Exploring ADHD

Garber, S. W., Daniels-Garber, M., Freedman-Spizman, R. (1990). Is your child hyperactive? Inattentive? Impulsive? Distractible? Helping the ADD/Hyperactive child: A practical; program for changing your child’s behavior with and without medication. Villard Books. New York, NY.

This is but one of the books that I have chosen to read regarding ADHD. When Franni was first placed with us we were told that she had been diagnosed with ADHD, but that she rarely if ever was given medication as her parents admitted to taking it themselves for recreational use. She often displayed symptoms of ADHD whereas she was: easily distracted as result finding it difficult to concentrate, had difficulty following directions, needed very few hours of sleep, was unable to multi-task, prone to outbursts of anger, and failed consider cause and effect. Initially, we thought that we could manage and correct her behaviors, but after two and a half years of consistency and this final book, we chose to explore medication. Finally, we see a break through! It wasn’t until that we were able to combine the medication with the behavior modifications that Franni was able to finally apply those skills that we had been teaching her. This supported by Garber, et. al. (1990) in that “scientific students have confirmed that a combination of behavior therapy and medication was far superior to either treatment alone,” (p.73).

Authors Gerber, Daniels-Garber, and Freedman-Spitzman have studied ADD/ADHD for the past 18 years, a time in which “ADHD has become the most researched topic of all childhood behavior disorders,” (Garber, 217). And while these symptoms have long been studied in children and adults and the causes for these behaviors speculated upon, no specific cause has been found. It has been theorized however that it could be due to a genetic predisposition, a traumatic birth, diet, or environment. Regardless, however, of the cause of this disorder, the behaviors of such must be managed. Notice I stated “managed” as it has been noted, “ADHD is not a problem that can be totally cured…however many of the problems that accompany this disorder can be solved,” (Garber, 12).

Of additional concern to our family and specific to Franni is the correlation between ADHD and learning deficits. Garber, et. al (1990) finds that “approximately 75 percent of children (with ADHD) were found to have additional learning disabilities,” (p.8). This characteristic became apparent shortly after Franni was placed in our home and entered into the 3rd grade. On her initial placement tests, Franni scored at a beginning 2nd grade level in reading and math. Throughout the next few years we worked with the school, special education teachers, and individually assisted Franni with homework with very little change. It wasn’t until the beginning of 5th grade that we were able to eliminate some of the causes for her behavior, distractibility! Distractions were everywhere for Franni and she often found it impossible to focus on any one thing for very long. Garber, et. al (1990) describes this phenomenon as “walking upstairs to retrieve a coat requires the concentration of a dodge ball survivor to ignore the obstacles that block the path,” (p.128).

Once able to recognize that ADHD was the correct diagnosis for Franni, we were able to take steps to minimize the effects of this disorder. When Franni first arrived to our family, she had little concept of responsibility, life skills, chores, et. Furthermore, when given a direction, Franni would nod her head, walk away and seemingly forget everything that you had said, this quickly led to the frustration of all family members, as we did not have this problem with our other children. In researching ADHD, I was able to discover that children with ADHD “require more reinforcement to learn a rule, extra motivation to maintain their behavior, and negative consequences to learn the effects of inappropriate behavior,” (Garber et.al, 154). In an attempt to correct this we began “charting.” We simultaneously ran two charts in our household, one was the chore chart, which mapped out all the things that we expected of each of the children at a specific time each day, to include: brushing teeth, making beds, shoring, wiping off the counters, sweeping the kitchen, et. The other chart noted “good behavior,” whereas I attempted to provide a star sticker for each positive behavior that Franni displayed, i.e. doing something when told, using her manners, speaking appropriately to adults, sitting at the table throughout the whole meal, chewing with her mouth closed, et. Quickly this multi-charting became exhausting and we noticed that the “good behavior” chart was having little effect on Franni’s behavior and therefore it was abandoned. Had I have read Garber et. al’s (1990) book prior I would have seen the error of this attempt, whereas “parents and children are most successful when they work on one behavior at a time, and that’s even more true when it comes to ADHD kids and rules,” (p.155).

Since this time, we have maintained the chore sheet, as Franni has commented that it assists her in knowing when and what she is supposed to be doing at all times. Garber et. al (1990) finds that “mothers of hyperactive children… tend to be more negative, more directive and less responsive to the positive actions of their children,” (p.12). The chart however, has lessened the amount of reminding, explaining, yelling, and demanding that I must do throughout the day, instead, I merely ask “Have you checked the chart?,” thereby expending my energies on the positives that Franni has achieved rather than the negatives.

We have also employed varies methods of behavioral modification with Franni, to include: calmness and impulse control training, distraction “zapping,” aggression or anger control, and offered several techniques to aide her in attending during class. As stated before, with the combination of behavior therapy and medication we have seen great improvements in Franni’s behavior. While we are pleased with this process, however we remain concerned about the long-term effects of the medications, the necessity to continue this medical regiment into adulthood, and wonder if this is a disorder that she at some time may out grow. Garber et. al (1990) finds that “perhaps one-third to one-half on ADHD children outgrow the overactive aspects of their behavior,” (p.217). Yet, research has shown that many of these children remain distractible throughout adulthood, often finding it difficult to attend in college and changing jobs and moving frequently (Garber et. al, 1990). We often wonder what will happen with Franni as she moves toward adulthood, and like many other parents are over-whelmed with concern. In response to parental worries, Garber et. al. (1990) recommends that one should “not worry about anything more than a hundred feet or a hundred days ahead of you, If you take care of your child’s todays, then most of the tomorrows will take care of themselves,” (p.216). Wise words to live by, however difficult to adhere to.

Stephanie Lowrance-Henckel