Archive for the 'ADHD Parenting' Category

Judgment in ADD & ADHD

Tuesday, February 26th, 2008

Last week, I wrote a story about how I got kicked out of a cafe - because of a misunderstanding. The part that was most frustrating to me was that I felt that I was negatively and unjustly judged by the owner of the cafe. You can read the original article here (judgment in ADHD). I posted that I learned a very important lesson about how awful it can feel to be judged by someone unjustly - and how I could now better understand the issues that parents of kids with ADD and ADHD deal with on a regular basis (because of constant judgment from so called ‘well meaning’ strangers).

I must admit that this was a different type of article than I’ve written before (I mean - I got kicked out of a cafe because of my behavior and then I actually told you about it!). But I thought that many of you would relate to this story, and as it turns out, many of you did. There are 30 comments to this blog post at the time of this article.

… And these aren’t just any comments.

Many people really opened up and shared from the heart.

I wanted to write some more about this topic for many reasons. Most importantly - I want to honor and respect all of you who contributed to the information on this blog. Your comments helped many others… and they also helped me.

I am going to cover two main points here:

  1. More thoughts on judgment in ADD & ADHD
  2. Some thoughts that your comments have given me… and I value these tremendously.

Judgment in ADD ADHD

Let’s begin by defining the term. (Maybe this goes back to my good high school English teachers - I like to define terms…)

“Judgment: The act or process of judging; the formation of an opinion after consideration or deliberation.” The American Heritage® Dictionary of the English Language, Fourth Edition. Retrieved February 25, 2008, from Dictionary.com website.

As many wise people commented on my last article - we all love to judge, but hate to be judged. Kim shared this quite well in this comment here.

In Mark’s insightful comment, he explained a couple of critical points. He explained that we need to focus on understanding… and that when judging, it’s best to get as much information as possible.

We all judge things on a daily basis. Most of the time, these are quick, snap judgments, with little conscious thought. Ideally, we seek enough understanding about the issue to make an accurate judgment - as the definition explains: “the formation of an opinion after consideration or deliberation”.

Several other blog comments merit highlighting (and I won’t highlight them all… although I appreciate them all):

  • Jan B wrote a comment - about how no one seems to judge her, but she judges herself as a bad parent of her ADHD child. Jan, I appreciate your honesty and your willingness to share your difficulties and pain with me and all of the readers of this blog. My heart goes out to you - and I hope that you can find solutions and peace for what you are going through. As Jeanette commented, she doubts you are a failure as a parent. I doubt it as well. As readers of this blog know - it can be very challenging to raise an ADHD child - and deal with all of the stigma, ignorance and hurdles out there. Continue to provide support to your child, and I hope that things will improve for both of you.
  • Annie shared that she shed tears reading all of the comments about how hard it is for people who are judged harshly, as she can relate and has dealt with some very difficult circumstances.
  • Eileen shared that she was judged as an inadequate mother by her doctor! My word! I thought they taught us in medical school to respect and support our patients…
  • Gail shares how hard it is for the kids with ADD/ADHD who are regularly judged and can’t fall back on the ‘do you know who you are talking to?’ that I was able to use, as a doctor in the community. This one really got me thinking…

There are many more comments worth mentioning… But I don’t want to reproduce all of the comments here…

What are my biggest takeaways and insights from this?

  1. I get a ton of insight from your comments - thanks a lot for sharing! (and keep them coming :-)
  2. Judgment with ADD/ADHD is pervasive. And mostly it comes with little understanding, little empathy, and little desire to support and help.
  3. Often judgment comes from places where I would argue that it shouldn’t: A Doctor, a spouse, a teacher, etc.
  4. Judgment affects all involved in ADD/ADHD: Mothers (judged by strangers, spouses, doctors, extended family), the child with ADD, and adults with ADD/ADHD.
  5. When I was judged negatively, I was able to ’shake it off’. Although I was upset, I know that I am not a rude, mean and inconsiderate man. I also know that I am a medical professional and expert, and I am respected by many in my community. This is a luxury that I have due to my age and experience. So, this experience did not affect my self esteem. HOWEVER, if I were 6 years old, or even 16 years old with ADHD - this would have hurt, and it likely would have had an impact on my self esteem. This impact can start to create a ‘negative spiral’ - i.e. incidents which build up to prove to me that I mess up in life and that I am not worth much…
  6. Judgment has a big impact on teens and adults with ADD/ADHD as well.

