All posts by Nerd_Squared

Just a Type A personality trying to organize an ADD world.

Battle of the Attention Span

Children with ADHD can be an absolute delight. They see a world much more colorful than our own and it’s hard not to be swept away by their enthusiasm. A few days ago, my son ran from his room (naked) where I had sent him (clothed) only moments before, practically convulsing because he had to tell me NOW about his overly-complex-but-might-actually-work scheme. He invented a steam-powered automaton to reach books from the top shelf, where his object of desire sat out of reach (the fact said object was not what I asked him to get is beside the point). He then proceeded to impart the details (oh, GOD, the copious details) complete with flapping arms, detailed blueprints, and a financial plan, all without realizing his nakedness. He was a snow ball thundering into an avalanche, only interrupted by a brief moment of irritation when mommy pointed out his breezy behind.

I wish I could say I was always a hundred percent enthusiastic during these daily, often charming phenomenon, but I’m not. While I’ve come to understand my five-year-old simply thinks better when his nether regions are free, I’ve also realized his enthusiasm cannot run unbridled all the time (for the sake of everyone’s sanity). No one likes to contain enthusiasm, especially a child’s, but if you have an ADHD kid you know what I mean.

I suppose this scenario illustrates the difference between an ADHD and non-ADHD brain. One of us thinks brilliantly with pants off, while the other can’t think of anything until we’ve scrambled to put them on! Socially, we would label the naked thinker the “odd” one, but when you think about it, there’s technically nothing wrong with pant-less pontificating. Unfortunately, our society’s moral order favors pants. If you keep forgetting to put them on, you’re quickly isolated as a freak, loser, moron, degenerate, and so on. And this is one of the most damaging ways to deal with an ADHD person: mistaking clinical behavior for moral behavior.

No where does an ADHD child feel the weight of moral order more than in school. Why? Because teachers, on average, are attracted to the profession because they enjoy order and goal-oriented activity. This kind of adult brain, unfortunately, is often at odds with the ADHD brain because it functions at the opposite extreme. There has, actually, been research on this. In 2006, using a personality test called the Kolbe Index, Arizona State University requested five hundred students and teachers take the Index. Their scores were then compared. The average teacher tended to work best by organizing, researching, and attending to details. The average ADD student? Experimenting, taking chances, and hands-on problem solving.

What does this mean? Ultimately, it turns what should be strengths into classroom power struggles. If you’re a young child and your way of learning causes problems, you automatically assume you are in the wrong. If you’re a teenager, you might feel a tad rebellious about it, especially if your report cards have been filled with comments about your lack of attention. I fully recognize not all teachers are oblivious to this, but sadly, many are. And this is where your child’s method of processing becomes moralized (usually negatively so). His or her teacher has assumed the lack of focus is a deliberate lack of effort. Of course, I shouldn’t have to point out the teacher is wrong.

Because grades are such a big deal, this type of moralizing is more obvious in school. The self-confidence of ADHD children is slowly eroded away, and the erosion starts early. No matter how smart they are, they have trouble following through, hearing directions, paying attention, and keeping calm. When these behaviors are assumed to be an issue of willpower, how could they not feel bad about themselves when called out in class?

But parents must remember, moralizing happens at home too. And if you homeschool and are also your child’s teacher, you must be doubly aware of such assumptions. So what can you do? Intentional or not, teaching an ADHD child is hard! It is extremely difficult to get my son to listen long enough to learn something, and even more difficult for him to retain the information. What’s the best way to teach without screaming or having an emotional breakdown?

Luckily, there are techniques which do work. Even better, these techniques are not hard to learn, and their proper execution might spare your child years of negative indoctrination. There is a two tier method for teaching an ADD child, and they work for both parents and teachers. The first is Keeping Perspective and the second is Functional Interventions. Let’s discuss them one at a time.

KEEPING PERSPECTIVE

As mentioned previously, the system generally treats ADHD kids as problems. Please don’t assume I think teachers are villains. Indeed, I empathize with them for they are equally trapped in the politics of public school. Such politics restrict teacher’s creative abilities and encourage catering to core measures. It’s my belief that if a student is not 100% average, school is simply not designed for him.

Unfortunately, schools are designed to keep students at roughly the same educational level. Public schools simply lack the framework to foster your child’s unique mind. Instead of a welcome alternate pathway, ADHD children become unwelcome divergents. And because they have trouble focusing, they make easy scapegoats. The emotional burden this causes is dramatic and was evident in our son, Kallan, within just four months of kindergarten (you can read about it here: http://docndebt.com/an-elementary-mistake/ )

If you are the parent of an ADHD child, you are already familiar with his or her unique brilliance. Despite knowing your child’s creativity and intelligence, however, it’s tempting to jump on the negative bandwagon, especially when report cards start rolling in.

mcgonagall

“Dear Parent, your son would get better grades if he would pay attention in class and stop talking when he should be listening!”

The truth is, an ADHD brain cannot be rewired. You can’t fix it. There’s nothing to fix. But as a parent, you can be trained to help your child make connections he or she would otherwise miss. You can improve your child’s attention span by changing the way you interact during learning time. Work on your method first and your child’s confidence will blossom. When he is old enough to recognize his unique learning needs, you can back off and turn over the reigns.

The reason educators lose their cool are many, but the most common reason is that an inattentive learner makes you feel unimportant, taken for granted, and ignored. Second, it’s worrying when your child can’t seem to learn something, even when you’ve covered the same topic three hundred times. In other words, we start to take it personally.

I wish I could say ADD children “grow out of it,” but my husband still forgets things he should know, especially when driving. Despite having gone over directions in detail, my husband still gets lost on a frequent basis (even when he’s been to the same several times before!) Yet, he can navigate a first-person shooter with ease and remember every nook and cranny! If only I could hypnotize him into thinking he’s trapped in a live action game of Doom…

burns

Actually…that’s a terrible idea.

The most important thing to remember, as a parent, is that a child’s inability to pay attention is not a personal failing. Furthermore, it is not intentional. Last, their way of learning is not wrong.

When your son is running around without pants (seriously, why are your pants off AGAIN?), yelling during an invisible fight with light sabers (for the hundredth time, use your inside voice!), and you’re trying to corral him into one room (where are the dog gates!), it’s very hard not to lose your composure.

Like me, you’re going to fail to remain calm sometimes (okay…many times). There are days it seems like I have to turn into a raving maniac to get anyone to pay attention to me. If you have an outburst, then remove yourself from the situation to cool off (yes, I have been sent to my room before).  Once you’re alone, it’s time to remember ADD children cannot help their hyperactivity and lack of focus. Also keep in mind they are constantly subjected to other people’s displeasure, which slowly corrupts their self esteem. When you blow up, remember your kid is a victim of his own brain wiring.

Every day I must remind myself of this, not only for my son, but for my husband as well (who has ADD).  What I am about to write sounds terrible, but it’s my method of coping. Sometimes, I literally have to think of their ADD as a form of brain damage–as if they had been in an accident, suffered a terrible concussion, and permanently damaged their memory storage. I couldn’t blame someone for an accident that changed his brain and, frankly, ADD is a little like that. Only, the different wiring is from birth. As a non-ADD spouse and mother, I must have tremendous willpower to chose humor over anger and to remember it’s unintentional, especially when your husband fails to realize your son’s car seat wasn’t fastened until after arriving at his destination. Across the city.

crazy

To wrap up, the most fundamental task for being a good educator is to keep things in perspective. Do not blame your child (or husband). Try to keep your cool. Remember he or she must learn differently by their very nature.

FUNCTIONAL INTERVENTIONS

Below is a list of proven strategies for teaching an ADD child. They all focus on one of two things: Accommodating movement and capturing attention.

One sentence commands. This is a big one. When my son runs through the living room pantless, I say, “Kallan,  pants, please.” If I say, “Kallan, go to the laundry pile and get some clean pants and underwear, then brush your teeth,” I’ve already lost him. I can guarantee I’ll find him in the laundry room playing with the dryer sheets. People without ADD take their executive functioning for granted. It’s easy for us to remember several steps for a task, but this is not true for those with ADD. The more you limit commands to short, single sentences, the more follow-through you will see.

Confirm eye contact. Before issuing any command, it’s a good idea to ensure your child is making eye contact. It may not last long, but asking him to look at you before you impart something important is going to improve his retention. How do you know if you’re doing it right? If it feels like you’re training a dog, you’re doing great. Harsh, but true. It works!

