Happy Holidays!

Since the purpose of having a blog is to write pretty much whatever I want and post it worldwide for all to see, I wanted to take this opportunity to wish everyone a very Happy Holiday season.

Christmas and New Year wishes
by Ringu Tulku Rinpoche

Let us celebrate Christmas.

Let us celebrate New Year.

Let us celebrate every day, every hour

And every minute of our life.

Let us rekindle love, friendship, gratitude,

joy and enthusiasm in us today.

Let us live today a purposeful and harmonious day,

And tomorrow will be another day of celebration.

Let us live each day as a New Celebration.

Advice for Frustrated Parents

I recently had a parent ask me the following, and I thought it would be helpful to post my response so that others could see:

Parent: You wouldn't have any parenting advice for a frustrated parent of a 10 year old boy with ADHD(combined type), Mood Disorder, and Disorder of written expression. If you could give any advice I would be forever grateful! He gets so frustrated!

Me: Sounds like everyone is frustrated...and reasonably so! Parenting is never easy, and comes with a lot of extra challenges when your child suffers from any, let alone multiple mental health issues.

To a parent who gets frustrated, I would recommend a few things. First, get support. There are several communitities online that offer advice from specialists and other parents. One of my favorites is called ADDitude. They have a whole section on parenting issues as well as a forum section where you can post questions (http://www.additudemag.com/channel/parenting-adhd-children/index.html). Another great ADHD organization to follow, which sends out a terrific magazine, is CHADD (www.chadd.org). I would also consider finding a local support group in your area.

Another thing I would recommend is some relaxation exercises. There are some you can teach yourself, but the best way is to go to a professional. They can help you to learn guided imagery, progressive muscle relaxation, and several other useful techniques that you can use not only in the heat of the moment, but also as you are trying to, say, unwind from a hectic day.

Also, don't forget the importance of exercise--a great stress reducer!

And finally, (and a professional can also help with this) don't forget to constantly remind yourself of 1. the wonderful things about your child and your life. Perhaps keep a journal by the side of your bed and every night take 5 minutes to write all the great things your child did that day and the things you are grateful for. Or, for you and the child, put up post-it notes around the house with positive statements about the child so that he can see them and boost his self-esteem and you can see them and feel good about him; 2. Don't sweat the small stuff. No matter how bad things are for you, there are countless people out there with even greater problems. As hard as it is sometimes, always try to remind yourself of this.

I hope this begins to help. Best of luck to you and congrats for having such a dynamic, energetic child!

The Study Zone!

I recently met with Ilene Shwartz, M.Ed., an educational consultant and founder of "Strategiec Educational Solutions". She has created a wonderful product designed to assist individuals in organizing their workspace, called the "Study Zone".

The Study Zone is a portable work station with accessible organizers for supplies and important papers. Simple organizational strategies are embedded into this product to help manage homework, studying and paperwork. It creates a cozy, private work space in any environment.

The Study Zone is not only useful at home and school but also for:
• Children in two household families
• Students who participate in after school homework clubs
• Organizing children’s medical, therapy and school records
• Creating a keepsake organizer or resource file for future grades

Please contact me if you would be interested in purchasing one of these great items. The child Study Zone is $49 and the adult Study/Work Zone is $35.

ADHD's Newest Superstar

The New York Times published an article today about the "New Face" of ADHD --- Olympic superstar, Michael Phelps. As a result of his family making his struggles with ADHD public, doctors are reportedly seeing more and more kids take pride in their "disorder".

The debate centers around whether certain disorders, like ADHD, are a disability, a trait, or even possibly a strength. In the article professionals argue from all sides. Dr. Edward M. Hallowell, a psychiatrist and author whose books include “Driven to Distraction: Recognizing and Coping With Attention Deficit Disorder From Childhood Through Adulthood” (Touchstone, 1995), says the current “deficit-based medical model” of the disorder results in low-self esteem.

On the other hand, Natalie Knochenhauer, founder of A.D.H.D. Aware, an advocacy group in Doylestown, Pa, says “You can’t have a disability that needs to be accommodated in the classroom, and also have this special gift."

I say, why not? why can't it be both? When it comes to traits that are appreciated in a school setting: organization, time management, self-regulation...ADHD will cause an individual to struggle. When it comes to traits that are appreciated in an athlete...energy, incredible focus when it is something a person is interested in...ADHD will help an individual to succeed.

