Between Friends: Need Help with My Son with ADD

Hello Barbara,

Writing with a question about my 12 year old son with ADHD and oppositional tendencies. Recently, my son was assessed by the school psychologist and the results indicated that my son was really not aware of his level of oppositionality. This was very frustrating to my husband and myself because we make a lot of effort to discuss my son's issues with him and help him to see his behavior and his choices and alternative choices that would have been better.  He struggles with going to bed at night and homework after school. He often can be manipulative and aggressive about what he wants and still gets highly emotional when he doesn't get his way. 

When we try to talk with him about these things, he does a great deal to deflect attention away from himself and seems to expect everyone else to behave perfectly in order for him to exhibit cooperation. If I display the slightest frustration, this, in his mind, is license to oppose. He is very resistant to our efforts to teach him and discuss things with him. We have difficulty keeping him present when we try to talk with him about his behavior.  I do not make a habit of giving in to him. We have fairly firm and reasonable boundaries. But, yet, even without positive reinforcement, his opposition continues. 

We do not medicate him and are resistant to doing so because of history of addiction on his father's side, among other medical and existential concerns. How can we help Thomas to be more aware of his behavior and issues and help him to be more cooperative? His teachers report that he is similarly oppositional at school. What we need is some insight and some creative ideas to get through to him. I have been considering seeking out therapy at Brain Balance, a national company with a local office nearby. Their website seems promising, but I am concerned it could be a scam.  Wondering if you are familiar with them and their approach and if you had any thoughts about it. My concern is that it may be expensive and perhaps unnecessary therapy. There are a lot of companies that seek out and exploit scared, frustrated parents that ultimately just take your money. However, I do not want to miss out on the possibility of help either. Any and all thoughts on this would be much appreciated.

Thanks, 

Mary

Dear Mary,

Thanks for your thoughtful question. If you have confirmed that your son has ADD/ADHD through psychological testing by a Board-certified Ph.D. level psychologist, you may already know whether your son has the hyperactive type or mostly the inattention type or a combination of both. His age, 12, adds a complicating factor, as he is entering puberty and adolescence, when oppositional behavior tends to increase in all kids. Parents (and schools) are charged with setting limits on acting out behavior and communicating consequences to the kid for breaking the limits. As described in my book, KeepYour Eye on the Prize! www.keepyoureyeontheprize.org adolescents are forming an identity apart from their parents, but they have to learn how to express their feelings and problems verbally (like adults do) rather than acting them out, and this learning process takes time. Good for you for setting the limits and communicating about it. Keep it going despite the attempts to wear you down, manipulate you, or blame others for his lack of emotional control.

As you know, a major issue with ADD kids is their frustration with trying to learn in school because of the problems organizing themselves and focusing on what teachers are trying to teach. There are many strategies that can help them learn skills in this area. One book, Driven to Distraction, has helped many parents. I am not familiar with the Brain Balance organization.

For ADD kids, extracurricular activities, especially sports, can be a critical way to channel the kid’s energy in constructive ways, build a support group and self-confidence, and cultivate discipline and positive values like sportsmanship, “teamsmanship,” leadership, tolerance of frustration, and physical health. Sports can also be a powerful reinforcer for kids to take their studies at school seriously and avoid getting into trouble. One of my students with ADD told me about how cross-country running helped him learn how to focus mentally while it helped calm the internal mental and physical engine that was always consuming his emotional resources and “messing up” his life. It may take time to find the right fit, so don’t give up if the first sport or activity does not “take.”

For a few kids, dietary changes may help, like eliminating sugar, even though the research has not supported this scientifically. Be sure Thomas is not having caffeinated soda to complicate his sleep problem, which may get worse as he enters teenage, when kids become “phase-shifted,” staying up late and getting up late. The phase-shifting will eventually approach a more normal schedule for most. Melatonin 3 mg. can be a natural way to help induce sleep but check in with his pediatrician about starting this first.

As a sidebar, I know that you are against medications, but for many kids, an empathic Board-certified child and adolescent psychiatrist, who can work with the three of you to find the right med at the right dose (the smallest possible), together with brief, problem-focused counseling and additional time for tests (available for all kids with documented ADD) can be incredibly helpful. I have seen such doctors transform kids’ lives, and kids tell me that more than any admonishments from frustrated schools and parents, treatment got them out of their abyss by helping them experience something other than the mental chaos of distraction. They were able to feel less frustrated and see school as a place they were eager to attend rather than one they hated. Getting a handle on the focus and behavior at this age can help kids avoid drugs and other serious problems that can destroy their lives. By the way, for a kids with ADD, my psychiatric colleagues assure me that the ADD meds are not addictive, although there are side-effects that have to be weighed with the benefits. Although I mentioned avoiding caffeine to help his sleep problem, know that some caffeine in the morning helps them re-set their biological clocks and increases focus. This can be a more acceptable alternative to meds for some people with ADD.

Lastly, keep positive family time in your life by building in time together. Maybe it is dinner time, or maybe it is grabbing a burger after a sports event, going to religious services or movies, or taking mini-trips to a favorite retreat--whatever you all enjoy that can be a platform for building positive memories. These can begin to get the relationship focus off of the problematic behavior and onto a more positive track. As time goes on and Thomas learns how to discuss rather than act out his feelings, the relationship with you (and a treater if you choose one) can help him learn life strategies to manage his ADD effectively. ADD kids often see problems in unique ways and have creative ways to solve them. We want Thomas to get to that enjoyable place!