He's just extremely gifted!

Someone from a message board gave me a link to visit. It definately summed up Joey perfectly. I had asked the other parents of kids like Joey if their children were extremely overly-sensitive like mine. One mother just did the usual annoyance..."have you even looked into changing his diet"? UGGGHHHH I'm so tired of people saying that. These are people who don't HEAR what you just said and they assume that all kids with ADHD or whatever are really just having reactions to food and all parents who medicate their kids are lazy and horrible. I snapped back at her in a post, but then deleted it. I must keep my cool and remember that she is just IGNORANT.

I got off subject. ...she made me mad!

Anyway...
Another mother posted this link: http://www.sengifted.org/articles_counseling/Webb_MisdiagnosisAndDualDiagnosisOfGiftedChildren.shtml

I have actually read similar articles and I most certainly do believe that Joey is gifted. I had never read this much detail about it though. I am now 100% convinced. Now, he may very well have the "ADHD" and I do believe that medication can and does help in many cases. I also feel that some of the symptoms of ADHD are signs of giftedness and intelligence. Just because a kid is "different", many people want to label them as wrong, bad, defiant, etc. I have heard people call me that when they didn't like my different way of thinking or especially when I didn't conform to stupid things.

I am going to paste the article below, but first I will tell you why I asked if anyone had oversensitive children like Joey. A couple of days ago, Joey ate only part of an apple. He came to me looking sad and said that he did not want to eat anymore of it but he didn't know what to do. I said, "it's okay. You don't have to eat it. Just throw it away. But if you think you'll eat some more of it tonight, then put it in the frig."
Joey did not seem to like my answer at all. He piddled around the kitchen holding the apple and looking as if he was having a really hard time deciding what he should do. I had bigger issues to think about so I went on about my business and taking care of the baby. I was upstairs getting the baby to sleep, when I heard loud sobbing downstairs. I quickly went down there and found Joey standing in a dark corner holding the apple and sobbing. He said that it made him so sad to think of throwing the apple away. I guess he was thinking of the apple like it had human feelings. I was heartbroken seeing him like that, so I said, "well, we will not be throwing that apple away then!" I put it in a ziplock bag and put it in the refrigerator. I told Joey it would stay there until he decided what he wanted to do. It is still there. That apple will be there til it rots but I didn't know what else to do. He knew in his head that the apple doesn't have feelings but he couldn't convince his heart of that. I tried to tell him the apple would grow into a big apple tree and be happy. It didn't work though. OH, I might see if he will want to plant it or bury it in our back yard. I just thought of that!



Well, here's the article:
(posted on the SENG: Supporting Emotional Needs of the Gifted website)
--whatever is in red are the things that really stood out and/or describe Joey.


Title: Misdiagnosis and dual diagnosis of gifted children
Citation: Abstracted from: Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, bipolar, OCD, Asperger's, depression, and other disorders. (2004) Scottsdale: Great Potential Press. Available from the publisher.
Author: James T. Webb, Edward R. Amend, Nadia E. Webb, Jean Goerss, Paul Beljan, F. Richard Olenchak
Download a printer-friendly version (PDF)

Many gifted and talented children (and adults) are being mis-diagnosed by psychologists, psychiatrists, pediatricians, and other health care professionals. The most common mis-diagnoses are: Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (OD), Obsessive Compulsive Disorder (OCD), and Mood Disorders such as Cyclothymic Disorder, Dysthymic Disorder, Depression, and Bi-Polar Disorder. These common mis-diagnoses stem from an ignorance among professionals about specific social and emotional characteristics of gifted children which are then mistakenly assumed by these professionals to be signs of pathology.

In some situations where gifted children have received a correct diagnosis, giftedness is still a factor that must be considered in treatment, and should really generate a dual diagnosis. For example, existential depression or learning disability, when present in gifted children or adults, requires a different approach because new dimensions are added by the giftedness component. Yet the giftedness component typically is overlooked due to the lack of training and understanding by health care professionals (Webb & Kleine, 1993).

Despite prevalent myths to the contrary, gifted children and adults are at particular psychological risk due to both internal characteristics and situational factors. These internal and situational factors can lead to interpersonal and psychological difficulties for gifted children, and subsequently to mis-diagnoses and inadequate treatment.