I liken this discrepancy to pretty much any "disorder" or personality trait. Think of narcissism. Narcissistic Personality Disorder is characterized by the tendency to be excessively preoccupied by issues of personal adequacy, power, and prestige. Generally, this is thought of as a negative thing. But think about pretty much every Hollywood actor, CEO, or politician. Without a little narcissism, they wouldn't be who or where they are today.

Like most things in life, the argument whether ADHD is a "good" or "bad" thing is not black and white. And people like myself, Natalie Knochenhauer, and Dr. Edward M. Hallowell should be helping to bridge the gap rather than perpetuate it.

See the entire NY Times article at: http://www.nytimes.com/2008/11/25/health/25well.html?no_interstitial

Why Being Diagnosed with a Learning Disability as an Adult is NORMAL

Last week, I went to dinner with a group of old high school friends I hadn't seen in awhile. There I learned that my friend--we'll call her Lulu--had just come from being assessed for ADHD and learning disabilities. Lulu is 27, and has always been an excellent student. About a month ago, after completing an intense medical program at Columbia University, she had taken the MCATs in hopes of getting in to medical school and had, in her words, "bombed" the test.

Most of our friends who have known Lulu were shocked and surprised when they heard about the possibility of her being diagnosed with a learning disability or ADHD. They were even more shocked when Lulu explained that the psychologist had already determined that at the very least she definitely has ADHD. How could someone who has always done so well in school and come across as incredibly intelligent, have a learning disability?

Being a specialist in this area, I wasn't quite as surprised. Like a lot of older students and working adults I have come across throughout my career, even with very caring and observational parents, learning disabilities and ADHD often get overlooked throughout childhood and even throughout adulthood. Just last year I worked with a woman I diagnosed as ADHD at the age of 58, and she had never before been told that it was even a possibility.

Here's the thing. People with learning disabilities and/or ADHD aren't stupid! In fact, the reason the diagnosis can get overlooked for so long is a testament to how smart a lot of them are. They find ways of coping with their weaknesses, often working harder than the rest of us to keep up, but fooling everyone in the process---parents, teachers, and friends.

In Lulu's case, she had coped so well and is so intelligent that she made almost perfect grades throughout high school, SAT's, college, AND her med program, and only discovered that she might have an attention problem or other learning disability when her standard coping skills stopped working when she attempted the MCAT.

It is wonderful how much people focus on childhood interventions. My 5-year-old nephew has been going to PT and OT and every other T since he was two, and it has been tremendous for him. Still, the need for older adolescent and adult interventions is never going to change. And to parents who may be feeling guilty for not "seeing" the problem earlier, I hope this helps to explain that it's no ones' fault. The reason you didn't see your child's disability is because your child is so adaptable. Learning disabilities and ADHD don't form later in life or come out of thin air, it's simply that a person's environment changes to the point that they are no longer able to creatively adapt and cope on their own.

People like my friend Lulu are one of the main reasons I feel so passionately about coaching. Coaching allows individuals to work with professionals and come up with creative ways of reinventing coping skills so that they will work as challenges become more and more difficult. It is fitting the system to the person and not the other way around. People like Lulu CAN reach their dreams, they may just need a little help along the way.

The Learning and Study Strategies of College Students with ADHD

I presented this poster at the 2005 APA convention in Washington, DC. It discusses a study I conducted on the Learning and Study Strategies of College Students with ADHD, which compared them to their peers with and without Learning Disabilities. The study was also published in Psychology in the Schools.

ADHD and Neurofeedback

Here are two good Videos about ADHD. The first is about Diagnosing ADHD in Children. The second is about treatment - specifically Neurofeedback.

FREE Copy of Master Your Money: Paying Bills On Time with Adult ADD

Click the link to get a free copy of Master Your Money: Paying Bills On Time with Adult ADD. In these times of economic hardship, we could probably all take a few lessons!

http://www.additudemag.com/RCLP/sub/2750.html

Do You Have Adult ADHD? Why Diagnosis Is Critical

The following is a brief article from attitudemag.com

Attention deficit disorder (ADD ADHD) is being diagnosed in adults in their 20s, 30s, or, in some cases, in grandparents who are in their mid-60s.

