ADHD Article January 1999

Over the Christmas holidays I noticed that James was having problems even after taking his medication. As the holiday vacation progressed, it became clear, that the meds were having little if any affect on James and were providing absolutely no help for him from what I was witnessing.

I called the school and spoke to his teachers as soon as school resumed and found out that they had been experiencing problems both in the classroom and on the playground for quite sometime and for whatever reasons, they were just dealing with the issues on their own, or ignoring them rather than calling me to let me know there were problems.

Through observation and working together as a team, we came to a clear understanding that James' meds were no longer working well for him at their current level and so, I made an appointment with his dr. and we made the decision to increase his meds by 5mg in the morning only and we are back on track and James is doing well in class.

The point I guess I am trying to make here is that we CAN'T and shouldn't rely on the school or the teachers to notify us if there are problems at school. It's up to US, to monitor and make sure that our children are doing well in class and continuing to excel and make progress. Taking the stance that "No news is good news" is not wise in the case of our children and I encourage ALL parents to take an active role in their children's education. I make a habit of checking in with my children's teachers at least once, every quarter. I got in this habit because of my total lack of trust in the schools ability to take care of my children but over the years, I have found it to be a good habit to get into PERIOD, no matter what the reason.

NOTE: Please note that Dr. Dave Rabiner's site address has changed. Please change your bookmarks to reflect his new address www.helpforadd.com

My column this month deals with the type of treatment that children with ADHD receive on a typical basis. It appeared in a recent issue of ADHD RESEARCH UPDATE, the electronic newsletter I publish to help parents and professionals stay informed about new research on ADD/ADHD. I'd be happy to send you several sample issues of this newsletter to review. Just e-mail your request to addhelp@mindspring.com and type "samples" in the subject line.

VARIATIONS IN THE TREATMENT RECEIVED BY CHILDREN WITH ADHD

What type of treatment do children with ADHD typically receive in the US and how does this differ according to the type of provider consulted for treatment? These interesting and important questions were addressed in an article that appeared the September, 1998 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (pages 968-976).

The authors of this study began by identifying all children from within the population of second through fourth grade special education students in a particular school district who could be diagnosed as having ADHD. (As the authors point out, one cannot assume that results from this particular locale would also be found in other regions of the country, but their results are nonetheless instructive. It is also true, that the population of special education students with ADHD may not be representative of the general population of students with ADHD. Once again, however, I think the results from this sample are still quite instructive.)

After identifying the children who had ADHD, the authors interviewed the children's parents to learn about the treatment for ADHD that their child had received. Here is an overview of the major findings:

* 29% had received no care from any type of provider during the prior year;
* Of those receiving care in the prior year, 75% received treatment from a primary care provider, who was almost always a pediatrician. Over 2/3s of those children treated by a primary care physician did not any contact with a mental health specialist.
* 26% of children were treated solely by mental health specialists generally a child psychiatrist. Children treated by mental health specialists had higher levels of impairment than those treated exclusively by primary care physicians and were more likely to have an additional diagnosis besides ADHD.
* 24% of children were treated jointly by both a primary care physician and a mental health specialist.

Before moving on to highlight other aspects of the results, several points about the data above need to be made. First, it is striking that almost 1/3 of children with ADHD in this sample received absolutely no treatment of any kind during the prior year. Unfortunately, information about why no treatment was provided to these children is not presented. Second, it is striking that over 2/3 of children who were treated by a primary care provider had absolutely no contact with a mental health specialist during this period. This may reflect an important deficit in the care these children received, since primary care providers would be less likely to provide the kind of behavioral parent training and/or child behavior therapy that is often an important and necessary component of a child's treatment.

In regards to the general characteristics of the treatment that children received, here is a overview of what the authors found:

* For children treated solely by a primary care provider, the average total amount of contact with the provider during the past year was only 2.3 hours (it is hard to imagine that this could really be adequate). This compares to an average contact time of over 17 hours for those children treated by mental health specialists.
* Only 43% of primary care providers and only 52% of mental health specialists established any contact with the child's school. This raises serious concerns about the care that many children received, as the direct monitoring of school behavior is widely recognized to be an important part of effective treatment for ADHD. In fact, this is stipulated in the practice guidelines for ADHD that were recently published by the American Academy of Child and Adolescent Psychiatry. (By the way, this is an area where the ADHD Monitoring System that you received can be so helpful as using it will provide you with the regular feedback from your child's teacher that is needed to assess the ongoing effectiveness of the treatment your child is receiving.)

