| A diagnosis is an important piece of the puzzle we are | | | | way you deliver information to somebody with ADHD |
| trying to solve when we try to help kids with disabilities | | | | might be different from the way you deliver it to |
| learn how to function. Many parents are relieved when | | | | somebody who has ODD. While your tone may vary, |
| they get a diagnosis for their acting-out, "problem child" | | | | know that both of these kids need the same |
| because they see it as a guideline for the future. They | | | | information, because at 18 or at 20, they are going to |
| think, "Now we'll know what to do; this is it- we'll finally | | | | have to meet the same expectations. |
| get our child the help he needs." The truth is that I've | | | | Let's be very clear, there's going to be no free lunch in |
| seen families go through the drudgery of doctors and | | | | our society anymore. So kids who aren't making it are |
| diagnoses many times. I've worked with kids who had | | | | going to be homeless or they're going to be living in |
| Attention Deficit Hyperactive Disorder (ADHD), | | | | your home. And not only that, their behavior won't |
| Oppositional Defiant Disorder (ODD), Conduct Disorder, | | | | have changed. They're still going to be demanding, lazy, |
| Obsessive Compulsive Disorder (OCD), and many | | | | self-centered and domineering. You'll constantly hear |
| others. I've also seen individual kids with five different | | | | them making excuses, blaming others and playing the |
| diagnoses: every time they were hospitalized or went | | | | victim. What they won't do is change on their own. |
| to a new therapist, they would get a new one. But | | | | 3. With or Without a Diagnosis, Your Child Needs Skills. |
| sadly, in the end their parents were left with the fact | | | | It is very important that parents understand that no |
| that simply having a diagnosis didn't necessarily mean | | | | matter what the diagnosis is, these kids have to have |
| they could get help improving their child's behavior, or | | | | a bundle of skills if they're going to make it in the adult |
| get them the skills they needed to learn how to | | | | world. A diagnosis can help indicate how we deliver |
| function successfully. | | | | those skills to them. So for the girl who has ADHD, the |
| A diagnosis doesn't mean that you are assured | | | | boy who has Conduct Disorder, the teen who has |
| treatment for your child from which you will see | | | | OCD, they all are still going to have to work and |
| change. A diagnosis doesn't mean you're going to get | | | | support themselves. That's simply the reality of the |
| funding to help give your child the success he needs. | | | | situation: that is the way of the world. |
| And a diagnosis does not mean he's going to get the | | | | If you make excuses for your child by saying "That's |
| services he really needs. Sadly, there are no | | | | the diagnosis talking" and if you don't take any action |
| guarantees. I've worked with many parents whose | | | | to get him the skills he needs-and demand that he |
| kids had been given multiple diagnoses, but their | | | | learns them-you're giving up. And by the way, giving up |
| children were still punching holes in the wall, cursing | | | | is very easy to do. I'm not judging parents, by any |
| them out and having meltdowns at home and in school. | | | | means. These kids are overwhelming, and families do |
| So, What Does a Diagnosis Do For Your Child? | | | | give up because they get exhausted. But understand |
| Special Education Funding: In the states where I've | | | | this: these kids still need to get those skills. If they don't, |
| practiced, when your child gets a certain diagnosis, you | | | | there's a good chance they're going to end up living |
| can often access special education funding. The sad | | | | with you into adulthood, be out on the streets, or in a |
| fact is that children with labels attract money; children | | | | correctional institution. |
| without labels don't attract any money. That should not | | | | 4. Kids with Learning or Behavioral DisabilitiesNeed |
| be discounted, because money-the means to get the | | | | Training the Most, but They're the Ones Who Get it |
| services that will help your child learn how to manage | | | | the Least. |
| his life-is a big issue. Many schools and mental health | | | | Let's look at the diagnosis from the child's perspective. |
| agencies have huge financial difficulties, and children | | | | My son was diagnosed with Attention Deficit Disorder |
| with special needs are competing to get the services | | | | as a kid. We worked with the school, but he still |
| they need. | | | | always felt "less than" the other children. Understand |
| Special education funding often depends on what the | | | | that at the core of these kids with behavior problems |
| diagnosis is. If someone has a diagnosis of ADHD, for | | | | or learning disabilities, they're angry. They're ashamed |
| instance, they will attract special education funding if it | | | | of themselves and they feel like they're damaged |
| interferes with the child's education. But if somebody | | | | goods. And that just makes them feel more hopeless, |
| has a diagnosis of Conduct Disorder or Oppositional | | | | which triggers more acting-out. Their perspective on |
| Defiant Disorder, they usually won't get any special | | | | their diagnosis is, "There's something wrong with me." |
| education funding or services. This is because Conduct | | | | That's why they're always making excuses, blaming |