Many adults with ADHD say that they weren't even aware of the disorder until they had a child who was diagnosed. After seeing ADHD in their children, these undiagnosed adults gradually realized that they had the same signs and symptoms. Why would it be important to diagnose someone has made it through school, has a job, and has somehow managed to hang around the planet for more than a quarter of a century?

ADHD is not some monolithic diagnosis that affects all people the same way. Some people with ADHD have learning disorders, some do not. Some ADHD people are extremely intelligent, others have average or even below average IQ. Some come from supportive homes, others come from dysfunctional families and had to raise themselves. All of these factors affect the impact of ADHD on the life of the individual. The child genius who has supportive parents will be better able to compensate for his or her ADHD.

Many ADHD adults have learned to hide their cluttered desks behind closed office doors; they learn to look attentive even when they have no idea what has just been said. These and other survival skills help to cloak their ADHD.

But, eventually, even the child genius finds that coping skills only go so far. Frustration becomes more apparent as the gap between ability and actual performance grows. After years of being able to get by on innate intelligence and other abilities, these undiagnosed ADHD adults realize that there is nothing left in their bag of tricks.

Research on ADHD adults illustrates the scope of the problem. Twenty-five percent of ADHD participants in the study did not graduate from high school versus 1% of the participants who did not have ADHD.

On a positive note, half of the ADHD students who did not graduate were able to obtain a General Education Diploma by taking the GED test. Only 15% of ADHD participants had completed a bachelor's degree compared to more than half of the Non-ADHD group having completed a bachelor's degree or higher. Other studies report finding that as few as 5% of AD/HD people who attend college actually obtain a degree (American Journal of Psychiatry, April, 1998)

Three percent of the adults in the ADHD group were enrolled in graduate school or had completed a graduate degree, compared to sixteen percent of those in the Non-ADHD group were either enrolled or had completed a graduate degree program when the follow up survey was conducted.

Education and career goals are not the only reasons why these patients seek treatment. The ADHD adult begins to feel unable to cope, as the responsibilities of marriage, parenting, mortgage payments and more begin to pile on. This frustration may lead to self-medication with illicit drugs or alcohol, both of which present even more problems of their own. Jobs suffer and relationships perish. An overall sense of failure begins to take over.

Breaking this cycle of failure and frustration is the primary goal of treatment for the ADHD adult.

Introduction to ADHD Coaching

The following is an excerpt from my 2007 Dissertation study, "ADHD Coaching and College Students"

ADHD coaching helps the individual to problem solve various manifestations of their disability (Quinn et al., 2000) and a growing amount of research suggests its utility. However, the lack of empirical studies documenting its effectiveness has left many scientists and practitioners skeptical about the efficacy of coaching as an intervention for individuals with ADHD. Still, many professionals feel that ADHD coaching has the potential to be an effective treatment (Swartz, Prevatt, & Proctor, 2005).

ADHD coaching derives from the coaching model used in executive coaching and athletics, the latter which has also been the impetus for life skills coaching (Quinn et al., 2000). Coaching involves helping clients deal with aspects of their disability that interfere with academic performance and coping with difficulties such as procrastination, lack of concentration, ineffective self-regulation, poor planning, anxiety, social incompetence, or time management. Useful strategies for ADHD college students to learn include organizational skills, time-management, goal setting, and specific study skills (Finn, 1998; Willis, Hoben, & Myette, 1995). As opposed to traditional counseling and psychotherapeutic methods, ADHD coaching puts the students’ needs and interests at the center, fitting the program to the student rather than fitting the student to the system, extending to all aspects of ADHD individuals’ life (McCormick, 1998).

Coaching is similar to traditional counseling in several ways (Jaska & Ratey, 1999). Coaching and counseling are similar in that both coaching and therapy establish helping relationships that are supportive, respectful of client’s needs, confidential, and free of manipulation or abuse, work on setting goals and assessing priorities, and require a client who is willing to elicit change. Unlike counselors, coaches do not explore serious emotional, cognitive, or behavioral problems of clinical intensity, such as depression, anxiety or substance abuse (Jaska & Ratey, 1999). Therapy is about insight; coaching is about action and getting things done (Favorite, 1995). It is a pragmatic, behavioral, results-oriented, “just do it” sort of approach, as opposed to a process, insight-oriented, intellectual approach. In Nancy Ratey’s (2002) words, “Coaching focuses on what, how, and when—never why.” Coaching operates from a premise that the client is ready, willing, and able to work in a partnership with the coach and rise to the challenge of creating a better life (Ratey, 2002). If any emotional issues arise during the coaching process, the coach must have resources to refer the client. It is important that the coach have a working knowledge of psychological disorders in order to refer clients with more serious problems.