What this means, of course, is that many children were taking medication without the prescribing physician obtaining any direct feedback from the child's school about how well the child's symptoms were being managed. As a result, it is virtually certain that many children were taking medication who were not deriving any significant benefit from it any many were being maintained on a less than optimal dose. Results of a large scale intervention study that I hope to discuss in the near future (published results are not yet available) seem to clear indicate that carefully monitoring medication effectiveness makes a critically important difference in the success of this treatment.

* Only 2% of children treated by primary care providers received any type of psychosocial therapy, which include such empirically validated treatments behavioral parent training and child behavior therapy.
* Only 25% of the children received multimodal therapy, which includes a combination of medication treatment, school contact, and psychosocial interventions. Although the benefits of multimodal therapy vs. medication alone remains an important focus of current research, it is generally considered to be an important treatment approach with many ADHD children. In this sample, however, only a minority of children were receiving it. As expected, children treated by a mental health specialist were more likely to receive this combination of treatments than those seen by primary care providers alone.

As noted above, there is no way to know the extent to which the findings from this small segment of the population is reflective of the type of care that children in this country with ADHD generally receive. I must say, however, that this is not inconsistent with what seems to be the case in communities that I have practiced in. Overall, the results are pretty discouraging in that they strongly suggest the following:

* Many children with ADHD are receiving no treatment at all;
* Of those receiving treatment, basic elements of what would be considered to be adequate care (i.e. contact by the provider with the child's school and providing parents with instruction in specialized behavior management strategies) are often missing.

Although there remains much to be learned about how to most effectively promote the long term success of children with ADHD, much of what has already been learned is apparently not being routinely incorporated into the care that children are receiving.

Please do not interpret these results as indicating that primary care physicians can not provide adequate care for children with ADHD. I have been fortunate to personally work with a number of outstanding pediatricians and family doctors who did an absolutely first rate job of this. What the data show, however, is that there are many times when this may not happen. Also, as discussed above, there were many children seen by mental health specialists who were also not making any regular contact with children's schools or providing any type of behavioral intervention as part of the child's treatment. This is why it is important for parents to be vigilant in making sure that their child is receiving the different components of effective treatment that he or she may require.

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That's all for this month. Please get in touch if you would like to receive sample issues of ADHD RESEARCH UPDATE

David Rabiner, PhD
Licensed Psychologist
www.helpforadd.com

In my last article, "Classroom Coaching: Bringing Skills On-Line," I introduced the metaphor of driving to help children understand how observing clues in their environment helps them to cope better with the different "roads" in their lives, i.e, school, family life, friends' homes, etc. The intent was to offer a format for concerned adults (parent, teacher, or counselor) to deliver group coaching assistance to children in need of improved social and emotional skills.

The present article will extend the driving metaphor to several other social "rules of the road" that are are often deficient to varying degrees in many children. Among these "rules" include the consideration of timing, respect for boundaries, tolerance for the mistakes of others, and importance of fitting in. Each one of these issues comprise a critical social/emotional skill that helps children achieve smoother functioning no matter what "road" they travel. During a series of articles, I will examine these and other skills from the vantage points of individual children (composites of various patients of mine) who came for help with many examples of "driving-related" problems in their lives. Each child will portray a typical profile of varied social-emotional skill deficits.

Samantha (Sam) is an 12 year old girl who unabashedly described herself as "needing attention and wanting to be in control." Yet, she was often confused and easily upset by the reactions of others to her behavior. Her parents described her as extremely outgoing and enthusiastic among peers but tending to be unaware of "social signs and signals." Her teachers shared a similar view of Sam's troubles, explaining how she would often raise her hand and immediately begin speaking in class or "barge" into a discussion among others. These and many other social skills problems had contributed to damaged self-esteem and regular conflict between Sam and her parents.

