ADHD: Strategies for Success

When parents seek help, they have a mingling of hopes, concerns, and frustrations. From experience I have learned that parents whose children are having any kind of difficulty are asking five basic questions. These questions are not always stated openly, but they are there, at least subconsciously, waiting for answers. These questions are: 1. Is there anything wrong with my child? The desire of all parents for their children to be normal and healthy is universal and understandable. Our earliest dreams are of a child with no blemishes, physically, mentally or emotionally. But, of course, that perfect child exists only in our dreams. As human beings, no child is perfect. In fact, all of us as humans are a mixture of strengths and weaknesses, physically, emotionally, and mentally. These variations of development can at times cause concern. For example, Susan walked at nine months; Johnny didn't walk until 13 months. Sammy learned to read in kindergarten; Mary is having trouble still, and she is in the middle of the first grade. Are these normal variations or do they represent some kind of developmental abnormality? These are common and legitimate questions parents ask. Sometimes all a parent needs is reassurance that, indeed, their child really is normal and there is no need to worry. At other times, they know something is wrong and they actually are asking, "What's wrong and how bad is it?" 2. What's wrong with my child? When their child is sick or disabled in any way parents have a real need to know what the problem is. The more specific the diagnosis, the more satisfied they are. However, parents often go from place to place, professional to professional and agency to agency, without getting a specific answer. Not long ago, I saw for the first time a 12 year old girl who had a significant reading problem. "What do you understand Kim's problem to be?" I asked. "No one has ever told us," her mother replied. "I wish I knew." Kim's parents may have been given a diagnosis at some point in time. But they probably were not given one in terms they could understand and digest. Parents have a hard time complying with treatment or remedial programs when they have not been given a clear diagnosis or outline of the problem. 3. What caused it? This is a most important question to parents. They have a natural need to know the cause of anything that hurts or hinders their children. This intense need to know the cause is due to many factors. One that looms large is the universal tendency of parents to blame themselves for their children's problems. This is true whether their children have a simple cold ("I know I shouldn't have let him go out barefoot") or something more serious, such as a birth defect. ("I've always wondered if it was my fault for not taking my vitamins regularly.") When anything happens to their children, parents immediately look to themselves. They ask persistently, "What did I do wrong?" or, "What should I have done that I didn't do?" One of the things we try to do in this book is help parents see that multiple factors are involved in producing observed developmental problems and seldom does the responsibility rest on the shoulders of the parents. 4. What is my child's future? Besides guilt, concern over the child's future is the parent's most urgent worry. When possible, we will try to give parents a reliable appraisal of their child's future expectations. When we don't know, we will be honest. I am wary of making specific long range predictions: "He will never learn to read." or "She will definitely go college." Children are amazingly resilient and have a way of making fools out of those who are too dogmatic about them. I try to express the attitude I call optimistic realism: This means being honest regarding the child's level of function at this point but having an open mind about the range of future possibilities. 5. What can we do to help? This is a healthy, mature question. In the end, it is the most important one. When the parents are ready to ask this question, they can actively enter the therapeutic partnership with the child and others who might help. But they can only reach this point if the professional (doctor, teacher, psychologist, therapist) has honestly answered their questions about diagnosis, cause, and prognosis. Only then can they think creatively about solutions. In one of my favorite Peanuts Cartoons, Lucy, speaking to Charlie Brown, says, "There are no stupid questions. There are only stupid answers." I agree. Parents should never be timid about asking questions to which they do not have the answers.