Thursday, December 02, 1999

Addressing ADD at home


Local advocacy group offers support, updated handbook for parents of children with complex disorder

BY SUE MacDONALD
The Cincinnati Enquirer

gabe
Trudelle Thomas and her son, Gabe McMahan, 7, read in their Finneytown dining room.
(Glenn Hartong photo)
| ZOOM |
        Gabe McMahan's nighttime chores are tacked prominently on the kitchen wall every night, a list of tasks to help him keep the next-morning's school routine smooth and manageable.

        Sometimes, his mom uses an egg timer to keep the 7-year-old moving from one home task to another, whether it's cleaning his room or getting ready for dinner.

        “Having a timer helps keep him on track,” says his mother, Trudelle Thomas, a Xavier University English professor.

        They read Sometimes I Feel Like a Mouse (Scholastic; $4.99) to help identify feelings and emotions. And last summer on vacation, the Finneytown family avoided a structured week and opted instead for something that allowed Gabe to explore and burn off energy in the great outdoors: a 30-mile hike and canoe trip through the Canada woods.

        As families and researchers learn more about attention deficit disorder (ADD), they are finding that some very concrete and supportive practices at home, school and work are just as important as therapy, counseling and medicines offered by doctors, educational specialists and therapists.

        They're also discovering that very few children (or adults, for that matter), have only ADD, a disorder marked by an inability to pay attention, stay focused or control impulses. An estimated 65 percent of children are thought to be dealing with other problems as well, ranging from depression to obsessive-compulsive disorder, Tourette's syndrome to chronic fatigue.

        Once called daydreamers, goof-offs or class clowns, 1990s children with ADD (or AD/HD if they are also hyperactive) are expected to take proficiency tests, make good grades and compete in a world seemingly not suited to their learning styles.

        That's why experts recommend a broad approach involving practical skills for home and school, getting an accurate and complete diagnosis, educating teachers and doctors about ADD, and taking medicines, if necessary. It also means implementing activities and programs that help children stay focused, optimize their learning style and learn how to live with ADD for the rest of their lives.

        “Pills won't teach or replace skills,” says Lydia Bigner of Bridgetown, , an educational consultant and parent-member of the Attention Deficit Disorders (ADD) Council of Greater Cincinnati, an advocacy and support group for parents of children with ADD.

        “Our philosophy is that you treat the whole child — not just the medical and academic issues, but the social skills as well. Things like staying organized, paying attention, exhibiting self-control and following directions — those skills do start at home and they must be taught at home. They're reinforced at school.”

Updated handbook
        Because of the increasing amount of research and information available about ADD in the last 5-10 years, the local ADD council has updated and published A Parent's Handbook on AD/HD, a 122-page book about diagnosing, treating and supporting ADD and other related problems or behaviors.

        Mary Daniels, president of the ADD Council of Greater Cincinnati, says the emphasis on ADD as a broad-spectrum disorder has been nudged by the recognition that not all children outgrow ADD once they reach adulthood and concern over the growing use of prescription medicines such as Ritalin for millions of ADD children.

        The ADD Council wants parents of ADD children to understand that taking a pill is only part of a larger program of learning how to cope with ADD and its related behaviors, she says. And not all children need medicines, Mrs. Daniels points out.

        “A problem does not necessarily have to be a disorder, and a disorder doesn't necessarily have to be a disability, and a disability doesn't have to be a handicap,” she says. “It depends on the severity and how it affects or interferes with any of these areas of life. If it interferes, then it becomes a disorder.

        “There is overmedication and undermedication out there,” she adds. “We strongly profess a multitreatment program. That includes educating the parents and child as to what ADD and AD/HD are, educating teachers and doctors, and adding structure to your life or your child's life.”

        Mrs. Thomas, Gabe's mother, found tremendous support and plentiful ideas from other parents by joining the ADD Council, even though accepting her son's ADD was difficult.

        “I was really resistant to the diagnosis and the use of medication,” she says. “A big thing for us was a good school placement. Being connected with the ADD council has been a big help, because these people are making this work for their kids and themselves. I like that, because you don't often get that from psychologists and psychiatrists.”

        Gabe is a first-grader at Whitaker Elementary School in Finneytown. In addition to the routines and practices in place at home and school, he also takes the drug Ritalin for ADD.

        He calls it his “be-good pill,” and his mother says it has resulted in a “significant change” in his ability to pay attention and stay focused.

Practical knowledge
        Mrs. Daniels feels all parents can benefit from the practical knowledge that others with ADD have discovered, such as the role that brain injury or metal poisoning may play in ADD or the importance of regular, physical exercise for people who cannot take or do not respond to ADD drugs like Ritalin, Cylert or Adderall.

        Mrs. Bigner, whose 19-year-old son, Brian, has ADD, provided many of the practical tips for the book — things like posting family rules, setting up incentive programs for children's behavior and accomplishments, donating the proceeds of a family Swear Jar to charity (everyone deposits a dime whenever a curse word is uttered), and encouraging children to “STAR” (stop, review, act, review/remember) when they need to focus and figure things out.

        “What you have to do is come up with systems to help these kids organize themselves,” she says.

        Mrs. Thomas is the first to admit that dealing with a child's ADD is not easy.

        “I had to do a lot of gearing up to be his advocate. And I make a real effort to keep myself together,” she says, emphasizing the importance of regular walks and meditation to re-energize her parenting skills.

        “To do everything the right way, you'd have to quit your job and be a saint,” she says. “The biggest thing is having a success orientation, encouraging what Gabe does well. He's very artistic and he loves computers and he can play with Legos for hours at a time.

        “So many parents deal with this, and so many parents are in this boat,” she says. “You have to have it out in the open.”

What is attention deficit disorder?
ADD parents' challenge: Focus on practical ideas



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