Attention Deficit and School

\"distracted\"I take care of a lot of patients with ADD/ADHD.  I cringe when I say it, but I have developed a fair amount of expertise in the area.

I also have ADD: hence the name of my blog.

There will always be some controversy swirling around the subject.  Some feel it is over-diagnosed and medications are given out to kids who simply need better parenting.  Others feel it should be treated as a disease and should always be treated with medication.  I don\’t agree with either of these.

To me, ADD is a personality type.  Everyone has areas in which they excel and others that pose big problems.  That is just part of being a human.  Most of the time, the strengths in our personality also have matching weaknesses.  For example, a person who is very emotional and empathic (which is a very positive trait when dealing with people who are hurting) have a tendency to not stand up to others when they should (because they don\’t want to hurt them).  Compulsive type A are great employees when they are put in a role where attention to detail, but they tend to be less flexible and imaginative.

The same is true with ADD/ADHD.  While the ADD personality may lend itself to a more social personality, better leadership skills, and a more vivid imagination, it also causes trouble at school.  Here is how I explain it to parents and kids:

\"f1060628914031\"Q:  What can you say about kids at school with straight A\’s?
They usually answer "They are smart."
A.  No, actually you can only say that they are very good at school.  They possess the skills it takes to get good grades in school.  Are they smart?  Maybe.  But more likely they are very compulsive, able to pay attention for long periods of time, desiring to please the teacher, and good rule-followers.  Some people with average intelligence possess these skills and can do quite well in school. 

On the other side, there are plenty of very smart people who are not good at all at "doing school."  They would rather mess with their friends, are easily bored, don\’t like to do assignments they think are "stupid," and don\’t follow rules well.  My goal in treating ADD is to make the square peg fit in the round hole – to make kids who are not good at school to be able to do school better.

Makes sense?  You probably aren\’t going to change school to fit the student, so you fit the student to school.  Sad, but necessary.

\"square-peg\"On further contemplation of this, I realized that the skills that make a person successful leaders later in life: independent thinking, social-orientation, not accepting pat answers, and vivid imaginations, are actually a liability in school for many students.  Many teachers don\’t want a bunch of independent leaders in their classrooms, they want followers who do what they are told.  The exceptional teacher can engage the students who are not good at doing school.  It takes more work, so many teachers aren\’t willing to adapt.

I see this as a major problem in the schooling of our children.  We are not rewarding leaders and high imaginations.  Many very bright children come into school and have to slow down their learning from before they were students.  We have to keep all students at the same pace.  We don\’t let the fast-learners move ahead.  I know, because I have several of these kids.

\"phs_noenglish\" I don\’t know the answers.  I would rather not medicate the child and simply change the schooling setting; but I don\’t think the "no child left behind" fiasco will allow us to fall outside of the prescribed image by which success in education is defined.  Misguided laws like this make education an exercise in conformity, rather than an opportunity to nurse the strengths of each student so they can blossom when they have the chance to be on their own.

I was lucky.  My parents were very structured and my education didn\’t ask enough out of me for me to fail out at a younger age.  By the time that classes got demanding, I was taking courses that I wanted to take and that I felt were important.  Unfortunately, this is not the case with a lot of children.

38 thoughts on “Attention Deficit and School”

  1. You seem to think of the educational offerings as static, and limited only to what the local public school offers. But there are alternatives: charter schools, private schools, tutoring, home schooling, etc. No, these are not for everyone for various reasons, but they should be mentioned.
    Do you ever suggest changing the school instead of applying meds?

    And so you have touched on a point that is important: simply that in no way can a educational system that is changed with providing an identical education to everyone possibly be able to optimize the experience and outcome for a even a simply majority of its students. There is simply more variety in the student body than one organization can handle. The result is that the majority of students are taught to the lowest common denominator. Additional, as you illustrate, another result is the medication of students to be at the lowest common denominaor.

  2. You seem to think of the educational offerings as static, and limited only to what the local public school offers. But there are alternatives: charter schools, private schools, tutoring, home schooling, etc. No, these are not for everyone for various reasons, but they should be mentioned.
    Do you ever suggest changing the school instead of applying meds?

    And so you have touched on a point that is important: simply that in no way can a educational system that is changed with providing an identical education to everyone possibly be able to optimize the experience and outcome for a even a simply majority of its students. There is simply more variety in the student body than one organization can handle. The result is that the majority of students are taught to the lowest common denominator. Additional, as you illustrate, another result is the medication of students to be at the lowest common denominaor.