A coach may deal with feelings such as frustration, fear of failure, avoidance behavior, and loss of confidence. However, these feelings are dealt with in terms of what motivates client’s behavior and helps/hinders goal achievement. Coaching is based on a holistic, “wellness” model, intended to improve daily functioning and well-being or individuals without significant psychological impairment. It is an educational process rather than a treatment process. Coaches do not have to be licensed, formally trained, or possess a formal degree. Coaching is also more flexible than therapy since in-person meetings are not essential. Coaches and therapists can sometimes simultaneously work with a client, but boundaries must be made clear.

Get a free Issue of ADDitude magazine!

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I highly recommend this magazine (but I am in no way associated with it nor benefit from it's sales) . It is brought to you by CHADD, a terrific organization -- all things ADHD. Click the link above to subscribe.

ADHD and Academic Difficulties

The following is an excerpt from my 2007 Dissertation Study entitled,
"ADHD Coaching and College Students"

ADHD and Academic Difficulties

There are three subtypes of ADHD: Predominantly Inattentive, Predominantly Hyperactive/Impulsive, and the Combined Type. In the Predominantly Inattentive type, the individual experiences the symptoms of inattention at the clinical level, but not the hyperactive-impulsive symptoms. In the Predominantly Hyperactive-Impulsive type, the individual experiences the symptoms of hyperactivity and impulsivity at the clinical level, but not the symptoms of inattention. In the Combined type, the individual shows clinical levels of symptoms of inattention, hyperactivity, and impulsivity (APA, 2000).

While students with ADHD seem capable of learning, their hyperactivity, impulsivity, and/or inattention make concentration difficult and negatively affects their performance (Fowler, 1994). Both motor and verbal hyperactivity may keep these individuals from being able to sit quietly during lectures. Impulsivity causes difficulty in any task requiring a delay such as raising hands to answer questions, reading or listening to directions, asking questions to clarify information, planning, and organizing (Zentall, 1993). Inattention leads to problems focusing on tasks and assignments.

Traditional school practices make academia an ordeal for many students with ADHD. The current degree of fit between the within-person variables of an individual with ADHD and standard classroom environmental variables is not effectively producing a successful outcome for students with the disorder. Students with ADHD risk school failure at a higher rate than students without disabilities who have equivalent intelligence (Rubinstein & Brown, 1981). As children, individuals with ADHD struggle with failure rates double to triple those of other children, with about 50 percent repeating a grade by adolescence (Ingersoll, 1988). One early study reported that 80% of students classified as having ADHD scored at least two years below their peers on measures of reading, spelling, math, or written language (Anderson, Williams, McGee, & Sylva, 1987).

Some studies have shown that younger students with ADHD may exhibit deficits in a specific academic skill. For example, one study found that approximately 15% of children and adolescents classified as having ADHD presented with profiles similar to students classified as having reading disorders (Aaron, Joshi, Palmer, Smith, & Kirby, 2002). Controlling for IQ and phonological processing skills, another study found that children and adolescents classified as having ADHD do not exhibit deficits in reading vocabulary (Nussbaum, Grant, Roman, Poole, & Bigler, 1990) or have problems with the comprehension of short passages (Javorsky, 1996). Instead, students classified as having ADHD had problems with the comprehension of longer passages (McGee, Partridge, Williams, & Silva, 1991).

In spelling, studies (that have controlled for IQ differences) have found that students classified as having ADHD score lower on standardized measures of spelling than their peers without disabilities (e.g., August & Garfinkel, 1990). Although spelling is primarily a phonological-orthographic (sound and sound-symbol) task, some researchers have suggested that the spelling problems of students classified as having ADHD may also be, in part, a selective attention task (e.g., Zentall, 1993). One study showed that the spelling performance of students classified as having ADHD could be improved simply through practice with target words (Fitzgerald, Fick, & Milich, 1986).