Remove distractions from the environment. As you probably know, ADHD children cannot tune out environmental distractions. If there is a red piece of paper on the ground, it is always there, screaming “RED!” Everyone else can forget about it and work on the math problem, while the child with ADD is thinking about what he would like to draw on the red paper. Eventually, parents learn what their ADHD kid is distracted by. Just make sure homework is done in a place where all the toys, crayons, and Legos have been removed. Don’t let them study in their room, where distractions abound. Try the kitchen or sitting room. And above all, keep the TV and computer off!

Allow music without lyrics. One of the central issues with ADHD is an inability to stop outside stimuli from invading your brain. As I understand it, there is a constant background noise of thoughts which can sabotage homework. This can be ameliorated by replacing brain noise with outside white noise.  You’ll be amazed how far a white noise CD will go. Even simpler, hop on youtube and you’ll find an awesome collection of background noise options: rainfall, ocean waves, meditative chimes. This simple trick can really aid concentration, but be sure not to use music with words. Lyrics pretty much defeat the purpose of having something on that can be ignored.

Purchase a wobble chair. Oh, man! These things are great. Rest assured I have no business arrangement with this company. I am simply an impressed customer. The idea is simple: ADHD children need to move around, and sitting at a desk is agony for them. They are constantly being told to “be still!” The problem: it’s physically impossible. My husband still paces the house a hundred times when he’s on the phone. When he sits during a movie, he shakes his leg nonstop.

So, instead of fighting it, accommodate it! There are chairs on the market designed to wobble while the child sits at a desk. It allows her body to move, which, in turn, actually improves her concentration. The average wobble chair runs around fifty bucks, which isn’t too bad because they last a long time. If your child has any kind of personal action plan at school, discuss the need for him or her to move while focusing, and make them approve a wobble chair for school use.

Use a bouncy band. Much like the wobble chair, a bouncy band is a rubber band children can place on their desk legs. It allows them to move and exercise their legs whenever desk time is required. They are less expensive than the wobble chair, but don’t last as long. If you have the money, why not get both? And consider its use at home, too. If you homeschool, this might be the trick you need to get your child to sit down and do some paperwork! These bands can be found all over the internet. This brand is sold on Amazon.com. Please check my (growing) list of internet resources and links for companies offering these kinds of ADHD products.

bouncy band

 

Give them a fidget. Ah, thank god for fidgets. I had no idea what these were until I looked online for some kind of stupid wobbly thing my son could play with to stop him from molesting everything in the grocery aisle. I was shocked to discover there is an entire industry devoted to fidgets! Designed for ADHD and autistic children, fidgets allow little hands to remain busy. For many children, this improves their concentration and can help them remain at a desk for prolonged periods. I am particularly fond of desk fidgets like the one below, called the Desk Buddy. These rest on desktops so fingers can get sensory stimulation. They are small, cheap, and are less distracting to other children when used in the classroom. The Desk Buddy is only ten dollars and can be obtained through Amazon.com,

desk buddy

Wait five seconds. This intervention saved my sanity. My son has a habit of saying, “what,” any time I tell him something. For five years, I repeated myself, often getting angry he couldn’t listen to an answer he asked for! Then I learned this little trick. Remember that ADD children have slower processing times. They literally have to push aside all the incoming information to hear your comment from everything else. If you give a command to your child, wait five seconds. This allows processing time. Since starting this, moral really improved in my household. Now every time my son says, “what,” I remain silent for five seconds. Most the time (about 90%) he figures out what I said and the conversation continues without having to repeat myself.

Does this sound familiar: “You have until the count of five before you go in time out!” If you’re the type of parent who counts down to a reprimand, this trick will work wonderfully. First, announce you’re starting the countdown. Then wait five seconds. If there is no response, start with the countdown. Allowing this brief pause before starting the count can allow time for processing.

And more importantly, this technique can be used during learning time. When explaining an important concept, use brief sentences, then wait five seconds before continuing on. I think you’ll be impressed with the change.

Give verbal & visual encouragement. You know, many ADHD children go through their school day without an iota of encouragement. Not ONE. What they do hear is a lot of redirection, “calm downs,” and reprimands. If your child attends public school, imagine what it would be like to hear how you fall short at your schoolwork, only to go home and do more schoolwork. Schoolwork that you’ve been told you suck at. It’s not terribly encouraging.

Every child needs to hear encouragement, but parents have to be aware of what’s going on to provide it in the right context. If you see your son sitting and reading, tell him how great that is! Did he finally complete a project that was due two weeks ago? Tell him how proud you are! Even better, make a chart on the wall that can track your child’s progress. Use stickers to represent small successes leading up to a big reward. ADHD children are visual learners, and visual aids are very useful, especially with younger children.

Restrict TV and computer time. The devilry of TV and computers will be discussed in a later post, but for now, suffice it to say that TV has been shown to decrease attention span and increase a child’s demand for immediate gratification. A study by the American Academy of Pediatrics has shown that the amount of TV watched at ages 1 and 3 were both associated with attention problems at age 7. You can download the study at this link:

http://www2.aap.org/advocacy/releases/tvapril.pdf

This is one of many peer-reviewed studies showing that even small amounts of TV time can have affects on children, particularly ADHD children, who are already programmed to latch onto immediate visual stimulation. An addition to TV and other media (such as games on your cell phone) is no joke. Child who are ADD/ADHD or on the Autism spectrum can become as addicted to visual stimulation as any drug. I have seen it both in my personal and  professional life.

If you want to encourage your ADHD child to focus, media must go. And that means you’ll have to monitor your own use of it. Watching TV around an ADHD child is kind of like drinking a beer next to a recovering alcoholic. Try decreasing your exposure a little at a time. You might be surprised how much you were missing while sitting in front of the TV or at the computer.

Timed exercise breaks. This is a no-brainer. ADHD kids have to move! To learn a little about how important this is, click here and I’ll try to convince you: Child In Motion. It will be torture to make your child sit for too long, for both of you. Ensure there is adequate time to move. Here’s the catch: once distracted, it’s hard to get them back again. Make sure there is an agreed upon break time, and stick to it with a clock.

Set your child up for success. This may seem silly, but it’s important to emphasize the need to set realistic goals. It’s easy for ADHD kiddos to become discouraged and give up, even when they’re perfectly capable of doing a task. When working with your child, make sure you’ve set a goal which will be reached during the day or learning session.

Arrange Escape Valves. This is simply giving your child a task when focusing on an assignment, such as nightly homework. Give him a minor chore, such as letting the dogs out, allowing him to move without becoming too engaged in something else.

Aromatherapy. As a physician, I’m dubious when it comes to alternative therapies, aromatherapy included. However, there have been some interesting studies about the effects of essential oils on concentration and ambient mood. In addition, essential oils are harmless (unless you drink them), so why not try them?

One group of scientists wondered how they could help patients with anosmia (people without a sense of smell). They found a regimen of inhaling certain essential oils not only improved their sense of smell, but also seemed to affect their memory (the olfactory portion of our brains is very close to our primary memory center).

Other studies showed lavender and rosemary had a statistically significant effect on anxiety, mood, memory, and analytic processing. Lavender was better than rosemary in increasing correct answers on math problems, but both improved mental processing times and improved mood.

The studies around aromatherapy are really so interesting, I will cover them in another article which will not only review the current studies, but provide the correct way to use oils. For now, having the scent of Lavender around your child while he or she studies may have beneficial effects.

I hope this article was helpful. There are so many techniques out there for dealing with distracted children, it would be impossible to cover them all. In the end, you must find what works best for your child. It won’t always be easy.

Some days, it will be a major victory just to convince your son to wear pants.

And that’s okay.

Father’s Day

The Ceremony of the Father

History of Father’s Day in America

Father’s day had a bit of a rough start. It’s inception began in 1910 when Sonora Dodd, a Washington native, started a local celebration for fathers in honor of her own. Her father was a civil war veteran who raised six children alone. His birthday fell on June 5th. His daughter petitioned the local pastors to participate, but June 5th didn’t give them enough time to organize, thus, the celebration was relocated to the third Sunday of June.

Later in her life, Sonora decided to convince the nation to adopt the holiday, and she was smart enough to enlist the interest of groups producing men’s wares: ties, tobacco, clothes, shaving supplies, top hats, and other manly man things purchased in the early 1900s.

Gotta be honest, it wasn't a bad style!
Gotta be honest, it wasn’t a bad style!

The idea was solidly backed by those with commercial interests, but not so much by mainstream society. There would be several failed attempts to make an official Father’s Day. In 1966, Lyndon B. Johnson finally established the third Sunday of June to be a holding place for the celebration. It wasn’t until 1972, however, that Richard Nixon would sign it into law as a nationally recognized event.

