How to stop calling out in class | ADHD Information

LOL

We're thinking about getting a new car in 08; my son THINKS he'll be driving that ... I don't think so! We have a 97 Caravan, which is not thrilling to him, but, hey, my daughter learned to drive in it and she survived the "embarassment." BTW, it's in good shape/safe to drive!

[QUOTE=williemom]

Hi Diane V,

I have thought about Strattera but was dissuaded by the pediatrician whose reasons are unclear to me. We're meeting with a psch nex week and I'm going to ask him about it, along with the other you mentioned. One of the things I learned from the Barkely stuff is that the symptoms do change as kids get older, and Wellbutrin is given "off label" to kids who have impulsivity. It's been good for us for that purpose, but now, as the symptoms change, we need to look back to, as you say, "first line."

One of the things another pschy said to us a couple of years ago when we told him of the poor reaction to stimulants is: "Could be bi-polar." That realy infuriated me and still does, because this kid is so clearly not that. Turns out that sort of assumption was popular for a while and no longer is. Wonder how many kids lives were sidetracked because of it?

[/QUOTE]

Funny, I just had the discussion with someone about "flavour-of-the-month" diagnosing.

It may be Williemom that your dr doesn't want to use strattera because for me, at least it does nothing for either focus or the hyperness. It's also excruciatingly expensive, considering that it doesn't work on 2/3 of the main problems of ADHD.

On a personal note, I would like to quote dizfriz, and I presume this is a positive statement, "As I understand it, medicated teens have a driving record that is very close to the norm. This is a treatable problem."

The norm for teenagers that is. How positive that is I am not real sure.

I helped my son get a 68 Chevy, It was an older car and as my son reported people were afraid he did not have insurance and considering he was driving a tank tended to get out of his way. I counted my blessings.

Dizfriz

For us Strattera is cheaper than Daytrana. There are lots of people who do very well on Strattera. The main reason we didn't do that first is about time. Daytrana was quicker. We could rule it in or out in a matter of weeks. Strattera is a minimum of 8 weeks before we'd see full effect. I so far am not thrilled with Daytrana. The only thing I like is that we can take it off when we want. She has had a hard week adjusting to side effects and she is "flat". That stimulant stupor, if you know what I mean, and she's only taking 10 mg. Sooooooooo we shall see. Anyway, I hear you, it feels never ending.

Much good, thought-provoking info from all, following the original post of williemom.

Well, my 16yo DS (presumably ADHD/inattentive according to testing in schoo, takes Adderall-XR prescribed by pediatrician) is now eligible to test for his learner's permit to drive, and my husband and I are delaying letting him take the test, due to his nature and other considerations. Hopefully, when the time comes, he will be successful with driving! At times, driving is a huge challenge, even for those of us who have been driving "forever..."

MetisRebel

If I have an agenda here, it is to give information as accurate as I can make it. More importantly I want to express my view that there is nothing "wrong" or "broken" with these kids. They are what they are and I want to convey that it is not a recipe for disaster. Adhd kids can grow up to be wonderful and successful adults with the right help and direction. These kids have a rough time in the restrictive environment of school as it is in out society. This is not the fault of the kid but we have to realize that this exists and do what we can to help the child. As adults, they can play to their strengths.

I think we agree on many points but come from different directions which prompted my reply to your post. The place of adhd children and adults in our society needs to be addressed. Schools do not like to do this for the most part.

I try to do my part and really do not disagree with you on what I see being your main points.

This is a very good and supportive forum. All together can do a lot to help parents deal with Adhd and help these children grow up to be well adjusted, productive adults. Your insight from the prospective of an adhd adult is, I think, especially helpful.

Anyway, on to other things.

