A child does not have to have all of the symptoms of ADHD in order to be diagnosed. Only 6 hyperactive/impulsive symptoms are needed to diagnose ADHD primarily hyperactive/impulsive.  The child needs 6 of the inattentive symptoms to be diagnosed with ADHD primarily inattentive.

If the child has six in each category, the combined ADHD can be diagnosed.  However, 3 year olds probably need to have 7 or 8 of the symptoms since more of the symptoms are normal at that age.  It is also important that the child be compared with his/her peers when deciding whether the symptoms are present.  Finally a child must also meet the impairment requirements in DSM IV in order to be diagnosed.  If the child is not significantly impaired, the diagnosis should not be given.

If you have concerns, I recommend that you take your child to be evaluated by a child psychologist or by his/her pediatrician.

~Dr. C

Today I am going to discuss some of the advantages of joining a support group. Support groups can help you in several ways. To begin with they offer you a group of peers with whom you can swap frustrations, successes, and strategies. Frequently talking to peers is less threatening than talking to professionals. Sometimes peers have practical insights which we professionals might overlook.

Next, peer groups offer you a place where you can learn which local professionals work well with ADHD. Other parents know which professionals have been able to help them. They also know which school teachers and counselors are sensitive to ADHD.

Peer groups are able to recommend or even provide advocates and help you to better understand your rights. They are also able to set up professional presentations so that you can learn more about ADHD. There are regional and national conventions at which you can learn from many different experts. ChADD, http://www.chadd.org, for example, will be having their national convention this November in Anaheim. I will be there with Elwood and lots of other fun surprises. I hope that I will be able to meet those of you who attend.

Finally, sometimes you can meet parents at support groups who are willing to swap baby sitting with you. As you all know, it is not always easy to find people you trust who are willing to stay with your children while you have a well needed, relaxing night away from responsibilities.

Peer support groups can be a very worthwhile investment in time, energy, and money.

We are building a Support Group of our own! It’s Dr. C & Elwood’s ADHD Club. Sign up for our newsletter to receive helpful tips to help your child and your family!

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Frequently Asked Questions about ADHD:

“How can you tell if your child really has ADHD?”

The most common way to evaluate a child for ADHD is to first interview the parents in order to obtain a complete family psychiatric history, a description of the child’s behaviors, and information about the pregnancy, delivery and early development. Parents and teachers are also asked to complete symptom checklists. In order to diagnose ADHD a child must also be significantly impaired. In my work with families, I find that most parents who have children with ADHD have a reasonable idea what the problem is before they come to see me.

“What are positive effects of medication? Negative effects?”

Positive effects include a reduction in hyperactivity, impulsivity, and distractibility. People have the ability inhibit thoughts so that they can stay focused on one topic. Negative effects include decreased appetite, insomnia, stomach aches, and headaches. Sometimes the medication can increase tics. Some children appear to have their personalities depressed when the take stimulant medications. This appears to be unusual. If one experiences negative effects, sometimes they just go away as you get used to the medication. If not, you can ask your physician to try another medication.

“Doesn’t it seem like ADHD is a modern day epidemic? Is ADHD even real?”

ADHD is a real neurological disorder. People with ADHD have a lower level of brain activity in a part of their brains. Some structural differences have also been identified. In the past, children who could not succeed in school, could work on the family farm or some other job which was more ADHD friendly. We now have fewer jobs available which work well for people with ADHD. It is being identified frequently now since we are looking for it, are more sophisticated in our ability to identify it, and also because we make greater demands on younger children than we did in the past. ADHD was first identified over 100 years ago and has been treated with stimulant medications for over 60 years. In fact using stimulants to treat ADHD was the beginning of child psychopharmacology.

More on the way!

When you put your hand up, you can block out the sun. One little hand can stop you from seeing the biggest object in our solar system. This phenomenon is truly amazing.

ADHD, just like your hand, can block out your ability to see and enjoy your child. There is a tendency to find ones self focusing entirely on ADHD related problems and losing sight of the child as a whole. It is easy to fall into this trap when every night you spend four hours helping your child do homework, when every time the phone rings during a school day you begin to feel anxious that your child is again in trouble, when you feel unable to take your child into stores or to other children’s homes to visit, and when you spend considerable time in counseling sessions because of the ADHD.