In math, studies have shown that students classified as having ADHD performed significantly lower than their peers without ADHD on timed tasks of math calculation, even when differences in IQ were controlled (Ackerman, Anhalt, Holcomb, & Dykman, 1986; Zentall, 1990; Zentall, Smith, Lee, & Wieczorek, 1994). As in the studies of spelling, researchers have speculated that the slower speed of students classified as having ADHD on math tasks might be attributed to their inability for sustained attention on repetitive tasks and lack of mastery of rote skills. Other studies suggest that students classified as having ADHD may have more difficulty on timed math tasks because of a combination of weaker computational skills, slower visual-motor speed, and more off-task behaviors (Barkley, Anastopoulos, Guevremont, & Fletcher, 1991; Zentall, 1990).

In addition to specific problems with one academic area such as reading, spelling, or math, researchers have reported that younger students classified as having ADHD exhibit handwriting difficulties; however, the reasons for these difficulties may be confounded by other factors. When controlling for visual-motor skill, for example, differences in handwriting errors between students classified as having ADHD and students without the disorder were not significant (Zentall & Kruczek, 1988). This finding suggests that the handwriting difficulties of students classified as having ADHD may be due to visual-motor deficits (Zentall, 1993). Alternatively, both poor handwriting and deficits in visual-motor skill may be the result of a third variable, failure to sustain attention to tasks that involve repeated practice (Zentall, 1993). Zentall and Kruczek (1988) found that students classified as having ADHD made more errors and had poorer handwriting ratings on a copying task than students without ADHD even after repeated practice on the task.

Barkley (1998) found that adults who were diagnosed with ADHD as children not only had lower levels of educational attainment but also reported having been suspended or expelled from school more often than their counterparts. Taken together, expulsion and dropout rates for these students approach 50 percent. Studies suggest that these early failures in academia lead to a lifelong downward spiral in terms of academic performance for students with ADHD.

Please contact me for a full list of references.

Academic Impairment of College Students with ADHD

The following is an excerpt from my 2007 Dissertation study. The study referenced by Reaser, Prevatt, & Petscher is actually my own ('Reaser' is my maiden name):

Academic Impairment of College Students with ADHD

Few studies have investigated the nature of academic dysfunction experienced by college students with ADHD in relation to symptoms of the disorder. In these few, college students diagnosed with ADHD have reported problems with study skills, as well as note taking, summarizing, outlining, and test taking (Zwart & Kallemeyn, 2001). Reaser, Prevatt, & Petscher (2007) found that college students with ADHD report significant difficulty in the areas of time management, concentration, selecting main ideas, test strategies, motivation, anxiety, information processing, and self testing, as related to their peers. Similarly, Javorsky and Gussin (1994) reviewed studies suggesting that college students classified as having ADHD often exhibit problems with study strategies, note taking, summarizing and outlining, and test taking. Heiligenstein and Keeling (1995) found that the self-reported histories of college students classified as having ADHD revealed low academic achievement, as well.

Other documented problems that contribute to academic failure for college students with ADHD include negative attributional style (internal, stable, and global causes) and internal restlessness (Tominey, 1996; Weyandt, Iwaszuk, & Fulton et al., 2003). Wallace, Winsler and NeSmith (1999) found that students with ADHD demonstrated motivational impairments characterized by a preference for easy work, less enjoyment of learning, less persistence, and a greater reliance on external than on internal standards to judge their performance. Based on surveys of disability service coordinators, McDonald-Richard (1995) reported that academic performance by students with ADHD was hindered due to problems in self-regulation, task persistence, and attention.

Heiligenstein, Guenther, Levy, Savino, & Fulwiler (1999) compared a small number of students (n = 26) who were first classified as having ADHD in college with students without ADHD (n = 28) who presented with career concerns at the university counseling center. Students classified as having ADHD reported poorer functioning than the comparison group on several academic variables. The students classified as having ADHD had lower mean grade point averages, (ADHD M = 2.5; comparison M = 3.2) and were also more likely to be on academic probation. In the same study, on the Inventory of Common Problems, a self-report rating scale for college students, the ADHD group reported significantly more academic problems than the comparison group. Moreover, students classified as having ADHD did not differ significantly from the comparison group on questions relating to anxiety, depression, interpersonal relationships, physical health, substance use, and lethality (e.g., suicidal ideation). From these findings, Heiligenstein et al. suggested that understanding the pattern and development of academic impairment in ADHD is particularly important because the majority of their participants did not have academic problems that were apparent during childhood. Consequently, they hypothesized that the onset of academic impairment and subsequent classification of ADHD may be related more to external factors (e.g., academic difficulty at a particular university, loss of family structure that supported academic success, absence of individual education services) than to the presence of ADHD symptoms per se.