| Disorder and ODD are behavioral issues, which can be | | | | others, and saying, "It's not me, it's them." In this way, |
| determined not to specifically interfere with learning. | | | | they defend themselves from the feelings of shame |
| Medication for Your Child: Getting a diagnosis also can | | | | and anger. They see that the other kids can meet their |
| lead to a prescription for your child. With ADHD, in | | | | responsibilities and they know they can't-or won't. They |
| many cases medication can be very helpful. For OCD, | | | | see the other kids getting along socially, and they know |
| medication is almost always indicated unless there are | | | | they don't get along with anybody. They have a big |
| other medical concerns. But there is no medication that | | | | denial mechanism that neutralizes those thoughts, and |
| deals specifically with behavioral issues like ODD or | | | | many of them end up walking around in their own little |
| Conduct Disorder, because again, these are cognitive | | | | self-centered world, acting out and becoming more |
| in nature. Doctors may try different medications, | | | | and more destructive. |
| including some anti-psychotics, but most often these | | | | In my opinion, if any child needs to learn how to |
| behavioral disorders don't respond to medication. | | | | manage their behavior effectively, it is a kid with |
| "Someone Finally Understands My Child's Problem!" | | | | learning or behavioral disabilities. In fact, they need it |
| Many parents feel lost with their acting-out or learning | | | | more than the other kids who are successfully learning |
| disabled kids, as if nobody understands their child-or | | | | how to do it as they develop. When a child has a |
| has a solution for them. Many times when you get a | | | | learning or behavioral disability, he needs to work |
| diagnosis, you feel as if somebody finally understands | | | | harder to be prepared for adulthood. Unfortunately, |
| what's going on, and that may very well be the | | | | these kids are the ones that need training the most, |
| case.Unfortunately, just because someone | | | | but they're the ones who get it the least. |
| understands what's going on, it doesn't make your child | | | | I used to work with kids in a youth correctional center. |
| more treatable. While the vehicle of treatment may | | | | Many of them had a lot of learning disabilities. Very |
| change from diagnosis to diagnosis, the goal remains | | | | few of those youth were what would be considered |
| the same: to help that child acquire the skills he will | | | | "normal" school kids. They all had a diagnosis of |
| need to function as an independent adult. He still needs | | | | something like ADD, ADHD, Oppositional Defiant |
| to be held accountable for his actions. | | | | Disorder, or Conduct Disorder, which becomes |
| Getting the diagnosis can affect funding and perhaps | | | | criminalized when you get into your late teens or even |
| get your child a prescription, but it does little else. And | | | | mid-teens. These are the kids - the kids with untreated |
| parents who feel hopeful when they get that diagnosis | | | | ADHD, untreated ODD, and Conduct Disorder-who |
| have only won half the battle. The sad reality is that | | | | start doing criminal things in adolescence. And if they |
| our current public and private mental health system do | | | | don't learn how to manage themselves effectively |
| not yet possess the knowledge and theory base to | | | | somewhere along the way, they get lost in the |
| effectively treat their child. I'm sure there has been | | | | correctional system. Or they become lost in lives of |
| success out there for many individual cases, but the | | | | substance abuse because it gives them a release |
| families I've dealt with have experienced a lot of | | | | from the pain of not being able to function. So you |
| disappointment at the outcome of the treatment | | | | often see a high percentage of drug addiction and |
| milieus they've been involved with. | | | | alcoholism amongst these children. And you see a high |
| 1. A Diagnosis Does Not Relieve Your Child of | | | | percentage of people in prison who have learning |
| Responsibility. | | | | disabilities. Many, many inmates can't write and read, |
| In my opinion, there is nothing wrong with saying, "My | | | | and thousands and thousands of people get their |
| child behaves this way because he has ADHD." Just | | | | GEDs in prison while they're doing time. |
| know that does not relieve either the parent or the | | | | 5. To Medicate or Not to Medicate? |
| child of the responsibility of learning how to function | | | | My view on medication is that it's up to the parent to |
| appropriately. In other words, if you use the diagnosis | | | | decide what's best for the child. I urge parents to go |
| as an excuse for not challenging your child's behavior | | | | into it with an open mind, to weigh out the benefits and |
| and not doing things that will promote change, I think | | | | the risks. Try to determine ahead of time how you will |
| you're making a big mistake. Let's face it, kids with | | | | know if the medication is working or not working, within |
| OCD, ADHD, Conduct Disorder, and ODD are all going | | | | a proscribed period of time. So it's not only "Put my |
| to become adults some day, and they're going to need | | | | daughter or son on medication," it's "If we put them on |
