The best advice I can offer is this: the labels really don’t mean too much - they are merely a means to an end. In reality what matters is that your child has been looked at closely and that his particular sets of strengths and weaknesses has been determined. That a plan has been devised that takes full advantages of his strengths, remediates or develops work-arounds for his weaknesses, and that uses medication if needed in an appropriate manner. Call it Aspergers, call it ASD, call it ADHD, call it SID, call it floobaflooba syndrome, so long as in reality the intervention is custom fit to his documented needs. Sometimes the labels are good shorthands, sometimes they are not. There are kids who really do not fit any of the labels and kids who could be squeezed into several different ones. As much as we’d like to think that the label somehow gives us power over the condition, it does not.
Now putting on the academic hat - yes autistic spectrum disorders (including Aspergers) include attentional problems, both of distractablity from certain stimuli and hyperfocusing on others. They tend to learn in a hyperspecific manner. They can be fairly insensitive to stimulii that others would react to (such as social cues and verbal approval) but hyperreactive to others (noises, tags, smells). Routines are important because varying from routine requires having abstracted the concept. Whether he gets the label or not incorporating some of the techniques used for ASDs may be useful if he fits some of these elements.
When we first started becoming aware of the myriad constellation of problems in our son, we did spend some time looking for The Answer–a diagnosis that would explain who he was and why he is the way he is. We had a very wise pediatrician at the time (our son was about two then) who told me that we needed to focus on helping him learn to live with his challenges, and that as long as therapy was effective, and he didn’t seem to be getting worse, a diagnosis was not important. We stopped looking for diagnoses and labels for several years.
However, we discovered that Labels DO have power in the public school system, for better or for worse. The Hearing Impaired label gives our son specific rights to therapy and teaching strategies, which he needs to be a successful student. The ADHD label, though, has less power, since there is no ONE strategy that is effective for ADHD. In some respects, we’ve even found the ADHD label to be misunderstood. For example, our son has hyperactive/impulsive ADHD, with very few problems paying attention to what’s going on around him. I have to keep telling teachers that if he doesn’t seem to be paying attention to what’s going on, it’s MUCH more likely that his hearing aid batteries are dead than that it’s because of his ADHD.
The ADHD label also does NOT qualify as a disability in our school district. That means that we have to prove he has learning disabilities before specific services can be provided. He does have problems with reading and writing, but he’s not doing badly enough in school to qualify for additional services in those areas. Ideally, he would be receiving extra help just because he needs extra help (and he has shown significant improvement when he has received additional help outside of school), but the system doesn’t work that way.
One reason we are looking at Asperger Syndrome is because it IS a recognized disability. If he has the label of AS, he WILL qualify for additional services with no additional proof necessary.
My son displayed symptoms of ADHD from about three years old. I didn’t start him on medication until he was eight. We had an extremely disciplined household in an attempt to help him through his inattentiveness and lack of self-control. There were lists tacked up on every wall for him to consult, there were all kinds of positive reinforcements for him to work toward. There were the years of strictly organic/natural food to rule out the idea that modern preservatives or colorants might be causing ADHD-like symptoms. When he was eight he started showing signs of depression and telling me he hated himself for not being able to sit still at his desk, I knew that it was time to look at medications. The difference has been amazing. You should see all the “books” he has authored and illustrated. Sometimes my amazement at the change in him makes me tearful. He’s so much happier now, and frankly, so am I.
But another good part of our past few years of tribulations was the realization that I had so many of these traits myself. Last February I started taking Adderall, and its been my year to shine. My career has shot off like a cannon ball. I haven’t been depressed since I’ve started Adderall, and I’ve had issues with depression since about 12 years old. And now, I have to shake my head and wonder where would I be now if I’d been treated for ADHD when I was younger. I would have gone to college. I wouldn’t have been fired from so many jobs because of my inability to remember details. I wouldn’t have married my first husband, because I’d have probably had more self-esteem and realized that I didn’t have to take the first person who told me I was attractive. For me to deny my son a chance at life that I never had would be child-abuse, in my opinion.