  3. This post would have made me feel so much better when I finally relinquished control to stop the fighting and allowed my son to make the decision to quit school, even though there were so many out there that believed in him so much that his catholic education had been paid for. I had to swallow hard and realize that even though I loved school and he came from a long line of people that loved school that school as such just isn’t for everyone. That was such a hard thing for me to swallow but I have to say since that day we have had a happy and productive home. He has a job that he loves and pays well and I could finally concentrate on and pass algebra so I could get my degree. Now that he is out from under the pressure of school he wants to go get his ged and go on to college. I think he will do fine in college. It was primarily the structure of school that he absolutely could not deal with. We’ll just pray and know that he will be fine at whatever he decides to do.

  4. This post would have made me feel so much better when I finally relinquished control to stop the fighting and allowed my son to make the decision to quit school, even though there were so many out there that believed in him so much that his catholic education had been paid for. I had to swallow hard and realize that even though I loved school and he came from a long line of people that loved school that school as such just isn’t for everyone. That was such a hard thing for me to swallow but I have to say since that day we have had a happy and productive home. He has a job that he loves and pays well and I could finally concentrate on and pass algebra so I could get my degree. Now that he is out from under the pressure of school he wants to go get his ged and go on to college. I think he will do fine in college. It was primarily the structure of school that he absolutely could not deal with. We’ll just pray and know that he will be fine at whatever he decides to do.

  5. Our kids go to a private school and we have the same problem. There are very few schools that take an approach that allows kids to excel in areas of strength. There are very few options for most parents. Homeschooling is a problem often because it is common for the parent of an ADD student to also have ADD.
    The fact is, the medication really works. It does allow kids to do well in school despite their personality types. It also is fairly clear that medication does not cause problems later in life, it actually prevents them. The rates of drug use, delinquency, and other measures go down dramatically when an ADD kid is treated.

    I like your second paragraph, Matt. Yes – it is the lowest denominator. Kids often complain that they have no personality on the meds, but they are happy with the fact that they are not getting into trouble as much and are seeing success.

    I just fear it teaches them the wrong things. Medication is often the lesser of the two evils.

  6. Our kids go to a private school and we have the same problem. There are very few schools that take an approach that allows kids to excel in areas of strength. There are very few options for most parents. Homeschooling is a problem often because it is common for the parent of an ADD student to also have ADD.
    The fact is, the medication really works. It does allow kids to do well in school despite their personality types. It also is fairly clear that medication does not cause problems later in life, it actually prevents them. The rates of drug use, delinquency, and other measures go down dramatically when an ADD kid is treated.

    I like your second paragraph, Matt. Yes – it is the lowest denominator. Kids often complain that they have no personality on the meds, but they are happy with the fact that they are not getting into trouble as much and are seeing success.

    I just fear it teaches them the wrong things. Medication is often the lesser of the two evils.

  7. Great blog — our 8 year old has sensory integration disorder and has been diagnosed with everything from development delay to ADHD. On of the major components is speech processing. When we have a teacher that is interested, engaged and informed there is not a lot required to make his school year good. But when they’re not it only takes a month or so and he’s behind the 8-ball. We have a stack of reports that get fowarded each year and we’ve still met with the teacher 2 months in and they haven’t taken a look. I’m now a firm believer (if I wasn’t before) that teachers can make all the difference with disorders like SID and ADHD. Ian.http://www.waittimes.blogspot.com

  8. Great blog — our 8 year old has sensory integration disorder and has been diagnosed with everything from development delay to ADHD. On of the major components is speech processing. When we have a teacher that is interested, engaged and informed there is not a lot required to make his school year good. But when they’re not it only takes a month or so and he’s behind the 8-ball. We have a stack of reports that get fowarded each year and we’ve still met with the teacher 2 months in and they haven’t taken a look. I’m now a firm believer (if I wasn’t before) that teachers can make all the difference with disorders like SID and ADHD. Ian.http://www.waittimes.blogspot.com

  9. I’m pretty sure I have ADD but 50 years ago it wasn’t on the radar screen. My son also has it but has managed to make a great life for himself (he’s a teacher) and understanding it serves him well. One grandson dropped out the last year of high school but none of us worry. He will find his spot in life. None of us were ever medicated and I personally have done quite well in spite of or because of it, I’m never sure. Good post…ciao