There is still likely a lot more that I can learn from this post - and I credit you - my readers for sharing such insights that have helped a lot.

This ties into my final conclusion:

How do we improve judgment in ADD and ADHD?

It starts exactly like this - people sharing with one another - to support one another, to education one another, and to create a community. We can then educate more people out there and begin to destigmatize this disorder.

Let’s agree that people should judge ADHD as much as they judge cancer - i.e. it is a medical condition which doesn’t merit judgment.

What can you do right now?

Share this post with others who know about ADHD, and even more importantly, share it with people who need to know more about ADHD.

Do YOU agree?

Please share your comment on this post. You know I’ll read it, and so will many other people.

Thanks for reading and contributing.

Dr. Kenny

p.s. To help to learn more about ADD and ADHD, you can get your hands on my comprehensive program with Dr. Russell Barkley at Secrets to ADHD Success. For the adults, our program, Secrets to Adult ADHD Success is in prelaunch - but you can sign up for a priority notification list here.

So what is the issue about judgment and ADD ADHD?

It Feels Awful To Be Judged…

Monday, February 18th, 2008

Last Sunday, I had quite an unusual experience. It taught me a very important lesson… and I’d like to share it with you.

My wife, daughter and I were planning to go to a pottery painting place not far from home. Now, I had some work which just had to get done, so we agreed that I would drive my wife and daughter to the shop where they could paint pottery, and I would take my laptop and go to a café just next door.

This happened to be a very cold Canadian Sunday… It was less than -20 degrees. Being Sunday afternoon, I was wearing jeans, a t-shirt, and a hoodie (under my warm winter jacket).
I dropped my wife and daughter off, and walked next door to the café. It wasn’t a Starbucks, but rather a nice little French shop. It had very fancy pastries – but since I’ve been watching my waistline, I just ordered a coffee. I saw an electrical outlet, and I sat near it – plugging in my laptop so that my battery wouldn’t run out. I used my ‘air card’ so that I could connect to the internet.

This café was really warm… and humid. So, as I was wrapped up in my work, I took off my sweatshirt.

About 40 minutes after being there (as the only customer in the café), several people came in and were talking. After about 5 minutes, some were leaving, and a woman stood with the door open to say goodbye.

Now, remember how cold it was?

Remember I was just in my t-shirt?

After about 90 seconds, I politely asked the woman if she could close the door, as it was getting cold in the café.

She said: “I’m just saying goodbye to my family.”

I replied: “Can’t you say good bye with the door closed?” At this point I was getting cold, and frustrated. I did raise my voice somewhat to be sure she could hear me.
She stayed with the door open, talking for 2 more minutes.

I put my sweatshirt back on, and didn’t say anything else.

I want to share one thing here. I didn’t mean to yell or berate this woman (And I don’t believe that I did). But I do know that I spoke louder, and my wife tells me that sometimes I sound a lot ‘gruffer’ than I intend to when I raise my voice.

Back to the café.

It’s now been just over an hour, and although I’m really wrapped up in my work, I realize that I am getting really hungry, and I should get up and pick up some food.
But then ‘he’ entered.

A man came from the back of the café, and started to talk to me.

He was angry that I had plugged in my laptop without asking for permission. He started talking about the fact that this was not an internet café, and couldn’t I go around the corner where there was an internet café?