DON’T LET ADHD STOP YOU FROM ENJOYING AND APPRECIATING YOUR CHILD!

Find fun activities which you can enjoy doing with your child on a regular basis.
Limit the amount of nightly homework time.
Reduce the amount of energy you spend on ADHD related problems.
Appreciate your child’s assets instead of only focusing on the deficits.
Don’t take the problems personally or too seriously.
Create an ADHD friendly home environment to increase success to reduce the stress.

Remember that your children will only be children for a short time period. If you spend all of your time on the problems, you will miss out on all the fun. Don’t let ADHD block out your son or daughter. If you don’t start enjoying them now, they’ll be grown up before you know it.

To oversimplify, there are two types of solutions: ideal ones and practical ones. If your children fight frequently, the ideal solution is to teach them to get along better. This is often quite difficult to accomplish. Some practical solutions are to separate them (just yesterday I recommended separate bedrooms for two siblings) or pay them for getting along. It doesn’t feel right to most of us to pay our children to treat each other appropriately, but sometimes even this technique can help reduce family stress and break the pattern.

It is important to remember that one size does not fit all for ADHD. Some children, if you let them run around a great deal prior to bed, will settle down and go to sleep. Other children might become over stimulated. The goal is to when in doubt try something. If it works, great. If it doesn’t, alter your plan or try something else.

~Dr. C

WHY COUNSELING

SAMUEL R. CARON, Ph.D.

We all know that the treatment of choice for children with ADHD is a combination of medication and counseling. The medication increases brain activity and thus improves functioning. What I am going to discuss today are the purposes for the counseling component.

My first goal when I counsel ADHD families is to educate children and parents about ADHD. I use my 10 video lessons (http://www.adhd1.net/adhd-dvd.htm) to help me accomplish this. Understanding the disorder helps parents make informed decisions. It also aids them in better differentiating between misbehavior and ADHD related problems. It allows them to feel more comfortable with the medication when they understand the disorder and the purpose of the medication. It gives them the information they need to explain what is going on to skeptical relatives and friends.

Understanding ADHD

The children also need to understand the disorder. Understanding ADHD allows them to blame ADHD for historical inadequacies. This is probably better than their previous conclusions since so many children with ADHD decide that they are bad, stupid, crazy, lazy, uncontrollable, unlovable, etc. This education helps achieve a second counseling goal of improving the child’s self-esteem, which is so frequently damaged.

While encouraging the child to blame previous problem behaviors on ADHD, I simultaneously discourage them from continuing to use ADHD as an excuse. It is important that children take responsibility for their behaviors. On the other hand, we simultaneously want to make their environment more ADHD friendly so that they have a better chance of succeeding. Helping families develop ADHD friendly environments is a third goal of counseling.

Reward Programs

Setting up reward programs; improving family communication; constructing external reminders such as signs around the house; developing consistent family structures; reducing family arguing; practicing personal problem solving strategies; developing reasonable expectations; if necessary, reducing the amount of time spent daily on homework; having more family fun; helping parents to stop taking the problems personally; etc. are all ways to help make the environment more ADHD friendly.

Another counseling goal is to educate the children and parents about medication. It is easy to fall into the trap of thinking of the medication as a good pill or a smart pill. We discuss the fact that there is no medication that will make them smarter or keep them out of trouble. Although the medication does help improve concentration and reduce impulsivity, the children must try in order to improve. I want children to take responsibility for any improvements since this can also help improve self-esteem.

I think that some children resist the effects of the medication if they believe that we are trying to control them. That is why it is essential not to tap into their oppositionality with regards to medication.

Educate the Family

Another goal of the counseling is to educate siblings about ADHD. This can help them better understand the problems. We want the siblings to be our allies in treatment, and we do this by involving them in the treatment process.

A major counseling goal is to repair what is broken. ADHD can impair the relationships the child has with his parents, siblings, teachers, and peers. It is important to try to repair these. ADHD can also strain the relationship between the parents. It is essential that the parents are able to work together as a cooperative team in order to cope better with the problems.

Another goal of counseling is to determine whether other family members also need treatment. Every full sibling has a 40% chance of having the disorder. It is not unusual for the primary care taker to be depressed, and so this also needs to be explored. Parents might need marital therapy if the problems are affecting their marriage.