I don’t know that ADHD is a disease that can be cured. I’m thinking not. I’d probably be just fine if I could run wild on a desert island somewhere, but I have to live in this culture and society, which is one I can’t function in and show a maximum of my abilities without chemical help.
Kiminy, Yep. “A means to an end.” The “right” label can open the doors to services and more comprehensive evaluations. In an earlier post I had referenced how many more kids are now identified as autistic spectrum than in years previous as a consequence of our looking for it more. We look because we know we can get these kids help by attaching that label to them.
ADD may just not be a useful label for your child - it doesn’t provide a great short hand for who he is, even through he shares some of those features. It doesn’t get him much.
I spent years avoiding labels for my older son and in retrospect it wasn’t such a great decision. Since I accepted the labels, we’ve gotten more services, more funding and an appropriate school placement. He’s still the same kid but better supported.
I think the biggest thing for us was learning the language of school support and advocacy. Yeah, he has a label that gets him services that he benefits from. We refer to that label when speaking to them about his IEP, for example. He is a complex individual (as we all are), with complex needs, which means we can’t stop trying, can’t stop looking at his evolving needs. Accepting the label was a necessary evil, but it didn’t change him in our eyes.
Not a problem. It’s the rare thread where I might actually say something worthwhile, so I’m happy to take advantage of the opportunity. I wish you the best of luck with your son.
BTW vis a vis Asperger syndrome, if you haven’t read The Curious Incident of the Dog in the Nighttime you should. It is a quick read but does a great job capturing the flavor of the disorder in a bittersweet and humorous story. There will be details that only people who know the disorder will appreciate.
I was, for a long time, diagnosed with ADD. I still am, in fact, but I’ve stopped taking my medication for a variety of reasons I won’t go into. I don’t want to get into the debate, as I really hate debating about ADD, but I will comment on a few things:
Cillasi, you are spot-on.
Although this probably isn’t a disorder symptom, I was unable to read verbal/physical emotional cues for a pretty long time–basically, until I made a proactive effort beginning my freshman year of high school to understand such cues. I’m still figuring it out.
Kiminy and Vlad/Igor, kudos and best wishes. You sound like great, truly concerned parents. The road ahead will be tough, as the road behind you has been. Speaking from experience, being part of an ‘ADD family’ is nothing but an uphill battle–but there’s no feeling in the world like making gains and seeing things finally go right.
It’s true. The drugs make a huge, huge difference. Although I’ve stopped taking medication, again for a variety of reasons I’d rather not go into, I’m forever grateful for what it’s done for me and how it’s changed my life.
Nor in mine. I’m not an ADD or ADHD person, never even suspected to have it, but I can tell you that Ritalin and Adderall contributed to some of the best test scores I ever got in college. Take some while studying to enhance concentration, take some before the exam for the same reason, and it worked wonders.
So what stops me from deciding that I’m not really an A- student, I’m an A+ student with a ‘disorder’ that prevents me from performing up to my potential?
said:
He even thought that you have to have OCD to an extent to go far in the business world.
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And when you’re an engineer they just say that you have ‘attention to detail’ and that you’re ‘extremely methodical’ or ‘very organized’.
I was that kid. Does that mean I had a disorder in need of medication?
It sounds familiar. This exchange was rather typical with my mother when I was a kid, and these days I have to set various alarms so that I can make it to work on time every day. I’ll start to get dressed and then, hey there’s my photo album and I start looking at that but then wait, I need to put back these DVDs and then wait, I’d like a slice of pizza… Eventually I manage to finish getting dressed, but I can’t do it unless one of the alarm clocks goes off to make me wonder ‘Why the hell is that alarm clock going off? OH SHIT!’
Some things though, I can focus on for very long periods of time, practically until dragged away from it. Circuitry and logic design, for example, get my complete focus for hours or days at a time. It is not unusual for me to spend 30 or 40 hours straight coding. Can’t remember to do anything else until it’s done, and then once it’s done there’s always a period of ‘refining’ until I either drop from exhaustion or consider it ‘perfect.’
So should I start thinking about seeing a doctor to find out if I have ADD, or do I just have a ‘different than average mindset’ that makes me excel in one area while I lag in others?