As most of us know, Father’s Day isn’t particularly exciting.  Most of us spend time with family, get a gift for dad, maybe take him out to a game, and other types of bonding. As I was researching the internet for Father-related religious and/or spiritual material, I was surprisingly disappointed. There was very little out there! There was even less among Pagan resources! Surprising, because we pride ourselves on recognizing the spiritual importance of duality, especially male and female.

Why Turn Father’s Day into a Tradition?

By “tradition,” I mean a ceremony performed with solemnity each year that is eventually passed to your children. The fact Father’s Day started out as a commercial interest (and, well, still remains one) is irrelevant. A father has tremendous spiritual importance in a family. Regardless of one’s religion or lack thereof, I think we can all agree to that! While we should show our dads a bit of thankful recognition every day, Father’s Day becomes a convenient time to reflect on this vital, personal, and growing relationship. And it’s not just the family who shows their respect this holiday. A father has time to reflect on his obligations to his family and share his thoughts.

So, why not add a little more meaning to this year’s Father’s Day? Have dinner, go to the game, give a present, and do everything you normally do. But at the end of the day, gather up mom, dad, and the kids, and share a private moment.

Father’s Day Ceremony

As a disclaimer, this ritual is for a traditional nuclear family: Mom, Dad, kids. That’s because it’s my family’s current arrangement. This is also for families whose father is still living. While I’ve thought about a ceremony for fathers who have passed, I haven’t gotten there yet.  I want to say I acknowledge many kinds of families, and I support family diversity in all forms.

This is a simple ceremony families of any creed can do together (yes, even atheists). This ritual honors a Father’s role, a time to charge him with the sacred duties of fatherhood and for him to impart his personal blessing on the family, not simply as a dad, but as the half-soul of his children and spouse. The following ritual was written by myself and my husband, so it is deeply personal to us. Your family will no doubt have very different blessings, but if you’re having difficulty, feel free to use ours as a launching pad for inspiration. As far as I know (and I’m probably wrong), this is the only Father’s Day specific ritual on the internet.

If you are agnostic or atheist, this ritual can easily be tailored to a simple humanistic tone. There’s no reason an atheistic family cannot have moments of ritualized meaning together. Ceremony may have the feel of something religious, but that has nothing to do with a specific god or faith, only emotion.

Likewise, if you do belong to a particular faith, it will be easy to adjust this ceremony to your specific God.

Living the Mythology, Performing the Symbols

In Paganism, fatherhood is a divine duty and Father’s Day falls on a auspicious time of year–near the height of summer. In countless myths throughout time, the sun is the male power, the warm energy which seeds and enriches the earth, allowing her to bring forth life. The third Sunday of June approaches the Summer Solstice, called Litha in modern-day Paganism, when the sun is at its apex. It is the longest day of the year. Even today we follow ancient patterns, living their truth in ways that cannot be described, but somehow experienced and, thus, understood. We honor the Father when the Sun reaches his solar climax, coinciding with the kill of the hunt, the union of consort, and the triumph of male divinities across time.

A Father’s ceremony, however, is not complete without the Mother. While this is his day to stand unique, the goal of the ritual is to experience the union of the two: for the children to sense the meaning of creation and the special relationship shared by their parents. This is a symbolic truth anyone may experience, regardless of creed. It is a truth for secularists. It is a truth for the religious. You have only to adjust the words to reflect your own creed, and share meaningful time with your children.

The ceremony begins with the entire family sitting together. The setting, lighting, music, and incense/candles are all personal preference. We did ours sitting on the floor in front of the family alter, but it would be lovely outside as well. To begin, one of the family members draws a circle around the family, creating a sacred space (the choice of who makes the circle depends on the representation preferred by the individual family). The circle can be drawn with a finger, stick, or, in our case, a quartz rod we bought for our son to make prayer circles.

What is the meaning of the circle? Unity of course. Inside, the family is the center of all, unbroken, an entity together. Here we fill the circle with kind meditations and positive energy, just as any other prayer in any other faith. Take a moment to enjoy being together, with these wonderful creations who share half of your own essence and body.

When you’re ready to begin, the mother pours a drink into a chalice. In this case we used grape juice since the kids would be drinking it, but wine would work just as well for older children. The chalice has always been a symbol of the mother, of life, of the womb.

Next, each child is handed a (non-spillable!) spice. Recommended spices are cloves, cinnamon sticks, or star anise seeds. Each is traditionally male centered in mythology, particularly the star anise and cinnamon. These are the father’s symbols carried by the children, representing the seed which created them.

star anise

Our family used the star anise which was perfect. They don’t make a mess and have a lovely scent and texture. 

To perform this ceremony, the father writes a blessing for each member of his family. Likewise, the family writes a “charge” for the father. This involves some personal creativity. Being Pagans, we wrote a Pagan ritual, but as I’ve said before, a personal blessing is just that…personal. It can include anything one wishes.

A “charge” is a kind of ceremonial command, in which one brands another with a sacred duty. I wrote up all the things I thought a husband and father should be and do, and turned it into prose. It’s a little like writing wedding vows, so you’ll want to give it some time and thought. This isn’t something to be rushed.

In regards to the father’s blessing, this is also something deeply personal, that only a father can write. He writes a prosodic blessing for each child and his wife. These writings, along with the charge, compose the core of the ritual.

When the charge and the blessings are complete, the ritual can be truly beautiful. They are shared in the following sequence:

The mother starts the blessing by placing one of the seeds into the chalice. She then reminds her husband of his sacred and traditional duties.

Our charge:

“A Father is the other half of the mother.

We ask you to remember husband and wife are whole when together.

We ask you to remember you embody the God of the Green; Lord of the Hunt. It is man’s lifeblood which spills to allow life, given to the earth in perfect unity.”

The child places a seed in the chalice. The following is read by the mother or the child, if old enough.

“A Father is a warrior.

We ask you to protect what is yours, to keep us safe as your most valuable possessions.

We ask you to lead with strength and passion, to teach us how to steel our wills when life makes demands that seem too great to endure.”

The child or his/her sibling places a seed in the chalice.

“A Father is a sage.

We ask you continue to grow in knowledge and wisdom.

We ask you to be a storyteller, a visionary, and a man of myth and art so we grow into complete contributions to humanity.”

The child or mother places the last seed in the chalice.

“A Father is the best of his children.

We ask that you see yourself when you look at us, to care for us as you care for yourself.

We ask you to keep your honor. Teach integrity. Guide us in moral instruction.

You are Odin;

You are Zeus;

You are Osiris.

You are the honored Lord of our family.”

The Mother’s chalice, representing herself and her fertility, now contains the Father’s seeds. Young children need not understand this symbolism, and it will probably dawn on them as they age. The important part is that they eventually understand, perhaps subconsciously, that they are the products of a sacred union, represented by chalice and seed.

The Mother takes a drink while the Father gives his blessing.

My Wife:

“You have made me more.

Without you, I would not be a father;

You have made me less.

Without you, I would no longer be whole;

You have made me many.

With you, I have made a family;

You have made me one.

With you, I have seen our future;

You have made this possible,

My love.”

The son takes a drink as he receives his Father’s blessing.

“My son:

You are kind.

It is my duty to teach you compassion, to protect that gift.

You are overflowing with life.

It is my duty to give you the tools to harness that power.”

The daughter takes a drink as she receives her Father’s blessing.

“My Daughter:

You are strong.

It is my duty to show you how to protect others.

You are smart.

It is my duty to guide you onward to discovery and truth.”

The Father takes a drink as he concludes the family blessing.

“My Children:

You are our future.

It is my duty to teach you, to give to you, to show you, to guide you.

You are my life.

It is my duty to be what you look for in yourself and in others.

From you to me, to my father, and to his father, and to his father…to the First Father.

We are all connected.

We are all one world.

We are all one family.”

If there are any Father’s Day gifts, they can be given here, or the circle may be broken after a moment of meditation. Breaking the circle releases the good energy into the world, your family’s hopes and dreams for the future.

I hope you can see there is a ton of playroom in designing this ritual for your own family. This was a truly meaningful ceremony in our family, one that didn’t take much time, but left a huge impression. Many blessings in generating your own Father’s Day celebration.

Growing List of Video Resources

Totally ADD

Here is the main Youtube page for a fantastic collection of videos targeting the adult ADD audience. The videos span everything from humor, to parenting ideas, to adult career choices. I particularly enjoy Rick Rants, videos from a sarcastic older man who would probably be fun to drink with. Ironically, this website is an ADD trap, so keep track of time when you click the link!

Totally ADD

An Elementary Mistake

You know, there’s a lot of social engineering we take for granted.

 Media. Organized religion. Politics. Public education.

