Parents of ADHD
Teens:
school issues, social and peer relationships
online conference transcript
Alan R. Graham,
and Bill Benninger are our guest
speakers. They have been working with with ADD, ADHD teens and their parents
for over 20 years.
David is the
HealthyPlace.com moderator.
The people in green are audience members.
David: Good
evening. I'm David Roberts. I'm the moderator for tonight's conference. I want
to welcome everyone to HealthyPlace.com. Our topic tonight is for Parents of ADD,
ADHD Teens.
We'll be covering school issues, social and peer
relationships, what to do during the summer, driving issues, how you, as a
parent, can help your child, and some good coping mechanisms for
yourselves.
Our guests, psychologists Alan Graham and Bill
Benninger have been working with children, adolescents and adults with
Attention Deficit Disorder and their parents for over 20 years. Besides doing
direct therapy, they work with individuals and groups over the phone on a
conference call line and they publish the newsletter,
ADDvisor.
Good Evening, Dr. Graham and Dr. Benninger and
welcome to HealthyPlace.com. We appreciate you being here tonight.
People in the audience may have different levels of understanding Dr. Graham,
I'd like you to define ADD (Attention Deficit Disorder), ADHD (Attention
Deficit Hyperactivity Disorder) and then we'll get into deeper issues.
Dr. Graham:
ADHD is a disorder of the inability to inhibit behavior and
impulses. It is marked by hyperactivity, impulsiveness and inattention. ADHD
kids are fidgety, interrupt others, break into lines, always have to be first,
daydream and are unfocused. ADD (attention deficit disorder) is all the above
without the hyperactivity.)
David: For
those in the audience, I'm assuming that most of you have, at least, a basic
understanding of ADD, ADHD. However, if you have any question on this subject
tonight, please feel free to send it in.
It's almost summertime now, Dr. Benninger, and
I know parents are sitting around and wondering what they can do with their ADD
teen. What are the issues that parents face during this time of year and what
are the solutions?
Dr. Benninger:
Supervision is a major summertime issue. It is very important that
ADHD teens be closely supervised. Even though it can be difficult, even paying
a "sitter" for older kids may be important. There are many camps that
may also be a good resource.
David: What
kinds of things should parents be concentrating on during the summer, in terms
of working with their kids?
Dr. Graham:
Structuring their kids time so that their environment predictability
is a priority.
Dr. Benninger:
I think behavior issues and responsibility are very important. These
can be worked on by keeping them accountable. Daily reward systems, even for
older kids, can be of significant help.
David: I
think that's one of the issues that parents deal with all the time --
accountability. How would you suggest they help their teenager with
that?
Dr. Graham:
If you want, for example, to encourage your child to maintain a job
during the summer, make attendance at the job, the criteria for using the car.
Develop a set of incentives that the teenager is well aware of that encourages
the responsible behavior you want to see in your child.
Dr. Benninger:
Structured behavior modification systems work very well.
David: Can
you explain that?
Dr. Benninger:
Picking out 2 or 3 behaviors that you want your teen to work on,
using the rewards that Alan is talking about on a daily basis. This is
important because ADHD teens need much more structure and accountability than
non ADHD teens.
Dr. Graham:
Financial incentives can work too. Your teen can earn money for desired
behavior.
Dr. Benninger:
It is important to let the teen help select a list or menu of
rewards that helps keep them interested. Money, movies, driving screen time,
time with friends can all be incentives.
David: Here
are some audience questions:
teresat:
How can a parent help an add child retain what he or she has learned at school
in the summer.
Dr. Benninger:
Good question - They aren't going to have much more trouble than the
average teen unless they have a learning disability. Adhd is a disorder of
doing - not knowing. It is important to strike a balance as you don't want to
burn out a teen that already dislikes school.
Dr. Graham:
It also depends on your child's attitude toward school. Would they
be interested in summer school? Would it have to be a fun course? Is a tutor a
possibility?
Sunshine777:
Dr Benninger you say there are many camps, but where would one go to
find out where or who these camps are? I have looked in the ACA and there are
maybe 1 or 2 and they are back east.
Dr. Benninger:
I would contact
CHADD, the national organization for ADHD. They can probably help. Be
prepared. ADHD specialty camps can be expensive.
