ADHD Properly Diagnosed (James W. Forgan, Ph.D., and Mary Anne Richey)

Have you ever asked yourself, “Why seek a professional diagnosis? Why not just begin a homeopathic or behavioral treatment?” One dad, a prospective client of Jim’s, called and asked abruptly, “Why should I drop a grand with you to diagnose my son when I can just start counseling?” Jim explained that a thorough evaluation and proper diagnosis help determine the most appropriate treatment. 

Let’s face it: You can build a house without a set of plans. It may take a lot longer, cost a lot more, and have hidden problems, but it can be done. Likewise, do you think a smart general enters a war without a battle plan? Absolutely not. So why start treating your son for something you suspect but haven’t confirmed? 

The diagnosis serves multiple purposes. First, it may provide parents with a sense of understanding, which is often accompanied by relief. Parents may be relieved to know their child really does have something fundamentally different about his mind. The diagnosis also can help parents shift their mindset about their child. 

Second, the diagnosis may provide you and your son with access to school services. Most public and private schools require a professional diagnosis or an evaluation to provide any formal accommodations. Accommodations are adjustments such as extra time to complete tests or homework, seating near the front of the class, or frequent breaks. Furthermore, as boys with ADHD prepare to take college entrance exams, a diagnosis and a complete evaluation report by a qualified individual are required to receive accommodations. 

“My Son Has ADHD. Now What?” (James W. Forgan, Ph.D., and Mary Anne Richey)

You may not always recognize boys with ADHD, but believe us, they are everywhere. The American Psychiatric Association (2000) stated in its text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders that “The prevalence of Attention-Deficit/ Hyperactivity Disorder has been estimated at 3%–7% in school age children” (p. 90). That’s a lot of kids! 

Furthermore, some organizations say up to 9.5% of the population has ADHD. According to the Centers for Disease Control and Prevention website (2011), 5.4 million children ages 5–17 have been diagnosed with ADHD by a healthcare professional. The CDC data showed that as of 2007, 2.7 million children in that age group were receiving medication for ADHD. 

Assuming these numbers are accurate, a teacher can expect that at least 2 children in a class of 20 students will have ADHD. On a sports team of 12 players, there will be at least one with ADHD. In a church with a youth population of 100 children, at least 12 will have ADHD. How many kids live in your neighborhood? In addition to your own son, there are probably some boys with ADHD living around you. Boys (and girls) with ADHD are everywhere. 

Therapy series : Oral Motor Excercises 1

Lips

1. Open and close your mouth

2. Pucker your lips (like whistling), then relax

3. Smile, then relax

4. Pucker and hold, then smile and hold

5. Put lips together tightly, then smack open

6. Pucker your lips and swing left, then right

7. Puff out cheeks and hold air in, then slowly blow the air out

Source : Clarian Health Partners, Inc., 1998

What is active listening?

Active listening is a way of showing understanding. It involves listening carefully and then, from time to time, describing how you think the person is feeling, or summing up what you think she has said. Let her correct or add to what you have said. Keep listening until you can tell she feels understood. Here are some ideas to help you be an active listener with your child:

• Take time to listen carefully to what the child is saying.

• See if you can identify what the child is feeling.

• Ask the child: “I wonder if you feel ___________ (sad, alone, frustrated, confused).”

• After you describe the feeling, the child may want to correct or add to what you have said. Listen carefully.

• Maybe you will want to try again to describe what the child is feeling.

Active listening lets the child know you care about what she feels. Taking time to understand what children feel sends a powerful message to them. It says to them, “You’re important to me. I care about your feelings. I want to understand how you see things.” Understanding is a powerful way to show love.

If we take time to listen to and understand our children, they are more likely to become confident and caring people. It takes many years to learn how to be as understanding as we would like to be. But it’s well worth the effort.

Source : Principles of Parenting. H Wallace Goddard.

Being Understanding: A Key To Developing Healthy Children

Being understanding with our children can result in less conflict in our relationships with them. Being understanding is also an important part of helping our children become secure and healthy people. And being understanding is a powerful way of showing love. Most of us feel that we are already good at understanding our children and at showing that understanding. But there are surprises in the process of understanding. The ways we try to show understanding often don’t work very well.