I apologized, and I was a little taken aback. I was pretty surprised that he was so angry about me plugging in my laptop. Once I heard more of what he was saying (and got over the surprise), I acknowledged that I hadn’t asked – and I was sorry. (And I wondered – in the 21st century, aren’t all cafés used to laptops?) I immediately unplugged my computer.
As soon as I had apologized (twice by now), he moved onto topic #2. He didn’t accept my apology – he just got angrier.

He asked me how I could yell at the woman who owns the café when she was just talking to her family?

I explained that it was the coldest day of the winter, and I was politely asking her to close the door – because she had it open for several minutes and I was getting cold.

(He briefly acknowledged that she could be chatty… but that didn’t stop his anger at me).

He said I yelled at her, and how could I be so rude?

I explained I was trying to make sure she heard me, because the door was open for so long. And I didn’t intend to yell.

After some back and forth, I retreated. I didn’t want to be arguing with this man, and I really didn’t mean to insult his wife – the co-owner of the café.

“I’m sorry, I didn’t mean to offend her”.

Again, he didn’t acknowledge my apology, or accept it. He just went back to the laptop issue.

When I responded to the laptop issue, he went back to me being rude to his wife. We were going in circles, and I was getting tired of it. I didn’t think I was so rude to begin with, and I certainly didn’t feel like arguing with this man over these issues.

And then it all changed with his next question.

“What, were you just out on the streets?”

“Pardon me?” I asked, with obvious surprise on my face.

“What, were you just passing through Oakville?”

I was shocked. He was looking at me as a vagabond. A transient. A vagrant. A drifter…

I just listened with an obvious look of surprise on my face.

I started playing this through in my mind. To him, I’m just a young guy in jeans and a t-shirt. I ordered 1 coffee and sat there for an hour, and I insulted him by plugging in my computer and yelling at his wife.

“No, I wasn’t just passing through Oakville. I live here, and own a home here.”

He then said something else – which frankly I don’t remember because I was so surprised by his questions and insinuation.

Now, I’m not one to use the fact that I am a doctor to get things in life. But if there was ever a time to share my profession, now seemed like a good one.
“I’m not just a guy from the street – I’m a physician and I work at the hospital in town.”

He now started to back track a little. He clarified – “here in Oakville?”

“Yes, I said, here in Oakville”.

He then went on to say something about how they get lots of doctors and other professionals in their café, and I still shouldn’t have used my computer or yelled at his wife.
After multiple apologies from me – and his accusations of me being a bum, rude, etc. I started packing my bag and told him I’d pay him for the electricity that I used because he was so offended that I used his plug.

He walked away, and I went to the cash to pay. I paid for my coffee, and left $5 for the electricity. I must admit that I was surprised that they actually accepted $5 for what was probably 25 cents of electricity.

Why did I even leave money for this?

I decided on the spot that after being judged so negatively, it was better to just ‘take the high road’, and leave with my dignity. I didn’t think that I was nearly as rude and inconsiderate as this gentleman perceived me to be, and arguing and fighting with him would just worsen his perspective of me.
(It was interesting that his wife apologized to me as I was paying…)

I left the café, surprised that I was essentially kicked out. I was angry and upset that I was judged so negatively – particularly that the owner assumed I was a ‘street bum’.

I left there thinking: ‘It feels AWFUL to be judged’.

And then it dawned on me.

This is what happens to parents of ADHD kids all the time!

Their child misbehaves, and people around look at them with judgment in their eyes.
Harshly criticizing them for their child’s misbehavior.
It doesn’t matter how dedicated these parents are, or how much effort they put into treatment of their child’s very real disorder. These people judge and criticize harshly, and wrongly.

Now, I’ve had many discussions with parents about how when other people judge them as bad parents, that it is just ignorance, and they should ignore it. Most parents appreciate that I acknowledge this issue.

What I didn’t realize was how awful it can feel to be judged so harshly – especially for an unjustified reason.

So, although it was an experience that I wish hadn’t happened, I believe that it has given me valuable experience, which will help me to relate to you – a parent of a child or teen with ADHD or ADD. I understand it much better now, and I’ll do a better job discussing this issue with you – on my blog, in my newsletter, and for my patients in my office – we’ll have better discussions about it as well.