Dr. Graham:
In the Chicago area, the Sunday newspapers often advertise camps for
ADD kids. Also some camp specialists are around who can help. School counselors
too. I would also look in the yellow pages under "camps" and see if
any work with ADD (Attention Deficit Disorder) or learning disabled or special
needs kids. Also special education districts or programs may know as
well.
David: Also
Sunshine, how about contacting your local school district for some
suggestions.
Noele: So,
would you say that it is more important to focus on the more serious issues and
let some of the small stuff slide? To work on a piece of the problem at a time,
rather than to tackle this head-on? And if so, how do we get schools and
teachers to see this?
Dr. Benninger:
I would say yes to that Noele as well. Getting teachers to see this
is sometimes difficult. First you must try to maintain a good relationship with
the teacher despite differences that come up.
Dr. Graham:
Certainly, you want to pick your battles with your child. You have
to make an assessment if the power struggle is worth it. Remember that you do
not have control over your child's actions. You only have control over your own
actions. Make sure that any response you make is something you feel comfortable
doing.
Gailstorm:
My 15 year old son has frequent explosive, angry tantrums that can last for an
hour or so. Then he settles down to a slow burn. What do you suggest outside of
medication and therapy that I can do to help curb this type of behavior?
Dr. Benninger:
In general, angry tantrums are not necessarily only ADHD (Attention
Deficit Hyperactivity Disorder), especially as you describe. I would be sure
your psychologist knows these details and completes a thorough
evaluation.
Dr. Graham:
When your child experiences a meltdown as you describe, rational
thought is gone and trying to reason with him at that time is useless. Let your
child know that you will wait until he is calm before you will talk to him and
that you will walk away when he is in a meltdown. Tell him this at a calm
moment, not when he is in a meltdown.
A good resource, Gailstorm is a book by Ross
Greene,
The Explosive Child.
Dr. Benninger:
Excellent recommendation Alan.
David: I'm
sure, Dr. Graham, that for parents dealing with explosive children, it must be
emotionally and physically exhausting? How can a parent live with that day in
and day out?
Dr. Graham:
Again, pick your battles. Also, give yourself a break. I always tell
parents that you could be "parents of the year" and still feel
frustrated and angry much of the time, even if you are doing everything
right.
Go to ADD support groups, stay in touch with
other parents of adhd teens. Go out with your spouse. Keep yourself
replenished.
Dr. Benninger:
It is important for the parent to take care of themselves to avoid
becoming depressed. Try to get a regular night out by trading services with
other parents of adhd teens.
LisaHe: I
have learned that ADD (Attention Deficit Disorder) can precipitate ODD,
Oppositional Defiance Disorder in teens. What is your view on that?
Dr. Benninger:
Oppositional Defiance Disorder (ODD) occurs in about 30% of ADHD
teens, but it's a logical problem. You'd be frustrated too if you struggled
like an ADHD child does. This may be due to the constant negative feedback they
get throughout their life that they are "lazy",
"underachieving", that they could "do it if they try". So
they see themselves as losers and celebrate their
"outcastness".
Dr. Graham:
By being oppositional.
Dr. Benninger:
How to handle this? Structure, rewards, consequences, consistency,
persistence.
David:
Another issue I want to touch on here, because like every teenager,
an ADD teen wants to drive when he/she comes of age. But as we all know,
impulsivity isn't one of the best traits for good driving skills. What should
parents be aware of here and what are your suggestions for handling the issues
that come up?
Dr. Benninger:
Small steps, a lot of practice with an adult, a limited driving
range, incentives for responsible behavior are all important. It could be that
they will have to wait an extra year or so before they can drive
independently.
Dr. Graham:
First of all, ADHD is a developmental disorder of impaired
behavioral inhibition. These kids are up to 30% delayed in their ability to
control their impulses. Your 16 year old who wants his/her license may have the
control of an 11 year old. In our last
newsletter, we listed
some guidelines for letting add kids drive.
Don't let them drive until you feel comfortable
as a passenger in the car. Use the car as an incentive for responsible
behavior.