Ways NOT to show understanding

Many things we think show understanding actually have the opposite effect. They make a person feel mad or misunderstood. Following are some examples of things that we should avoid:

• Don’t give advice.

“What you need to do is . . . .”

“If you would stop being such a baby you wouldn’t have that trouble.”

• Don’t talk about your own feelings and experiences instead of theirs.

“I understand.”

“That same thing happened to me.”

“That’s nothing. You should hear what happened to me.”

“I know just how you feel.”

• Don’t make the child’s pain seem unimportant.

“Everybody suffers. What makes you so special?”

“Why don’t you grow up?”

“Stop that. You’re driving me crazy.”

When people feel bad, they feel that their pain is so bad that no one can really understand it. That’s why a person who is hurting would probably rather have you say, “Your pain must be awful. I wish I could understand just how sad (or hurt or lonely) you feel.” Sometimes the best way to show understanding is to admit that you can’t understand just how bad a person feels.

How can I show understanding?

The key to understanding what the other person feels is identifying her feeling. After we have listened carefully (and watched carefully) to learn how a child is feeling and acting, we might do one of the following:

• Acknowledge or identify the child’s feeling.

“You feel strongly about this!”

“You seem to feel very concerned (hurt, upset, confused).”

• Invite more discussion.

“I would like to understand how you are feeling. Will you tell me more?”

“Uh huh.”

• Understand that the person’s pain is special for that person.

“I wish I could understand better how you feel.”

“Ouch. I don’t know if I can even guess how terrible you feel.”

• Use active listening.

“Let me see if I understand. You feel like . . . ? “

“It sounds like you feel lonely (confused, sad, etc.).”

Source : Principles of Parenting. H Wallace Goddard.

Toddlerhood series : How can I help my child behave?

• Keep your toddler busy. Keeping your toddler busy may sound like an absurd suggestion, since toddlers are seldom still for a moment. But by providing constructive outlets for his energy, you can

encourage your toddler to behave well. When he seems fussy or cranky, he may settle down if you offer him a distraction or make him laugh. He enjoys many kinds of toys—pull toys, play clay, big

cardboard blocks, simple wooden puzzles, cars and trucks, riding toys, toy telephones, and computers. He also likes lots of things you might not think of as toys—a wooden spoon to bang on a

pot, or a stack of plastic containers to build with. Don’t forget the great outdoors, either. You can set up wonderful pastimes outside (some of them indoors, too, with proper precautions). Give him a shallow pan of water and some kitchen utensils—a plastic measuring cup, a set of measuring spoons, a plastic turkey baster, and a sieve, and he’ll be happy for a surprisingly long time. Give him a spoon to dig in the dirt with, and a bucket to fill and empty. Go for walks, and talk to him about the things you see—trees, buses, dogs, other children. Visit playgrounds that offer a variety of climbing equipment. The busier you can keep him with acceptable activities, the less time he’ll have for things that are dangerous or destructive.

• Set limits on what he’s allowed to do. It can be hard for parents to set limits for active children. You want your child to love you. But your job isn’t to be your child’s favorite person all the time. It’s to

keep your toddler safe from harm and help him grow in appropriate ways, even when he might prefer to have all the freedoms of his big brother. Your child needs you to ask him to do some things he won’t like, and keep him from doing others that he would like. He needs you to set a consistent bedtime for him, to keep him from hitting other children, and to let him know he can’t fill up on candy every day just before dinner. He may react angrily when you put limits like these on his behavior, and that’s natural. It’s probably a sign that you’re doing you’re job as a parent if he occasionally stomps away or yells, “I hate you!”

• Remove unnecessary temptations. Keeping your child away from temptations might seem to be an impossibility. After all, your toddler is at an age when everything seems to tempt him—the fragile vase on a living-room shelf, the hot cup of coffee on the breakfast table, the scissors you’re using to clip a few coupons. But you and your toddler will have fewer struggles if you can remove (or take other steps to protect him from) the items that could harm him or that you don’t want destroyed. Right now you never know what he’ll want to get into, so the best approach is to simply keep him away from anything you don’t want him to touch, swallow, or use as a plaything.

Source : Questions Parents Of Toddler Ask. Ceridian Corporation.2001

Toddlerhood series : Why does my toddler act the way she does?