Yours respectfully

Dizfriz

Hi Diane V,

williemom, we struggle with stimulants also, but at 13 in middle school and new educational/neuropsych eval, it's very clear my daughters struggling is MAINLY due to her inattention. We also feel we need to go back to first line ADHD meds. Our plan A/ plan B....we always have 2 plans ahead , is Daytrana which we are trying now, hoping the different absorption will lessen the side effects.....for her.....then plan B is Strattera because it is non stimulant and seems to work best for inattention which is her primary issue. Have you thought about Strattera? [QUOTE=williemom]Is there a current authority on meds? I read the guide that was just posted and know all those medications. But is there someone who describes differerent behaviors and seems to know the likely medication choice for each? I know it's highly personalized. But is it really just a crapshoot in which we have to trial and error? We're seeing some new behaviors and want to try stimulants again -- the first time he reacted very bad, totally anxious, crying, unable to sleep -- and we quit after two tries -- Adderall and Concerta. We've like Wellbutrin for 5 years but it's not working now. I just wonder where the best avenue of approach is because I've yet to find a doctor who seems competetent and confident in what they are doing.[/QUOTE]

Is there someone in your area who specializes in ADHD? They may be able to whittle down the choices enough so that there will be less trial and error.

How is the child without medication?

To williemom

Current research is suggesting that the individual reaction to the medication is primarily due to which specific genes are involved. Barkley thinks that soon, we will be able to take a gene map of a kid and prescribe medication accordingly. Right now it is trial and error. MetisRebel's suggestion is your best bet.

Dizfriz

To MetisRebel

Good questions and worthy of discussion. My discussion marked by *

You make some interesting points Dizfriz. I did read some of Barkley and he makes some interesting points. However, in a number of areas, I don't agree with him.

However, I do have to say:

One of the biggest struggles for ADHD parents [and adults] is that people with ADHD often do NOT learn from consequences. I suspect because consequences can never, in the real world, be consistent enough to meet most of our needs.

The big question for ADHD'ers is not "how to be consistent" it is "how to thrive in an inconsistent world?"

*I agree, adhd can be rough on people with the disorder however many manage to be quite successful if they can learn to manage it and find the right slot in our society.*

I agree with him that it is genetic. The question becomes, "If it is a genetic "defect" why isn't it decreasing?" [evolution]

*I do not see it as a "defect". There is nothing broken or wrong with their brains for the most part (there are some causes that stem from damage but most are heritable). It is seen primarily as a developmental disorder. Certain parts of the brain develop more slowly than in non ahdh kids and this deficit usually remains in adulthood. It is most probably a genetic drift issue rather than natural selection. Adhd individuals seem to find mates and have children quite successfully. Adhd is only seen as a disorder when it reaches the point to where it causes significant problems in major life activities-school, work, personal relationships and related. What we are talking about is approximately the top 7% in symptoms. For these, it is a "disorder" but not a defect. It is, if you would, a throw of the genetic dice for most. *

If it is NOT decreasing--then it must provide some useful human need. What is that?

What are ADHD'ers good at? Action. Movement. Hyperfocus.

*I see them as being good at solving problems in front of them, not so good at dealing with things with no feedback in the present. *

In what environments are these useful? Have you ever noticed how many of us don't feel pain when we are overstimulated? How many successful black belts say they were diagnosed ADHD as children? How many great generals/warriors sleep very little?

*If you note my post, I discussed some areas where adhd individuals can do quite well.

Why do we need intense stimulation then "crash"--what circumstances in life would need that kind of talent?

How many artists? Actors? Creative people need to work in huge blocks until finished the project then crash out?

* The work is in front of them and they work at the point of performance, real time if you would.

I don't see ADHD as a "deficit" or a "disorder". I believe it is only labeled that because in this society we are expected to conform in certain ways that do not suit our abilities. nfortunately, in order to get along, sometimes we must medicate or find strategies to cope with our personal worlds.

With the advent of the technological revolution, multi-tasking and the speed of the world--who else can keep up with it? Perhaps that is why more of us are being born each generation. Many 'hackers' and brilliant 'techies' cannot pass in school yet they have an intimate understanding of how computers think.

When we find the areas where our talents are useful and the environment that supports our odd habits and needs, then we thrive.

If we ever finally make into space--I suspect that ADHD'ers will be the first ones starbursting into unknown galaxies...

*Some good points. Please understand that I am simply giving my opinion and nothing official. I am not a spokesperson for adhd. I raised an adhd child and I do have perhaps a little extra knowledge due to years of reading on the subject and am trying to share this with parents struggling with adhd.*

*The justice of the diagnosis in our society is another question and one I do not really feel qualified to discuss, interesting however. *

Dizfriz

Dizfriz39367.5109490741 [QUOTE=Dizfriz]

Ah, well thank you for the interesting discussion [it's that brain-play dichotomy]

To MetisRebel

Good questions and worthy of discussion. My discussion marked by *

You make some interesting points Dizfriz. I did read some of Barkley and he makes some interesting points. However, in a number of areas, I don't agree with him.