From what you describe it’s possible you do have mild ADD. However, as you seem to have found coping strategies that allow you to function without medication, IMHO there’s no need to see a doctor. It’s also possible that it decreased in severity when you exited puberty.
Things only become disorders when they impair your ability to function. If you can function at present, and everyday life isn’t a constant mental struggle, I’d say you’re fine. OTOH, if it concerns you and you can afford it, an evaluation with a good psychologist couldn’t hurt.
It’s also possible you have (IIRC this is the correct term) shadow syndrome ADD. A shadow syndrome exhibits enough of the symptoms of a disorder to qualify for diagnosis, but none of the symptoms are severe enough to cause disfunction.
That’s the thing. I don’t know if there’s any way to tell. Am I impaired? Do I actually have a level above where I currently am that’s where I’m ‘supposed’ to function? I think I demonstrated (however wisely or unwisely) during college that Ritalin and Adderall can both be performance enhancers for me in terms of being able to complete projects with fewer mistakes than when I did them without medications.
I don’t know if there is any way to tell if my ability to function has been ‘impaired’ so that it’s below where it should be.
I wasn’t aware that AD(H)D, OCD, and Tourette’s were on the autism spectrum. All the psychology texts I’ve read have stated that OCD was an anxiety disorder, and listed AD(H)D and Tourette’s in their own categories.
I know it’s not a very satisfying answer, but I’d say that the baseline is very subjective. If you felt that this particular characteristic were keeping you from getting everything that you wanted out of life, it might be worthwhile to seek out treatment.
This isn’t all that unusual. I have some pains in my foot that come up when I spend a lot of time walking or running. If I were a competitive athlete, or even just a serious runner, this would be a huge hindrance, and I’d probably see if an orthopedist could do anything for me. As it is, I don’t walk or run long enough distances to cause the pain often enough to make it worth my while.
On the other hand, I have very slight farsightedness. Most people could get through their lives just fine without doing anything about it. However, I spend a very large percentage of the average day either reading or writing something close-up, both at home and at work, and it was causing a lot of fatigue over the long haul, so I got some reading glasses and they made a big difference.
You are right, these disorders are not austism spectrum disorders, despite the tendency for some peope to lump them in there. I think this because of some overlap of behaviours, however none of mentioned disorders exhibit the autistic triad of impairments identified by Lorna Wing (ie impairment in social interactions, language and communication and imagination - meaning lack of flexibility, repetitiveness, imaginative play etc).
It is the presence of these behaviours that make a disorder on the autism spectrum, not many other commonalities like attentional and organisational problems similar to ADHD or repetitive behaviours that appear superficially similar to tic behaviours in Tourettes or OCD rituals.
Just checking in to let you guys know I haven’t forgotten about you and that I do intend to complete what I started with you. Unfortunately, I spent my entire weekend splitting time between helping a family member in need and fulfilling a promise I made to a very important customer. I have made some more research progress, but nothing I can post for you yet.
On the points you are making, I agree with you, so I’m not arguing with you at all. I am just trying to get you to think about it a little differently, for now. When I get to my post that deals specifically with the thinking behind Direct Instruction, I will elaborate on this more.
For now I’ll just say, what if the crossword puzzle were in Aramaic? I know that sounds silly, but the thing I think you are overlooking is this: Even if you don’t complete it, you get satisfaction from the answers that you fill in. Or what if a loved one or a business colleague was trying to help you and getting increasingly frustrated with you every time you didn’t know one of the answers?
My point is that if a) don’t feel you have any ability to make meaningful progress on the task and b) efforts at the task cause a great deal of distress for you and those around you, your desire to even try to do the task is going to be impressively low.