Internal Factors
First, let me mention the internal aspects (Webb, 1993). Historically, nearly all of the research on gifted individuals has focused on the intellectual aspects, particularly in an academic sense. Until recently, little attention has been given to personality factors which accompany high intellect and creativity. Even less attention has been given to the observation that these personality factors intensify and have greater life effects when intelligence level increases beyond IQ 130 (Silverman, 1993; Webb, 1993; Winner, 2000).

Perhaps the most universal, yet most often overlooked, characteristic of gifted children and adults is their intensity (Silverman, 1993; Webb, 1993). One mother described it succinctly when she said, "My child's life motto is that anything worth doing is worth doing to excess." Gifted children -- and gifted adults-- often are extremely intense, whether in their emotional response, intellectual pursuits, sibling rivalry, or power struggles with an authority figure. Impatience is also frequently present, both with oneself and with others. The intensity also often manifests itself in heightened motor activity and physical restlessness.

Along with intensity, one typically finds in gifted individuals an extreme sensitivity--to emotions, sounds, touch, taste, etc. These children may burst into tears while watching a sad event on the evening news, keenly hear fluorescent lights, react strongly to smells, insist on having the tags removed from their shirts, must touch everything, or are overly reactive to touch in a tactile-defensive manner.

The gifted individual's drive to understand, to question, and to search for consistency is likewise inherent and intense, as is the ability to see possibilities and alternatives. All of these characteristics together result in an intense idealism and concern with social and moral issues, which can create anxiety, depression, and a sharp challenging of others who do not share their concerns.

Situational Factors
Situational factors are highly relevant to the problem of mis-diagnosis (Webb, 1993). Intensity, sensitivity, idealism, impatience, questioning the status quo--none of these alone necessarily constitutes a problem. In fact, we generally value these characteristics and behaviors--unless they happen to occur in a tightly structured classroom, or in a highly organized business setting, or if they happen to challenge some cherished tradition, and gifted children are the very ones who challenge traditions or the status quo.

There is a substantial amount of research to indicate that gifted children spend at least one-fourth to one-half of the regular classroom time waiting for others to catch up. Boredom is rampant because of the age tracking in our public schools. Peer relations for gifted children are often difficult (Webb, Meckstroth and Tolan, 1982; Winner, 2000), all the more so because of the internal dyssynchrony (asynchronous development) shown by so many gifted children where their development is uneven across various academic, social, and developmental areas, and where their judgment often lags behind their intellect.

Clearly, there are possible (or even likely) problems that are associated with the characteristic strengths of gifted children. Some of these typical strengths and related problems are shown in Table 1.

Table 1: Possible Problems That May be Associated with Characteristic Strengths of Gifted Children

Strengths
Acquires and retains information quickly.

Possible Problems
Impatient with slowness of others; dislikes routine and drill; may resist mastering foundational skills; may make concepts unduly complex.


Strengths
Inquisitive attitude, intellectual curiosity; intrinsic motivation; searching for significance.

Possible Problems
Asks embarrassing questions; strong-willed; resists direction; seems excessive in interests; expects same of others.


Strengths
Ability to conceptualize, abstract, synthesize; enjoys problem-solving and intellectual activity.

Possible Problems
Rejects or omits details; resists practice or drill; questions teaching procedures.


Strengths
Can see cause--effect relations.

Possible Problems
Difficulty accepting the illogical-such as feelings, traditions, or matters to be taken on faith.


Strengths
Love of truth, equity, and fair play.

Possible Problems
Difficulty in being practical; worry about humanitarian concerns.


Strengths
Enjoys organizing things and people into structure and order; seeks to systematize.

Possible Problems
Constructs complicated rules or systems; may be seen as bossy, rude, or domineering.


Strengths
Large vocabulary and facile verbal proficiency; broad information in advanced areas.

Possible Problems
May use words to escape or avoid situations; becomes bored with school and age-peers; seen by others as a "know it all."


Strengths
Thinks critically; has high expectancies; is self-critical and evaluates others.

Possible Problems
Critical or intolerant toward others; may become discouraged or depressed; perfectionistic.


Strengths
Keen observer; willing to consider the unusual; open to new experiences.

