----- Original Message -----
From:
To: bcc@behaviourchange.com
Sent: Thursday, August 09, 2001 8:34 AM
Subject: Can your method help?
We have a 6 year old boy - we have been to Dr. Xxxxxxx - who diagnosed ADHD with
extreme anxiousness. His behaviour can be clearly broken into two main elements:
At home - typical ADHD - whole household at each others throats by end of
evening!
At school - extremely nervous, sad and anxious - described as "quiet - sad
boy".
Your input please
Name of parent withheld
Our Reply
Hi Xxxxx,
Please understand before you read my comments that I am by
no means an expert on ADHD. So please take my comments to someone who is
and see what they say about my view.
Your son has ADHD and ADHD is a disorder
that results in his behaving in a particular way at home -
but - this same ADHD (with the significant addition "with extreme anxiousness") results in a different
behaviour at school i.e. the home behaviour is not repeated.
Your child behaves in a different way when in
the different environment and with different adults
at school. The (apparently) powerful child that you have at home
becomes a "quiet - sad boy" when in school.
Of course the change from home to school is a massive
change for a six year old but what is clear is that external circumstances can
(and do) effect his behaviour. This is important because with other
more serious conditions external circumstances often have an almost nil
effect - this would be the case with a a seriously autistic child for instance.
Emotional disorders can be context sensitive
- that is to say - that they can only occur in a particular environments but for me, when
this is the case, it gives advisors a major opportunity to extract (where
possible) from environments those elements that tend to produce aspects of
behaviour that are positive and attempt to apply them to environments where
those positive aspects are not present.
But what if it also the case that - in addition
to the above - your child's inappropriate behaviour is dependant on
particular triggers or responses from home? Well, then, should he really
be described as having a disorder?
In other
words the "disorder" should be viewed as relationship-based rather than
child-based.
If this were true then work with the child alone will be
far less effective than work carried out through the parents looking particularly at their responses to the inappropriate
behaviour.
You say that your child at home is "typical ADHD" I would be
interested to know what you think that is.
I have to tell you that when parents of children diagnosed
as having ADHD describe their child's behaviour to me it is often essentially
identical to the behaviour described by parents who have never heard
of it and with whom I work successfully.
Also when the ADHD parents describe their current
responses to this behaviour it tends to fall into the same - "in urgent need of
change" category that the non ADHD parents fall into. In other words I
often judge their responses as representing a large contributory
factor.
Once ADHD has been diagnosed, parents tend to stop looking
at their own responses. The professionals who diagnose ADHD - which essentially
describes what exists - seldom add to the description
a prescription of what to do.
Although I do not claim to be an expert on ADHD I have
many successful years working to change (sometime very
extreme) home and school based behaviour. The prerequisite for my work is
that the parents understand that their child is not to blame for their behaviour
- in fact they are usually just as trapped by it as their
parents are.
The fact that these children with severe inappropriate
behaviour often appear to be controlling events at home, and appear very
powerful, rarely means that they are happy. In fact the "quiet - sad boy"
that the school describe is, in my view, more likely to be an
accurate description of your real six year old.
"the whole household at each
others throats by end of evening" does not
sound to me like a family that has any plan whatsoever to handle the
inappropriate behaviour nor one that has any idea of the emotional effect
of this daily trauma on an (apparently controlling) six year
old.
If a diagnosis (ADHD) prevents parents from looking at
their handling of the problem at home, it is a terrible indictment
of this diagnosis.
Why?
Because in any case, even if it is ADHD, there is (as
far as I am aware) no other therapy at home other than careful
behaviour management.
I cannot help you with ADHD I can help you to manage your
child's behaviour.
Warwick Dyer
Behaviour Change Consultancy
