So many books have been written to help us understand the needs of misunderstood kids. On this page, I highlight key statements from one of the best resources available. .
Driven to Distraction
Written by Edward M. Hallowell, M.D., and John J. Ratey, M.D.
Published by Simon & Schuster, 1994
Hallowell begins by stating that in order to understand what ADHD is and is not, one must look at what it is like to live with this disorder. He then proceeds to share his own growing up experiences having ADHD, and the case studies he has collected over the years.
Hallowell points out that research through the years discredits the theory that ADHD and related disorders are the results of bad parenting. He emphasizes that ADHD is "a neurological condition...no more a thing to be ashamed of than being nearsighted." (page 10)
As children with ADHD enter school, the most difficult challenge ahead of them will be to maintain a healthy self-esteem. Hallowell writes, "Whatever talents these people may have, they often never get to use them because they give up, feeling lost and stupid." (page 26)
Not everyone responds well to medication. Statistics indicate that 85% of adults will benefit from medication. Hallowell, however, emphasizes that ADHD is complex and therefore, requires a complex treatment. Medication is only one part of that complex treatment for both children and adults. Other components may include education, behavioral modification, environmental changes, and psychotherapy. (page 30)
The problems one encounters as a result of having ADHD do not end when medication/treatment starts. Hallowell states, "The management of ADD is really a lifelong undertaking." (page 60)
Families may face a slow destruction if a member has ADHD and it is not diagnosed or treated. Consider this scenario described by Hallowell:"The child with ADD chronically fails to meet obligations, do chores, stay up with school work, keep to family schedules...participate in family life cooperatively, and in general, 'get with the program' at home. This leads to chronic limit-setting by parents, with increasingly stringent penalties and increasingly tight limitations on the child. This in turn, makes the child more defiant, less cooperative, and more alienated, which leads parents to feel more exasperated with what increasingly appears to be an attitude problem, under voluntary control, rather than the neurological problem of ADD.....Gradually, the child's role in the family solidifies around being the 'problem child,' and he or she becomes the designated scapegoat for all the family's conflicts and problems." (page 128)
Siblings of children with ADHD may suffer silently or loudly, but they definitely suffer. Hallowell explains that siblings are naturally going to feel resentment or confusion when the other child receives the attention (whether positive or negative). Hallowell states, "The diagnosis can require a whole rethinking of the family roles." (page 132)
A common source of conflict in families in which a member has ADHD is control. The parent's sense of control is threatened and the parent overreacts by trying to "control every last detail." The result of this is, according to Hallowell, that "the controlling hand serves to raise, rather than reduce, tension and conflict within the family." (page 137) To alleviate the resulting conflicts of control issues, Hallowell details a helpful system of negotiation for families to implement. (page 139)
The person who has ADD may also have other related disorders which significantly affect his or her daily life. These are explained by Hallowell and include hyperactivity, depression, anxiety, agitation or mania, substance abuse, Conduct Disorder, Oppositional Disorder, Borderline Personality features, Obsessive-Compulsive Disorder, and/or learning disorders. He cleverly calls this chapter, which could seem overwhelming, "Parts of the Elephant," reminding one of the joke about how to eat an elephant--one bite at a time! (page 151)
Hallowell, throughout the book, emphasizes proper diagnosis and states, "The most important 'test' in making the diagnosis of ADD is the taking of the individual's history." He then outlines the steps to take to proceed through the process of diagnosis. (page 195)
Particularly helpful, related to diagnosis, are the lists of diagnostic criteria which Hallowell includes. Especially informative is the list of conditions which may "accompany, resemble, or mask ADD." (page 203)
Hallowell does not endorse simply diagnosing oneself; he does, however, provide a starting point with a list of 100 specific, detailed questions which as he puts it, "can increase the reader's feel for what ADD is, and offer a rough assessment as to whether professional help should be sought...an informal gauge." (page 209)
After diagnosis, it is important that the child understand what ADD is and how it is treated. Hallowell points out that "telling the truth to the child, and to the school, helps destigmatize ADD...telling the truth implies there's nothing to hide, nothing to fear, nothing to be ashamed of." (page 217)
Telling the truth also applies to educators. Hallowell emphasizes that "if a child is receiving special treatment in the classroom for ADD, the other kids should be told about this and told why." This is, of course, with the parents' and the child's permission. He continues, "since an individualized classroom treatment plan should be set up for the child with ADD anyway, and since the other children will notice it, it is best if they have an accurate explanation for it. Hallowell explains further how to share this information with children. (page 219)
Structure is the foundation of treatment for the person with ADD. Hallowell observes that the person with ADD cannot be expected to depend on internal controls. This person must rely on external controls such as lists, reminders (verbal and written), note pads, filing systems, schedules, alarms, etc. Hallowell assures that "once in place, the system will be calming and confidence-building." (page 221)
Especially beneficial in relationship to establishing structure is Hallowell's list "Ten Tips On Structuring and Organizing the Life of the Child With ADD." (page 224)
Another aspect of treatment is psychotherapy. Hallowell discusses the importance of "being heard" and shares that "the treatment of ADD should never overlook that the patient is a person first, and a person with ADD second." (page 225) -- This is good advice for teachers, also.
Medication for children with ADHD is a controversial issue at present. Hallowell clearly explains the concerns related to medications and the types of medications used and their purposes. (page 235)
Hallowell concludes his book with a discussion of problems in the treatment of ADD, and he lists specific, practical strategies for living with ADHD--strategies to be used by the patient, the parent, and the teacher--100 tips in all! (page 245)
is hearing a student say,
"Thank you for understanding me."
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