We have allowed these social machines to make decisions for us, with the pretense of being vital to our happiness and, perhaps, our very survival. Even when we recognize their flaws, they continue to grow thanks to hungry commercial industries that profit from social engineering. While I can wax poetic about each of these topics (and will gladly do so in the future! I know! You’re thrilled!), this article tackles the giant manufactory of public education. My goal: to convince you that Schooling is essentially the Force. Oh yeah, really. Just look what it has done to these children:

Don’t let the Force destroy your child’s destiny…

Indeed. You see the inherent dangers. Like the Force, school has a light side and a dark side, and seems to hold everything together. And, lest we realize too late we’re serving Sith Lords, we may wish to consider the degree we allow schooling to dictate our lives.

Consider… we arrange our lives around a system which takes our children for a large portion of their early lives. That seems potentially dangerous to me, and we know many of our schools fail to meet minimum standards. Despite this, our society treats the school system as a moral paragon, which only ignorant, stubborn, ingrates reject. But… are homeschoolers the problem, or has traditional schooling robbed us of our children’s most precious years? Even worse, maybe the system actually does what its supposed to do?

Meaning… has the system been a huge success… at generating standard citizens?

Everyone is under the impression our children can live up to their greatest potential in America. Well, my ADHD husband, the son of a physician who could afford to send her son to private school his entire life, has a few things to say about that (a topic for another time). He had a faux impression of being given every opportunity. Everyone believed it, including his parents and his teachers. Oh, Robert, you have so much potential, but you’re just not motivated. And that’s what he heard his entire childhood until college. Then the mantra changed: oh Robert, you just can’t get yourself together. He was in his 30s before he started to think, maybe, the problem was trying to force himself through an improperly shaped cookie-cutter for too long. School may work for the 100% average student, but who determined what an average student should be? I’ll tell you presently. But I warn you, you’re not going to like it.

The “American Dream” is saturated by scholastic pedagogy. Education is the most extolled virtue in our country, immediately behind another dangerous, naive naive belief that with enough hard work you can get it/do it/be it. But here’s the problem: A majority of Americans have lost faith in achieving the Dream, which, to me, means its foundation was never sound to begin with.

American-Dream

We must routinely question the foundations, especially when they’re tied to American identity and self-worth. So why don’t we? Well… read on.

Now, I’m not an education, history, or psychology expert. I’m just a mom with a slightly unconventional family… different enough to realize the system doesn’t work for us, but “normal” enough to see hundreds of other families in the same boat. While I can’t claim to reveal any great epiphanies, my friends, family, and employers can assure you I have one unique trait, one that allows me to crash through institutionalized walls like a crazed Kool-Aid man. That talent? I am fantastic at being a giant pain in the system’s ass. Oh yes, my friends. From day one, I was sprinting down the off-beaten path, my two middle fingers kept in check only by holding a giant megaphone to ensure everyone knew how I felt about it. If the system was a cashmere sweater, I’d be the uncultured jerk picking at its lose threads. Unraveling the status quo is my forte.

ahem, anyway…I admit it wasn’t until recently that I started to question the methods, practices, and history of public schooling. After all, I was in public school since kindergarten, and look how awesome I turned out!

world of warcraft

(I know, right? Just what I said…this is how everyone plays World of Warcraft.)

Now that I have done my research, I can’t look back.  But with our announcement to homeschool, we were reminded not everyone felt it was a good idea. In other words, our change of clothes was not only a social faux pas, but an assumed criticism of other people’s fashion.

“Come now, dahling, surely you can see those cashmere sweaters are getting threadbare! Can’t we interest you in this delightful super suit?”

Removing Kallan mid-kindergarten was met with stone-faced stares, tears, sadness, and downright anger. On average, however, the emotion was simple apprehension and worry about Kallan’s education. When Kallan was enrolled in Kindergarten, I was 100%  pro-public school. I never even questioned it. My thought process was: Son = 5 years old = Kindergarten. I knew about homeschooling, of course, but it was always that weird thing religious fundamentalists did to ensure their kids weren’t infected with ridiculous…. ideas.

creationism

(“Peace be with you, clever girl.”)

When Kallan’s mood and school work started to suffer, however, I realized I was left with the options of homeschooling or private school. Then I realized private school wouldn’t solve anything. The reason he was unhappy was because the system wasn’t made for an ADHD child. So, homeschooling was the only real alternative.

We started talking about it, with considerable apprehension. But as my research continued, I realized the apprehension wasn’t from any actual proof homeschooling was harmful. Rather, it was from the unspoken assumption that education was best left to the experts. The basic theory is as follows: Children’s education should be left to trained educators for the same reason haircuts should be left to trained stylists — doing it yourself will likely result in a lopsided hairdo, eventually requiring a buzz cut to fix everything you fucked up.

Well, I cannot deny that I suck at cutting my kid’s hair.

haircut

But, uneven bangs have only added to his adorable charm! Likewise, I came to believe this change in education, while unconventional, was completely within our ability to manage at home. Not only was it something we could accomplish, but, I realized, something we could do better than anyone else.

I will share the questions I asked, then you can see what you make of my findings. If you’re debating homeschooling, trying to convince a spouse/family member, or are my mother and terrified of more lopsided haircuts (love you, mom), then the following  may be worth your time.  Don’t be apprehensive — I’m only going to point out how your entire childhood was completely wasted by the system. :D

Question 1: Where did public education come from, anyway?

Remember when I asked who was responsible for determining what an average child should look like? The answer is surprising, and there’s no way to discuss it without sounding like some kind of basement troll conspiracy theorist. In a nutshell, when we talk about public education, we are referring to compulsory schooling. Meaning, mandatory attendance of school, six hours a day, five days a week, nine months a year, for twelve years. Do we actually need that much schooling to transmit fundamental academics?  Really? Have you ever asked? And if you did, were you ever given satisfactory proof of its necessity? There is no evidence, at all, anywhere, to prove children need formal education for that long. Benjamin Franklin, who lived before compulsory schooling laws went into effect, started his own Independent Newspaper when he was 15 years old. Can you imagine if he had been forced to remain in public school until 18? What could today’s children accomplish if their entire day, week, and year were not determined by what is, when you think about it, a rather uncompromising and entrapping schedule.

Before compulsory schooling, children learned from family and their community. They often found apprenticeships around 13 (what today is considered a helpless child), and learned a trade by doing. Children were not removed from the community, but were an active, creative, and necessary part of it. These days, if you see kids at the store during a Monday afternoon, they are out of place. That doesn’t seem right. What has the American culture done to itself?

Compulsory schooling became a thang in the early 1900s, about the time  a tremendous number of epic douchebags were diving into their vaults of gold. You may recall their names: George Peabody, Andrew Carnegie, and John D. Rockefeller are a few.

scrooge2
These were the Scrooge McDucks of their age, and they realized mandatory education was the most effective way of creating a harmless electorate, servile labor force, and horde of mindless consumers. I wish I was being dramatic.

Before these social barons got involved, school was not something one went to, nor was it a legal obligation. Washington, Franklin, Jefferson, Lincoln…these dudes were not the products of a school system. They were self-educated men, and they excelled because they pursued their passions. Lincoln, for example, had less than a year of formal schooling, and the majority of his childhood was spent as a farmer and carpenter (this is why he was good with the ax). Still think we need 12 years of structured schooling? Here’s a fun aside.

Everyone knows Lincoln is one of the most famous lawyers in history, but he didn’t study law, he read law, and he passed the bar at 27 years old. Being a country man, he was out of his league when asked to defend a high-profile, city client. The city lawyers sharing the case thought Lincoln was dumber than snake mittens, so they basically stood him up when the case was moved to another city. Realizing the game had changed, Lincoln identified what he didn’t know, filled the gaps, then PWNed those jerks at a later date as the president. BOOM!

The basic idea behind mandatory school laws was essentially Social Darwinism — a method of ensuring poor and middle class children were not misfits in the streets, but productive members of society… productive for the social elite, that is. You see, in Lincoln’s time, our society was still (mostly) Libertarian. Everyone was still inventing stuff. Gobs and gobs of fantastic inventions and patents galore. But, the country was making a gradual shift from a productive economy of rural start-ups (when innovation is necessary for survival), to industrialized consumerism. It started with the Civil War, then bled into the World Wars. Compulsory attendance laws would be the legacy of an after-war world.

So, lets jump back to the business barons.

Let’s introduce Rockefeller.

irocker001p1

Do yourself a favor and research this man, for his legacy is still affecting our politics. Look at that quote. Good God. What a privileged jerkface. Even now, our congress is fighting over building the Keystone Pipeline, a giant, environmentally destructive project which puts money in the hands of oil men (when we should obviously be investing in green energy). Like all epicly rich dudes, Rockefeller was into oil. He was the co-founder of the Standard Oil Company, which made him the world’s richest man, and the first to be worth more than a billion dollars. At the time of his death, his fortune was 1.5% of the American economy.

