The ADDed Benefits of AD/HD
The following is an edited transcript of a forum conference held on
April 25,1996 in the ADD Forum on CompuServe
This file is copyrighted by the participating individuals, and also by CompuServe, and cannot be copied and distributed electronically or by other means without the express written permission of the copyright holder(s).
Nationally known ADD specialist, John Taylor, Ph.D., a family psychologist, speaker and author, appeared live with us April 25, 1996.
He is especially well known for his practical advice about the issues of ADD children and teens in school and shares tips from his current workshop "Secrets to Academic Success for ADD/ADHD Students: A Toolkit for Teachers, Parents, and Professionals."
Dr. Taylor resides in Salem, Oregon and has been very prolific: writing and lecturing on ADD in children, as well as, publishing a catalogue of ADD resources and directory of support groups.
CARLA NELSON (SYSOP): How did you get into this line of work . One of our members wondered if you saw ADD in yourself or your family?
JOHN TAYLOR, Ph.D.: We have 8 children, 3 of whom have ADD and, my mother swears assuredly, that I definitely had been a hyperactive child.
CARLA NELSON (SYSOP): That so often turns out to be the case. But, not all the experts who appear to be ADD themselves admit to it.
Has there been an explosion in support groups out there?
JOHN TAYLOR, Ph.D.: Yes, the Northwest has enjoyed increased development of support groups for various special needs children and issues.
CARLA NELSON (SYSOP): OK, moving on to specific questions, one parent asks whether age of diagnosis has a material affect on the outcome and wants to know in particular what to do if it's not caught until high school.
JOHN TAYLOR, PH.D.: This question is in two parts:
Yes, age of diagnosis definitely does affect outcome. The earlier the better! In "Helping Your Hyperactive/Attention Deficit Child," I go into great detail on correlates and diagnostic indicators during infancy and preschool years. I did so because too much water has gone over the dam by first grade in too many cases.
I believe that the early child educator is probably the most important professional in the field of ADD.
Now, for the second question, you pursue the same game plan, that is intervene in as many directions as possible.
I customarily encourage parents to explore the feasibility of intervening from four different "tool kits" or avenues of approach. These are:
- Academic methods, such as classroom techniques for controlling fidgety, squirmy, and roaming attentions.
- Psycho-social methods such as work with self- esteem, anger control, friendship skills, temptation resistance, and increasing family harmony between parents, siblings, and the ADD child.
- Biochemical methods, such as the use of prescribed medications.
- Working with sensory and perceptual modalities such as can be obtained from occupational therapists in a school setting.
With teenagers, insight and willingness to use these tools from these four tool kits are crucial. I devote an entire chapter to the topic of sustaining cooperation in treatment.
CARLA NELSON (SYSOP): Besides age of diagnosis, what are the most significant factors in predicting success for ADDers? Type of intervention? Type of ADD? Intelligence? Degree of ADD? And/or existence of comorbidities?
JOHN TAYLOR, PH.D.: Research shows that the single most reliable predictor of overall adjustment as an adult is history of the quality of relationships with peers.
The most consistent factor in ADDults who seem to be adjusting successfully is the experiencing of support from at least one authority figure (I might add, usually a TEACHER) who expresses faith and confidence in the ADD individual.
The other factors listed in this question play important but secondary roles and interplay with these two factors.
Certainly, intelligence level is important. It is correlated with the likelihood of the ADD teenager becoming juvenile delinquent and sociopathic as an adult.
"Degree of ADD symptoms" is also a very significant factor. In my experience, those, who are severe in their symptom level as children, run the greatest risk of maladjustment as adults, which I symbolize by the "Six S's":
- Sociopathy–not having a sufficient conscience.
- Substance abuse.
- Strained intimate relationships.
- Self-actualization impairment.
- Stress susceptibility.
- Sensitivities and allergies
CARLA NELSON (SYSOP): Thank you for the detail! Speaking of intelligence, if our forum population is any measure, there is a significant proportion of gifted/LD in the ADD population which also makes one wonder how many more ADDers were gifted but unrecognized as they compensated well enough to stay at grade level or above. How can one tell if it's Gifted/LD/ADD or "just" ADD?
JOHN TAYLOR, PH.D.: Wow! Good question, I have long maintained that ADD has a dumbbell-shaped correlation with intelligence level. Meaning that it is disproportionately over-represented among those with IQ's above 130 and below 70.
The best way to differentiate an "eccentric" bright genius type of person from a bright ADDer is thorough review of history and the application of an accurate screening checklist or two.
I would be willing to send any "forumite" a copy of the Hyperactivity Screening Checklist that I supply to my seminar participants, and that appears in my books. It is very user friendly, takes only three minutes, and has very high validity.
The norms and validity are explained in one of the appendices in "Helping Your Hyperactive/Attention Deficit Child". They can just call our toll-free number 1-800-VIP-1ADD.