References

Heiligenstein, E., Guenther, G., Levy, A., Savino, F., & Fulwiler, J. (1999). Psychological and academic functioning in college students with Attention Deficit Hyperactivity Disorder. Journal of American College Health, 47, 181-185.

Heilegenstein, E. & Keeling, R. P. (1995). Presentation of unrecognized attention deficit
hyperactivity disorder in college students. Journal of American College Health, 43, 226-228.

Javorsky, J., & Gussin, B. (1994). Serving college students with Attention Deficit Hyperactivity Disorder: An overview and program guidelines. Journal College Student Development, 35, 170-177.

McDonald Richard, Mary. (1998). Students with attention deficit disorders in postsecondary education: Issues in Identification and Accommodation. A Comprehensive Guide to Attention Deficit Disorder in Adults, (pp. 285-306). New York: Brunner/Mazel publishers.

Reaser, A., Prevatt, F., & Petscher, Y. (2007). The learning and study strategies of college students with ADHD. Psychology in the Schools, 44(6), 627-638.

Tominey, M. F. (1996). Attributional Style as a Predictor of Academic Success for Students with Learning Disabilities and/or Attention Deficit Disorder in Postsecondary Education. Paper presented at the International Conference of the Learning Disabilities Association (Chicago, IL, Feb. 19-22, 1997).

Wallace, B. A., Winsler, A., & NeSmith, P. (1999). Factors associated with success for college students with ADHD: Are standard accommodations helping? Paper presented at the Annual Meeting of the American Educational Research Association (Montreal, Quebec, Canada, April 19-23, 1999).

Weyandt, L. L., Iwaszuk, W., Fulton, K., Ollerton, M., Beatty, N., Fouts, H., et al. (2003). The Internal Restlessness Scale: Performance of college students with and without ADHD. Journal of Learning Disabilities, 36, 382-389.

Zwart, L.M. & Kallemeyn, L. M. (2001). Peer-based coaching for college students with ADHD and learning disabilities. Journal of Postsecondary Education and Disability, 15(1), 1-15.

Mental Health And Our Economy

While I plan on posting a lot of facts and data about ADHD/psycho-educational coaching and how it differs from traditional psychotherapy, I wanted to begin by extending some personal thoughts about one thing that is on everyone's minds these days--the state of our economy--and my passion--mental health.

Regardless of political viewpoint, I think we can all agree that our happiness on this earth comes down to one thing--how we feel. How we feel about ourselves, our loved ones, our society...our future. It's our perception of how we are succeeding in life and how the ones we love are succeeding in their lives, that causes us to either wake up with a smile or cry under the covers all day.

In times of financial hardship, it may seem that things like paying for mental health services and furthering our education need to take a backseat. How are we supposed to worry about getting happy and getting better organized when the milk carton is half empty, right?

In my opinion, it is when times are the worst that people need things like psycho-educational coaching or good old talk therapy the most. Coaching has helped many people not only learn better skills in organization, motivation, and time management, to help them compete in a competitive job market or manage their finances, but it has also changed people's perceptions and how they feel about themselves. When you are attempting to learn new skills your confidence grows, and that milk carton that before was half empty becomes...half full!

In my 2007 dissertation study on coaching, the number one thing my participants stated that they had gained from the experience was "realization, awareness, and understanding". Right behind that was "increased focus and control" and "increased organization", followed by...you guessed it..."more positive."

I know it's hard to look beyond the day to day, but we only have one shot at this life. So why not make it the happiest, most fulfilling life we can lead? Whether you see a therapist or coach, or even hash your problems out with a good friend over coffee, take care of your mental health and continue to develop your life skills. Even in the worst of financial times, if you or your child had a physical illness you would go to the doctor, right? Well, the same goes for what you can't see.

Take care.