A talk by Roger Yeager, PhD, M. Ellen Gellerstedt, MD, and Dan DeMarle, M.S.

Dr. Yeager was up to bat first, and he noted that our audience was made up of people who have been dealing with the subject of ADHD for a long, long . . . long time, while others were quite new. He gave a brief introduction to the topic so we were all starting on the same foundation for the presentation. He explained that the term ADD was and would be used although the technically correct term is now ADHD. The speakers were going to use these terms interchangeably tonight.

ADD is a biologically based difference in how some areas of the brain function. That means a couple of things: it is not caused by bad parenting, and it's not just a willful child and, believe it or not, it isn't caused by sugar. ADD is around for the long haul; it doesn't go away so it is necessary to look at it from that perspective. In addition to the usual list of characteristics, Dr. Yeager noted resilience, imagination, creativity, boundless energy, and risk-taking as examples of the exciting aspects of ADD.

"ADD can be thought of as a skill deficit problem", he noted. It was frequently a question of degree and frequency. Tonight's talk, although directed at parents, would be of value to adults with ADD if they reflected on their younger years.

Every child and family has unique strengths and needs. Parenting challenging kids requires that you become a chef, not just rely on a cookbook recipe. When using a cookbook approach, you have to follow a recipe exactly and if you're missing some of the ingredients, or don't like the results, you're stuck. But if you're a chef, you know how to substitute or what to improvise. You know what's possible and when and how to use the possibilities.

"Tonight, we'll give you some recipes but also show you how to become a chef in the field of behavior." Just as the techniques and strategies must be tailored to the individual situation, often a team of people have to work together to execute the treatment. Prepare a custom developed plan to enhance the strengths of a family and teach skills to compensate for the deficits. Treatment is not a "One size fits all" proposition. There are four areas the team would address tonight.

What is the goal of treatment? To get a good fit of children's skills/deficits and those of the parents. Find a coach, one who will help keep the "big picture" in mind, and monitor progress over time.

Educate yourself, your family and others about ADD as a skill deficit and how it manifests itself in your situation i.e. know that a lack of organization in a child is a skill deficit, not stupidity. Parenting difficulty is a lack of special skills, not incompetence. Part of the education process is to learn what does and what doesn't work.

Mental Health Interventions include behavior management. There are caveats to this which include: positive reward systems help; use consequences rather than reasoning; don't yell or hit; expect performance; don't blame, don't shame or humiliate; avoid inconsistency; affirmations are important; and avoid the "how comes".

Individual Therapy - Why is it needed? Where is it not needed?

Family Therapy - Remember that ADD may exist in only one member of a family, but it affects the whole family.

Social Skills Training is also an important area to be aware of.

Dr. Yeager then turned the microphone over to Dan DeMarle who addressed educational interventions.

Dan noted that an analogy would be helpful for his portion of the talk. Imagine yourself as a terrible gymnast, which isn't too much of a stretch for some of us?! Although strong in other areas, you just hate gymnastics. But you know that for the next 12 years, you'll be judged on your gymnastic ability. Either you'll pass or fail. Then you're told that the way you perform may well affect your future children's quality of life. This is very much the way children feel as they're going through school.

ADD kids are at risk for difficulty in school. "Children with ADD are fragile learners, power learners, active learners and at risk for problems with self-esteem. ADD kids need to be involved, both mentally and physically, in what they're being taught. For children with ADD, we must learn that if it's important, make it novel. If you can't make it novel, make it active", Dan said. Using the right instructional techniques for these children enables the child to turn their natural activity level from a negative into a positive.

In school there are strategies for both environmental modifications and interventions to change behavior. There are ways we can teach children to do better on homework. Don't become the "homework monster", though, when there's trouble in this area. More important than turning a particular assignment in the next morning is that the child needs to know you are a loving, caring parent they can turn to when they need you the next time. One solution may be to split up the homework between parents. Another way may be to involve a tutor.

Schools can and should be an invaluable asset to you as a parent working with your child. Unfortunately, in many cases the parent and school can be at opposite ends of a tug of war with the children caught in the middle! What we want to happen is to have parents and school staffs working together for the benefit of the child's future! The two most important aspects of the parent/teacher relationship are effective communication, and having a joint understanding of the child's strengths and needs both at school and at home. Again, a coach (particularly at school) can be an invaluable asset.