One of the things I struggle with as a parent of a child with neurological issues is really grasping everything.  There are times when I feel that I have a handle on things and there are times that I worry about all kinds of issues.  Does he have other psychological and behavioral issues?  Is he suffering from clinical anxiety, does he have ODD, what is immaturity, bad behavior and what is executive functioning deficits?  Sometimes I think I might go mad with all of the questions running around my head!

One term that I have heard fairly often and frequently worry about is ODD, Oppositional Defiant Disorder.  Many parents have not heard about this disorder but it apparently is one of the most common psychiatric problems in children affecting around 5% of the child population.  It also affects a high percentage of children with ADHD … around 30 to 40% of those with ADHD also have ODD. In fact it is exceptionally rare for a child to only have ODD; ODD is commonly associated with ADHD and depression/anxiety.  Oh that lovely comorbidity thing again!!

So what is ODD?  One of the best descriptions I have heard of ODD is by Jim Chandler, MD, FRCPC.  (http://jamesdauntchandler.tripod.com/).  According to Chandler, “ODD is a psychiatric disorder that is really just the far end of the stubbornness spectrum.  The line that divides being just difficult and stubborn from ODD is a set of diagnostic criteria.”

The criteria for ODD are:

A pattern of negativistic, hostile and defiant behavior lasting at least six months during which four or more of the following are present:

• Often loses temper
• Often argues with adults
• Often actively defies or refuses to comply with adults’ requests or rules
• Often deliberately annoys people
• Often blames others for his or her mistakes or misbehavior
• Is often touchy or easily annoyed by others
• Is often angry and resentful
• Is often spiteful and vindictive

The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning.

Now why do I worry about this so much and why am I confused?  I think any parent of child with ADHD probably struggles with getting their child to cooperate with homework, chores and the other necessities of life.  Our son often throws fits and refuses to cooperate.  This is pretty much a daily occurrence.  Are they outrageous, knock down fits?  No.  He occasionally has an outrageous fit but not often.  But why does he throw these everyday fits:

• Is it because some times he gets his way?
• Is it because of executive functioning deficits which cause a low threshold for frustration?
• Is it a side effect of the medication?
• Is it a transition issue?
• Is it because he is exhausted from school?
• Is it signs of ODD?

I think this is the most difficult part of our son’s neurological challenges – not knowing the answers to everyday occurrences.  Am I doing something wrong?  Am I doing something right?  What should I be doing?  And the internal battle of questions rages on and on in my head non-stop.

I decided to do some research into ODD for today’s blog post because it is an area I have been concerned about but have not really had the time to research.  What I found to be the key criteria for ODD is spitefulness and vindictiveness.  This coupled with a blaming others for his or her mistakes or misbehavior are key signs of ODD.  According to Chandler, “the destructiveness and disagreeableness are purposeful.  They like to see you get mad.”  It is this description that turned on the lightbulb for me.  Our son often refuses to cooperate but he is not spiteful or vindictive. He is “oppositional” mostly because he does not want to do what I am asking not because he wants to see me get mad.

To read Jim Chandler full pamphlet on Oppositional Defiant Disorder, please go to http://jamesdauntchandler.tripod.com/ODD_CD/oddcdpamphlet.pdf.  It is a straightforward description with examples that I found to be tremendously enlightening.  Most other sources of information that I found online stuck with the Diagnostic and Statistical Manual of Mental Disorders definition as an ongoing pattern of disobedient, hostile and defiant behavior toward authority figures which goes beyond the bounds of normal childhood behavior.  Most sources of information are very clinical with very few examples.

So I am happy to say that our son’s stubbornness does not seem to fit within the range of Oppositional Defiant Disorder.  Yeah!  Cross that off the list, for now (J).  So now I need to worry if it is a side effect of the medication ….. sigh.

The Website: www.totallyadd.com
The Film: http://news.globaltv.com/Loving/2009300/story.html

Description of the Film from the totallyadd.com website. The description can be found at: http://totallyadd.com/about/the-film/

ADD & Loving It?! is a refreshing, witty and inspiring documentary about adult Attention Deficit Disorder (also known as Attention Deficit Hyperactivity Disorder, or ADHD). The one-hour film, which will be broadcast on Canwest Global Television in the fall, is hosted by actor/comedian Patrick McKenna and written, produced and directed by fellow comedian, Rick Green.