Holy shit.

Rockefeller did a lot of good for society and revolutionized philanthropy, but his personal motives were questionable, especially when set beside the wishes of the average, poor/middle class populace. Rockefeller’s projects were guided by two principles: Fundamentalist Baptism and Social Darwinism. I don’t have time to go into Social Darwinism here, but let’s summarize it as “not great.” Social Darwinism became a mechanism abused and distorted by politicians to declare blacks racially inferior, to forcefully sterilize mentally retarded people, and so on, ad nauseam.

Rockefeller formed the General Education Board in 1902. This is the point in American’s history when education fell under the control of the government. And it never left. As parents, we don’t think of our kid’s class room as government property, but it is. Behind the colorful billboards and smell of glue, hides the ever present government process at work. And who is in charge of school boards now? Lobbyists and corporations. Why are they so interested in public education? The answer is that public education is a hugely profitable business, worth about 650 billion dollars a year.

Because we’re used to seeing it, one has to stop to consider the influence commercialism has on our schools. When I was a Junior in High School, a product called Surge came onto the market, though it didn’t last long. It was a highly caffeinated, highly-sugared drink, a forerunner of today’s hugely successful energy drink culture. One can of Surge was 230 calories, 62 grams of carbs, and 51 mg of caffeine. I remember thinking it was “so cool” our school allowed Surge representatives to come to our assembly and toss free drinks to kids, during school hours. Now as an adult, and particularly as a physician, I am horrified my school allowed us to consume that kind of trash and I wonder what the administration got in exchange for hooking some of us on a drink that was a major contributor to childhood and adolescent obesity.

When I was in middle school, we attended a school-wide assembly to listen to a representative for “Bring it to the Max.” The speaker was skilled at motivational techniques, and he got us excited about selling magazines in exchange for small rewards. I remember being told if I sold ten magazines, I’d get some stupid key chain. The rewards escalated. If I could get a hundred subscriptions, I got something uber cool, like a set of shelves for my locker. The highest rewards included weekend vacations and bikes. The school earned money based on how much we sold. Man, I left there completely psyched to sell magazines! It consumed my next few weeks, and I was devastated when I couldn’t sell enough for a fun prize. I remember crying on the final day, because I had less than ten sales (all pity purchases). Looking back, I’m furious my school used me in such a way. And no one, including my family, saw the problem with a school using its students as private fundraisers. I can’t blame them. I mean, every public school was doing something similar.

Today, public students are forced to watch commercial-filled Channel One (a privately owned, “student-aimed” channel), to see Pepsi and Coke posters and vending machines in their hallways, to use curriculum materials printed by Shell Corporation and other big oil companies,  and thousands of similar exposures. Teachers, also, are the victims of commercial interests, often forced to adhere to government contracts to purchase school materials, or stick to “school-aka-corporate-approved” lists of subjects to cover. We cannot remain ignorant about the advertising aimed at our children, or the corporate bias influencing our schools.

The institutionalization goes further than academic exposure. It’s seen in the environment. Our schools often look like prisons or nuclear bunkers, with rows upon rows of straight desks, controlled activities, and schedules dictated by bells:

The first floor hallway in PS 149.

When I was in middle school, our principal decided there was too much talking in the hallways. Maybe this was true. We had hundreds of students in one building, and all regurgitated into the halls for four minutes between classes. In our hurried attempts for socialization, we congested the pathways. However, the chosen option was to demarcate small squares where conversation could occur. Squares were duct-taped in the hall, allowing for a max of three children to have conversation. Anyone talking outside was given punitive actions. Nice. Real nice.

All this because corporations were given free licence to use public education for their own benefit.

Just to emphasize the degree of corporate influence in the early 1900s, consider that, for many years, only two men, Rockefeller and his buddy,  Carnegie (of the Carnegie Foundation), spent more money on forced schooling’s early years than the government. They funded teachers, schools, Universities, and curriculum. They influenced the Education Board by awarding grants to those who followed along without complaint. And here was their philosophy, according to Frederick Gates, who was Rockefeller’s business adviser.

“In our dream we have limitless resources, and the people yield themselves with perfect docility to our molding hand.  The present educational conventions fade from our minds; and, unhampered by tradition, we work our own good will upon a grateful and responsive rural folk.  We shall not try to make these people or any of their children into philosophers or men of learning or of science.  We are not to raise up among them authors, orators, poets, or men of letters.  We shall not search for embryo great artists, painters, musicians.  Nor will we cherish even the humbler ambition to raise up from among them lawyers, doctors, preachers, statesmen, of whom we now have ample supply.”

Shocking, isn’t it?

If you want a complete timeline of compulsory education, here is a decent summary: Timeline of Compulsory Education

Public education was founded on the concept that, if you came from working class society, you didn’t go to school to learn (that was for private schools), you went to be taught how to be a good worker. Only then would you be effective fuel in the furnace of the industrial revolution. Furthermore, the corporate moguls used the Prussian educational system to base American school on. Yeah… Prussia really wasn’t the leader in hands-on enlightening experiences. Unless you were talking about a public flogging, in which case you might be quite satisfied.

So, how did Prussia surgically extract the soul from its children? By ensuring kids were separated by age, subject, and performance grading. Sound familiar? So, lets’ talk about those grades…

Question 2: Who Gives a Shit about Grades?

For adults, our time to escape the system is passed. Let’s face it… we learned to perform solely for the purpose of single letters.

That’s right. Grades. Oversimplified symbols representing our worth, intelligence, potential, and ability to please the institution. We lived our childhoods under the shadow of  A, B, C, D, and F. Let me say that again: our entire childhood, meaning a minimum of 12 years (since most public schools require you, by law, to be present in school from the ages of 6 to 18), was aimed toward the goal of earning a grade. This is such a prevalent part of American life we persistently fail to recognize how absolutely ridiculous it is. Unless you’re reading The Scarlet Letter, I defy you to tell me how a letter describes one’s worth. It can’t. Just look at the ways a person’s character is graded by a teacher in this example:

Report cards

After discussing corporate machinations, the idea of getting grades on character traits is spine chilling. Just look at the “worthy” traits… exactly what you hear about in corporate training when you get a new job. What about innovation? Creativity? Leadership?

In addition, there is no evidence out there that grades mean anything. No study has ever found a correlation between intelligence, quality, innovation, or potential, and the degree of one’s “good grades.” We constantly talk about how Einstein failed math and became a genius who changed our world. In other words, the uselessness of grades is part of our culture’s mythology, and yet, we still focus on getting good grades above anything else. It seems nothing is more important than good grades. If you have time, watch this documentary. Consider how brilliant this young man is, then watch him decline into anxious failure as he is forced to produce his work according to format. Then consider the reaction of well meaning parents and teachers, none of them who question that, maybe, the school is the problem:

Parents know there is more to our children than what is on a grade report, but that hasn’t stopped us from allowing our children to be filed under a grading system. I had it easy. I was one of the few who didn’t have to struggle to make good grades. Therefore, I didn’t think about it much. In fact, I was proud I didn’t have to struggle, and I admit it gave me a bit of intellectual superiority. Today, I realize I was one of the completely average children the school system was designed for. I am the factory worker. And now I’m a doctor working for a major corporation. I’m proud of my work, and I work for a company who treats me well, but there’s a part of my soul wishing to throw off the shackles and run to foreign countries to provide mission work. Maybe, some day, I will. Or, maybe I will remain a corporate monkey to ensure my children have the resources to escape the system. Who knows.

Let’s take my husband’s childhood as the opposite example. He has a spontaneous genius that far outweighs my textbook regurgitation. Yet, his entire youth was one giant string of anxieties and disappointments, all over his grades. An ADHD kid trying to make A’s in an institution already designed to cripple his natural learning style? It’s no wonder he started to have self confidence issues in fourth grade, when homework and grades start to count. Soon, school was nothing but a progressive trial in trying to prove he was a smart and worthy human being, all the while constantly disappointing teachers and parents. It’s not fair, and it’s a dumb way to waste a child’s potential. Was getting assignments in on time and making good grades really a measure of his intelligence and capability? Obviously not.

So, think about it. Really think about it. What does a grade mean? Anything of actual value? Prove it. All that time we spent making A’s?

Wasted.

It should have been spent learning something of value. Nature walks. Finishing the book you couldn’t put down. Exercising. Enjoying the evening with friends. Getting sleep. A thousand happy moments were wasted typing papers and filling out worksheets. And frankly, many of us are still recovering from the damage it caused.