  10. I’m pretty sure I have ADD but 50 years ago it wasn’t on the radar screen. My son also has it but has managed to make a great life for himself (he’s a teacher) and understanding it serves him well. One grandson dropped out the last year of high school but none of us worry. He will find his spot in life. None of us were ever medicated and I personally have done quite well in spite of or because of it, I’m never sure. Good post…ciao

  11. Great post, Dr. Rob.
    I’m in agreement that ADD/ADHD is more a learning/thinking style than a disability, but one often not conducive to most school environments. I manage more ADHD than I anticipated that I would, and I find that the majority of the time medications are very helpful. Some people are able to adapt and manage school without meds, but for the ones that aren’t they can make a big difference.

    I’m less comfortable treating the subgroup of kids who have no good social, organizational, or self-control skills due to poor parenting. Some of these kids seem strictly behavioral issues that need a little bit of consistency and love to iron out. Unfortunately, that can be in short supply. They also tend to respond to medications, probably because of the “no personality” side effects. It bothers me to treat kids with meds for having crappy parents (who probably should be the ones seeing mental health). It seems like the alternative is to watch them fail school and likely get mentally or physically abused at home. So I treat them

  12. Great post, Dr. Rob.
    I’m in agreement that ADD/ADHD is more a learning/thinking style than a disability, but one often not conducive to most school environments. I manage more ADHD than I anticipated that I would, and I find that the majority of the time medications are very helpful. Some people are able to adapt and manage school without meds, but for the ones that aren’t they can make a big difference.

    I’m less comfortable treating the subgroup of kids who have no good social, organizational, or self-control skills due to poor parenting. Some of these kids seem strictly behavioral issues that need a little bit of consistency and love to iron out. Unfortunately, that can be in short supply. They also tend to respond to medications, probably because of the “no personality” side effects. It bothers me to treat kids with meds for having crappy parents (who probably should be the ones seeing mental health). It seems like the alternative is to watch them fail school and likely get mentally or physically abused at home. So I treat them

  13. I thought this was an excellent post. You are so right about the laws not helping those situations. I have been battling up hill this year for help in modifying for those students that benefit from a different approach. I’ve said before, we can get the same results, we just need to do it in a different way. I can see why there is so much burn out in this field as well.

  14. I thought this was an excellent post. You are so right about the laws not helping those situations. I have been battling up hill this year for help in modifying for those students that benefit from a different approach. I’ve said before, we can get the same results, we just need to do it in a different way. I can see why there is so much burn out in this field as well.

  15. I was originally diagnosed with ADD when I was thirteen, but after a year on the medication, my parents found out that I was taking an extra pill every afternoon so I could perform better at soccer (I was taking dexedrine at the time). I made it to college, but ended up dropping out. I spent my early twenties bouncing around from job to job, occasionally taking some classes, but never finishing .
    About two years ago, at twenty-eight, I decided to return to school full-time, and finally earn a degree. I’m not sure what I expected to be different, but I ended up, predictably, having the same issues as before. I managed to squeak through a couple semesters, mostly scrambling toward the end, and begging professors to base my grade heavily on the final. Last October (2007) it all caught up to me. I was taking some difficult classes, that I didn’t find all that interesting, and I fell so far behind that I couldn’t catch up. I ended up dropping them, without a refund, and decided to seek some professional help.

    My doctor prescribed Ritalin, then switched me over to time-release Concerta. After three months I returned to school, and I started out alright, but ended up with the same issues. Talked to the doc again, and decided to up the dosage (36-54). This was just this week.

    This post perfectly describes the problem I’ve always had with school. I feel like I’m capable, honestly more than capable, of working in an educated environment, but there’s no way to do that without getting the degree. The people around me (wife, parents, brother, friends) try to be understanding, but I can see their frustration, and I want to be able to tell them, that I am more frustrated than all of them put together.

    I’ve been married for eight years, and I have a seven year old daughter. I’m lucky to have supportive parents, who are helping us monetarily. But I’m starting to think that I’ll never get there. I know that pills aren’t a cure-all, and that it still takes effort on my part, but it feels like I have a new Mercedes sitting in the driveway, but I can’t find the keys. I don’t know how to describe it better than that. I want to try, I want to be organized and be able to prioritize my life, and I’m hoping that being on the correct dosage will help this out.