David: Just
so everyone knows, at the top of the conference I mentioned that Drs. Graham
and Benninger publish a newsletter entitled
ADDvisor. You can
subscribe to that by sending an email and putting "subscribe" in the
header and body of the email and send to:
ADDvisor-subscribe@egroups.com,
or you can simply send an email to: Alan@ADDvisor.com and mention that you'd
like to subscribe to the newsletter.
By the way, Dr. Benninger, does it cost anything
to subscribe or is it free of charge.
Dr. Benninger:
The newsletter is free (and very helpful).
David: Good.
Here's the next audience question:
teresat: Are
most adhd teens immature for their ages?
Dr. Benninger:
Yes they are, teresat. You can see it in behaviors, interests,
socialization.
Dr. Graham:
Yes, Teresat, but it is in the area of behavioral inhibition. They
may be more mature in other areas.
David: On
the average, emotionally speaking, how many years behind is an ADD child from a
child without Attention Deficit Disorder?
Dr. Benninger:
30% so, get out your calculators!
David: So
that's important to keep in mind when you are dealing with your ADD teen.
He/she will be 3 or more years emotionally behind their age.
And here's an audience comment regarding letting
your teen drive:
Sunshine777:
Because we feel that driving or having your license is a privilege
our son doesn't have his yet, but he sure manages to find the car keys and take
the car out for a joy ride. Thank goodness there have been no accidents, but he
couldn't understand why we were so upset to find out. "But Mom I'm a good
driver, don't you trust me?" Then he goes into his negative feelings about
himself. But someone suggested to allow them to take the lessons because of the
liability issues.
Dr. Benninger:
Sunshine - it's not that you don't trust him (that's a
manipulation), you need to be sure he's safe and that he can follow the rules!
I don't have any problems with lessons - that's supervised practice.
joan3:
Nothing seems to work on my son in regards to him taking
responsibility for things he does and it is "never his fault". What
can I do to reach him?
Dr. Graham:
Joan, whether you son takes responsibility for his actions or not,
you remain consistent in your administration of appropriate consequences.
Repetition is key. Eventually, hopefully, he'll get it. Many ADHD kids were
very problematic as teens but grew up to be productive, happy adults.
Dr. Benninger:
Alan is right - be consistent - try not to get worn down -continue
to see the positive too.
David: There
is a taped interview of Drs. Graham and Benninger and a discussion of the
"7 Ways to Improve Your Child's
Behavior" on a New York phone number that people can call.
1-212--461-2734. All you pay for is the cost of the call.
Michele1:
Would you know of a coaching program through the net for add, adhd kids and
teens, similar to the coaching program offered through
The ADD Coach
Academy.com? Theirs is for add adults mainly.
Dr. Graham:
ADD College
Bound.com is a program offered by Dr. Craig Porterfield. It is for bright
teens, try it. He has a newsletter and teleconference calls as well.
David: Here
are a few audience responses on successful parenting of teens:
antmont: I
found that my son who takes tae kwondo has learned to be more responsible for
his actions. He has become a leader among his friends. I and my son worked on
getting a car to work and he earned his money to pay for his insurance and car
repairs, and then I let him get his driving license. He is a good and
responsible driver.
Dr. Graham:
I love to hear success stories. ADD kids are creative, bright,
exciting and fun.
Dr. Benninger:
I have found tae kwon do to be excellent for ADHD teens especially
with a good instructor, even if I can't spell it!
Nadine: My
son is 5 and his teacher thinks he has Attention Deficit Disorder. I was told a
year ago that he was bright, gifted. Now he fidgets in class, interrupts,
daydreams, he is totally unfocussed, shifts from one uncompleted task to
another, appears not to be listening to what is being said, has difficulty
playing quietly. However he is not hyperactive. What is your opinion?
Dr. Benninger:
He could be ADHD, the inattentive type.
Dr. Graham:
Yes Nadine, it may be that your son has ADHD primarily inattentive
type. It may be worthwhile to get an evaluation to help determine if what you
are seeing is ADD or something else.
Dr. Benninger:
but you need to find a psychologist that specializes in ADHD for a
evaluation. If medication is in the picture, this could be effecting things as
well.
sms: A 15
year old 9th grader wants to stay up late on school nights (11, 12, 1am+), and
doesn't get up in the morning without big conflict. Then he gets to school just
in time or late. Organization is an issue anyway, and it is being stressed
further by this pattern. "Experts" suggest that we allow him the
freedom of running more of his own life in this regard, and letting external
sanctions shape his behavior (like feeling tired, and school detention for
being late). We tested for 5 weeks, while this makes Mom nuts.
