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ADHD

Is ADHD an American Disorder?

May 18th, 2013
by jmholland.
4 comments

In the American mindset I think we often have blinders when considering the reality we create for our kids. For example, this article shared by my friend Tracy Rosen on FB talks about how children in France are not diagnosed with ADHD. If they do have symptoms psychologists in France take the view that it is a psychosocial phenomena. I have long felt the same way. As a teacher I was able to be successful with students who moved onto other grades and teachers and became “ADHD”. Maybe I had my own blinders but I often think kids who struggle with impulse control and attention, when placed into a predictable environment that allows for a certain amount to these behaviors can be successful. The other thing about the French perspective is that all areas of life are considered to contribute to behavior, even nutrition. Check out this quote below.

The French holistic, psycho-social approach also allows for considering nutritional causes for ADHD-type symptoms—specifically the fact that the behavior of some children is worsened after eating foods with artificial colors, certain preservatives, and/or allergens. Clinicians who work with troubled children in this country—not to mention parents of many ADHD kids—are well aware that dietary interventions can sometimes help a child’s problem. In the United States, the strict focus on pharmaceutical treatment of ADHD, however, encourages clinicians to ignore the influence of dietary factors on children’s behavior.

My wife and I decided when my son was 2 years-old that he had difficulty dealing with artificial colors and flavors. There is plenty of artificial ingredients in America but maybe not so much in France? We asked his teachers not to give him fake stuff at class parties. We had a lot of trouble explaining this at first. It did not compute that green frosting on a cupcake could be artificial. Finally we figured out if we told them he is allergic to food coloring and coached him to recognize packaging that was likely to to have artificial flavoring he could manage it himself. Anything that had pictures of fruit on it but said “10% Real Fruit Juice” was not real. He was so sensitive he could figure it out for himself through taste. We went to a function once where there was lemonade, fake lemonade that is. My son had one sip and said, “I can’t drink that, it tastes chemically.” He then had a melt down about 5 minutes later. I suggest this to my students parents who struggle with their kids’ behavior all the time but I think in America we don’t necessarily make that connection between the mind and the body.  This is especially true in high poverty neighborhoods where access fresh fruits and vegetables are rare but more importantly that families in these neighborhoods look for extremely satisfying sensory experiences. I attribute this to the financial relationship between happiness and poverty. If you can’t have the car you see on TV at least you can have the hamburger and it looks so good.

What I Have Learned or Re-Learned

May 13th, 2012
by jmholland.
1 comment

A few notes on what I have learned or re-learned recently.

Don’t wear ties to school, the kids like to yank on them. At least not this year, when I had my class from the beginning of the year I could teach them but, since I came in half way through, I have to choose my battles. (Besides I don’t like ties that much.)

Finger paint is an effective projectile, if you have enough of it.

Sorry doesn’t mean anything to kids, unless it is accompanied by a consequence first.

One weekend full of abusive language in one child’s life can effectively disrupt the the lives of 17 kids and 2 teachers for approximately 2 weeks. I learned this when one of my more challenging students came to school and dropped some not so choice words. She was angry and the words were completely out of context. Since that day I have decided that one layer of teaching this class is providing a safe place for students who live in difficult situations to let go of their anger. Its kind of like primal scream therapy some days.

Parents care what teachers think of them and they listen. I did a home visit and changed the nature of the connection between myself, a parent, and a child tin an almost palpable way.

When trying to convey a story to a difficult class of active young children it can be helpful to cross-over storyteller to performance artist and become the story.

If a child displays ADD or ADHD type behaviors but, with proper support is able to change those behaviors, the behaviors may be learned instead of a chemical imbalance. Either way, accommodating those behaviors, without trying to encourage small steps of improvement, is a disservice to the child.

Sit in the pocket and you can see the whole thing. This last one I just learned. Thursday I had a really rough day. I took offense to something an adult said earlier in the day and it sent me into a spiral. The kids could sense I was not in the zone and kept making it worse. The only moment that I felt learning was actually happening was during a music and movement time. The class had just finished singing the Tooty Ta by Dr. Jean and they all yelled and clapped “Woohoo!” During the truly uninspired performance by my kids I pulled back from the moment and realized that I had allowed my frustration from earlier to color my vision of the moment. I had only seen two children actually sing and perform the song.  I said, “Wait a minute. You guys were not that good. If you want to try it again and really sing, then we can clap and shout.” I turned on the music and they launched into the performance. Every child sang. Every child participated. Every child gave their best effort and there it was, a real teaching moment of beauty. As I sang and did the performance with the class I encouraged them, “That’s it. That’s my class!” When they finished we all yelled and cheered. While we were doing the song I kept remembering my own daughter performing the song on stage 7 years ago with her friend. I realized I had pulled back from the situation so much that I felt like I was sitting in a pocket of time. I felt like I imagine a great quarterback feels when the chaos swirls all around, time slows down, and that perfect pass becomes apparent because they are able to wait for it. (I only imagine this, I have never been a quarterback). That was the best two minutes of the whole day.

On Friday, I was determined to take that experience and expand it. It worked. I was more patient, the kids were more connected to myself and their peers, and there was much more learning.

Medicating Tantrums

Sep 4th, 2010
by jmholland.
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My wife sent me this article from the New York Times on a boy who was prescribed medication for tantrums… at 18 months. I could hardly believe it but I really got angry when I read about the snowballing avalanche of medication that Kyle Warren was prescribed as he was shuttled from one doctor to another in a search for an answer. It is an increasing trend that is an emergent reality that is harmful to students. The pharmacological approach to managing children has increased exponentially since the terms Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) entered the medical vernacular in the 1970s.