And I will be much more direct and challenging with ‘the offenders’ if I ever see someone doing such harsh judging (though I’ll watch to not raise my voice too much – or I may sound too gruff!)

All the best,
Dr. Kenny

P.S. if you are a parent of a child with ADD or ADHD, and you want to decrease the number of times that you have embarasing and difficult times, then learn more about strategies that work. Visit this blog often (and sign up in the box on the right), and you can learn from my comprehensive program with Dr. Russell Barkley – Secrets to ADHD Success.

P.P.S. Please feel free to comment at the bottom of this post and share your experiences with this issue - this blog has led to a lot of useful discussion between people interested in learning about ADD/ADHD

P.P.S. Why don’t I name the cafe, and tell all of you not to go there? Well, I acknowledge that there are always two sides to every story, and I don’t want to be vindictive (even though I was really ticked off at the time!)

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Teens, Sex and ADD ADHD

Wednesday, January 30th, 2008

As a Child and Adolescent Psychiatrist, I spend a lot of times with teenagers - often with their parents out of the room. I hear a lot of things about the world that teens live in… And I often can’t share it with the parents due to confidentiality rules.

One of the topics which comes up a lot is: Sex.

There are two major issues which comes up around this topic:

  1. Teens ARE sexually active
  2. They often have questions - and often don’t feel that they can ask anyone…

And most parents aren’t aware of what is really going on with their teens, and they often can’t talk to them about sex.

How does this relate to ADD/ADHD?

Research has clearly shown that teens with ADD and ADHD are much more likely to engage in sexual activity - and risky sexual activity at that.
Research has also shown that:

  • Teens with ADD/ADHD have first sexual intercourse earlier
  • Teens with ADD/ADHD are more likely to have teen pregnancies
  • Teens with ADD/ADHD are more likely to need an HIV test (i.e. they have had sex without protection)
  • etc.

A new study was just released which reveals the sexual practices of teenagers. The research was published in the January issue of Pediatrics and Child Health. The study found that 27% of teens were sexually active at a mean age of 15 years. The last time that they had sex, 76% had used a condom, according to the study.

Another conclusion of this study was that teens don’t know enough about common STIs - i.e. sexually transmitted infections/diseases. While most teens know about HIV and its risks, this study finds that most do not know about common STIs like chlamydia.

This study documents that by age 17, 45% of the teens surveyed were sexually active.

What should a parent of a child or teen with ADD or ADHD do about this?

You need to realize that:

  • Your ADD/ADHD child is at risk of early sexual intercourse.
  • Your ADD/ADHD child is at higher risk of teenage pregnancy.
  • Your ADD/ADHD child is at higher risk of Sexually Transmitted Infections.

It is also very important for you to remember that many parents of kids/teens with ADD and ADHD struggle to maintain good communication lines with their child or teen.

Why?

Because often there are issues with day to day life which create arguments, frustration and anger.

So when there is an important issue to discuss, there is little rapport for a safe, open and non-judgmental discussion.

I encourage parents to let go of day to day ‘little issues’ (which create a lot of fights and arguments) so that they can have the discussions about issues which are very important (and can be dangerous) - like sex, as well as drugs and alcohol.

How do you create such a relationship with your ADD/ADHD child or teen?

  • Learn a lot about ADD and ADHD.
  • Focus on your child’s strengths.
  • Work with your doctors and therapists.
  • Use great resources which are out there for you - like Secrets to ADHD Success.

The bottom line:

Although the issue of talking to kids and teens about sex can be controversial, and you may agree or disagree with my opinions, the truth is that kids and teens with ADD and ADHD are at higher risk of sexual issues than non-ADHD kids and teens.
It is best to equip yourself with the right knowledge and work proactively (i.e. educate your child early on) rather than working reactively - and dealing with crises after the fact.

Please share your thoughts, comments and experiences by posting a comment on this blog post below.