Grades are necessary for college entrance, to give colleges a number (your GPA) for which to rank you. That is the only purpose of grades and, frankly, there’s something a little evil about it. How will my son’s life be different if he isn’t worried about making As? I’m not sure, but I’m going to find out.

Question 3: Don’t We Need Trained Educators to Teach Our Kids?

Um. Nope. Sorry. I’m not saying grade school teachers are worthless buttheads that should go get real jobs. On the contrary, I had delightful teachers as a child who had great personal interest in my life. But the truth is, it doesn’t take a degree to teach a child. They are naturally programmed to learn and the more we interfere with turning education into a process, the more harm we are likely to do.  And, in an effort to maintain Core Measures (more about that elsewhere), we are stunting our children’s growth. No Child Left Behind? More like, No Child Gunning Ahead, or No Child with Actual Enthusiasm. Or, even, No Teacher with Freedom. Do they really need to have every aspect of what they learn spelled out?

The answer is yes, if you’re attempting to make an army of employees and consumers.

But if you want your children to flourish? Let them manage their education themselves. Evolution has given us a delightful, complex, and wondrous brain capable of doing just that.  As products of the system, parents believe we are not competent to teach our children, but who could be more qualified? We do not need advanced degrees or training in childhood education to identify a child’s enthusiasm and to foster it. If you find a topic you are unfamiliar with? Learn it with your child!

When you free yourself from school’s schedule, you free up a fantastic amount of time to teach your children. Think  about the amount of time taken up by BS when you went to school: the time spent getting into lines, monitored lunch breaks, pep assemblies, changing classes at the bell, etc. Then think about the amount of time spent on projects that were meaningless! How often did you ask a teacher, “but what is the point?!” Just think how much children prepare for standardized testing (since good scores on standard tests are how schools get funding)?

In other words, how much actual learning takes place in which kids are interested in the subject matter, and the subject matter actually applies to usable skills? Now, imagine your child being free to pursue whatever he or she is into at the moment. Every day is open for them to jump into their passions, get involved in a volunteer project, or find an apprenticeship. That’s learning!

In the end, if you’ve made it this far, I hope I’ve convinced you that public schooling has questionable motives and questionable execution, and I hope I’ve given you some ammunition for those questioning your decision to home school. Keep in mind that what I’ve written about here are only three simple tracks leading into a much deeper rabbit hole.

Children are the best part of us. Don’t be afraid to teach them. Don’t be afraid to stand up to the establishment on their behalf. And, if public school is something you cannot escape, don’t be afraid to question school authority.

And try not to think too much about how much Surge you drank in high school. After all, you only need one kidney.

I Wish I had a Truck Brain

The decision to homeschool didn’t take long once the idea was in our heads. We needed a modern solution to an outdated social standard and homeschool was it (private school was the runner up, but it shared many of the same problems as public schools. This topic is discussed elsewhere, and if you’re not convinced public school is outdated and potentially harmful, I’ll convince you).

As a bit of background, we refer to Kallan’s active brain as a shiny race car — beautiful, powerful, and able to take turns that would cause any other brain to sail off the edge of the cliff.  My brain is a large, somewhat rusty truck which putters along but can store an amazing amount of material. It may not be fancy, but I’ll take my family’s race cars and trucks over all the sedans jamming up the streets.

Anyway, a mere four months into the curriculum we knew there was a problem.  Our son’s self-confidence started to plummet, and we heard comments he had never uttered before:

“Mommy, I’m just not as smart as the other kids.”

I realize I may be biased, but frankly, our son is a fucking genius who sees the world in a unique way I envy. Want evidence? Here is a Ghost Robot he invented when he was two years old.

ghost robot

Kallan was no longer the forever-smiles kid, and we could no longer endure his self-defamation. But when to start homeschooling? Should we wait until the end of the year? This seemed reasonable at first, until my son dropped a ton of bricks on me.

“Mommy, I don’t like my race car brain. I wish I had a truck brain.”

That was the moment the decision to homeschool was made. We would not allow my son to feel inferior simply because schools pattern lives around imaginary constructs called grades. Naturally, Kallan’s internalized shame hit my husband hard, as he can relate to Kallan more than anyone else in the family. Rob knows what it’s like to be told you can’t keep up with the others, when inside you’re bursting at the seams with brilliant ideas. He’s still thinking about it, as evidenced by the following:

“I Wish I had a Truck Brain”

They say my brain is special.

I think faster than the rest.

Daddy thinks like me,

But Mommy’s is the best.

 

She can study really hard;

She can memorize.

When I sit down to study,

I’m completely paralyzed.

 

They say if I “can just slow down,”

Enough to learn this thing…

But that’s just it!

I can’t slow down.

I want to play and swing.

 

I want to learn like all the rest,

I hate my race car brain.

Why can’t I be normal?

Why suffer through this pain?

 

They say my brain is special,

Not some sadistic jest.

But I wish I had a normal brain,

‘Cause Mommy’s is the best.

–Written by Robert Ren.

You’re Just not Motivated

[This is a work in progress and mostly unedited. It will be completed soon, but feel free to start reading.]

It’s terrible, but true: some patients are the jagged little rocks scattered about your otherwise peaceful Zen garden. They never leave (either your practice or the actual appointment), have bizarre needs, and always manage to turn your feng shui into feng fray. When I was an intern, the martyr resident who normally treated Julie’s family called in sick, necessitating a rescheduling of the day’s appointments. Three of us had an available opening, but the other residents had a slightly panicked look on their faces.

“Hey, uh, Ren! You need numbers for graduation. You could get both kids in one visit!” grinned Dr. G. with a snap. “Two in one.” His smile was suspicious … everyone knows interns are incapable of smiling until the next wave of indentured servants start in July. Besides, he kinda looked like this:

totoro creepy smile

“Uh huh. You’re an intern too, why don’t you want the numbers?”

Pfft. Are you kidding? I’ve got tons of numbers. I was just being nice.” He turned to walk away muttering something along the lines of “harbinger of doom,” which naturally led a group of mature, budding physicians to burst into an infantile battle of “you-owe-mes.” Our nurses were not amused.

Unhappy Laverne

Our Attending intervened with the perfect solution of Rock-Paper-Scissors, and thereafter I remained the physician for Julie and her two sons.

They didn’t come in much, but when they did, I had thirty minutes to address problems with both boys. Rather than thirty, however, these clinic appointments often stretched to an hour, putting the rest of my day off an already tight schedule. The boys, Andy and Mark, both possessed frames made for quarterbacking, whereas Julie was extremely thin and looked like she either lacked enough money to buy groceries, was anorexic, or was doing drugs (cocaine can produce a similar wasted-away effect, and I often thought this was one of her demons). Her children were polite but silent as I listened to a high-strung, poorly educated, suspected drug-abusing mother tell me about how they were defiant, violent, destructive, and often ditched school. They were early teens, maybe 14 and 16 years old. There were entire days Julie had no idea where her boys were until they made their way home after dark.

“Andy? Mark?” I’d ask gently, knowing very well there were two sides to this story. “What do you think about what your mother has to say?”  Frankly, I always trusted the boys more than their mother, who was either high when she came in, or manic from untreated bipolar disorder. I was never sure what she wanted me to do. She thought there was some kind of magic pill I could provide to “bring the boys in line.”

In response, the boys would shrug and tell me stories about how school “just didn’t work for them.” How they “couldn’t learn anyway,” and had “worthless teachers.” While they sat there, they would fidget. Constantly. Tapping shoes. Grinding teeth. Getting up to pick things up in the room or play with the otoscope. Shake their knee. They just couldn’t stop, and their mother was no better. She was practically vibrating in place, opening and closing her purse, rubbing her arms (another drug hint, usually associated with meth), and shifting in her seat. I could never get more than three sentences in before she was interrupting me again. By the time they left my office with encouragement to visit their social worker to be set up for further psych testing, I was exhausted.

Several months after one family visit, the mother came to see me alone. I winced when I saw her name on my schedule, but I entered with a smile and asked how the boys were doing.

“Oh, same as always.”

I nodded, as I noticed she looked less gaunt than normal.

“Did you ever get them into the case worker?” I prompted, already knowing the answer.

“Ah, well, I meant to, but I just keep forgetting. You know how it is. But, listen, doctor, I won’t take up your time. I just needed to know how far along I am.”

I paused. “Along?”

“I’m pregnant. I need to see if I’m early enough to get an abortion. I just can’t have another kid, yet alone one like those boys.”