ADD & Loving It?! explores and explains the disorder by following Patrick’s journey for a diagnosis so he can confirm what he’s always suspected – that he has ADD. Along the way, Patrick and his wife Janis open up about their challenges and struggles, something Janis admits “we’ve spent our whole lives trying to hide.”

Patrick notes, “Some people think the diagnosis is the kiss of death, while others think there’s no such thing; it’s nothing, it’s all made up.” But after talking with the experts and with ordinary people, as well as drawing from his own experience, he confirms that ADD is real. It’s genetic, it can destroy lives, and adults with ADD have a higher rate of accidents, addictions, suicide, bankruptcy, divorce, illegal drug use and financial problems.
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In this video I share what we have immediately seen with medication for our son’s ADD. It is a testimonial for anyone consider medication for their child.

I wanted to provide you with a quick update on our journey with ADD. As of a couple of weeks ago, we put our son on Adderall on a very low dose. The results have been immediate! Although I agree that ADHD and ADD are overused terms in our society, ADHD truly is a neurological disorder that can respond quite well to medication.

We were lucky. Our son responded immediately to the first medication we put him on. We realize that as he grows, we will probably need to modify or switch medications. Each medication’s efficacy is relative to each individual’s body chemistry.

Our first day that we put him on medication, we immediately noticed that he was much more task oriented than he had ever been; he was highly communicative and his responses to others were much more empathetic. This may sound like a silly example but on the first day of medication, he peeled an entire cucumber by himself and presented it at the dinner table. He had never done anything like that before.
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Homework can be a frustrating time for any parent. This is especially true if your child has ADHD or learning disabilities. Here I share some times I have gained from first hand experience that make homework time a lot easier and enjoyable. Good luck!!

For many of us parents, homework time can be a very frustrating part of the day. This is especially true for those of us who have children with ADHD or learning disabilities. How can you work with your child to make homework time easier? I call it the 3 R’s — Routine, Reward and Relax!!

First, if you can, meet with your child’s teachers with you child at the start of the school year. Present a united front and lay out expectations for the year and explicitly offer advice and options if the child is having trouble with the material (age appropriately). Set up a system to regularly communicate with the teachers. We use a communication notebook that goes back and forth to school every day.

2. Make homework a daily routine – at the same time and the same place. Make sure the environment is comfortable and appropriate and aids concentration and productivity. We use our kitchen table and make sure that we have all the materials on hand that we will need. We also make sure that no one else is in the room!

3. Set up a short term reward system. Points, poker chips, pretend money, stickers or something immediate for that day such as TV time or game time are all a good basis for a reward system. Children with ADHD are highly motivated by short term rewards which could be daily or weekly. Develop a system that works best for you and your child.

I have found with my son that the more visual the reward system, the better it works. Post it somewhere on your refrigerator or anywhere where it is in plain view. It reminds your child of what they are working towards.

4. Break down the homework into smaller tasks with breaks in between. Plan with your child what is to be done and when break are to be taken. Plan together what the activities will be during the short, timed breaks. Even within subjects, break down the homework into smaller, more manageable pieces. For instance, for math homework, only show one column of problems at a time.

5. When and if you child reaches a frustration point, take a break but make the break explicit. “You seem like you are getting frustrated. Let’s go take a break for 5 minutes and then come back to the work refreshed.

6. When homework is finished, have your child organize it and put it away in their back pack so it is ready to go for the next day.

7. This is a good time, too, to plan for the next day. Lunch, snacks and outfits are all next-day tasks that can be taken care of so that the morning routine is easier.

8. As your child gets older and more independent, transition from homework helper to homework coach. A homework coach helps with planning for homework and projects, discussing what needs to be done and offering guidance on breaking the tasks down, and offering encouragement.

So remember, it is Routine, Reward and Relax!! I hope your nights of homework go smoothly. Until next time …. take care.

Karen

In this continuing series, I share the struggles and insights that I have gained from working with my amazing son with ADHD. In this segment, I discuss ADHD and temper tantrums and offer practical advice on how to handle your child while in the midst of a tantrum. Thanks for watching!!

 
Sorry it has been a while since I made my last video log. It has been a crazy time with graduations and end of school year activities!!

Continuing on with Segment 2 of Our ADHD Journey, we have been actively evaluating schools, reviewing our IEP and looking for an ADHD therapist.

The topic I would like to discuss today is ADHD and tantrums. Although my son has the inattentive form of ADHD, his ADHD does affect his anxiety levels and his impulse control relative to emotional reactions. We have figured out through trial and error what works for our son when he spirals into an emotional temper tantrum. Recently, I was reading several blogs online and our approach was confirmed by an adult who has ADHD and was able to explain why our approach works effectively.