QUESTION: How can an ADHD child be helped to stabilize his/her grades. My child's grades go from A' to D's and back again.
JOHN TAYLOR, PH.D.: Thank you, it sounds as if that can be a really frustrating situation.
I would check, first of all, to find out what is turning the child off and on between various subjects/teachers.
My first hypothesis would be personality clashes/meshes which can have tremendous impact on the performance/motivation of ADD students.
Also, certain subjects tend to be troublesome ESPECIALLY when they fly in the face of unique configurations of limitations that an ADD student might have.
Find out what he perceives the teacher as doing wrong in the subjects in which he gets low grades. Start with his opinion, even though it is obviously very biased
Always start with "needs" whenever a child is malfunctioning. A useful guide is that all misbehavior (in this case, "under-functioning" or "under- performance") reflects unmet needs.
I wrote a book called "Understanding Misbehavior" that portrays how to elicit from any child what the underlying "needfulness" or goal or purpose is for his or her misbehavior or "under-performance".
In my opinion, there are basically five goals to most interpersonal misbehavior/"under-performance" of ADD children and adolescents.
Once you know the child's goal or purpose and, therefore, his or her needfulness, you then have indications of how to meet the needs better and how to support the child and get his or her needs met in a more "win/win" way, including increased productivity at school.
CARLA NELSON (SYSOP): Relating to unmet needs is another question a couple of parents both posed and that is what it looks like when the classroom most closely fits the learning style of the ADD child? Ideally, should it be structured and traditional or more unstructured like Montessori?
JOHN TAYLOR, PH.D.: Thanks for that very thoughtful question. The answer, typical of ADD responses, is "neither yes nor no."
ADD children tend to do well in Montessori environments.
There are a number of reasons, not the least of which are that the child can change activities every 20-30 minutes and is never asked to go beyond his or her readiness and interest level in any activity.
ADD children need order and predictability in their classroom and home environments so some structure is needed.
I would recommend against dangling mobiles, bright circus-like bulletin boards with a zillion colors, the use of pointers, flashing Christmas tree lights, and moving novelties on the teacher's desk.
The student should not be placed/seated such that visual distractions appear e.g. animals in cages, windows, and foot traffic.
I have seen every location within the traditional classroom recommended as the ideal location for positioning a distractible student. I STRONGLY recommend the FRONT CORNER WITH LOWEST TRAFFIC as the best location for distractible/hyperactive students in a traditionally-arranged classroom.
Where there are clusters or circles of desks, I recommend facing the distractible student toward a wall and placing docile, organized students within the same cluster.
Unfortunately, order and predictability from the teacher often are accompanied by punitive coldness which is utterly devastating to most ADD students.
The ideal is, of course, a mix: warmth and flexibility tempered with order and firmness.
CARLA NELSON (SYSOP): Another parent asked about how to detect ADD in a very young child with reasonable certainty.
JOHN TAYLOR, PH.D.: Oh, easy! Let's start with PRE- BORN, how's that for young?
The first behavioral indication of hyperactivity is hyperactivity as a fetus which, in my estimation, occurs in approximately 30% of children later diagnosed as having ADHD.
The first behavioral indication after birth is a colicky baby–easily summarized as having trouble with feeding, crying, or sleeping during the first six months.
The four tell-tale crib indications that I use in diagnosing hyperactive babies are:
- Excessive rocking.
- Head-banging against the headboard.
- Climbing out of the crib.
- Taking the crib apart.
When I do a live demonstration featuring parents of ADHD children in my national seminars, tell-tale sign number four gets the biggest laugh from the audience.
Also, look for 3 or more ear infections prior to the second birthday. ADHD children will typically start having ear infections six to nine months after cessation of breast feeding.
Then, during toddlerhood, there are numerous indications, but five chief ones, that I customarily use as a quick guide, happen to spell the word "RADIO" so it is easy to remember and use them.
These indications often occur in nursery schools and preschools:
"R" stands for Recklessness.
"A" stands for Aggressiveness.
"D" stands for Destructiveness (through three avenues): rough play, temper tantrums, and taking things apart through curiosity.
"I" stands for Incorrigible, i.e., under-responsive to discipline attempts by care providers.
"O" stands for Overactive. They have the poke, touch, feel , grab, fidgety squirmy, as well as, the Seven Mouth-based Indications of True Hyperactivity:
- Loud talking
- Twitching, grimacing and tics around the mouth and lips
- Chewing on things
- Teeth grinding
- Making lots of clicks, whistles, and sounds
- The tongue does a tour around the outside of the mouth when concentrating. I call it "the tongue tour."
I would also recommend use of the "Hyperactivity Screening Checklist", that I mentioned earlier, as it can contribute to the diagnosis of a child as young as 2 years old.
CARLA NELSON (SYSOP): A number of those "RADIO" points are aimed more at the hyperactive than the inattentive, correct? I said a big yes to half of them, but only half .
JOHN TAYLOR, Ph.D.: Yes, I would agree. This is "hyper", not the straight ADD.