    But it’s hard to explain it to the people that I care about, when it appears to them as if I just don’t care. I have more desire, and more motivation than I think most people do, I just have such a hard time dealing with the monotony of how school is set up. I don’t learn by rote, I learn by discussion and investigation. I’m not a manual reader, I am an on-the-job-training type of person. But, the career path that I want is one that is dominated by degreed people, and it is next to impossible to get in the door without that piece of paper. And I would be very good at this job. Actually, I would be great, and I’m not trying to be egotistical, just honest.

    I didn’t actually intend on this post being so long (now that I’ve started, I feel like I could just keep on going and going…) but I really am interested in figuring out how to just finish off this part of my life, and move on (without quitting). You seem to be pretty well versed, so I thought I’d throw it out there.

    Sorry for the dissertation.

  16. I was originally diagnosed with ADD when I was thirteen, but after a year on the medication, my parents found out that I was taking an extra pill every afternoon so I could perform better at soccer (I was taking dexedrine at the time). I made it to college, but ended up dropping out. I spent my early twenties bouncing around from job to job, occasionally taking some classes, but never finishing .
    About two years ago, at twenty-eight, I decided to return to school full-time, and finally earn a degree. I’m not sure what I expected to be different, but I ended up, predictably, having the same issues as before. I managed to squeak through a couple semesters, mostly scrambling toward the end, and begging professors to base my grade heavily on the final. Last October (2007) it all caught up to me. I was taking some difficult classes, that I didn’t find all that interesting, and I fell so far behind that I couldn’t catch up. I ended up dropping them, without a refund, and decided to seek some professional help.

    My doctor prescribed Ritalin, then switched me over to time-release Concerta. After three months I returned to school, and I started out alright, but ended up with the same issues. Talked to the doc again, and decided to up the dosage (36-54). This was just this week.

    This post perfectly describes the problem I’ve always had with school. I feel like I’m capable, honestly more than capable, of working in an educated environment, but there’s no way to do that without getting the degree. The people around me (wife, parents, brother, friends) try to be understanding, but I can see their frustration, and I want to be able to tell them, that I am more frustrated than all of them put together.

    I’ve been married for eight years, and I have a seven year old daughter. I’m lucky to have supportive parents, who are helping us monetarily. But I’m starting to think that I’ll never get there. I know that pills aren’t a cure-all, and that it still takes effort on my part, but it feels like I have a new Mercedes sitting in the driveway, but I can’t find the keys. I don’t know how to describe it better than that. I want to try, I want to be organized and be able to prioritize my life, and I’m hoping that being on the correct dosage will help this out.

    But it’s hard to explain it to the people that I care about, when it appears to them as if I just don’t care. I have more desire, and more motivation than I think most people do, I just have such a hard time dealing with the monotony of how school is set up. I don’t learn by rote, I learn by discussion and investigation. I’m not a manual reader, I am an on-the-job-training type of person. But, the career path that I want is one that is dominated by degreed people, and it is next to impossible to get in the door without that piece of paper. And I would be very good at this job. Actually, I would be great, and I’m not trying to be egotistical, just honest.

    I didn’t actually intend on this post being so long (now that I’ve started, I feel like I could just keep on going and going…) but I really am interested in figuring out how to just finish off this part of my life, and move on (without quitting). You seem to be pretty well versed, so I thought I’d throw it out there.

    Sorry for the dissertation.

  17. Great, great post, Dr. Rob.
    My views:

    ADHD is definitely over-diagnosed in some areas, but underdiagnosed and treated in other areas.

    Froelich et al. (Arch Pediatr Adolesc Med. 2007;161(9):857-864 ) Conclusions: Of US children aged 8 to 15 years, 8.7%, an estimated 2.4 million, meet DSM-IV criteria for ADHD. Less than half of children meeting DSM-IV criteria report receiv- ing either a diagnosis of ADHD or regular medication treat- ment. Poor children are most likely to meet criteria for ADHD yet are least likely to receive consistent pharmacotherapy.

    No two people with ADHD are alike. For some, it is indeed a personality type; for others (especially children whose parents cannot manage the child’s behavior, or who are not getting any treatment) it is more in the disability category.

    Having a non-standard child does require an upgrade in parenting skills. Some parents are willing to step up their game, and others can’t seem to (In some cases, can’t; in others, won’t.)