Having taught 4-year-olds for a dozen years in some of the worst social conditions, including teaching students who experience poverty, drug abuse, and violence in the home I have seen some extreme behaviors. Often extreme behaviors are not connected directly to their cause but show themselves indirectly. Expressions of the stress of living in poverty, scrambling for basic needs, or under physical threat, can look a lot like hyperactivity.The worst expressions of this type of stress were from child who had experienced sexual abuse at the hand of a close family friend or relative. They didn’t know who to trust.

I had several students whose parents had taken their children to a pediatrician and been prescribed drugs before even entering school. Many times it was a parent’s inability to cope with a child’s extreme behaviors that led to the medication for ADHD and ADD.

I also had students whose parents would ask me to complete survey’s regarding their child’s behaviors in school. This is often the first step in a doctor’s diagnosis for attention difficulties. I know that several times I completed the survey thinking, “There is no way this child is ADD.” only to have the child come to school in two weeks on a medication regimen. Students who are put on ADD drugs often have their personalities completely changed by the medication. A child who was a lively conversationalist becomes reticent and withdrawn. They are sometimes listless and uninterested in what is happening around them.  Occasionally, a child with true ADD would set foot in my classroom and over time might be put on medication by a parent. These students did seem to benefit from the medication but, these students were not lifeless or withdrawn when they were on the medication. They were just more easy to focus and communicate with. These students didn’t change so much as become more able to express who they are naturally.

Image: http://www.tips4healthy.com/wp-content/uploads/2010/06/crying-child.jpg

Olympian Michael Phelps and Preschool – (an ADD Story)

Aug 11th, 2008
by jmholland.
No comments yet

When does a deficit become a strength? When does who a child is become more important than society’s norms? When and how do we decide if a child, especially a pre-k student, needs a medical intervention for behavior? When does a bunch of energy become “too much” energy for a parent or a teacher?

My beautiful wife told me about an interview with Olympian Michael Phelps’ mother in the New York Times. It was arranged by a pharmaceutical company that Ms. Phelps is representing as a “celebrity mom” of a person who grew up with Attention Deficit (Hyperactivity) Disorder or ADD . The strange thing is that Michael never took the drug company’s medication. He was, however, on Ritalin for two years from age 9 to age 11. Then Michael and his mother decided he didn’t want to be on it anymore. His mom, a teacher, listened to the advice of his doctor and teachers who identified his lack of focus and attention in school as ADD. The “signs” were identified early.

Starting with preschool, teachers complained: Michael couldn’t stay quiet at quiet time, Michael wouldn’t sit at circle time, Michael didn’t keep his hands to himself, Michael was giggling and laughing and nudging kids for attention.

As he entered public school, he displayed what his teachers called “immature” behavior. “In kindergarten I was told by his teacher, ‘Michael can’t sit still, Michael can’t be quiet, Michael can’t focus,’ ” recalled Ms. Phelps, who was herself a teacher for 22 years. The family had recently moved, and she felt Michael might be frustrated because the kindergarten curriculum he was getting in the new district was similar to the pre-K curriculum in their old district.

“I said, maybe he’s bored,” Ms. Phelps recalled saying to his teacher. “Her comment to me — ‘Oh, he’s not gifted.’ I told her I didn’t say that, and she didn’t like that much. I was a teacher myself so I didn’t challenge her, I just said, ‘What are you going to do to help him?’ ”

In my years as a pre-k teacher I have encountered true ADD only a handful of times. Every time a child I taught was put on medication it was because the parent couldn’t handle a kid, not because I couldn’t. Often parents have asked me, do you think she needs medication? I always have to say I don’t know, she seems to be able to learn just fine. There are some things about ADD and attention that we confuse when we talk about learning. When we look at the description of Michael’s pre-k experience his learning is never an issue. It is only behavior when he is not learning and how he effects other kids that is an issue for the teacher. Many times teachers confuse attention with learning. When we move our perception of learning from what kids do to what kids know as shown on age appropriate assessments then we take the child’s “behavior” and separate it from learning.

When Michael’s mom told his teacher, “Maybe he’s bored,” the teacher was offended. She thought that if he was bored that he was not within the range of normal child development. That he couldn’t be bored unless he was gifted. This isn’t the way it works. As many pre-k teachers can tell you active learners need to be engaged physically and intellectually. Michael’s mom mentions that in Kindergarten the curriculum was similar to the pre-k curriculum Michael had just completed. This happens to children who are in pre-k all over the country. When a child leaves my class knowing all 26 upper-case letters, lower-case letters, and letter sounds and then goes to Kindergarten with kids who don’t have any of these skills, the teacher can’t stretch far enough to keep up the accelerated pace pre-k students expect. Many times pre-k kids expect appropriate teaching as well, which may include center work, gross motor learning games, and alternated active and passive learning through out the day.

So here are the questions at hand:

If you teach pre-k or have a preschooler, when and how do you decide what is normal energy and what is ADD? What are some steps to take before medication? What has worked and what hasn’t? What is the difference between ADD in girls and boys? Finally, when are the teacher or the school at fault for creating the circumstances where a child is not successful and when is a child’s behavior so “out of the ordinary” that is prohibits success in the classroom? Please leave a comment and let me know what you think.

Photo from: http://bleacherreport.com/articles/46251-michael-phelps-gets-second-gold-us-wins-in-thrilling-fashion