Dr. Kenny

p.s. To get your hands on the breakthrough system which can help you to communicate better with your child or teen with ADD/ADHD, visit: Secrets to ADHD Success.

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ADHD or Gifted?

Tuesday, September 18th, 2007

Sometimes children who are very intelligent (referred to as gifted) can be diagnosed incorrectly with ADD or ADHD.

How could this happen?

A gifted child may be under challenged and bored in the classroom. When not stimulated enough, they can feel that it’s not worth paying attention and applying themselves.

It is generally best for kids and teens with the ADD or ADHD diagnosis to get a full psychoeducational assessment. This is testing for intelligence (IQ) as well as academic achievement. This would show if in fact your child is gifted or not.

Sorting out this issue can be complicated, and a new book has come out which discusses this in detail. If you are concerned that this situation may apply to you or your child, consider this great resource.

Dr. Kenny


Teens Need 9 Hours of Sleep

Sunday, September 16th, 2007

Teens are notorious for staying up late and sleeping in late - if given the opportunity. This situation is even worse when we add in MSN chatting, video games, TVs and DVDs, etc.

About 40% of kids and teens with ADD/ADHD have sleep difficulties as well, so this can make it even harder for teens with ADHD to get a good night’s sleep.

I have just read a great article on Newsweek about teens and sleep. It is definitely worth a read.

Here are some highlights:

  • Teens need 9 hours of sleep per night.
  • When teens get less sleep, they are more prone to irritability, headaches, etc.
  • When high schools have started later in the morning, there was better attendance, and fewer car accidents.

This article finished up with a number of excellent tips to help your teenager sleep better.

Enjoy!

Dr. Kenny

ADHD The Good News - Back To School Edition

Sunday, September 9th, 2007

I have recently been fortunate enough to be the guest on a talk radio series on ADD and ADHD, called ADHD The Good News (click there to listen to the previous episodes).

Recently, a radio show was done on helping kids and teens with ADD or ADHD get back to school.
I was able to get a copy of this show for you, and I’ve placed it here. Just click on the player button to start listening.

I recently posted my ‘Back to School Tips for ADD or ADHD‘, and you can read them by clicking on that link.

Here is the radio show:

Back to School for Kids with ADHD: 8 Tips To Do It Successfully

Sunday, September 2nd, 2007

By: Dr. Kenny Handelman
Child Psychiatrist and Expert in ADD/ADHD

To download a copy of this free report, just click here: ADHD Back To School Tips

Transitioning from the freedom summer holidays to the structure of being in a classroom can be difficult for children, especially those with ADD or ADHD (I will use ADHD for the rest of this article, but I mean both). To ease the transition, parents should prepare their child for going back to school and gradually re-introduce them to homework. I suggests parents follow these tips to ensure their child with ADHD is ready for school:

1. Changing the routine to suit getting to school can be a real challenge for children with ADHD. Start with the school bedtime and awakening times 2 weeks before school starts, so that your child has time to get used to being up early and being mentally alert for school.

2. Create a list of expectations for the different parts of your child’s day. Put extra planning into the areas of concern from last year – whether that is getting ready in the morning, getting homework done at the end of the day, or other chores or responsibilities.

3. Make a daily schedule for your child that includes recess, lunchtime and any after-school activities. Post it on the fridge where your child can see it the night before and send it to school with them so they know what is expected from them that day

4. Homework can be especially hard for children with ADHD. They may forget to write it down or leave a book at school. It is best to keep a homework log with the teacher and frequently remind your child to bring it and any necessary books home after school. You can also ask the teacher to make sure that your child brings it home each day, and you make sure she/he takes it to school. Create a ‘homework routine’ - designate a certain period of time everyday for your child to complete homework. Be sure to reward them when an assignment is completed

5. Remember that you are your chlid’s advocate at school. Make an effort to speak to the teacher about your child’s learning and behavioral needs early in the school year. Ensure that the resources which can help your child are put into place, and that everyone who needs to provide input is on board.