Parents and teachers regularly come into contact with passionate children like Sam. They love to participate and can't tolerate the thought of being left out of anything they desire. They relentlessly pursue connecting and contributing no matter what social fall-out it may cost.To their credit, they often have very valuable ideas to offer but overlook the importance of timing, boundaries, and reciprocity. Therefore, instead of receiving the approval they crave they often feel unfairly treated and frustrated.

It is especially challenging to coach skills in children like Sam because of their high degree of sensitivity and controlling nature. Delivering the coaching skills requires a lot of verbal diplomacy or the message gets pushed away as unfair criticism. For this reason, it is useful to abandon the direct "head-on" approach since this leads to collisions between adults and the Sams in their life. The following is a recommended coaching approach to children who fit Sam's profile:

"I can see how much you want others to notice you and all the neat ideas you have to offer. So much of the time you have something to contribute or ask for, and sometimes you end up feeling pushed aside for no good reason. You end up feeling frustrated, and probably blame the other person. But blame can get in the way of understanding what happened. Maybe there's a way of getting past the blame and looking at what is going wrong when you are on the road to get attention."

In this opening appeal, the coach joins with Sam to express understanding of her feelings and begin building the partnership. Sam must not feel criticized at this delicate juncture or she won't feel safe enough to keep an open mind and accept the coaching help. I emphasize to parents/teachers that the first level of coaching is to empathize with, not diminish, the child's experience. (Diminshing might take the form of saying "everybody has to deal with this" or "I had the same problem and learned to stop acting that way.") As a way of deflecting feelings of self-blame from hitting Sam's fragile self-esteem, the coach normalizes the problem and introduces the notion of auto-pilot program:

"All kids find themselves in tough spots at one time or another. People are not treating them the way they want to be treated. Sometimes it's easy to figure out. Maybe the kid really did something wrong, like hit someone or throw something at somebody. But other times a kid is meaning no harm but people still don't treat them well. In these cases it may seem to the kid that it's everyone else's fault for treating them badly. All they want is to be included, or to be heard, or to show something to others, and so on. In other words, they don't think they are doing anything wrong to deserve this kind of bad treatment from others.

"Let's throw out the idea of who's at fault because that just gets in the way of solving the problem. Instead, let's look at it as a matter of road conditions. Drivers have to be aware of road conditions in order to drive safely and observe the rights of other drivers. As the road swerves, they have to stay in lane. If the temperature drops, they have to look out for icy patches. When it's unsafe, they must not pass other cars. But what if a driver always drove the same way no matter what condition the road? It would be like having an auto-pilot program that controlled the car for them. Usually the auto-pilot automatically gets them where they want to go. But when road conditions change, they would be at greater risk of accidents and would anger other drivers. Ofcourse, they would not be trying to do these things but that would be the outcome."

This second level of discussion finds the coach distinguishing between intentions and outcome. Children with Sam's profile have difficulty accepting responsibility for their actions because they do not "try" to make others angry or rejecting. Alternately, their hope is for praise and acceptance, so the outcome is especially difficult to swallow . By identifying with the driver who relies on the "auto-pilot" program, the child accepts the notion that just because their "driving habits" steer them well in some places doesn't mean they will work smoothly in other places. The "auto-pilot" acts as as the "chalkboard" where the coach can talk about the automatic behaviors that get Sam into so much trouble with others. Parent Coaching Cards can also serve as the chalkboard, since they offer a place to review how the "auto-pilot" program may be "programmed." Next, the coach can speak more directly to the skills that need to be learned:

"When kids rely on their auto-pilot in dealing with others they usually forget to check road conditions. If a kid's programmed for maximum contribution and control, kind of like you, backfires occur, especially in school and at home. That's because there are other drivers who want their share of the road. But kids can learn how to check road conditions so that things go more smoothly with friends and adults. Here are some of the important "rules of the road" that kids can learn:

1. Timing

Timing is all about picking the right time to speak up so that what you have to say will be received in the best possible way. If you were really driving, it would mean that you choose the right time to pass another car. When the time is not right, you would not to risk trying to pass another car. Timing can be tricky to figure out when you're a kid. Here are some ways to improve your timing:

A. Consider what's going on around the person before you approach them. Are they in the middle of a conversation with someone else? Are they reading?
B. Check their nonverbal language. What kind of expression do they have? Does their body posture tell you that they are open or closed to a conversation?
C. How important is it that you talk to them at that time? Is there something else more important that just happened? Can your contribution wait for a better time?

