching points when approaching your child about their issues:

All of us have issues, especially adults, since we've had more time than kids to grow into them. This statement opens up discussion without pointing fingers. By offering examples of our own issues, you can make what is usually a very touchy subject a humorous and intriguing one. Perhaps you were bullied or excessively teased as a child by an older sibling. If so, this may have left you rather reactive to incidents touching upon this raw nerve. Explain how this issue lurks in the background of your personality just as other issues do so in them. Reveal how the bully issue makes it hard for you to think clearly in certain situations since you get trapped in old feelings. Jumping to conclusions, misinterpretations, and narrowed thinking are some of the resulting problems that set the stage for trouble, in adults and children.

Use the STOP (Situation - Trap - Outcome - Plan to Prevent) format to process issues-based incidents. Processing is akin to rewinding the tape of what happened so that you and your child can calmly review the sequence of events. It begins by describing the situation in all of it's elements, i.e., child's expectations, people present, exact words spoken, etc. Next is a frank discussion of the entangling issue, i.e., sibling rivalry, rejection perceptions, sensitivity to criticism, etc. The outcome, such as punishment or social embarrassment, is then identified. Finally, children can plan to be on the look out for those situations where their issues are triggered. Review past circumstances where your child was trapped.

The prevention of future troubles is aided by preparation, management, and processing. You can prepare your child for improved coping by speaking beforehand about what is likely to happen in a given situation. Rehearsal of self-talk strategies is the next coaching task. These are brief, pointed mental scripts that children can tell themselves when they face emotionally challenging situations. Statements such as Don't take the bait, can't always get it right, or It's someone else's turn, help them manage the stirred up feelings. Issues management can also be fostered by rehearsing situations with your child so that they can practice these silent self-control strategies. Afterwards, process your child's experience by reviewing how well they coped with their issues.

Be patient, it requires a lot of practice for your child to learn objectivity when their issues are triggered. As most adults already know, it is very difficult to desensitize oneself from our issues. Children have even more trouble. It's easy for them to get caught up in thinking that another person intended for them to feel the way they do. Gently point out that the feelings effect of what happened is not always the intention of the people involved in the incident.

Dr. Steven Richfield is a child psychologist in Plymouth Meeting. His column appears monthly. He can be contacted at 610-275-0178 or