6. Consider a daily behavioral report card. This can be a useful tool to help parents and teachers communicate. It can also lead to the opportunity to provide frequent, small rewards to encourage your child to keep on track at school.

7. Remain positive with your child, and help them to build on their strengths. Remember that transitioning from summer holidays to school can be especially challenging for children with ADHD. Celebtrate all successes, no matter how small – anything from a good mark, to a good report from the teacher, to making a new friend.

8. Keep track of how your child is doing in the transition back to school. Be sure to review this with your child’s doctor 2-6 weeks after the school year starts.

I hope these tips help you to manage this successfully. Please feel free to leave your comments and suggestions on this post on my blog (just scroll down and enter them in the box below).

Dr. Kenny Handelman

p.s. To learn more about ADD/ADHD, please join my free newsletter: The ADHD Doctor

p.p.s. To learn the secrets to succeeding with ADD/ADHD, in a breakthrough program that I developed with leading researcher and author in ADD/ADHD, Dr. Russell Barkley, visit: Secrets to ADHD Success

p.p.p.s To find the highest recommended books in ADD/ADHD, visit: The ADHD Bookstore or The Canadian ADHD Bookstore

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ADHD Talk Radio - Back to School

Friday, August 24th, 2007

I am pleased to let you know that I will be interviewed on Talk Radio on Saturday August 25th at 12 pm Eastern Time (for 1 hour).
The topic: Helping your child with ADHD return to school.
The radio station: 610 AM in St. Catharines, Ontario.
If you live close to St. Catharines, or even as far east as Toronto, you will likely be able to tune in.
However, most of you (the readers of my blog) are all over the world, and won’t be able to tune in - unless you use the net!
To listen to the radio show live online, visit this link at Noon Saturday August 25th: ADHD Talk Radio Live Online.

This show may be rebroadcast in many Canadian Cities (as has happened in the past), and if I find out the schedule in time, I will post it here for you.

To hear my last series of radio shows, visit this link: ADHD The Good News. There are 4 radio shows (each almost 30 minutes long) which cover many aspects of child and teen ADHD.

I hope to have you join me for this radio show - and it is a ‘call in’ show, so feel free to call in with a question!

Dr. Kenny

ADD/ADHD Tips for the Summer Time

Thursday, July 12th, 2007

In this article, you will learn 11 tips for parents of kids and teens with ADD/ADHD to have a smooth and enjoyable summer.
The summer is ideally a time for relaxing, recharging batteries, and building on relationships. These tips will help you to make the summer go well, and improve your relationship with your child.
If you like to learn by listening, you can listen to me discuss these tips on a talk radio show about ADHD in the summer.

1. Create and stick to a summer routine as much as possible
It is important to have a routine even during the summer. While it may not be as consistent as during the school year, children with ADHD need the structure of routine.

2. Prepare your child for changes in their routine
Talk to your child about upcoming changes in their routine and remind them of any upcoming events frequently. Plan your child’s schedule with them and post it where he/she can see it.

3. Summer holidays don’t have to be a drug holiday
ADHD is a challenging year-round condition, not a seasonal problem to be dealt with only during the school year. While many parents consider ADHD medication to be important for academics, it is important to remember that ADHD also affects social interactions, emotional development and psychological development. The summer is a time when children have an opportunity to improvethese areas, but ADHD symptoms can interfere with that.

4. Get your child involved in activities
Talk with your child about their interests, like scouts, art or sports. Locate programs in your area offering an activity your child will enjoy so they will stick with it and build strengths they are interested in.

5. Develop a list of expectations and post them in a central location
Clear and consistent communication about your expectations is key. Develop a list of expectations for the various activities your child will be participating in and be sure to reward your child for appropriate behaviour.

6. Be consistent with consequences for inappropriate behavior
Develop a list of consequences for inappropriate behavior and make them very clear. Be consistent in enforcing them, even though you may feel more lax about enforcing them in the summer. Stick to it!