Based on some of the other posts, I want to make a few clarifications on my post about the definition of ADHD. I didn’t say all that much about conclusions in that post. Maybe if I tell you what I DO conclude from that info, it avoid some needless debate:
[ul]
[li]There is no doubt that the ADHD criteria refer to a distinct group of kids. I am not suggesting that the whole thing is imaginary.[/li][li]ADHD kids have difficulty doing things that we expect kids to be able to do, like succeed at school.[/li][li]While we don’t know one way or another, there is strong reason to believe that there is a “continuum” of types of kids on which ADHD kids are clumped at one end.[/li][li]While we know that ADHD kids are different, we don’t know that they are “disordered”. In this case, by disordered I mean that their brains are in some way “defective” or less than optimal.[/li][li]While there are many children who may meet the criteria for ADHD, not all of them are “disabled” in their daily lives by it. If there is a level of “ADHD-ness” that represents disorder, the next question is where to draw that line. The US has drawn it in one place while Europeans have drawn it in another. We do not know wheter either of them is correct.[/li][li]Given the subjectivity of the criteria, and the difficulty of gathering the right information, there is a great deal of opportunity to overdiagnose ADHD. For instance, it could be that a child meets the criteria but is having trouble in school because of an unrelated problem at home. Experts in ADHD are able to reach a fair amount of agreement about who is and who isn’t. However, the diagnosis is often made by regular physicians and psychiatrists who are not experts in the disorder and do not properly check the DSM-IV caveats. Even if I am wrong with my position, which is more on the extreme end, I think there is pretty wide consensus that ADHD is overdiagnosed.[/li][li]Even among experts, there is a lot of stuff that still just plain isn’t known about ADHD. There is starting to emerge evidence that there are observable brain differences. However, these differences are small and it is not at all clear whether they amount to “dysfunction”.[/li][/ul]
That’s as far as I’m trying to take the evidence up to this point.
For those that can’t stand the suspense, I’ll describe a little of where I am trying to go with this.
At least the mental health field is doing research and gathering data on this. However, in education there is a deplorable lack of research about teaching methods, not only for ADHD kids but for all kids, including “normal” ones and those that are classified into various “disabled” or “slow” learning categories. The simple fact is that “keepers” of education, at least in this country, are not pursuing scientific approaches to evaluating or improving teaching methods. If any of you have read through the transcript and report from the President’s commission, you have seen a fair amount of discussion about this lack.
This leads to the key problem that keeps me continually pissed off about these various categories of kids who don’t perform well at school. If you try to teach a person something and they don’t learn it, two obvious possibilities come to mind: Either the person is not capable of learning it, or you aren’t teaching it well enough. Our education system operates on the assumption that if the kids don’t learn, it’s because of a problem with the kids. After all. a lot of the kids do learn. (I am not talking about how “fast” you go, by the way.) I am convinced that we teach too poorly for these kids, and that if we did a better job of teaching–even if they still met the criteria–most (if not all) of them would no longer be suffering impairments as a result of their differences. In other words, they could learn what they need to know while continuing to be different in the ways that they are. And not be miserable.
I will also talk a little about medicating ADHD kids, but I’m not planning on trying to do too much with that area. I don’t have any interest in reopening that portion of the debate, and, having thought about it more, I don’t think it is particularly necessary. Better that we agree to disagree on that point and focus on some of the other ways we can help these kids and their families. If we can bring these kids up to the level of their peers, the question of whether they have a disease becomes a philosophical one, if not a metaphorical as suggested in the OP.
I will also point you to what I have been able find wrt Direct Instruction specifically as it pertains to ADHD. And that will cover the “research” portion.
After that, I will move on to what I think is far more important. I am going to try to give you some background on Direct Instruction in terms of the theory behind it, how it works, and what it’s for. I will also share some information on the techniques. Hopefully, I will be able to share enough with you that you can begin to judge it on its own merits, rather than just on my personal credibility. I hope that it will be enough information for those who have need of it to see that it is worth finding out more about.
I think the coming week will be less hectic for me and I can make good progress on this. Once I’m done scouring the web for sources and reading ridiculously long reports, the process should speed up significantly. If it’s not obvious, I type pretty damn fast, and I enjoy writing in general. Considering the length of some of these points, I’m assuming that those who are still with me enjoy reading.
Nonetheless, I am largely limited to waking hours when I am not at work and after the kids have pretty much settled down for the night.
This may very well be. However, for the sake of clarity, let’s try to nail it down a bit better. By what factor do you think ADHD is overdiagnosed? How do you come to your conclusion? (I throw this out there for everyone, not just Smartass.