2. Boundaries

Boundaries are about the space that separates people from another. We all need some space of our own. If you were driving, it would have to do with keeping your car in the lane, and not swerving into the other driver's lane. For kids, it means not invading the space of others, but instead, respecting the boundaries of others. Here are some ways to improve your handling of boundaries:

A. Notice the distance that separates other people when they are talking to each other.
B. If you have questions about the boundaries of others, it's ok to ask them if they need some time by themselves.
C. Don't take it as a personal rejection if a person does need some space.
D. Remember that different people have different needs for space. Just because you might like having people close, and not like putting up boundaries, doesn't mean that someone else feels the same way.

3. Reciprocity

Reciprocity has to do with thinking about the feelings of others before you say or do something. If you were a driver, it would have to do with being courteous about using your turn signals or letting another driver get in front of you. For kids, it concerns sharing control over decision-making, inviting others to express ideas, and asking the right kinds of questions. Here are some ways of becoming more aware of reciprocity:

A. Ask yourself from time-to-time, "Is the other person in as much control over things as I am?" If they aren't, try talking a little less and asking them questions about what they want to do and their life.
B. Review the time you spend with friends. Think about it and then talk about about it with someone else, such as a parent or teacher. Think about how decisions were made and whether both of you had equal contributions.

These are some of the substantive coaching formats that parents, teachers, or counselors can offer to children like Sam. The intent is for them to develop greater attunement to the social environment so that they may elicit more favorable responses from friends and adults.

Dr. Steven Richfield
Parenting Pointers
January, 1999
www.parentcoachcards.com

My name is Christie Beighley and I am a social worker at the local mental health center in Lexington, NC. A friend and I will be starting a Women's ADD Support Group on Thursday, Feb. 25th. We will be meeting at First Presbyterian Church in Lexington, NC at 7:30pm every other Thursday. The co-leader has her master's in counseling and also works here at the mental health center. I may be reached at (336) 248-4530 for directions and/or more information. Your assistance is most appreciated.

Sincerely,
Christie Beighley

I'm a dual certified teacher and self-employed in home tutor. I specialize in tutor students with behavioral problems, such as ADHD. Here is my site address for your information. tutor.hypermart.net/tutoring.html

Sincerely,
Rick
J. Richard Kirkham B.Sc. tutornow@geocities.com

My name is Lilly and I have Tourette Syndrome and ADD and OCD and other disabilities. My url is www.angelfire.com/in/tourettesyndrome/links.html Thank You for your time

Lilly Francis
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1. A chronic, abnormal focus on a single idea.
2. The inability to let of a disturbing thought that has no usefulness (continual checking the window to make sure that you closed it)
3. Doing things that are contrary to your own standards or wishes.
4. time - consuming rituals can take over the sufferers' life making it hard to function normally outside of the home
Facts:

1. The National Institute of Mental Health-
a. survey showed OCD affects 2 % of the population
b. more common than schizophrenia, bipolar disorder, or panic disorder
c. at least 1/3 of cases of OCD in adults began in childhood

2. Sometimes accompanied by:
a. depression
b. eating disorders
c. substance abuse disorder
d. a personality disorder
e. attention deficit disorder
f. other of the anxiety disorders

3. Associated with other disorders:
a. Tourette's syndrome - characterized by involuntary movements and vocalizations
b. trichotillomania - ( the repeated urge to pull out scalp hair, eyelashes, or eyebrows)

Characteristics associated with OCD:
1. over concern with diseases
2. over concern with germs
3. need to wash continually
4. irrational fears
5. bad thoughts continually
6. overly worried about the what if's of life
7. urges to hurt others
8. repeating actions continually
9. need for assurance on a continual basis
10. need to touch all the time
11. overly organized to the point of nothing out of order
12. need for rituals

Behavioral Therapy:

Exposure and Response Prevention

a. the patient is deliberately and voluntarily exposed to the feared object of idea, either directly or by imagination, and then is discouraged or prevented from carrying out the usual compulsive response.