It works like this. When our son gets himself all worked up about something and is “throwing a tantrum” (he does not kick and scream wildly but it is definitely a tantrum), we get him very physically active. Usually we do this by PLAYFULLY picking him up and spinning him around or tossing him in the air (yes, he is still small) or chasing him around – again playfully. The calm soothing voice or rubbing his back approach does not work at all. The reason why this works was explained by the adult with ADHD in this way. A person with ADHD in a temper tantrum has a brain that is totally racing at that point. Physical activity or loud music helps to calm the brain down.

One emotional aspect of ADHD is that little issues can be perceived as big issues because of the way the ADHD brain works. That coupled with a weakened impulse control results in these tantrums. This is not simply the case of the child behaving badly.

We have also started to name the behavior when it happens as a first step toward self realization that his behavior is not appropriate. We hope this is a first step towards self-control in the future. By giving the behavior a name, like the temper monster, we are helping to externalize the behavior so he can recognize it when it happens.

Believe me, I know that it can be physically and emotionally exhausting working with a child with ADHD. But when tantrums occur, we have found it the be most helpful to

1. Step Back
2. Get Silly
3. Jiggle the Tantrum Out Playfully.

Good luck! Thanks for watching and until next time!!

Karen

The Atomic Mom shares …” a five year period during my life in which this life did not belong to me. I didn’t even belong to me. Anger and rage were both daily issues, and the slightest rise in voice tone was enough to make me quiver.”

The Atomic Mom shares her amazing story and gives others hope that there is a way to move on when you are living a nightmare.

Please read her story at: http://atomicmom.typepad.com/atomic-mom/2009/05/once-life-was-a-dark-place.html

This is a short video on my reasons for eating organic foods.

How I have worked with my son and his teachers’ in order to help him learn the abstract concept of coins and values.

A MULTISENSORY APPROACH TO UNDERSTANDING COINS AND THEIR VALUES

INSIGHTS INTO LANGUAGE BASED LEARNING ISSUES

As you may know from visiting the Lipstick Wisdom site previously or from watching some of my other video blogs – my son has learning issues; specifically language based learning issues. This basically means he has problems with learning new concepts (information going in – receptive language issues) as well as problems with language concepts coming out (expressive language issues). You would not notice a thing on everyday interactions but when you ask him a question, the problems become apparent.

So I wanted to share with you some of the strategies that I have used at home to help my son understand abstract concepts. The abstract concept I am going to discuss today is coins and the values of coins. This one was a doozy – let me tell you!! He has made tremendous progress – he is not 100% consistent but definitely progress has been made. It probably took us about 8 weeks before significant traction was made on his learning his coins and the values.

First of all, I must share with you that my son’s best learning occurs when the learning is coordinated with physical movement (kinetic learning). I guess before the concepts of time and coins were introduced, I used kinetic learning approachs but not 100% of the time. Now I try to use kinetic approaches as much as possible.

We (his teachers and I) started out with the standard multisensory approach of worksheets, enlarged paper coins in the classroom, play coins in the classroom and even some real coins. We practiced and practiced through this approach for several weeks to no avail. He could not identify the coins and he did not understand the difference between the physical count of coins and their values.

Then we started mixing things up trying to come up with an approach that would help make the concepts stick in his mind. The strategies we used included: (I show physical examples of these in the video)
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March 6 1009: 18-year-old Jesse Logan took her own life after a nude picture of her was passed around by e-mail. TODAY’s Matt Lauer talks to her mom, Cynthia Logan, and Internet safety expert Parry Aftab about the dangers of “sexting.”

By Mike Celizic
TODAYShow.com contributor
updated 9:26 a.m. ET, Fri., March. 6, 2009

http://www.msnbc.msn.com/id/29546030/

The image was blurred and the voice distorted, but the words spoken by a young Ohio woman are haunting. She had sent nude pictures of herself to a boyfriend. When they broke up, he sent them to other high school girls. The girls were harassing her, calling her a slut and a whore. She was miserable and depressed, afraid even to go to school.

And now Jesse Logan was going on a Cincinnati television station to tell her story. Her purpose was simple: “I just want to make sure no one else will have to go through this again.”

The interview was in May 2008. Two months later, Jessica Logan hanged herself in her bedroom. She was 18.
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I would like to share with you where the concept behind Lipstick Wisdom came from and, along with that, part of my story of having a child with learning issues.