However, I do have to say:

The big question for ADHD'ers is not "how to be consistent" it is "how to thrive in an inconsistent world?"

*I agree, adhd can be rough on people with the disorder however many manage to be quite successful if they can learn to manage it and find the right slot in our society.*

I agree with him that it is genetic. The question becomes, "If it is a genetic "defect" why isn't it decreasing?" [evolution]

I believe we are agreed that it is a genetic "difference" [or not, I suppose]. I suppose the great questions are: "what is the value" or "where is it useful" or "what can be the positive outcome"?

If it is NOT decreasing--then it must provide some useful human need. What is that?

What are ADHD'ers good at? Action. Movement. Hyperfocus.

*I see them as being good at solving problems in front of them, not so good at dealing with things with no feedback in the present. *

Hmmm. I would be inclined to say that many tend to see in patterns, as opposed to details. That's not appreciated in certain endeavors.

*If you note my post, I discussed some areas where adhd individuals can do quite well.

Why do we need intense stimulation then "crash"--what circumstances in life would need that kind of talent?

How many artists? Actors? Creative people need to work in huge blocks until finished the project then crash out?

* The work is in front of them and they work at the point of performance, real time if you would.

I agree that "long term" isn't our usually strong suit. That's why I suggest we made great explorers, warriors, generals and would be the first people to jump on a rocketship--because we wouldn't be able to "plan" the fear as someone with a slower mind or less risk-oriented would.

When we find the areas where our talents are useful and the environment that supports our odd habits and needs, then we thrive.

If we ever finally make into space--I suspect that ADHD'ers will be the first ones starbursting into unknown galaxies...

Nobody's an "expert" including the "experts" since the DSM seems to change yearly . And the Australian and European definitions of ADHD differ from the American DSM.

I just enjoy different viewpoints and conversations. Learn lots that way too!

*The justice of the diagnosis in our society is another question and one I do not really feel qualified to discuss, interesting however. *

I'm open to thinking about it...or conversing about it. There's a number of "mental health diagnosis" I believe are based on people's very real need to cope with real societal/political and economic realities and stressors.

It's sorta like "why do so many adoptees have learning disorders? where does one start and the other end?"

For the person trying to cope in a world where pattern/swift/high risk thinking/action aren't appreciated, the struggle is very, very real [welcome to my world]. And for the parent attempting to raise a child in a world that doesn't appreciate the talent the child does have--it's painful to watch and try to assist with that struggle.

Thanks for the discussion

Dizfriz

[/QUOTE]

Good question

The issue is not punishment. I neither like nor believe in punishment. Punishment is to hurt. Discipline is to teach. I do believe in teaching by consequences especially for ADHD kids. ADHD kids have a hard time connecting what they do and the consequences. This what we are after, helping them make the connections.

Adhd children do not self regulate well-that is the deficit. For these kids, the motivation for changing and the tools to do so needs to come from outside himself. Just telling him or expecting him to successfully tell himself to stop on his own is very difficult to impossible for him. He is not being bad or defiant he is just has a hard time self regulating. In other words the motivation and tools that allows him to do or not do something needs to be outside of himself. Think "How can I modify the environment to where he can regulate himself".

The consequences can be quite light if they happen fast. For instance the teacher can have a signal between them like tapping a pencil that lets him know to be quite. Sometimes it works sometimes not but the principle is effective. ADHD is an output disorder. They know what to do, doing what they know is where the deficit is.

A metaphor: We speed even though we know we shouldn't. We know what to do but we cannot resist the impulse to speed-doing what we know. This is what adhd kids have trouble with all of the time. They know what to do, their problem is doing what they know-self regulation.

Now imagine you have a gadget on your dashboard and every time you exceed the speed limit by one mile per hour you hear a "ding" and one dollar is taken right then from your bank account. Bet you wouldn't speed much. Same principle...light consequences but every time and withing 15 seconds or less after the behavior. This is where you get behavior changes. If you get 10 cents for every minute you are under, watch yourself slow down. ....external consequences light and swift.