    David Rabiner has some excellent resources for parents and clinicians. His discussion of the recently-completed Multimodal Treatment Study of Children with ADHD (MTA) is particularly clear.

    Other authoritative sources of information:
    NIMH on ADHD. Medline Plus on ADHD National Resource Center on ADHD

  18. Great, great post, Dr. Rob.
    My views:

    ADHD is definitely over-diagnosed in some areas, but underdiagnosed and treated in other areas.

    Froelich et al. (Arch Pediatr Adolesc Med. 2007;161(9):857-864 ) Conclusions: Of US children aged 8 to 15 years, 8.7%, an estimated 2.4 million, meet DSM-IV criteria for ADHD. Less than half of children meeting DSM-IV criteria report receiv- ing either a diagnosis of ADHD or regular medication treat- ment. Poor children are most likely to meet criteria for ADHD yet are least likely to receive consistent pharmacotherapy.

    No two people with ADHD are alike. For some, it is indeed a personality type; for others (especially children whose parents cannot manage the child’s behavior, or who are not getting any treatment) it is more in the disability category.

    Having a non-standard child does require an upgrade in parenting skills. Some parents are willing to step up their game, and others can’t seem to (In some cases, can’t; in others, won’t.)

    David Rabiner has some excellent resources for parents and clinicians. His discussion of the recently-completed Multimodal Treatment Study of Children with ADHD (MTA) is particularly clear.

    Other authoritative sources of information:
    NIMH on ADHD. Medline Plus on ADHD National Resource Center on ADHD

  19. Tara: I am with you 100% in that we treat sometimes to not penalize kids for having bad parents. No question.Chrys: Don’t get me started on No Child Left Behind… it could be one of the worst things ever to be passed as law. Pure stupidity, in my opinion.
    Scott: I don’t give medical advice online, but I would suggest pursuing your diagnosis and treatment very aggressively. Don’t let one medication and one set of adjustments be the end of your trial.
    Liz: (your post was tagged as possible spam because of the multiple links). You impress me with all of your bibliography. It bothers me when people say it is not a real problem. I have seen far too much in the positive to not believe medications can do well. Nothing, however, will effectively compensate for bad parenting. It just harms kids universally. Most of the time the parents had lousy parents as well. That is actually why it is gratifying to treat ADHD – seeing kids pulled out of the cycle.

  20. Tara: I am with you 100% in that we treat sometimes to not penalize kids for having bad parents. No question.Chrys: Don’t get me started on No Child Left Behind… it could be one of the worst things ever to be passed as law. Pure stupidity, in my opinion.
    Scott: I don’t give medical advice online, but I would suggest pursuing your diagnosis and treatment very aggressively. Don’t let one medication and one set of adjustments be the end of your trial.
    Liz: (your post was tagged as possible spam because of the multiple links). You impress me with all of your bibliography. It bothers me when people say it is not a real problem. I have seen far too much in the positive to not believe medications can do well. Nothing, however, will effectively compensate for bad parenting. It just harms kids universally. Most of the time the parents had lousy parents as well. That is actually why it is gratifying to treat ADHD – seeing kids pulled out of the cycle.

  21. Rob: bibliography– that’s what being a grad student in education (specifically, remediating learning disabilities and attentional difficulties) will get you –facts & links galore. On the costs (and transmissability) of bad parenting–I agree 100%.
    Scott: do join your local chapter of CHADD — most of the adult ADHD’ers I know say that having a support group (in addition to medication, if necessary) makes a HUGE difference. Go to CHADD, look for the yellow bar at the top, and click on the link that reads “Finding Support”. AND — since you are in school–have you contacted your universities disability services office (DSO)? If you haven’t, you should. Not all DSOs are equally helpful, but you won’t know until you try.

    In general — I’ve heard great things about Nawa Academy, a California-based boarding school for non-traditional learners in grades 7-12. I also have a non-exhaustive national list of schools for dyslexic learners; many also include ADHD’ers.

  22. Rob: bibliography– that’s what being a grad student in education (specifically, remediating learning disabilities and attentional difficulties) will get you –facts & links galore. On the costs (and transmissability) of bad parenting–I agree 100%.
    Scott: do join your local chapter of CHADD — most of the adult ADHD’ers I know say that having a support group (in addition to medication, if necessary) makes a HUGE difference. Go to CHADD, look for the yellow bar at the top, and click on the link that reads “Finding Support”. AND — since you are in school–have you contacted your universities disability services office (DSO)? If you haven’t, you should. Not all DSOs are equally helpful, but you won’t know until you try.