I’ll save the description of my inner turmoil during this patient case, lest I launch into a ten-page diatribe about responsible reproduction.  But to summarize, I followed through with my medical obligations the best I could, and provided all the information to my patient for her to make a safe choice. Julie was relieved she was under twenty weeks and was scheduled for an abortion the next day. It was her eighth abortion, and twelfth pregnancy.

This case may be an odd one to use for an ADHD topic, but it has some excellent points that fit into the larger cultural debate about ADHD and the validity of the diagnosis. Certainly, Julie and her family could be the case study of countless social issues including poverty, lack of education, drug abuse, teenage violence, and reproductive rights. But what I wonder is, how much of what I saw was the result of nature, and how much was nurture?

So, let me first summarize the debate surrounding ADHD: Is it a real diagnosis, or is it a made-up shenanigan by pharmaceutical companies which doctors and teachers have bought into? This is a question of vital concern to those who are confronting ADHD in their lives, either because a teacher has suggested it to a parent, or because a child is having learning difficulties, or because an adult is struggling to manage his or her life. There is a perception among social and professional circles that ADHD is a misleading title for what the medical profession calls PPP: Piss Poor Parenting. But is it really?

Naturally, I’m writing a blog about ADHD, so my readers can assume I believe in the medical validity of the diagnosis. I am also a physician trained to recognize it (although its treatment I deferred to specialists). I’m a clear advocate for the diagnosis, but I will also tell you why and list the points used against it. The reader can decide for himself. Julie’s family will provide a case study for us to consider throughout this discussion.

ADHD is Still Debated Among Medical Professionals

This is a common assertion made by anti-ADHD advocates. But is it true? From personal experience, there was never a time in my medical career, either pre-med, medical school, or residency, when the diagnosis was up for debate. It was presented as fact, with copious amounts of evidence regarding the diagnostic method, the associated factors (e.g. an increased incidence in males), and clearly positive results after patients started stimulants.

The Pianist

Mrs. G was one of the tiniest women I had ever seen. She was in her nineties. When I met her, she was enveloped in the blankets of her hospital bed, like a newborn wrapped in an over-sized baby blanket. She couldn’t have weighed more than seventy pounds. Her skeleton was easily traced for there was no muscle left. Purple veins cross-crossed under her skin, like a child had drawn on her with purple marker. Her skin was fragile and soft…ever so soft, like paper made from tissue wrap. Like rose petals. I loved touching her arm. Even over the hardness of her sunken frame, her skin was like silk.

You see, Mrs. G was dying. Quickly. Her tiny frame, her emaciated and fatigued body, was courtesy of stage four squamous cell carcinoma of the lung. That is usually a cancer caused by smoking, but Ms. G never touched a cigarette in her life. Her husband, on the other hand, smoked around her daily. He died three years prior of his own lung cancer.

Ms. G was a pianist. She loved music. Even dying, she recounted the works of all the great composers. She played the piano in the air, her deft and thin fingers commanding a tune only she could hear. She was sick but her mind was sharp. She had much to speak about. Her grandchildren. Her garden. Her parents. She tended to regress when she got her Morphine. That’s when she talked about learning to play the piano and that’s when her eyes were the brightest.

When in a peaceful delirium after pain medication, she told me about the keys of her father’s piano. The softness of the ivory. Her dad’s finger marks on the keys, telling her where to place her hands. Her father died when she was a teenager, but she continued to use his piano until she was older and married. She said following his fingerprints was like being taught to play by an angel.

As the days passed, she had more trouble breathing. Eventually, she was placed on a BiPAP. I’ll never forget how shocking it was to walk in the room and see this small woman strapped to an enormous face mask. She was alone at the time. The machine forced air into her. As it did so, it took away her ability to speak, dried her out, and imprisoned her. Never have I seen such a perfect example of a treatment being worse than the disease. Her delicate fingers were clutching the bed covers as the machine battered her with breaths. It was violence. The BiPAP was her aggressor. I couldn’t stand it and neither could she.

When I walked closer, I realized she was saying something under the mask. I lifted it. “Take it off. Off,” she whispered.

“Ms. G, if we take it off, we will have to give you lots of Morphine.”

She nodded.

I hesitated. “It will be…it will be the end. You won’t wake up.”

A single tear fell down her cheek. “I know.”

So we did it. We gave her a loading dose of Morphine and pulled off the monstrosity wrapped around her face.

She went quickly. Faster than expected. Her family did not get there in time.

But her hands were in mine when she passed.

Rose petals.

Playing music.

Forever.

The Diabetic

It was Saturday afternoon. It was one of those rare days when the weather was perfect for laying in the cool, newly sprouted Spring grass while chubby white clouds drifted over. Glancing out the window with unadulterated yearning on my face, I ached for the rare potential to relive a careless day from my youth. Instead, I was making rounds in the hospital. Since it was the weekend, I had double the patient load. My hope to escape to the outdoors was piteous. There would be no escape from the sick today.

Standing inside a dark room while my pneumonia patient coughed violently into the bedside commode, I felt as if I was going through clinical withdraw from…from life. My dark reverie was cut short as the pager went off for the hundredth time that morning, its aggressive soul-puncturing beep calling me from the room on yet another unpleasant errand.

The nurse who paged me informed me her 53 year old patient, Ms. D, had a blood pressure of 220/120 and was refusing any medications. I sighed and reviewed the medical information on my patient list. “Morbidly obese, urinary tract infection, high cholesterol, chronic kidney disease; admitted for hypertensive emergency.” In other words, our average patient. I made a quick check of her morning lab work before visiting her and was unsurprised to discover her diabetes test had come back positive. Very positive.

When I entered the room, it was with a smile. Maybe the patient was scared and no one had explained the urgency of treating her high blood pressure. Maybe she just needed someone to spend time with her. I went in with a goal—to bring her blood pressure down to a safe level and to have a much needed discussion about her new diagnosis.

The nurse met my eyes when I entered. I could tell from her exasperated look the patient was being difficult. There’s a certain visual malevolence nurses get when they are fed up with a patient. It’s as unmistakable as a stray dog watching you from a bowed head…reach for that food bowel and you’re going to get bitten.

Ms. D met the profile I expected with her list of diagnoses. She was fantastically obese, her stomach overhanging down her thighs. Her small knees sat above large calves which were marred by the leathery skin changes caused by lack of circulation. Her gigantic upper arms strained the cuffs of her gown’s arm holes. She had an IV in place which was secured with half the hospital’s available tape…if that thing came out, it wouldn’t be replaced easily. Her legs jutted out in a splayed and aggravated fashion, her bed sheets kicked carelessly off the side of the bed. She was hot. The room was freezing. She looked old, much older than early fifties. She breathed heavily, a consequence of the pressure from her immense abdomen, as well as the pull from two massive breasts which rolled off to the side since she was also braless.

She was Caucasian. Her hair was flaxen and thin, pasted to her forehead and uncombed. It had the yellow tinge of nicotine, indicating she was a heavy smoker. She had a dour look on her face, accompanied by silver-framed glasses squished against the bridge of her nose. The lenses were covered with greasy finger prints. She had pig-like eyes hidden behind the flesh of her face. She had few teeth.

As soon as she saw my white coat, she ‘harumphed,” and turned her face to the wall.

I paused. The patient was easy to dislike from first glance, but I thought maybe I would be the doctor who could get through to her. “Ms. D, I am Dr. Ren. I’m one of the resident physicians here. I am helping to cover for the weekend.”

“You’re too damn young ta be a doctor. Get out and send a real one.”

I laughed, gently. “What does a real doctor look like?”

She turned then, looking as if I surprised her. “A real doctor is old…like me.”

“Unfortunately, I’m the only one here. My attending will be by later. He has grey hair, if that will suit you.”

She sat up with some effort. “Never mind. If you’re it, you’re it. I suppose you want me to take some of that crap for my blood pressure?”

“I do. Your blood pressure is high enough it could hurt your brain or your kidneys.”

She crossed her arms like a petulant child. “I don’t want it. I came here because I was pissing fire and now you all have me here like a prisoner! Day after day after day of medicine and bullshit! And the food here sucks! Just sucks! No salt, no taste!”

I smiled to myself as she ranted. Glancing at my patient list, I saw she was only admitted yesterday morning and had been placed on a low sodium diet because of her blood pressure.

“You’re always free to leave, Ms. D. Though it would be nice to take care of some of your other medical problems while you’re here.”

“I ain’t got no problems! Just this UTI or whatever you call it.”

“Actually, your high blood pressure is a big problem. If you would let me treat it, we could talk about it more.”

“No. No medicine.”

I thought maybe she didn’t understand what hypertension was. “Do you know what high blood pressure is?”

