Like Father…
Every year about this time I start seeing relaxed, sunburnt kids reluctantly gearing up for the coming school year. For those with ADHD (Attention Deficit Hyperactivity Disorder) returning to the classroom can be a stressful prospect. When I ask if they feel ready, I normally get a shrug or a headshake no; But Josh, a stocky fifth grader who often seemed tense and angry, actually smiled.
“Yep,” he said. “Looking forward.”
“Why is that?” I asked him.
“School’s just easier.” He searched for a word. “It’s more peaceful…… I guess.”
This surprising answer gave me a big clue for diagnosis and treatment. Josh, in fact, performed well academically. He was a smart boy and was better at staying organized, controlling his emotions, and completing tasks in the classroom. Obviously it was a setting that worked for him. While this is not always the case, there are a set of ADHD children for whom a nurturing-structured classroom is a great fit.
At home it was a different story for Josh. He was rude, especially to his dad, and aggressive with his siblings. His seven-year-old sister called him “The Tasmanian Devil.” He rarely did what he was asked without a fight, his room was chaotic, and, in his mom’s words, Josh “just seemed to fall apart.” When asked to take out the garbage, he procrastinated for hours. When repeatedly reminded, finally he kicked the can over, refused to pick up the contents, shoved his brother out of the way, and ran upstairs. There, he closed himself in his room and threw his books and toys and pillows against the door.
I had a long talk with Lindsay, Josh’s mom, and asked her how she felt about Josh’s ADHD. She made an exasperated gesture. “When I heard the diagnosis I just thought, “Oh great. Now I’ve got two of them!”
I asked her what she meant by that. “Josh’s dad is the same way,” Lindsay said. “He forgets everything, so I constantly have to drive stuff to him at work. We plan to meet for dinner, he’s an hour late. We go to the theatre and the real drama is whether he’ll actually show up in time. He doesn’t really listen, so he gets mad because he thinks I’m “springing stuff” on him that I never told him about. He’s always struggling because he’s so disorganized, and that means he feels like he’s screwing up, so he’s angry a lot. Josh is a carbon copy.”
Obviously this fact—that Josh’s dad also had ADHD and that Josh’s mom felt the condition created chronic problems for her—was having an impact on Josh’s behavior. As often happens, it would be possible to benefit the patient by modifying the environment. In this case, getting Josh’s mom, some support, getting Josh’s dad some treatment, and getting mom and dad some help with parenting skills would produce great benefits for Josh.
Since those steps have been taken, Josh’s behavior at home has gradually improved. When he comes in to see me after he gets back from vacation this year I’m hoping things are so good at home that he’ll be as reluctant as every other kid to start school!