Therapist should:
a. be well trained in the specific method developed
b. make sure patient is highly motivated
c. make sure patient's family is cooperative
d. make sure patient fulfills "homework assignments"

*note from the author*-

My son exhibited a considerable amount of these behaviors and I found that the valerian root, kava kava, St. John's wort helped tremendously. Vitamin/minerals added in the right dosages daily balanced over time. The E'ola herbal drops in conjunction with the above made life bearable.

I found that being firm but loving helped quite a bit and not letting new rituals start to be added to the existing ones.

There is light at the end of the tunnel and my son doesn't exhibit this disorder anymore, though the habit of trying to ritualize things occurs occasionally. I just tell him it's not needed and that 's the end of that discussion. I used to wonder how I survived the moment much less the day.

Special Interest-

OCD individuals are protected under the Americans with Disabilities Act.

ADA Information Line
U.S. Department of Justice
(202)514-0301
Job Accommodation Network
President's Committee Employment
People with Disabilities U.S. Dept. of Labor
West Virginia University
809 Allen Hall
P.O. Box 6122
Morgantown, WV 26506
(800) 526-4698
Pharmaceutical Manufacturers Association publishes a directory of indigent programs for those who cannot afford medications.
Physicians can request a copy of the guide by calling (800) PMA - INFO
SPECIAL THANKS TO " PILOT PARENTS PARTNERSHIPS"

Unfortunately, not all teachers know how to teach to an ADD student. When asked, many parents are at a loss on how to help that teacher help their student. And let's face it, not all student learn the same way. One teaching style can't be perfect for all students all the time.

Those of you who know me or have read my book know that I am working to promote ADD-Friendly classrooms. I dislike the current system which requires parents to battle the teacher, the school, and the school district just to get special help for their failing or at least, struggling student. I believe this conflict is not healthy for the child, he often feels that he is to blame. Not only can't he pass school and always seems to be in trouble, but now the two sets of adults he cares most about (his parents and teachers) can't get along because of him.

However, ours is not an ideal world. Currently, many parents find themselves having to become the proverbial "squeaky wheel". Yet when asked for suggestion on the types of accommodations the student needs, the parent may be ill equipped to give ideas to the teacher or the student study team.

Although there are as many different approaches as there are ADD students, I would like to offer some suggested accommodations. Remember, however, that a structured, predictable environment goes a long way to minimizing the need for special accommodations.

Learning. Since ADD is a concentration issue, learning is often difficult because an ADD student can't focus long enough to understand what is being taught or read. Teachers and parents can help this student in several different ways.

1. Prior preparation. When my daughter, Caron, began having trouble with her algebra, she and I struggled to help her understand what was being taught. A friend of ours suggested that we work several lessons ahead, that way she would already be familiar with the material before the teacher taught it. This has turned her D into a B. She participates more in class and has an easier time listening without getting lost. If a teacher can let a parent know ahead of time what will be taught, the parent can have their student preread or prepare ahead, making learning easier for the student.

2. Highlight. Another way to help an ADD student or any student for that matter learn better is to allow them to highlight important information in their text book. Parents might consider asking the school if they can purchase the text for this purpose. ADD students have a difficult time sorting through all the words to determine what is important to know. Teacher can suggest what to highlight while teaching the lesson. As a teacher, I sometimes copy pages of the text on to overhead slides and highlight the important points and have them copy my model. This also aids the parent in knowing what to have the student study for a test.

3. Copy of outline/notes. Taking notes can be completely frustrating for an ADD student. Not only do they have a hard time concentrating long enough to get the information and remember the thought long enough to write it down, but also many ADD students are dyslexic or have other learning differences to boot. As an accommodation to compensate it is effective to give a copy of any notes to be copied by other students to the ADD student. This may seem like an unfair advantage, but ADD student are already at a disadvantage, this just levels the playing field and gives her the chance to be successful.

4. Reader/Tutor - One on one interaction is the best way to teach an attention deficit student. The more direct the learning situation, the less distractions, the more a student will learn. By having someone read to her, or teaching her one on one, the better the chance for her to both understand and retain the information.