    In general — I’ve heard great things about Nawa Academy, a California-based boarding school for non-traditional learners in grades 7-12. I also have a non-exhaustive national list of schools for dyslexic learners; many also include ADHD’ers.

  23. This seems to be an entry more about students who do a good job with the task-specific requirements of the school environment, rather than something specific to people with ADHD. ADHD is not specific to school, and not all people who do not excel in school-oriented tasks (like taking quizzes, participating in group discussions, etc.) have ADHD. Some students are shy, some are what was called “gifted” in my time (and shunted over to special “gifted” programs in public school, that emphasized their high-achiever oriented style), some perhaps have other types of disorders like Asperger’s that can remain undiagnosed for years.
    So, yeah, all systems that try and treat people not so much as individuals but as groups tend to do poorly in catering to the needs of anyone who falls outside of the bell curve. Ask anyone who’s gone through special education if it’s really that helpful to them.

    But again, none of this is unique to ADHD. Being creative or hating school or feeling bored doesn’t mean you have ADHD. ADHD, when properly diagnosed, has to occur in multiple settings — which means at home or at work. School is just one part (and in some cases, not even the most important part).

  24. This seems to be an entry more about students who do a good job with the task-specific requirements of the school environment, rather than something specific to people with ADHD. ADHD is not specific to school, and not all people who do not excel in school-oriented tasks (like taking quizzes, participating in group discussions, etc.) have ADHD. Some students are shy, some are what was called “gifted” in my time (and shunted over to special “gifted” programs in public school, that emphasized their high-achiever oriented style), some perhaps have other types of disorders like Asperger’s that can remain undiagnosed for years.
    So, yeah, all systems that try and treat people not so much as individuals but as groups tend to do poorly in catering to the needs of anyone who falls outside of the bell curve. Ask anyone who’s gone through special education if it’s really that helpful to them.

    But again, none of this is unique to ADHD. Being creative or hating school or feeling bored doesn’t mean you have ADHD. ADHD, when properly diagnosed, has to occur in multiple settings — which means at home or at work. School is just one part (and in some cases, not even the most important part).

  25. ADD seen by PCP’s is a different beast than that seen by psychiatry/psychologists. I will see and treat 10-20 patients before referring one. That referral is usually due to comorbidities rather than ADD (in general). In general, the specialists will recommend meds on weekends, while most of the kids I treat really don’t require it. I leave it as an option, but the appetite suppression is a big enough issue that I will try to keep them off of weekend doses.
    Clearly I am only addressing a segment of ADD/ADHD morbidity. There are sometimes behavioral issues at home, but certainly that is not always the case. I agree that fitting or not fitting in school is multifactoral, but for the majority of the ADD children I see it is the dominant issue.

    The purpose of this post was to generalize about the majority, not address all of the possibilities. The main reason I wrote it was to emphasize that it is not always intelligence that determines success and failure and school. I really believe that our education system has it wrong, badly wrong. The skills necessary to be a leader are often a liability in the school setting. We are dumbing down the future leaders and forcing them to submit to rules simply because it is the easiest way to do things. The No Child Left Behind law pretty much sealed this fate by requiring teachers to all conform and not to innovate.

  26. ADD seen by PCP’s is a different beast than that seen by psychiatry/psychologists. I will see and treat 10-20 patients before referring one. That referral is usually due to comorbidities rather than ADD (in general). In general, the specialists will recommend meds on weekends, while most of the kids I treat really don’t require it. I leave it as an option, but the appetite suppression is a big enough issue that I will try to keep them off of weekend doses.
    Clearly I am only addressing a segment of ADD/ADHD morbidity. There are sometimes behavioral issues at home, but certainly that is not always the case. I agree that fitting or not fitting in school is multifactoral, but for the majority of the ADD children I see it is the dominant issue.

    The purpose of this post was to generalize about the majority, not address all of the possibilities. The main reason I wrote it was to emphasize that it is not always intelligence that determines success and failure and school. I really believe that our education system has it wrong, badly wrong. The skills necessary to be a leader are often a liability in the school setting. We are dumbing down the future leaders and forcing them to submit to rules simply because it is the easiest way to do things. The No Child Left Behind law pretty much sealed this fate by requiring teachers to all conform and not to innovate.