The externalization of consequences is for young, adolescent, and adult ADHD individuals. If one expects the ADHDer to self regulate, he will fail. If the consequeces are in the environment, he can and will succeed often quite well.

Hope this of some help.

If you need more data, the is a good transcript of a Russell Barkley workshop where he explains much of this. It is from 2000 but is still reasonably up to date.

http://www.schwablearning.org/articles.aspx?r=54

Good luck. Raising an ADHD child is aggravating, frustrating, scary, thrilling but most of all worthwhile.

Dizfriz

Dizfriz39366.6589467593Wow, you have really given me something to think about. I will definitely look up the transcript. No one inmy sphere really seems to know much. You've told me more here than just about anyone. Thanks.

It is so easy to go overboard with consequences when you have an ADHD child that I really don't believe it is appropriate to use in this circumstance. Ongoing consequences (and do these kids really get punishment vs consequence?) just creates a breeding ground for the undesirable ODD comorbid. I would suggest a nonverbal cue from the teacher like crossed fingers, hand on hip, etc. Something that only the two of them are aware of in the room. The idea here is to teach, not train like Pavlov's dogs. Set a baseline of how many interruptions are occurring daily and then establish a benchmark goal. Let's say he's interrupting the English teacher five times per class. So the initial goal would be to reduce that to three per class, then once that is reached, two per class, etc. The child choses a desirable reward for reaching the goal so that he is motivated.Anyone have suggestions for how to minimize the interrupting, calling out in class? My son is 12 and while most kids in the class did this at a younger age he's still doing it. Any suggestions for how to help the teacher would be much appreciated.

If the child is ADHD then the consequences need to be in the environment. Consider ADHD as a defect in self regulation. He is not able to self regulate so needs external consequences are needed to help him. The consequence needs to be fast but not severe. A quick time out, Hand him a few math problems and he cannot talk until he does them, something to help him regulate his impulsive behavior. BTW this behavior is a diagnostic symptom of ADHD.

A good truism....ask the ADHD child to self regulate, they will fail; put the consequences in the environment they can and will succeed.

The key is speed, not severity.

Good luck and keep trying. They are worth it in the long haul.

Dizfriz

OK, but then, if it's not a discipline issue, why punish with consequences? I can see how this works - and has worked -- with real young kids. What I'm not getting is how to transition this to older kids. Thanks so much.

Great idea, I think she will like this. She's already tapping his shoulder gently. The idea of trying to reduce things in steps is great - we did this way back in kindergarten.

That Schwab stuff was interesting, although some parts scared me. "An ADHD child is typically 30 percent younger than actual age, so would you give an 11 year old a license, send a 12 year old to college" etc. He says:

"You have one of the few 18-year-old teens with AD/HD that wants to go to college, because very few of them will ever go to college, right? You�ve got one who does. You�re sending a 12-year-old to college. If that were true, what adjustments, what accommodations would need to be in place in a university environment for any 12-year-old to succeed in that environment?"

Eeek.

It may be helpful to explain what I mean by consequences. Consequences are what happens after a behavior. An example of internal consequences is when you feel bad when you do not get something done that needs doing or feel good if gets done. An external consequence is seeing the results of your behavior in front of you (in the environment). When the consequence is delayed the adhd person has a hard time connecting what they do and what happens. They have a difficult time staying on task when they can see (in their mind) no results. While most can generate rewards internally-inside themselves- to a usable degree, people with ADHD need to have this in the environment-outside themselves-and they need to see the results of their behaviors quickly after they do something. They need to see, in the environment, the positive rewards for making good decisions and negative rewards, if you would, for not good decisions. It doesn't take much if it is quick. As in my example the teacher has a signal to stop talking. She gives a positive nod or a quick pat on the shoulder when he does. If he does not then there needs to be a small consequences as soon as reasonably possible. My point here that both can be lite and still get the job done.

Interrupting is a major symptom of adhd. They have something to say and they have to say it "now". This is not "bad" behavior but it is inappropriate at times and needs to be handled. The most effective is to have both positive and negative available. To an adhd individual the consequents are what changes behaviors. No consequences, no behavior change.

Russell Barkley sometimes calls ADHD an Intention disorder. They intend to do but without the external consequences they don't.