5. Resource help - Because of the distractions in the classroom, ADD students often develop gaps in their understanding about what is being taught. Resource teachers can help fill this gap. However, a caution here, ADD is unlike other learning difficulties, these students are not learning impaired, they just miss some information. This is why so many of these students can't qualify for special education assistance.

Homework/Class work - One of the more frustrating aspects of ADD is that many of these pupils fail to do or complete assignments or take forever to do them. I remember going to my room to do my homework, with every good intention to do so, only to discover that two hours had passed and I had nothing done. Frustrated, I went upstairs and lied to my parents that my work was done. I was told it was laziness, but I now know it was an inability to focus on the work.

However, there are ways to help get work in. I will cover some ideas here, but you can find many more in my book published on my website at www.hyperactiveteacher.com

1. Syllabus - Why is it appropriate for college a course to provide syllabus for adults students with test dates and homework assignments made up to 4 months in advance; yet younger elementary, jr. high, or high school students are expected to remember to do the work assigned that day? A simple weekly syllabus allows the parent and student to know what is going to be assigned and allows them to plan ahead to get the work done. Also, the accountability of this approach makes it more difficult for the student to say he doesn't have any homework. I suggest all students get a syllabus, but if a teacher won't do that, maybe she will give the parent of an ADD student a copy of her lesson plans for the week.
2. Coach/Peer Coach - I received this letter in December that makes this point well.

Dear Rick,

Thank you for your newsletter and providing a wonderful forum to help educate families, teachers, etc. about ADD. My son, who is now 11, was 'diagnosed' with ADD when he was in second grade.

Our son goes to a school for gifted children, where quite a few students have learning differences. The teachers are very sensitive to each child's special needs and individual programs are developed continually. My son has been doing very well, except he is very slow doing work, often does not write down assignments, and needs help keeping his trapper (larger notebook with lots of folders for each subject) organized.

The school has a peer-mentoring program which was just started for our son. He has been teamed up with a 12th-grade boy who works with him every other day sharing ideas for organizing his work, checking his homework assignments, tutoring, etc. He set up a small (1 inch) notebook for our son for math with paper, folders, and special spaces for homework to do-homework done to hand in, etc. My son was thrilled (both with the system, but also with the process of working with the older student!).

Our son's mentor gets high school credit for working with our son, and works directly with the resource room's special teachers developing strategies to help the children.

Barbara

A coaches job is not to teach, but rather to help the student be organized and is getting all the work written down and books to take home. Some school use resource help for this purpose, others have there yard duty take this role for certain students other use reliable and/or older peers.

3. Another effective accommodation is to reduce the workload, especially for repetitive assignments. This is especially effective for those student who are capable of learning quickly. Even though I could ace every test I took, I still failed in school. If learning is the goal and I was able to demonstrate my learning, why did my inability to finish homework cause me to fail? Teachers should consider reducing work loads and then expecting that the work assigned be well-done.

On-task Behavior - ADD student will be off-task. No ifs ands or buts about it. By definition ADD students CAN'T control concentration. Therefore, we must come up with ways to distract a student back on task.

1. Teacher Proximity is one of the most effective ways to remind a student to get back to work. Having the ADD student sitting in the front and near the teachers desk makes it possible to remind the student to get working without the other students knowing or being distracted.

2. Reminder Queues also work. A silent signal like touching their desk or soft finger snap or jiggling of keys in your pocket can be enough to remind a student to get back on task.

3. Movement allowance - Hyperactive ADD students have a difficult time sitting still. Sometimes constructive activity like handing out papers can help to settle a student. Allowing this student to get up and stand in the back or get a drink or sit in an isolated seat in the back of the room (by choice) often helps the student try to solve his own restlessness.

Testing - Testing can be difficult for many, especially timed tests. The added pressure of time will cause some not to even try.

1. No or extended time limits - Many national tests both academic and vocational exams are allowing waivers for test takers with disabilities. Most schools are unaware of the waiver policy of these tests. Teachers should consider what the objective of the test is. If it is to how quickly a student can answer question, then timed tests are appropriate. If it is to discover how much the student knows, maybe timing the test is not important. I do believe there are times that timed tests are important. But I do not believe they should be the norm.