  27. Dr. Rob,I am an adult with ADD. I only take 1/2 the Adderall prescribed to me – because that is all I need (most days). πŸ™‚ I find that it tends to cause me to have less creative moments – which is frustrating! On days when I need to be able to concentrate in the evenings, I take another dose around lunch time – but, that is really rare!

    My son, who is 16, exhibits some symptoms of ADD – but, I have discovered that if I can stay on track – I am better able to help him stay on track – both at home and at school. This makes me wonder if some of the ADD behavior is learned from a parent who is completely unstructured! πŸ™‚ I will say, however, that we have had him in a private, Christian school since 1st grade because the public school system here is so stinkin’ huge (there are over 1,000 per kids, per grade on the high school levels).

    What are your thoughts on the effects of fish oil supplements? I have heard from several friends that they have noticed remarkable improvements in their kids ability to concentrate after a few months on these supplements.

    Great post!

  28. Dr. Rob,I am an adult with ADD. I only take 1/2 the Adderall prescribed to me – because that is all I need (most days). πŸ™‚ I find that it tends to cause me to have less creative moments – which is frustrating! On days when I need to be able to concentrate in the evenings, I take another dose around lunch time – but, that is really rare!

    My son, who is 16, exhibits some symptoms of ADD – but, I have discovered that if I can stay on track – I am better able to help him stay on track – both at home and at school. This makes me wonder if some of the ADD behavior is learned from a parent who is completely unstructured! πŸ™‚ I will say, however, that we have had him in a private, Christian school since 1st grade because the public school system here is so stinkin’ huge (there are over 1,000 per kids, per grade on the high school levels).

    What are your thoughts on the effects of fish oil supplements? I have heard from several friends that they have noticed remarkable improvements in their kids ability to concentrate after a few months on these supplements.

    Great post!

  29. Dr.Rob
    As a mother of two sons with ADHD, the oldest is now 32 and still struggles. He is on his second marriage with six children between them both and it is constant stress. Keeps quiting and starting jobs which is very hard on his wife and children. At this point in time I do not think he is taking medication. He is reading some new book that stated most children that were labeled ADHD as children were really bi-polar. Do you think this is true? Has been on all the typical medications that most children start on and did well on them . As an adult that still needs to be medicated which ones do you think are the best? I feel he needs one to control his ADHD plus one for his moods. My youngest son is doing well at this time better than we thought he could ever do , he does take his mediation still.

  30. Dr.Rob
    As a mother of two sons with ADHD, the oldest is now 32 and still struggles. He is on his second marriage with six children between them both and it is constant stress. Keeps quiting and starting jobs which is very hard on his wife and children. At this point in time I do not think he is taking medication. He is reading some new book that stated most children that were labeled ADHD as children were really bi-polar. Do you think this is true? Has been on all the typical medications that most children start on and did well on them . As an adult that still needs to be medicated which ones do you think are the best? I feel he needs one to control his ADHD plus one for his moods. My youngest son is doing well at this time better than we thought he could ever do , he does take his mediation still.

  31. Hey Dr. Rob,
    provocative post (that means GOOD, to me!)

    We just saw our pediatrician, who is VERY reluctant about ADHD diagnoses. Our recent teacher conference had all the teachers adament that H. needs more meds.

    He has grown. Pediatrician agreed to 5 mg more Ritalin plus prescribed a “screen time diet” of maximum of 2 hours per day (TV/gaming/computer). Good lord but we were allowing 4 plus hours on weekdays (an hour before school and 3+ after). Weekends? Well, other than an hour or so out to breakfast and an hour of swimming?…

    It has been HARD but well worth it! Lots more time just talking to us (parents) and playing with pets. Board games and rummy (= family time socializing as much as playing)

    It has been great.

    Whenever possible, if you can, this “screen time diet” is a GREAT idea.

    tl

  32. Hey Dr. Rob,
    provocative post (that means GOOD, to me!)

    We just saw our pediatrician, who is VERY reluctant about ADHD diagnoses. Our recent teacher conference had all the teachers adament that H. needs more meds.