CARLA NELSON (SYSOP): I noticed in your book, when you described the inattentive variant, I agreed with most of your points (but not quite all), and found one point particularly insightful. It was about the "inward" versus "outward" directed energy. Could you detail that aspect please?
JOHN TAYLOR, PH.D.: I have observed through my 20 years of practice, specializing in ADD children and adolescents, that hyperactives tend to be OVER- assertive, pushy, abrasive, self-centered, bossy, "power-strugglish", argumentative, and demanding.
They tend to show these traits both toward peers and toward authority figures, which result in power struggles and intense conflict.
On the other hand, the inattentive sub-types tend to be inward, withdrawn, hiding their feelings, underassertive, docile, polite, much more cooperative and obedient, respecting boundaries and limits, suffering in silence, being victimized, placating, and being doormats when confronted or bossed.
In my opinion, the single most important social skill to train both groups in (believe it or not) is ASSERTION.
Neither group is successfully gaining "win/win", i.e., reciprocity in their relationships with authority figures or peers.
No wonder the most common complaint both groups make about their lives when interviewed by psychologists and counselors is that they don't have enough friends.
I have devoted considerable coverage to these general topics, in fact an entire CHAPTER in "Helping Your Hyperactive/Attention Deficit Child."
CARLA NELSON (SYSOP): Excellent point about the need for win/win! That does apply to all types, agreed!
Along similar lines, a parent asks how to help develop social skills in a 5 year old who is very unpopular with peers.
JOHN TAYLOR, PH.D.: The most helpful resource for that purpose is Kelly Bear Feelings and Kelly Bear Behavior.
Read along with the child as Kelly Bear learns about sensitivity to others and the impact of her actions on other bears. "The Sharing Circle Handbook" is a resource full of practical methods for accomplishing what this parent wants.
Specifically, I recommend explaining to the child the single most important facet that all ADD children must learn about their behavior–its direct and immediate impact ON OTHER PEOPLE AND THEIR FEELINGS.
In fact, such an awareness, I believe, is the very core of conscience.
I've devoted considerable work to developing conscience in ADHD and ADD children in part because of their terrible risk of becoming sociopathic.
This parent needs to teach her child the direct NEGATIVE impact of the misbehavior on others and that the child's misbehavior will lead to "lose/lose" situations.
When children misbehave, they think they are pulling off a "WIN/lose". The first step in building conscience is to show them is to show them that all they are doing is creating a "lose/lose".
However, this "forumites" question did not say "misbehavior", but referred to "poor social skills".
The best way to redeem social skills is to demonstrate them to a child this young. Tell the child exactly what to say the next time. Role play and rehearse, both exaggerated incorrect as well as correct versions. ADD children learn better with a contrast than with pure modeling of correct behavior.
CARLA NELSON (SYSOP): Thanks, as it is one of my own
That [having been] said, the only way I see to IMPLEMENT all those great ideas would be if all the parents were NOT ADD, and all the teachers WERE ADD
Is there anything you can say to start that might make the gap between the IDEALS and the REALITIES seem less daunting?
JOHN TAYLOR, PH.D.: Yes. When I wrote the original pioneering book (giving extensive coverage to family relationship issues in ADD families, over a decade and a half ago) there was almost nothing out there on parents' feelings, sibling rivalry, social skills training of ADD children, self-esteem uplift methods of ADD children, marital stresses in ADD families, and supervising the play of ADD children.
Since then, extensive addressing of such issues has started to occur, as well as, many advancements in biochemical treatment options, and, of course, educational opportunities with the enactment of the 1991 memorandum, ADA, etc.
ADD IS NOT A CURSE. IT IS A BLESSING THAT MERELY NEEDS TO BE HARNESSED!
CARLA NELSON (SYSOP): I don't think anyone here would quarrel with that!
Before we go, I want to give your 800 number again and note that, in addition to your books, they can obtain video tapes and a resource catalogue with many interesting products!
JOHN TAYLOR, PH.D.: Sure! That's so nice. The organization is "A.D.D. Plus". The toll-free phone number is 800-VIP-1ADD (800-847-1233). Our E-mail address is email@example.com.
Our Web site address is http://www.ADD-plus.com
CARLA NELSON (SYSOP): And you will join us again next month and you will be speaking on topics including alternative therapies and related health issues such as allergies, is that correct?
JOHN TAYLOR, PH.D.: Definitely! This is one of the most controversial subtopics in the entire field of ADD and some of the most exciting research. [It is] at the forefront of ADD science and is coming from the subfield of allergies.
CARLA NELSON (SYSOP): Those of you who live in the Northeast might also like to know that Dr. Taylor will be giving workshops in New Hampshire and Rhode Island soon. Call the 800 number for details.
Thank you again so much for your time! This was most informative!
JOHN TAYLOR, PH.D.: Your welcome, it was a real pleasure to be with you in cyberspace.