What we are talking about is structuring the environment to help the adhd individual. I look at ADHD adults that I know who do well in life. All have the consequences in the environment. Heavy equipment operators, computer people, skilled craftsman, emergency room physicians, self employed all have a common characteristic; they see the results of their actions fast and can use them to modify behaviors. Jobs where adhd individual do not do well: CPA, investment bankers, file clerks, any kind of paper shuffling. Many adhd individuals have very successful businesses as long as they have someone taking care of the details like payroll, invoicing, payables and any other vital job that has no immediate consequence. They spend their time doing what makes money.

Now having said all of this, the most productive method with adhd children is to stress the positive-good decisions. Work with them and reinforce as much on the spot as you can. The positive will change much more behavior than negative but the negative has to be there as well but focus on the positive. There are a number of reinforcement systems on the net including the marble system presented on this forum. You and the teacher have to find an idea and modify to fit the situation.

There is a lot more that can be said but I run out of time. I had a much better written and edited version but this forum has one problem that is unfortunate. If for some reason the message does not post, all is lost, you cannot go back unless you copied and pasted to clipboard. In any case, I hope this is of some help. I raised an ADHD child. I did not have any of this information 30 years ago as it was not available and would have done things differently had I had this. Now we have a lot more available and I try on this forum to share, to perhaps be a help to others now going though this.

My son and I both agree that both his and my life would have been a whole lot easier if I knew then what I know now. No reset button on life however.

Keep tuned to this forum, there is a lot of experience here and some very good ideas. No one has all the answers. Get all the ideas you can and use what you will.

BTW Barkley can be a little intimidating (You ought to see him in person-hours of non stop data). The research has supported his theory well and much the progress in working with adhd will very likely be based on his work. Also keep in mind that much of what Barkley says is based on unmedicated adhd. Medication can bring many up almost to normal in these areas. As I understand it, medicated teens have a driving record that is very close to the norm. This is a treatable problem.

Good luck and keep plugging. It is a long but worthwhile struggle.

Dizfriz

Have you given consideration to writing a book yourself? Fantastic. Thanks for the help and kind words.You make some interesting points Dizfriz. I did read some of Barkley and he makes some interesting points. However, in a number of areas, I don't agree with him.

However, I do have to say:

One of the biggest struggles for ADHD parents [and adults] is that people with ADHD often do NOT learn from consequences. I suspect because consequences can never, in the real world, be consistent enough to meet most of our needs.

The big question for ADHD'ers is not "how to be consistent" it is "how to thrive in an inconsistent world?"

I agree with him that it is genetic. The question becomes, "If it is a genetic "defect" why isn't it decreasing?" [evolution]

If it is NOT decreasing--then it must provide some useful human need. What is that?

What are ADHD'ers good at? Action. Movement. Hyperfocus.

In what environments are these useful? Have you ever noticed how many of us don't feel pain when we are overstimulated? How many successful black belts say they were diagnosed ADHD as children? How many great generals/warriors sleep very little?

Why do we need intense stimulation then "crash"--what circumstances in life would need that kind of talent?

How many artists? Actors? Creative people need to work in huge blocks until finished the project then crash out?

I don't see ADHD as a "deficit" or a "disorder". I believe it is only labeled that because in this society we are expected to conform in certain ways that do not suit our abilities. Unfortunately, in order to get along, sometimes we must medicate or find strategies to cope with our personal worlds.

With the advent of the technological revolution, multi-tasking and the speed of the world--who else can keep up with it? Perhaps that is why more of us are being born each generation. Many 'hackers' and brilliant 'techies' cannot pass in school yet they have an intimate understanding of how computers think.

When we find the areas where our talents are useful and the environment that supports our odd habits and needs, then we thrive.

If we ever finally make into space--I suspect that ADHD'ers will be the first ones starbursting into unknown galaxies...

Is there a current authority on meds? I read the guide that was just posted and know all those medications. But is there someone who describes differerent behaviors and seems to know the likely medication choice for each? I know it's highly personalized. But is it really just a crapshoot in which we have to trial and error? We're seeing some new behaviors and want to try stimulants again -- the first time he reacted very bad, totally anxious, crying, unable to sleep -- and we quit after two tries -- Adderall and Concerta. We've like Wellbutrin for 5 years but it's not working now. I just wonder where the best avenue of approach is because I've yet to find a doctor who seems competetent and confident in what they are doing.