(Why is it that the picture “captured” on the video is always unflattering??)

I have been involved with technology since the 80s. I was a computer science major at William and Mary and then was a software and database programmer for a defense contractor in Washington DC. I also got an advanced degree in computer science from graduate school as well as a MBA. After grad school, I invested in start-up technology companies for 15 years. I am really good at digging up information on the web.

When I need to purchase something or hear the latest news or technology trends, I go online. I love the web and am on it all the time. The web did not serve me well, however, when I learned that my son has learning issues. I looked online and the information available was pretty limited. What I could find was pretty clinical. In my emotional state, it was hard to absorb the information in the way it was presented and I wanted so much more than was available. I wanted to not only find good information on language processing learning issues but I wanted to connect with other woman who had handled a child with similar issues and get advice and information from them.

The learning issues with my son are a challenge. I know that there are so many worse things that I could be facing and dealing with regarding my son, but I have to admit I worry about him and working with him through his issues is challenging. I am always seeking information and advice but I could also use some emotional support. That is what Lipstick Wisdom is all about. I know we are not there yet but I hope to build to a place where women can find the information, advice, community and support that they need regarding their life challenges and opportunities.

So my son. His learning issues are language processing based. He has receptive language issues — meaning that he has trouble getting the information into his long term working memory (receptive language issues usually involve short term working memory issues). He also has expressive language issues — getting the information out through word retrieval and expressive language.

I had signs that my son had learning issues early on. First, he had delayed speech development. This is not always a sign of learning issues but it is a strong signal. I also had trouble teaching him his colors. It took two years and a lot of practice including using a bowl full of colorful balls when practicing. I thought he was color blind!! I even took him to the county to be testing for color blindness. It turns out that color blindness is an inherited trait, a fact a missed during my research. So he was not color blind. The county ran other tests as well. He showed signs of development delays but nothing extreme. It turns out that for a county to take action, your child has exhibit SIGNIFICANT delays. I did not know this either – I would have taken earlier action had I understood this as well.

Finally, he was doing so poorly in preschool that I started pushing for testing. I received significant resistance from those around me — he is a boy, he is little, and my favorite, do you want him labeled as a retard!! It was really tough emotionally. Yet I pressed on because I knew that something was wrong. I really could have used some outside support. My advice to any woman who thinks their child has learning issues is to get your child tested. Ignore everyone who gives you reasons not to do it, if you think some thing is wrong … there probably is. Trust your gut instinct.

Development testing can be done through either your local county or your school district if the child is school age. There are also private testing options but they are expensive.

I choose to have my son testing both privately (through a local organization called Bryn Mawr Child Study Institute in Bryn Mawr, PA) as well as through the school district. The testing was not easy. Both the private testing and the school district testing require multiple sessions. The school district got pretty upset with me as well. According to the school district, having multiple testing done at the same time skews the results of the testing due to the “practice effect”. I still don’t understand this. In most situations with major implications, it is wise to get two opinions. In addition, with my son’s learning issues, there is no “practice effect”. We worked through it but be aware that the public testing may have objections with you doing private testing at the same time.

The results of the tests indicated that my son has language processing learning issues as I noted above. We were getting him private speech therapy and occupational therapy (most health care plans give you at least a partial reimbursement). The private testing entity recommended several schools in the local area that have teaching programs specifically geared to language processing learning issues. Our speech therapist gave an interesting recommendation. Because our public school offered half-day kindergarten, she suggested that we send him to the public school for their half-day session and send him to the private school for the other half of the day. We did that and it was fantastic!!! By going to both programs, he was going to be taught with techniques that most enabled him to learn (which, by the way, has increased his confidence dramatically) as well as get the socialization that the public kindergarten offered. We went from a boy who cried going to preschool every day and did not speak to anyone, children and teachers included, to a confident little boy who had friends and willingly went to school every day.

It was a dramatic and welcome change. One of the key elements in addressing learning issues is that the child is in a success based environment where they are reinforced for their achievements. Learning is still a challenge but we are slowly but surely making progress.

So that is my story regarding recognizing my son’s issues, getting him tested and starting down the path of success. I will share more advice on learning issues on a future video.

The bottom line here is that it was a very difficult time for me personally. A website that offered my information and support would have really helped me out. So here is the start of my personal story on working with a son with family issues. Can you share your story and your advice. Together we can build a tremendous resource and help out many many women facing similar situations.

Thank you so much for listening!!

Warmly,
Karen