Dr. Graham:
Dear sms, by letting your child have freedom that he is not capable
of managing, you are setting up a disaster. True, only he controls his actions,
but you can set up a series of incentives that can reward earlier bedtimes and
more cooperative mornings.
Dr. Benninger:
Natural consequences are not always the best if they create long
term problems of their own.
teresat:
What type of rewards would you suggest?
Dr. Benninger:
Ask your teenager - they can help you set up a menu. And since ADHD
teens shift their desires it will have to be flexible and fluid.
Dr. Graham:
Rewards? $$$$, use of the car, anything that you truly have control
over and your child wants.
David: I
want to ask about that. Is money really an appropriate incentive for good
behavior?
Dr. Benninger:
Absolutely - if it is motivating.
Dr. Graham:
I think so. Some people fear we are bribing our kids. But we work
for pay. We get paid for what we do. Why not use it for kids if it is
motivating.
David:
Here's an audience comment on that subject:
sms: Our
fear is that he will never develop his own healthy self-control if we manage
his life for him. For these issues, rewards didn't help for long (2 or 3
days).
Noele: If
it works don't fix it with money, bribes are bribes, but not with the ADHD
child.
Dr. Benninger:
Bribing is incentives for illegal - undesirable behavior.
Dr. Graham:
An ADHD child is externally motivated. If you wait for your child to
develop internal motivation, you may be asking something that they are not
capable of.
Dr. Benninger:
Alan is exactly right. The nature of ADHD limits the amount of self
control that will be developed. You have to strike a balance.
Sunshine777:
Dr. Benninger, I have a 16, soon to be 17 yr old who is having a very rough
year in high school. Now he says he cant take the stress of being on campus and
doesn't want to go to school anymore and doesn't care about not finishing
school or graduating. Right now we just want him to finish the year with the
credits and there are no incentives that he sees that are worth him going back
to school. In fact I have an IEP (Individualized Education Plan) meeting
tomorrow to see if we will be allowed to do home schooling. He is
ADHD/ODDOCD.
Dr. Benninger:
It really sounds like you have your hands full Sunshine - he may
feel differently after a summer break and some adjustments in his schedule. But
what about next year?
But this is a difficult problem for many parents
with this complicated set of diagnoses. Home schooling is okay but he misses
the important socialization.
Dr. Graham:
On the other hand, home schooling may get him through the year as
there are only a few weeks or days left.
David:
Meanwhile, what would you suggest for Sunshine since she has an IEP
meeting in the morning? What should she say at the meeting or ask for?
Dr. Benninger:
At the IEP meeting - ask the school what they see as most
enjoyable/motivating for him. Come up with as many positive programs/ideas as
you can - a shortened school day may also be an option.
Dr. Graham:
Ask for home schooling for the remainder of the year and explore a
smaller teacher student ratio and less stressful atmosphere for next
year.
David: Here
are a couple of audience suggestions too, Sunshine:
antmont:
Sunshine777, IEP may not be addressing all needs. Look for new evaluations and
then seek out programs outside of school program. Another school may work. You
have a right to look for other placements and the school district pays.
LisaHe: My
son goes to a technical school and he is doing very well, I don't think college
is for all children, it can just lower their self esteem and create chaos as to
their goals in life.
Dr. Benninger:
Good suggestions.
Noele: I
think that she should ask the IEP team to ask for a summer evaluation to see if
maybe they miss something in the diagnoses, as well as set up a proper set of
so called rules, realistic to her child's needs for the upcoming year. Ask that
it be reviewed as early as 2 months into the school year and so on, or maybe
extended school year. Just my thoughts.
jujubon:
Could perhaps a mentorship in an area of his interests motivate him?
Noele: Dr
Graham, have you found that a lot of teens find that they have been treated for
ADHD or ODD and then discover that they in fact had bipolar in addition, or
instead of?
Dr. Graham:
Noele, that occasionally occurs. Bipolar disorder is an inability to
self regulate emotions which leads to a gyrating emotional roller coaster. It
is very difficult to diagnose in children and teens.