“Yeah, I know. Means my heart is working too hard.”

I was surprised. “Do you know what can happen with pressures as high as yours?”

“Yeah. I can have a stroke.”

I paused, not knowing where to go from there. “Can I ask why you won’t let us treat it?”

“CAUSE I DON’T NEED IT!” She burst into a shriek which was heard down the entirety of hallway. I sighed and sat in the chair in the room, hoping it might make her less confrontational. I kept a cool temper, though she was starting to irritate me. The outside looked lovely from her room and I couldn’t believe I was sacrificing a beautiful day to deal with her nonsense.

I thought a change in subject might help. “Can we talk about another issue? Besides your blood pressure, I saw some concerning things in your blood work. Would you like to discuss it?”

“Go right ahead, little miss doctor.”

I took a moment to cool down. The nurse was watching me with a conspirator’s grimace as I began to recognize the enormity of the problem this patient must have caused for the nursing staff.

“Do you know what diabetes is?”

The patient looked at me warily from the corner of her eye. “Yeah…a sugar problem.”

“In a sense, yes. It looks like your other doctor tested you for diabetes and it came back positive. I would like to tell you what tha—”

“YOU GAVE ME THE DIABETES?!” Her voice rose to an impressive level. I wouldn’t have thought her smoker’s lungs would have allowed such projected volumes.

“Diabetes happens over time—” I started to explain.

“I DIDN’T COME IN HERE WITH DIABETES, AN’ I’M LEAVIN’ WITH DIABETES, SO I GUESS THAT MEANS YOU GAVE ME DIABETES!” She said this with complete condescension in her voice, as if I were wearing a dunce hat instead of a white coat. I suppose that’s when I got…irritated. I stood.

“Ms. D,” I said tersely. “You have diabetes because you’re fat and you eat junk food. You did this to yourself. There is only one person to blame here.”

“AND THAT PERSON IS YOU! GET THE HELL OUT OF MY ROOM!”

A glance at the BP monitor continued to read her blood pressures at dangerous levels. Mine was probably not too impressive at the time either. I left the room and grabbed her chart so I could document. I had to ensure my story was written down, to protect myself legally whenever Ms. D inevitably stroked out.

I paused in the middle of the hallway, feeling defeated and angry. I’m embarrassed to admit it, but a part of me wanted something awful to happen so I could say, ‘I told you so.’ I wanted to scream back. Write a passive-aggressive note in her chart. I was full of rage that this fat, mouthy woman accused me of something ridiculous, tested me, and tossed my kindness back into my face. I wanted to cry, because the world outside was beautiful and I was tied to these awful people. These sick people who couldn’t take care of themselves or understand why they were sick. I felt enraged at a social system that encouraged chronic illness and failed to treat it. And I felt hopeless, because she would leave the hospital and be right back in, waiting for the next white-coated victim to try and help her.

Sometimes, there’s no way to help, no way to explain. And yet, I’m the one who felt like the failure, for losing my temper, for failing to reach her. All the training I had about trying to understand the core of a patient. Was she afraid? What was her emotional reaction really caused by? Did she want to die? Did she need attention so bad? What could I have done different? Did I do the wrong thing by giving up and walking out? And…is it really my job to proffer psychological analysis on each difficult patient? I just don’t have the time.

The nurse followed me out, asking what she should do.

“Just put her on a sugar free diet.”

I went to write my note.

Child in Motion

Those who do not deal with ADHD children cannot possibly appreciate their need for movement. Allowing a hyperactive child the ability to move is absolutely vital and often underestimated. This is not only underestimated at school, but at home as well. Frankly, an ADHD child cannot possibly succeed in any task unless the surrounding adults recognize the issue and accommodate it.  Often, teachers and parents worry about their child conforming to an educational ideal–a child who can sit at a desk and absorb information. Forcing a hyperactive child to remain at a desk virtually eliminates all his potential to learn that day. It would be the same as putting ear plugs in a non-ADHD child, then demanding to know why she can’t answer any questions. This happens all the time, and I am guilty of it too. After all, I was the average student in school and I had certain assumptions about education. It’s an understatement to say my son’s interaction with the world took me by surprise. But, I’m learning.

In this article, I hope to convince readers hyperactivity should be recognized and accepted as part of the ADHD child, and is not something which can be altered any more than you could alter his or her eye color. In a separate post to come, I will discuss some of the ways to handle hyperactivity in a positive way. But for now, let’s see what living with the overly excitable child is like.

From six months on, my son was a “flapper.” At first I didn’t recognize it for what it was–I remember him laying on his back as a chubby, happy baby, flapping his arms as hard as possible. With his little fat arms pressed against his side, his hands flapped at the wrists so fast they blurred. He looked like a turkey desperately trying to reach the sky. Or this…

 I laughed, commenting about his energy and assuming, like most children, he was simply exploring what his body could do. In addition to flapping on his blanket, he loved, loved, loved the jumper.  He would spend almost two hours at a time in it, bouncing nonstop until someone finally took him out of the seat. Again, I thought this was benign activity that would slowly fade away.

Oops.

The flapping continued. As he hit nine months, I worried because I knew autistic children flapped as a way of managing excitement and emotional intensity. I reminded myself many children are flappers in their infant and toddler years. Several times in clinic, I told parents not to worry about this trait, as long as the child met his developmental milestones. Physicians are quite confident until it’s our own child!

Kallan was extremely sociable, however, so I gave up my autism fears, but I could still tell something wasn’t quite “normal.”  When Kallan flaps, he doesn’t just move his arms a little, he literally flaps like a baby bird trying to launch himself out of the nest. It’s impressively fast, and somehow, he is unconscious of the activity. And it happens all the time.  And it’s catchy–our two year old daughter has started doing it too, simply because big brother does it. The flapping happens continuously: when he’s imaging something exciting, watching a movie, hearing a story, playing a game, talking about anything, receiving praise, etc. I can certainly imagine how this would not only be distracting in a school setting, but a target of ridicule as well.

And flapping is not Kallan’s only chronic activity. While it’s the most observable, he is constantly moving.  He paces the room round after round, often lost in imaginative play. He sits on the edge of chairs because he can’t stay in one place long enough to bother. He chews his nails. He chews his shirt sleeves. He sometimes rubs his palms rapidly on his inner legs (which I know is his way to have hand stimulation, but of course its terribly embarrassing in public). He is constantly talking. He grabs things without permission and without thinking, which is often worrisome in stores. I know we are not the only parents dealing with this behavior, and it’s no wonder parents finally resort to medication. The problem, however, is that Kallan needs this kind of activity in order to learn. As soon as he is restricted physically, any attempt at teaching is lost.

So what does a parent or teacher do? Hyperactivity is not socially acceptable, and before one knows it, you’re in a meeting and they’re recommending your child undergoes a physician’s assessment to start medication. In the case of our public school, we haven’t had this conversation, but I know they simply don’t have the resources to properly filter Kallan’s activity load. We live in a middle-to-upper class district, and our schools are still underfunded and have too many children per class. Kallan’s kindergarten class has 25 students! How can a single teacher possibly deal with all those children while also fostering an ADHD child?

As a parent, the first step is recognizing the hyperactive behaviors. The second step is to realize the hyperactivity is not intentional. Once parents realize their son/daughter cannot help the activity, it helps to unburden us from anger and frustration. This is extremely important, because ADHD children can sense they are failing. They know when mommy and daddy are frustrated, and when parental anger is over something the child cannot control, children begin to feel shame. The longer ADHD goes unrecognized, the more shame children start to carry. Trust me, you can ask my husband about this one–his ADHD wasn’t diagnosed until adulthood and his path to emotional recovery has been long (and the focus of another posting).

Really, that is the first step: believe the hyperactivity is unintentional. It’s unintentional when your child doesn’t listen, says “what?” for the thousandth time, leaves the dinner table again, and runs around the store uncontrolled (making you look like a crappy parent while the other shoppers watch). They can’t help it,  and being criticized over and over again for hyperactivity they cannot control starts to undermine children’s confidence.

For many people, especially those who have not dealt with ADHD before, this is a hard thing to accept. It’s hard to believe a child cannot remember to sit at the dinner table after you’ve told him to sit four times. It’s natural for parents to eventually blow up, but if parents cannot recognize the involuntary nature of ADHD, they will not be able to deal with the hyperactivity without anger. Parents must be advocates for their children, because there are many people out there who believe ADHD is a made up diagnosis. Once you see your child’s over stimulation for what it is, how do you manage it without resorting to raised voices? How can you redirect hyperactivity at home and at school into a positive experience? That is the subject of my next post.