Ever since I have been counseling children and families, I have tried to combine my entertaining talents with my therapy skills in order to make my treatments more powerful.  I even conducted workshops for mental health professionals on how to use unique toys to improve counseling skills.  I also conducted workshops for ventriloquists on puppet therapy.  In fact, I am an honorary member of the Japanese Puppet Therapy Association.

For a long time I have wanted to use my skills to provide group family treatment for ADHD families.  However, living in a small town, it is difficult to start this type of group.  Also most people accept the fact that it is tricky to run groups for children with ADHD since they tend to set each other off.

That is why I have finally decided to run these groups online.  I am actively preparing them and hope that some of you will be interested in participating.  We can have fun while simultaneously improving the quality of family life.  More information will follow.

Today was the first day of school. I always worry that the other kids will tease me and call me a dummy. Dr. C told me that puppets like me are called dummies. I told him that I preferred puppet or vent figure, and he told me that he would just call me Elwood.

The first day of school is always hard for me. I worry whether or not I will like my teacher. I worry whether I will know the children in my class, and if they will be nice. I also worry about bullies.

Dr. C. made a shirt with me on it. I say no, no, no, no, no, no, no to a bully who wants my money. The shirt is in Japanese, so all I can read are the no’s. I told Dr. C that if I said no, no, no, no, no, no, no to a bully, the bully might hurt me. Next he told me that I could tell the teacher or the counselor, or the principal. I told him that then the other children might not like me. Finally he agreed that bullies can be a big problem.

The writing on the shirt is in Japanese because Dr. C. wore it when he spoke about bullying at the Japanese Puppet Therapy meeting. I got to be there too because I am the puppet. Dr. C. said that bullies are even a bigger problem in Japan than in here in the USA. I am sure glad I don’t live in Japan because I don’t like bullies.

Anyway, probably it will be ok for me this year. Usually I have friends and nobody bullies me. Also my friends can help me if there is a bully. That’s good to know.

That’s all for now from me. Elwood, signing off.

A high percentage of children with ADHD , particularly boys, also have Oppositional Defiant Disorder (ODD). ADHD alone can create friction within the family. ADHD, when combined with ODD, can make family life much more challenging. I have known parents who did not want to go home after work and face the frequent conflicts. Some were also concerned that if they did not go home, the problems might escalate even more. Family life with ADHD and ODD can become quite unhealthy for children and parents alike.

It is better to act than to react. In order to improve the situation it is a good idea to have a plan in place to improve family communication and cooperation. Consequences need to be clearly stated, and parents must follow through. I also want families to have fun together and accomplish goals as a team. I want people in families to treat each other with respect.

I have created a program specifically designed to encourage more peaceful families. The program takes into account the special needs of children with ADHD. I will be presenting the program in the near future in a series of teleconferences. I hope you will be able to attend.

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When medication helps, the effects can often be remarkable. It is easy to fall into the trap of putting all of the responsibility for the improvements on the medication and forgetting that the child is responsible for her/his own behavior.

Obviously the medication is an important part of the treatment. However you have to remember that children improve because they try to change. The medication does not make them act appropriately. It just makes it easier for them to improve if they try.

When we put all of the emphasis on the medication, the child can stop taking responsibility. Remember to emphasize that your child is doing better because he or she is trying rather than just focusing on the importance of the medication.

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.

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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.

WHY COUNSELING

SAMUEL R. CARON, Ph.D.

We all know that the treatment of choice for 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) 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.

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.

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.

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

I was thinking about the problems that parents have in public places managing children who have ADHD. The children easily can become overly stimulated and wild. They have a difficult time sitting still. They talk too loudly. The become bored easily. Many also have Oppositional Defiant Disorder in addition to ADHD. Before going out in public, it is important to :

1. Anticipate the problems so that you can develop a plan of action. It is always better to act rather than react.

2. Tell your child the ground rules in advance. Let your child know what the consequences will be both for compliance and non-compliance. Having a reward system in place is frequently helpful. Immediate consequences are very important.

3. When you arrive in the public place, identify a private place to which you can take your child, if needed, to deal with any problems. It can be embarrassing to discipline your child in front of lots of other people. A private place could be your car, the bathroom, or a corner away from everyone.

4. Plan a structure which will reduce the possibility that the problems will occur. For example, if you know that your children will fight with each other, keep them physically apart. At the Seder I recommended separating some siblings, and we even sat some of them with other families.

5. In a church or synagogue event, you should feel free enlisting the help of other adults. Don’t feel as if you are alone. Religious groups should function as extended families.

6. Don’t let one child’s problems interfere with everybody else’s enjoyment. If necessary, you can have a sitter on call, and entirely remove the child from the event without significantly interfering with your involvement.

7. Many problems recur. If you don’t figure out how to manage the problem properly the first time around, go “back to the drawing board” and come up with a better plan for any recurrence.

8. If your child takes medication, remember that medication is not just for school. It can also make it easier for your child to succeed in public places.

I hope these suggestions are helpful.