7. Talk to summertime caregivers about your child’s ADHD
It is important for coaches, camp counselors, and other summer caregivers to know what they can and can’t expect from your child. Parents can download a form on adhd.ca that can be filled out and given to people who will be supervising their child.

8. Develop a travel plan if you will be taking your child on vacation
Involve your child in planning the vacation and ask for their input when making decisions and planning activities. For long plane rides and car trips, be sure to pack fun things to do to keep your child occupied.

9. Focus on social skills
Social skills are often a challenge for children with ADHD. Promote participation in structured and unstructured activities like camp and informal get-togethers.

10. Recognize every accomplishment, no matter how small
Remember that transitioning from school to summer holidays can be challenging for children, especially for those who have ADHD. Be sure to celebrate your child’s successes.

11. Remember to have fun!
Often parents of kids with ADHD have so much to deal with to help their child, especially during the school year, that it can be hard to just ‘let go’ with your child and have fun. Make sure to take some time in the summer and just enjoy spending time with your child. Enjoy his or her strengths, and create great memories that will last a lifetime. Do something spontaneous and out of the ordinary. Build your relationship with your child by just enjoying each other!

I hope these help you to have a great summer!

Dr. Kenny

ADHD and Still Able to Pay Attention?

Friday, April 6th, 2007

This article comes from a subscriber’s question: “Dr. Handelman: I wanted to ask you my son has been diagnosed with ADHD but I have trouble accepting it. He is able to read books for a long time and he can play Nintendo for hours. How can they say that he’s got ADHD when he can pay attention?”

This is a great question and I’m glad that it’s been brought up because people with ADHD can pay attention.

Let me repeat that: People with ADD or ADHD still can pay attention.

The issue is that they are very inconsistent in their ability to pay attention.

Someone without ADHD can be consistent in their ability to pay attention. For example, a student with ADHD can be consistent paying attention to math in the morning, English late morning, and Science in the afternoon. For the student without ADHD, he or she can pay attention reasonably consistently on whichever day, at whatever the time.

Someone with ADHD can find it very hard to be consistent with paying attention. On a day to day basis, paying attention can be hit or miss. The level of attention can vary based on how interested the student is to the material, how important the material is, etc.

Even if he or she has trouble paying attention to a specific subject - i.e. Mathematics, if there is a big test coming up - he or she could put a lot of attention into paying attention for that test. However, if the next class is English (which is often easier to pay attention to for that person…) he or she could be totally distracted because all of the attention was ‘used up’ in the last class.

The important thing is that attention is inconsistent. I suggest that instead of thinking of an ‘Attention Deficit’ - you should think of an ‘Attention Difference’. People with ADHD can pay attention to things but they do it in a different way than people without ADHD.

One other angle with this issue is that ADHD symptoms are much less of an issue when someone is doing something that she likes, or in a small setting such as one on one. ADHD symptoms are much more significant when the individual is doing something she doesn’t like in a large group setting.

When I’m interviewing parents in my office about their children and the symptoms they have, I need to keep this in mind. If I ask: “Does your child have trouble paying close attention to details?” Some parents will say, “it depends”.

I then clarify - by asking: “Tell me what it’s like in a larger class in a subject they don’t like - or in a large group setting”. It then may be easier for a parent to recognize the difficulty.

The analogy here is cardiac disease. If someone has blocked heart arteries, he may not have symptoms sitting in front of the TV relaxed. But, if you make him run up two flights of stairs, he may get chest pain. When he is sitting on the couch, does that mean he doesn’t have cardiac disease? Of course not. The same applies in ADHD. If one is doing something fun, stimulating, easy and in a small group, it is easy. However, under ’stress test’ conditions, the symptoms come out.

And why can just about all kids with ADHD spend hours playing video games (if you let them)?

Because video games are designed to be tremendously stimulating. In fact, they are designed in such a way that the ADHD brain may excel - compared to non-ADD’ers.


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