Quiet Testing Room/Cubicle - Even though a teacher may try to create a quiet testing environment, erasing, swinging of feet, turning pages and other movements can be as distracting as noise. By moving the test to an empty room or cubicle in the back of the room, distractions can be reduced. However, a monitor or proctor needs to be nearby to distract the test-taker back on task.

3. Oral Testing - Sometimes giving the test orally will demonstrate the level of knowledge. This is especially true for essay type questions where depth of understanding is important

These are only a few of the accommodations that can prove effective for ADD students. Please note that many of these suggestion would benefit all student. Some I would not recommend for the entire class.

Rick Pierce, The Hyperactive Teacher, offers his own free newsletter. To receive it email him at hyper@ns.net He is the author of "How to Help an ADD Child Succeed in Life" which is available read and order from his website at www.hyperactiveteacher.com

1. DON'T BLAME OTHERS. Most of what happens to people in life is their responsibility. There are choices and option. Don't look for scapegoats or reasons to rationalize your shortcomings. ……. Parents, background, race, religion, drugs, alcohol, socio-economic status, hair color, shoe size…. The list goes on and on.

2. GEEKS AND DWEEBS WILL RUN THE SHOW. These guys and girls may not win the popularity contests in school now, but, not to worry….. they will prevail. They may be signing your paycheck some day!

3. THE LADDER TO CUSHY JOBS WITH PERKS HAS LOTS OF RUNGS. If you think you'll start at 50 grand or more with a company car, cell phone and expense account, then you'll buy the ocean front property I'm selling in Arizona! For most, those first few years will follow a sequence of "titles"…….important ones like grunt, snuffy, gofers, and bean counter (no particular sequence denoting status!).

4. YOUR BIOLOGICAL CLOCK TICKS ON. So sorry, you're not immortal. You will get old. You will age. You will get wrinkles, need bifocals, gain weight, get tired more quickly, lose your hair etc., etc.! Remember to be particularly patient with old people and take good care of your body….it's got to last many decades.

5. REAL LIFE DOESN'T JIVE WITH TV AND MOVIES. Problems are NOT solved in 30 minutes, and reality is not Elaine, Jerry, Kramer and George.

6. THE "IT'S MY LIFE" PHILOSOPHY WILL BE HISTORY. Fifteen years from now you'll see that this type of thinking and believing the high school prom was your greatest most outstanding, stupendous life experience. Your life is not an island. Everything you do WILL impact someone else.

7. FORGET THE 35-40 HOUR WORK WEEK IF YOU PLAN ON COMPETING. If you're looking at a professional career with top salaries, bonuses, incentives, stock options, career tracks, and great retirement plans, then you need to do a couple of things. First, get an outstanding education, and secondly, plan to work the 60-70-80 hour week work plan.

8. FAME IS SHORT LIVED. Sports heroes, beauty queens, cool dudes and school stars are quickly forgotten. The old saying that everyone wants "15 minutes" of fame is so true. Real long-term life is in the form of leadership, academics, and character.

NATURAL AND ALTERNATIVE THERAPIES FOR ADHD: www.naturaladd.com
GRANDMA'S PET WILDEBEAST ATE MY HOMEWORK: A practical guide for teaching and parenting adhd kids: www.adhdcounselorguy.com
FOCUS: www.cdipage.com/focus.htm
THE PHONICS GAME: www.cdipage.com/phonicsg.htm
LIVING WITH AN ADHD CHILD: www.adhdbook.com
ADDwarehouse: www.addwarehouse.com/indexbv.htm
DR. DAVE RABINER: Home of ADHD Research Update
BOB SEAY: add.miningco.com
DR. STEVEN RICHFIELD: www.parentcoachcards.com
MICHELLE DAVIS: www.freeyellow.com/members4/michelledavis/index.html
POWER ORGANIZER SUCCESS SYSTEM: www.powerorganize.com/

Copyright 1998 Brandi Valentine. All rights reserved. This Newsletter is copyrighted by the authors and/or publisher. ADDed Attractions may be used for non-commercial purposes only and may not be redistributed for commercial purposes without the express written consent of Brandi Valentine.

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