ADD TIPS

A note about clinical diagnosis: There is considerable disagreement about the meaning of psychiatric diagnoses. Basically, a diagnosis refers to a pattern of behavior; some of these patterns have been very closely correlated with discernible biochemical or neurological markers, while others have not. For example, we see clear biological differences in the blood chemistry of certain kinds of depressive people, while there is (so far) no such biological basis for obsessive-compulsive behavior. 

Also, psychology and psychiatry evolved in a time when the medical model of behavior was the dominant view. Therefore, diagnosis came about as a way of attempting to identify what the patient “had,” as if it were a disease like measles, mumps, or cancer. 

Nowadays, we are more aware of social conditions which might induce various patterns of behavior, so we aren’t quite as definite that there is something “inside” a person that makes them act the way they do. 

But, if we didn’t have some way of categorizing patterns of behavior, we’d be starting from scratch each time someone came to see us, and would have no basis on which to decide what kind of treatment could be effective, whether medication might help, etc. So diagnoses serve some purpose, even though the idea of categorizing a human being is objectionable to us. The important thing is, to see each person as an individual (in fact, to “start over” every time a new client walks in the door), and to use the diagnosis as a useful but not all-defining tool to help make sense of things- as far as it goes. 

The discussions of clinical patterns/syndromes/diagnoses are presented on this website in that spirit.

*For an interesting discussion of the realities of diagnosis, see The Dictionary of Disorder: How one man revolutionized psychiatry, by Alix Spiegel in the January3, 2005 New Yorker magazine. 



BASIC TIPS

1. Tell the truth to your ADD child

2. Use an accurate vocabulary

3. Metaphor of nearsightedness

4. Answer questions

5. Tell the child what ADD is not: stupidity, retardation, defectiveness, badness, etc.

6. Give examples of positive role-models, either from history, such as Thomas Edison, or from personal experience, like a family member (mom or dad?)

7. If possible, let others know the child has ADD, using the attitude that there is nothing to hide, nothing to be ashamed of.

8. Caution the child not to use ADD as an excuse.

9. Educate others, in the family and in the classroom. 

10. Coach the child on how he might answer questions other people may have, especially peers. 

STRUCTURE:

The ADD mind is like spilled mercury. Structure is the glass that holds it. Ten Tips on Structuring and organizing the Life of the Child With ADD

1. Make lists with the child, post them where s/he sees them easily.

2. Write down the problem: what, where, when.

3. Come up with specific remedies for each problem area.

4. Make use of concrete reminders like lists, schedules, clocks, etc.

5. Use incentive plans.

6. Give frequent feedback

7. Give responsibility wherever possible.

8. Make copious use of praise and positive feedback.

9. Provide the child with whatever devices he or she demonstrates can help.

10. Always remember: negotiate, don’t struggle.

MANAGEMENT TIPS

1. Ask the child what will help.

2. Structure
   Lists
   Reminders
   Previews
   Repetition
   Direction
   Limits

3. Post the lists, etc. in full view

4. Repeat, write down, speak directions again.

5. Make frequent eye contact.

6. Set limits and boundaries consistently, predictably, promptly, plainly. Take charge firmly and kindly.

7. Have as predictable a schedule as possible.

8. Have them make their after-school schedules.

9. Allow for escape-valve outlets such as leaving the trouble area for a moment.

10. Break down large tasks into small tasks. 

11. Watch for over-stimulation and intervene to calm down.

12. Seek out success.

13. Use feedback that helps the child become self-observant: “Do you know what you just did?”  “How do you think you might have said that differently?”

14. Make expectations explicit.

15. Use point systems.

16. Use “social coaching”: “Look at the other person when he’s talking.”  “Before you tell your story, ask to hear theirs first.”

17. Make games out of things.

18. Pay attention to connectedness.

19. Give responsibility to the child whenever possible.

20. Use physical devices such as timers, buzzers.

21. Prepare for unstructured time, like going to the grocery store.

22. Praise, stroke, approve, encourage, nourish.

23. Get their attention before beginning anything.

24. Encourage physical exercise. 

25. Always be on the lookout for sparkling moments. 

  From, Driven to Distraction, by Edward Hallowell and John Ratey.