| the skills to make it in the real world. Depending upon | | | | it and it works, what will we see in 4 weeks?" |
| the diagnosis, when they turn 18 or 20 any funding that | | | | Conversely, ask yourself, "How will we know it's not |
| might be available stops. Unless your child has a | | | | working and what will we do?" Parents should be |
| severe Pervasive Developmental Disorder, a | | | | informed consumers of the information regarding what |
| developmental disability, Schizophrenia or some other | | | | medication their kids are using, and what the therapist |
| critical disability, there is no more money for him after | | | | hopes to accomplish. |
| he ages out of your health insurance or leaves school. | | | | Medication can be over-prescribed. I've seen kids on |
| That is why it is imperative that your child gets the | | | | three or four very powerful prescriptions, and unless |
| skills he needs to function in the real world as early as | | | | you have a good doctor who is monitoring everything |
| possible. Otherwise, success will be very difficult for | | | | very closely, know that many of these drugs can be |
| him to attain in his life. Playing "Catch-up" is a really | | | | harmful to the liver and kidneys. It's important that you |
| tough task for kids with behavioral disorders, and a | | | | keep your child's pediatrician informed of the meds |
| significant number of them are never able to do it. | | | | he's on. That being said, I think medication should be |
| Let me put it this way: if you don't know how to | | | | tried if you and your pediatrician determine that it might |
| manage your feelings, manage your behavior, be | | | | be helpful, and after a thorough screening and |
| productive, and respond to people in an appropriate | | | | examination. Also, I think that medication should only be |
| way - if you don't learn how to do that by age 18, that | | | | prescribed by a child and/or adolescent psychiatrist. |
| diagnosis doesn't count anymore. Nobody cares. | | | | Only they have the firsthand knowledge of how these |
| Believe me, the guy you're working for at 7-11 doesn't | | | | very complex chemicals interact with other chemicals |
| care if you have ADHD or not. He wants you to stock | | | | in the brain. I don't think pediatricians or nurse |
| the shelves. And he wants you to do it with a nice | | | | practitioners or any other professionals who have the |
| attitude and a smile. If you're not willing to do that, he | | | | right to prescribe should be dispensing psychotropic |
| will get somebody else who will. And I believe in the job | | | | medication for children. |
| market that's coming, you're going to have to be really | | | | Personally, I think it's often worth it to take a chance |
| skillful to maintain any kind of decent career. Kids who | | | | with medication, if the drugs can support your child's |
| have disdain for fast food jobs are going to wind up | | | | ability to self-manage sufficiently so he can learn the |
| seeking that kind of work just to survive. | | | | skills he'll need. Don't forget, all these methods we've |
| It should also be understood that while the juvenile | | | | been talking about are different vehicles that work to |
| justice system tries to be flexible and understanding | | | | get information to our kids on how to behave and |
| about learning disabilities or other disorders, after the | | | | learn to grow up. They are all, in effect, "service |
| age of 18, kids enter the adult correctional system. If | | | | delivery vehicles". The service is that we're getting our |
| you tell a judge the reason you broke into a car is | | | | kids to behave and get some necessary life skills. |
| because you have ADHD, he's going to give you a | | | | Medication, special education, therapy, books and other |
| dressing down you'll never forget. While kids get a lot | | | | resources are all examples, different ways to deliver |
| of flexibility, the fact is, adults aren't able to hurt others, | | | | the service of independent functioning to our children. |
| exploit others or do mean things and get away with it | | | | Make no bones about it, as a parent, you need to be |
| just because they had a learning disability or conduct | | | | proactive and search out the best method for your |
| disorder as a child. That is probably the rudest | | | | child, in order to help him function in the grown up world. |
| awakening I see teens with behavioral disorders go | | | | I believe these kids can change, and that the process |
| through. One month they're in juvenile court running | | | | of change works best when it starts at home. I've |
| everyone around and playing games, and the next | | | | worked with acting-out children for thirty years, and I've |
| month they're in county jail and nobody but their | | | | found that if there's a culture of accountability at home |
| parents cares about them. | | | | or in school, it enhances these kids' potential to |
| 2. Don't Use a Diagnosis to Make Excuses for Your | | | | respond. Real change does occur, but it takes a lot of |
| Child. | | | | work and sacrifice on the parts of all the adults |
| Don't use a diagnosis to make excuse for your child; | | | | involved. I'll tell you what I've told many parents in my |
| use a diagnosis to understand him. When you do this, | | | | office: "It doesn't end with the diagnosis, it just starts |
| you'll be able to figure out a way to teach him how to | | | | there. |
| function and how to perform effectively. Certainly, the | | | | |