Tuesday, June 17, 2008

Psych 101: Attention Deficit/Hyperactivity Disorder (ADHD)

I work with a lot of children (and a few adults) who suffer from ADHD. It's very important, when possible, for a parent to participate also. The diagnosis doesn't concern me as much as the behavior, and how it is interfering with the child and family's life. This condition is often misdiagnosed, as many of the symptoms could be the result of other problems (for example, depression, anxiety, stress, difficult adjustment to life changes, grief, etc.). So I focus on the behavior, what triggers it, what happens in response to it, as well as what's going on in the child's life.

The DSM-IV-TR describes ADHD as "a persistent pattern of inattention and/or hyperactivity-impulsivity" that is displayed more frequently, and is more severe than what is considered normal for kids their age. "It must have been present before age 7," however many individuals are not diagnosed until later. "It must be present in at least two settings," and must clearly interfere with their functioning in those settings. These individuals usually don't pay close attention to things, are messy, don't finish tasks, are sometimes careless, and may appear to be daydreaming. They are usually impulsive (though don't always show hyperactivity; this is called ADD).

Family's typically have to adjust their life style to accommodate the member with ADHD/ADD. Unfortunately, often anger and defiance accompany this condition. The home of a person with ADHD can be very stressful for all. It doesn't have to be. The changes that you make in response to your child's needs should be oriented towards helping him to control the interfering behaviors, as well as facilitating his strengths. So, for example, don't call her from the kitchen to save a few steps, but go to where she is, look her in the eyes and give the direction. Flexibility is helpful. Controlling your own anger, and giving lots of positive feedback (when appropriate), and clearly defined consequences given consistently. Help them label, understand, and appropriately express their emotions (all of them). And never give up on your optimism, and confidence that your child can and will be successful and happy as an adult, having learned to cope with whatever obstacles confront them.

Tuesday, June 10, 2008

New Family

Last week we took a vacation (photos will follow) which included participating in my daughter's wedding. She married a nice young man who comes from a good family. A "good family" to me means that they are loving and supportive of their family members. I see a bad family as one that has toxic members, the kind of people that you don't want to be around. So when my son-in-law's (my first time using that term) father welcomed Linda and me to their family, I took a minute to think about that. Gradually a very good feeling came over me. I have some new family, who I am very happy about. This wedding was a big family affair. Spending time with family that you feel good about is rejuvenating. My parents, my brothers, and other (old) family members attended. I enjoyed it. I also got to see other people that I hadn't seen in a while, and to be honest, was not too eager to see. You know how that can be. They were fine, in fact, it was good to see how well we could all get along, actually we had fun together. It called to mind how beneficial it could be to let bygones be bygones. My point is that family, including extended family, and anyone else that you want to include who is caring and supportive is GREAT. And if there's something you can do to make those relationships work better, it is worth it. Now, I'm not necessarily suggesting that you marry your kids off to achieve this, but consider fixing some of those relationships that are in need of repair. It can really be worth it.