As your toddler begins to explore the world, he needs you to set firm but gentle limits on what he can and can’t do. You don’t want to stifle the curiosity and spirit of adventure that makes life so exciting for your toddler now. But you do want to keep him safe, and you want to teach him how to behave.

At this stage, your child is becoming her own person, separate from you. She wants to explore the things that interest her, which won’t always be the same as the things that you want her to explore. You’ll have fewer struggles over her behavior if you build some flexibility into your approach. If you want to look at the flowers with your toddler—but find out that she wants to make mud pies instead—she isn’t trying to be difficult. She’s just following her natural curiosity about the world.

It’s helpful to keep in mind that children don’t really begin to develop self-control until about age 3. Until then, your toddler has few internal “no’s” to stop her from doing what she wants even if she does know it’s something you don’t approve of. You have to help your toddler control her impulses because she can’t do it by herself.

Depending on her maturity, your toddler may be able to control certain things about her behavior, such as whether or not she kicks a playmate or pulls the cat’s tail. But she can’t control her feelings. She can’t help whether she feels happy or sad, or angry or calm. And she can’t control whether she wants to pull soup cans off the supermarket shelf even though you’ve asked her not to. So she usually isn’t trying to disobey when she has a tantrum or makes a mess. Instead, she’s saying, “Help! I don’t know what else to do right now.” She’s telling you that she needs you to help her keep from reaching her boiling point or find appropriate ways to express her feelings if she does.

Remember that your toddler doesn’t really want her own way all the time, even if it sometimes seems that way. She wants some control, but having it all would be scary. When she pushes, she’s trying to find out what is OK and what isn’t.

So your job is to decide what’s acceptable to you and what isn’t. It’s essential not to compromise on safety issues, such as using a car safety seat or requiring your child to hold your hand while crossing streets. But on some issues there may be no clear-cut line between what’s “best” and what’s not. You may have very different ideas from a close co-worker about what kind of snacks or toys your toddlers should have, and each of you can be making the right decision for your child.

Source : Questions Parents Of Toddler Ask. Ceridian Corporation.2001

Toddlerhood series : What are these years like for you?

These two short years are probably the most exhausting years of parenthood, but they can also be some of the most exhilarating. Sometimes you may think that you spend all your time trying to protect your toddler from harm and trying to save your home from total destruction. It’s natural to feel frustrated and exasperated a lot, especially if you have another job outside the home.

You might look forward all week to spending time with your toddler at the park on Saturday, showing him the ducklings you know he’ll love. When the weekend arrives, you find that he wants to go to the park, too, but he wails when you try to put on his jacket. When you come home, he doesn’t want to get into the bath, and then he doesn’t want to get out. He throws his food on the floor, then cries because it’s gone. Conflict may take up much of your life with him. On the other hand, your toddler can be enchanting. You may come home from work after a tough day and find that your concerns melt away when he crawls into your lap. He’s so full of wonder and excitement that some of it rubs off on you and you see the world through his fresh eyes. The sun and moon look bigger and flowers seem to pop up when he walks by. Watching him grow in skill and understanding brings delight and triumph every day.

These years may be easier if you

• Expect the unexpected

• Remember that every child develops at his own pace

• Take advantage of community resources

• Get together on your lunch hour with co-workers who have toddlers

• Accept that your child’s favorite word may be, “NO!”

• Visit Internet Web sites for parents of toddlers

Source : Questions Parents Of Toddler Ask. Ceridian Corporation.2001

Toddlerhood series : What happened to my “good baby”?

As your toddler begins to experience all these changes, she may seem like a very different person from the baby you held in your arms not too long ago. Suddenly, she’s slipping and staggering, climbing and collapsing, all around your home.

Walking, a joy in itself, opens up all sorts of possibilities for her. She can climb on things, reach things, and carry things. She’s interested in motion for its own sake, and she only keeps still when she’s sleeping. In fact, studies have shown that even professional athletes cannot go through all the movements of a typical toddler day without exhaustion and muscle soreness.

Your toddler wants to know everything about her environment. She uses all five senses. Give her something to hold, and she’ll touch it, smell it, taste it, and shake it to see if it makes a noise. So many things that were out of reach before are now accessible, and she’s interested in all of them—the knobs on your dresser drawers, the pans in the cupboard, the jar of pencils on the shelf, and the fragile china figurine on the table. She can take a reasonably tidy room apart in ten minutes.