Dr. Benninger:
This is an emerging area, and one worth careful evaluation with
someone who knows how to diagnose both disorders.
David: For
the audience, here are the links to the HealthyPlace.com ADD-ADHD Community, and
Bipolar Community. You can click
on these links and sign up for the mailing lists at the top of the pages so you
can keep up with events like this.
One of the sites in the
ADD Community, for those of you concerned about school issues, is "The Parent Advocate". Judy Bonnell is the
site master, who has a lot of experience in dealing with school-related issues,
and she shares a lot of her knowledge on her site.
LisaHe: Why
has no one mentioned their self esteem? When a child is proud of what he can
do, and not focus on what he can't do, can make all the difference, can't it?
And shouldn't you use those strengths that they have to build up their self
esteem, and concentrate on them?
teresat:
LisaHe, exactly what I was thinking.
Dr. Graham:
LisaHe, you are exactly right. We want to catch our kids being good.
Work at finding the good and build on them.
Dr. Benninger:
Self esteem is very critical in the big picture - on
our web site under
newsletters - there is an old newsletter with the content called "The
Game" read it, it can help.
David: Here
are a few audience comments:
Noele:
The Bipolar Child: The definitive and reassuring Guide to
Childhood's Most Misunderstood Disorder, by Dimitri and Janice Papolos is a
fascinating book!
jujubon:
That is how community based mentorships can help children with ADD and low self
esteem. They can even get credit for it.
LisaHe: Mood
stabilizers have helped my child a great deal.
Gailstorm: I
also have a son who is failing out of school but is very smart. He's being
evaluated next week again.
LisaHe: I
think waiting an extra year to drive sounds more like a punishment, why not be
prepared for this a year ahead of time.
Dr. Benninger:
LisaHe, sometimes you can't rush the maturation process - or the
ADHD problem symptoms. Remember the 30% age rule? Disappointing to ADHD teens,
yes, but safety is very important.
teresat: Can
you explain more on the difference between attention deficit disorder and a
learning disability? What is the specific difference?
Dr. Graham:
Teresa, a learning disability is a discrepancy between a child's
intellectual capability and achievement. This is caused by a significant
variability in processing either auditory or visual information. ADD is an
impairment of behavioral inhibition. These kids may score high on achievement
tests because they are learning but they fail in school because they are not
producing.
David: Here
again is Drs. Benninger and Graham's website address:
www.ADDvisor.com.
Dr. Benninger:
You can see our pictures - we are both very handsome.
Dr. Graham:
Oh Bill, you are so modest.
Dr. Benninger:
And for what it's worth, we are both parents of teenagers.
David: to
subscribe to the newsletter, write to:
Alan@ADDvisor.com or to ADDvisor-subscribe@egroups.com,
write "subscribe" in the header and body of the email.
There is a taped interview of Drs. Graham and
Benninger and a discussion of the "7 Ways to
Improve Your Child's Behavior" on a New York phone number that
people can call. 1-212--461-2734
Also, for those of you interested in Bipolar in
children, we had an excellent
conference with Trudy Carlson (or you can find it in the the Bipolar
Community, click on the conference transcripts link, and you will find Trudy's
conference transcript.)
Here's a verification from one of our audience
members:
Gailstorm:
Went to the website, yep they're right: 2 very handsome gents ;-)
Dr. Graham:
Aw shucks, Gail.
Noele: I
want to thank you both, Dr. Benninger and Dr. Graham for all of your wisdom.
I'm a parent with 3 kids. As mentioned above, want to beg the medical community
to see if there is more children with Bipolar than meets the eye. I have two of
the 3 with ADHD and Bipolar, and one just Attention Deficit Hyperactivity
Disorder. It's imperative that we diagnose these kids earlier for their sake
and ours, as parents. These kids often have both disorders. Please help me in
my mission of knowledge on this!
Dr. Benninger:
I agree Noele - but it's an emerging field with still lots to
learn.
David: It's
getting late. We'll call it a night. I appreciate our guests coming tonight and
sharing their expertise with us. And for those of you in the audience, thank
you for participating. I hope you found it helpful.
Dr. Benninger:
Thanks for having us!!!!
Dr. Graham:
Goodnight.
David: Good
night everyone.
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