- Jerome Schultz, you're a great expert on kids in the house, first of all, but you're also a clinical neuropsychologist on the faculty of Harvard Medical School in the Department of Psychiatry and the author of "Nowhere to Hide: "Why Kids with ADHD and Learning Disabilities Hate School." Why do you think there's been such an increase in ADHD diagnosis?
- Glad to start, thanks, Leana. I think there's three basic reasons. One is... And I've thought about this a lot. One is that we're expecting kids to do things earlier than we ever have. Things like having kids be able to read proficiently at the end of kindergarten, things that are developmentally inconceivable for a lot of kids. So, I think there's no room for variety in a child's profile. Kids have to be very good at everything. I believe I say it more often, I say the phrase "Excellence has become the new average." This makes average behavior, average academic performance or behavior look defective or deficient, and that increases the number of kids who get identified as having attention deficit disorder. The other factor, I think, is the decline of play in our environment. The things that kids used to learn by the informal curriculum of play have been pretty much taken out of their repertoire, and so these are things that they don't know how to do well, and we see them as deficiencies is another reason. The third reason I see is that there's an increase in stress and anxiety in very little kids, and if you're stressed, you have difficulty focusing and paying attention, and therefore you're more likely to be diagnosed or misdiagnosed as having ADHD. One of the reasons, the name of the condition is helpful is because there are organizations, there are support networks, there are societies parents can go to, places like Understood who talk about attention problems or ADHD. If you know what club you're talking about, you can get pretty good advice from some pretty intelligent people. So, I think there's a beneficial reason for having the condition. I agree with what Ned said earlier about the disability and deficit and disorder, it's a very negative kind of terminology. I think we ought to look a little bit more at kids' abilities and try to strengthen those and try to help them work around the weaknesses or work through those weaknesses at the same time. In so many cases that I've seen, medication, when properly assessed, properly administered, has such a profoundly important effect on a child's cognitive function, his ability to access the curriculum. I get concerned when we don't think about... I get concerned if we don't take away some of these medications after a long period of time, because we wanna see what the child is like underneath the medication. I think sometimes helping a child access a curriculum by using chemicals to create what's presumably a chemical imbalance in a child's brain is an appropriate thing to do.
- Do you think that there is a tendency to over-prescribe them?
- I don't have the statistics to support that one way or the other. I think that medication is being used with increasing frequency, and often it's used as an answer to a problem, and it's not necessarily the right answer. So, I get concerned about any time a child, especially a child, is taking medication without a lot of evidence to support its continued use.
- I mentioned before, when I grew up, you first have the learning disability, and then you have the anxiety about that. You know that you're gonna have a trouble, so it's sort of like a compounding effect. How can you help your child with that?
- I think one of the things that's missing from this whole picture is the issue of confidence and competence. I think one of the reasons that you have anxiety if you have learning disability or ADHD is because you have so many experiences not doing things well or not doing things right and then having other people judge you about that. I think the key to success, and what I talk a lot about in my writing and my speaking is helping kids get their feet on the ground of competence, letting them feel the joy of success and moving on from there. Kids who experience failure after failure after failure are in a state of escape. Their brains are looking for the exit sign. Unless we can give those kids a chance to do something that they can do well and own that success and take it and internalize it, and then step off in a more difficult direction, and hopefully one they choose a bit, then I think we're missing the entire piece here. I don't care what the diagnosis is called, I don't care about medications in this sense. I think the missing piece of this puzzle is letting kids experience success, and most kids we're talking about are living and working in an environment that continually demands that they do things that are beyond the cusp of their competence. Many of my esteemed colleagues have talked about seeing kids who are either interested or passionate in something, and when they are, they can perform better. I think that's absolutely true.
- Jerome, what do you do when you have a kid, how do keep that self-confidence? If they're in fifth grade and they're reading on a second-grade level, how do you be honest about it and still instill self-confidence?
- If we say to that child, "Hey, you're really "doing a good job reading," we're lying, that child knows we're lying. It's much better to say to a child, "You have a condition called dyslexia. "You're a member of a very large club "filled with a lot of very competent people "who don't happen to read very well," or "a club called ADHD where you have a lot "of competent people who aren't able "to focus and sustain their attention "when they want to, and there are things "we can do about this. "But if you're reading now at second-grade level, "we think that you have demonstrated to us "that you have been able to improve your reading "by six months over the past year. "That's taken you hard work and a lot of time, "and because you have the ability to do it, "we're gonna put our trust in you, "and you need to trust yourself "that you're going to be better at this skill "over time, but it's not gonna happen quickly." We have to be honest with kids, and we have to say to them, not only do I believe in you, but we have to get kids to the point where they believe in themselves. If they don't, they're looking again for that exit sign and trying to get out of a stressful situation over which they have little or no control.
- Thank you so much for being with us today. Please let us know what topics you want us to cover and any problems you might have that you want us to help you with. Thanks for tuning in, and over and out from Kids in the House.
Login or Register to view and post comments