It’s no surprise that parents, trying to keep up with this little tornado, sometimes wonder, “What happened to my good baby?” What happened is that she has become a curious toddler. She’s still “good,” but she sees the world from a different perspective now that she’s up on her feet. This change places many demands on parents and other caregivers. The care of a toddler is much more strenuous than the care of a baby. Toddlerhood involves many mood swings and much negativity.

It’s no wonder some people call this age the “Terrible Two’s.” Toddlers can be happy, throw a tantrum, and laugh again, all in the space of a few minutes. They can be demanding and persistent. They are famous for the number of times they can say “no” in a day. Saying “no” is their declaration of independence: “I’m me, an important person with ideas of my own, and now that I can do things for myself, I don’t have to do everything you want me to.”

To form her own identity and begin to separate from you, your toddler must establish the differences between you and her. This can be hard on parents. That it’s a normal part of development doesn’t make it any easier to cope with, but it should be reassuring. It means your toddler is trying to grow, and that’s just what you want her to do.

Source : Questions Parents Of Toddler Ask. Ceridian Corporation.2001

Toddlerhood series : What kinds of changes will I see in my toddler?

Every toddler grows at his own pace. Your child may be using a fork and speaking in complete sentences before his favorite playmate is doing either of those things, but both of them can be normal and healthy children. Just about the only thing that’s certain is that your toddler will seem to be changing continually. So you’ll want to use this list as a guide to the kinds of changes you can expect, not as hard-and-fast rules.

• Physical changes. This is a time of explosive physical growth. Your child is acquiring much more control over his own body, and this will enable him to do many things on his own, such as feeding, dressing, washing himself, and using the toilet. He’s becoming more coordinated, too, and this will allow him to learn to climb, throw objects, and run and jump. He’ll also develop the ability to do such things as finger-paint, pour from a cup, use a fork and spoon, and draw with a crayon.

• Intellectual changes. As your toddler explores his world, he’ll be learning many new things, because he’ll also be developing intellectually. This is a time of intense curiosity and adventure. Your toddler recognizes himself as a separate per son from others and wants to find out all he can about the things that don’t look like him (though he has a big interest in his own body, too). He’ll learn the difference between hot and cold, things that taste good and things that don’t, and objects that break and those that don’t. He’ll figure out that keys fit in keyholes, that shirts go on the top and pants go on the bottom, and that he can turn things on by hitting a button or switch. Toddlers also take a huge step forward in their ability to use language. Within two years, they acquire a vocabulary of about two hundred words and unconsciously pick up the rules of grammar and sentence structure. A toddler who says “I waked up” is applying one of the common rules of English—that most verbs form the past when you add “ed.” He hasn’t yet learned the exceptions, but he has learned the rule just by listening to normal speech patterns. At the same time, he’ll be starting to develop the ability to recognize and name colors, letters, numbers, and many kinds of sounds.

• Social changes. Your toddler’s awareness of himself as a separate person brings many social changes, including the development of a clear style of personality. He discovers that he has needs that go beyond physical comfort, and he’ll experiment with ways to get what he wants. But as he’s testing you, your toddler will also be learning to play with others his age. He doesn’t interact with his peers in the same way older children do, but he can form emotional attachments, and may become upset when he no longer sees a favorite playmate or caregiver.

Source : Questions Parents Of Toddler Ask. Ceridian Corporation.2001

Toddlerhood series : How will my child grow and change during these years?

The day your baby starts to walk, she becomes a toddler and begins the work of growing into a self-reliant person. Toddlerhood has no fixed boundaries, but this stage of life usually lasts from about ages 1 to 3. It ends when you can see that your child has gained a lot of the skills and maturity that she’ll need to start school in a year or two.

Toddlerhood is a long process of growth and development, but it’s filled with many joys for both of you. As your toddler begins to figure out who she is, you’ll take pride in watching her grow into an eager and curious child with ideas all her own. You’ll also discover that your toddler has new fears and uncertainties and needs lots of guidance—as well as love and understanding— from you.

Source : Questions Parents Of Toddler Ask. Ceridian Corporation.2001