    He has grown. Pediatrician agreed to 5 mg more Ritalin plus prescribed a “screen time diet” of maximum of 2 hours per day (TV/gaming/computer). Good lord but we were allowing 4 plus hours on weekdays (an hour before school and 3+ after). Weekends? Well, other than an hour or so out to breakfast and an hour of swimming?…

    It has been HARD but well worth it! Lots more time just talking to us (parents) and playing with pets. Board games and rummy (= family time socializing as much as playing)

    It has been great.

    Whenever possible, if you can, this “screen time diet” is a GREAT idea.

    tl

  33. TL:Thanks for you comment. I do think this is a good idea. As a parent (especially one of a hyperactive child), the sedative effects of the shiny screens are quite nice and make life easier. But parenting can’t be selfish all the time and it really is in the best interest for us to spend time playing and enjoying each other.

    We are going camping this weekend! Fun Fun!

    I was glad to see you – I hadn’t heard from you for quite a while. You are my the first commenter I ever had. Glad you are doing well with the Fam and especially the boy.

    Life is good for me too!

    Rob

  34. TL:Thanks for you comment. I do think this is a good idea. As a parent (especially one of a hyperactive child), the sedative effects of the shiny screens are quite nice and make life easier. But parenting can’t be selfish all the time and it really is in the best interest for us to spend time playing and enjoying each other.

    We are going camping this weekend! Fun Fun!

    I was glad to see you – I hadn’t heard from you for quite a while. You are my the first commenter I ever had. Glad you are doing well with the Fam and especially the boy.

    Life is good for me too!

    Rob

  35. Hello Dr. R.,
    Yep, we are well and glad to hear you are off for family camping! It would be snow/rain camping in my neck o’ the woods, nobody but the truly hardcore out in the woods…

    Screen time diet just keeps getting better. My husband and daughter and yours truly are all sticking to it too (I get a work exception, since my 9+ hr workday is in front of a monitor). I think just like how it helps smokers to have their doctor thoroughly interrogate them about just how much they smoke and telling them sternly and specifically NOT to… it really helps for pediatricians to intervene on kids and their gaming. A little gaming = okay and socially/demographically normal. But 12 hrs. plus on a weekend? That is where our kid was at… we slipped after he was sick but never dialed it back. I do NOT think this is too weird or abnormal, there are a lot of kids (especially boys) who never had a weird bed-ridden health thingy but still are gaming huge amounts. Not good for them socially or mentally.

    Hope you and other pediatricians will kind of get on it — your words carry a lot of value!

    (though my boy suggested tonight we call our pediatrician and see if he really meant it about this gaming diet. H. is thinking perhaps the doctor just wanted him to try it for a few weeks and we should bump him up to more video time. I am thinking NOT.

    Best to you and to your family!!!

    tl

  36. Hello Dr. R.,
    Yep, we are well and glad to hear you are off for family camping! It would be snow/rain camping in my neck o’ the woods, nobody but the truly hardcore out in the woods…

    Screen time diet just keeps getting better. My husband and daughter and yours truly are all sticking to it too (I get a work exception, since my 9+ hr workday is in front of a monitor). I think just like how it helps smokers to have their doctor thoroughly interrogate them about just how much they smoke and telling them sternly and specifically NOT to… it really helps for pediatricians to intervene on kids and their gaming. A little gaming = okay and socially/demographically normal. But 12 hrs. plus on a weekend? That is where our kid was at… we slipped after he was sick but never dialed it back. I do NOT think this is too weird or abnormal, there are a lot of kids (especially boys) who never had a weird bed-ridden health thingy but still are gaming huge amounts. Not good for them socially or mentally.

    Hope you and other pediatricians will kind of get on it — your words carry a lot of value!

    (though my boy suggested tonight we call our pediatrician and see if he really meant it about this gaming diet. H. is thinking perhaps the doctor just wanted him to try it for a few weeks and we should bump him up to more video time. I am thinking NOT.

    Best to you and to your family!!!

    tl

  37. I would like to go further and suggest that adults as citizens in society experience this same scenario. Society in general is leary of independent thinkers, fast learners, and ADD type traits in adults. It makes them feel inferior. I feel like I’m not good at socializing anymore because of experiencing this same scenario in adult life.
    Can’t change society and life not quickly anyway.

  38. I would like to go further and suggest that adults as citizens in society experience this same scenario. Society in general is leary of independent thinkers, fast learners, and ADD type traits in adults. It makes them feel inferior. I feel like I’m not good at socializing anymore because of experiencing this same scenario in adult life.
    Can’t change society and life not quickly anyway.

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