This article is not all-inclusive, but it does provide information about the importance of the counseling component.

Samuel R. Caron, Ph.D.
Dr. C & Elwood

Imagine my surprise when yesterday I learned that Amazon.jp was down to their last copy of the Japanese version of my ADHD DVD book. Of course I really don’t understand what that means because I don’t know if they started out with five copies or 500 copies. However, I was quite heartened to also discover that more copies are on the way.

A little bit of personal history might help you to better understand how in the world I ever ended up on Amazon.jp. Besides being a psychologist, I am also a ventriloquist. I started ventriloquism when my Aunt Sally gave me a Jerry Mahoney puppet for my seventh birthday. At that time I was recovering from rheumatic fever, and she thought that the puppet could hel p the process. Aunt Sally was absolutely right, and ventriloquism became my lifelong hobby.

When I grew up and became an elementary school guidance counselor, I continued to use my Jerry Mahoney puppet to help me establish rapport with the students at my schools. Next I used Jerry when I worked at a residential hospital for severely developmentally disabled people. In fact, while I was at the hospital, I almost got to entertain on the same bill with Bo Diddley, but that’s another story.

In private practice I became even more involved with puppets, having the money to acquire a small collection for myself and for my young patients to use. Therefore, I indulged myself. It was good both for me and the children. The puppets made my work and their treatment more successful and enjoyable.

About 15 years ago I commissioned Jerry Baum, a puppet maker, to create Elwood for me. It was the first time that I ever had a professional puppet. By the way, we used to call them dummies. Currently, the politically correct term is vent figures. We wouldn’t want to hurt the little puppets’ feelings!

Anyway, once I had invested in Elwood, I decided that it would be beneficial to utilize ventriloquism to educate children and families about various topics. Since than I have produced PSAs on child abuse, molestation, stranger danger, domestic violence, 9/11, and, most recently on combat PTSD. I also produced 3 programs about ADHD. I combine ventriloquism, humor, magic, animation, and original songs to educate children and families in an entertaining fashion.

My puppet, Elwood, has already taken me to Japan three times. One of my Japanese sponsors, Dr. Michiko Hara, is a pediatric neurologist. She likes my videos so much that she had them translated into Japanese and published a version with subtitles and a script book. That, in a nutshell, is how I ended up on Amazon.jp.

I am including with this first entry a short segment from the Japanese version. In this segment Elwood learns what the letters ADHD mean.

My newest puppet arrived today. Honestly, I have no idea why I ordered another figure. Maybe it’s just because I like them. The puppet is a soft figure, quite different from the rest of my collection. It is a big monster. Here is a picture of him:

Maybe he will represent the “oppositional defiant monster” which is often associated with ADHD.

My son suggested that today I include my list of the seven most destructive ADHD myths. I decided to list them in reversed order.

7. You have to be hyperactive to have ADHD.

Children with inattentive ADHD are not hyperactive. Many are hypoactive (less active). They are daydreamers who are distracted by their own thoughts.

6. A child who can play a video game for long periods of time can’t possibly have ADHD

Children with ADHD are better able to stay on task when the task is highly attractive, with built in rewards and punishments. Video games meet these criteria. Children with ADHD also do better one on one and in new situations.

5. Too much sugar and food additives cause ADHD.

Not only has the myth never been proved, but research has also not proved that special diets reduce symptoms.

4. Medication should only be used at times when the children are in school.

We used to use the medication only for school, deemphasizing the fact that the children have problems with ADHD throughout the entire day. By only medicating for school, we made home management much more difficult.

3. Children magically outgrow ADHD when they reach adolescence.

We now know that many people continue to have problems with ADHD throughout their lives. Often the hyperactivity decreases as people age, but the problems with inattention and impulsivity remain. However, some people with ADHD do have a significant decrease in their symptoms as they age.

2. Using stimulant medications leads to drug addiction.

Children with ADHD are at a greater risk for drug and alcohol problems than children who don’t have the disorder. Treatment actually reduces that risk.

1. ADHD isn’t a neurological disorder. It is just an example of poor parenting.

ADHD is a real neurological disorder which is usually inherited. Since many of these children are difficult to parent, it is easy to incorrectly conclude that ADHD is due to poor parenting. Lot of parents are still being unfairly blamed for this neurological condition.