Possible Problems
Overly intense focus; occasional gullibility.


Strengths
Creative and inventive; likes new ways of doing things.

Possible Problems
May disrupt plans or reject what is already known; seen by others as different and out of step.


Strengths
Intense concentration; long attention span in areas of interest; goal-directed behavior; persistence.

Possible Problems
Resists interruption; neglects duties or people during period of focused interests; stubbornness.


Strengths
Sensitivity, empathy for others; desire to be accepted by others.

Possible Problems
Sensitivity to criticism or peer rejection; expects others to have similar values; need for success and recognition; may feel different and alienated.


Strengths
High energy, alertness, eagerness; periods of intense efforts.

Possible Problems
Frustration with inactivity; eagerness may disrupt others' schedules; needs continual stimulation; may be seen as hyperactive.


Strengths
Independent; prefers individualized work; reliant on self.

Possible Problems
May reject parent or peer input; non-conformity; may be unconventional.


Strengths
Diverse interests and abilities; versatility.

Possible Problems
May appear scattered and disorganized; frustrations over lack of time; others may expect continual competence.


Strengths
Strong sense of humor.

Possible Problems
Sees absurdities of situations; humor may not be understood by peers; may become "class clown" to gain attention.

Adapted from Clark (1992) and Seagoe (1974)


Lack of understanding by parents, educators, and health professionals, combined with the problem situations (e.g., lack of appropriately differentiated education) leads to interpersonal problems which are then mis-labeled, and thus prompt the mis-diagnoses. The most common mis-diagnoses are as follows.

Common Mis-Diagnoses
ADHD and Gifted. Many gifted children are being mis-diagnosed as Attention Deficit Hyperactivity Disorder (ADHD). The gifted child's characteristics of intensity, sensitivity, impatience, and high motor activity can easily be mistaken for ADHD. Some gifted children surely do suffer from ADHD, and thus have a dual diagnosis of gifted and ADHD; but in my opinion, most are not. Few health care professionals give sufficient attention to the words about ADHD in DSM-IV(1994) that say "...inconsistent with developmental level...." The gifted child's developmental level is different (asynchronous) when compared to other children, and health care professionals need to ask whether the child's inattentiveness or impulsivity behaviors occur only in some situations but not in others (e.g., at school but not at home; at church, but not at scouts, etc.). If the problem behaviors are situational only, the child is likely not suffering from ADHD.

To further complicate matters, my own clinical observation suggests that about three percent of highly gifted children suffer from a functional borderline hypoglycemic condition. Silverman (1993) has suggested that perhaps the same percentage also suffer from allergies of various kinds. Physical reactions in these conditions, when combined with the intensity and sensitivity, result in behaviors that can mimic ADHD. However, the ADHD-like symptoms in such cases will vary with the time of day, length of time since last meal, type of foods eaten, or exposure to other environmental agents.

Oppositional Defiant Disorder and Gifted. The intensity, sensitivity, and idealism of gifted children often lead others to view them as "strong-willed." Power struggles with parents and teachers are common, particularly when these children receive criticism, as they often do, for some of the very characteristics that make them gifted (e.g., "Why are you so sensitive, always questioning me, trying to do things a different way," etc.).

Bi-Polar and other Mood Disorders and Gifted. Recently, I encountered a parent whose highly gifted child had been diagnosed with Bi-Polar Disorder. This intense child, whose parents were going through a bitter divorce, did indeed show extreme mood swings, but, in my view, the diagnosis of Bi-Polar Disorder was off the mark. In adolescence, or sometimes earlier, gifted children often do go through periods of depression related to their disappointed idealism, and their feelings of aloneness and alienation culminate in an existential depression. However, it is not at all clear that this kind of depression warrants such a major diagnosis.

Obsessive-Compulsive Disorder and Gifted. Even as preschoolers, gifted children love to organize people and things into complex frameworks, and get quite upset when others don't follow their rules or don't understand their schema. Many gifted first graders are seen as perfectionistic and "bossy" because they try to organize the other children, and sometimes even try to organize their family or the teacher. As they grow up, they continue to search intensely for the "rules of life" and for consistency. Their intellectualizing, sense of urgency, perfectionism, idealism, and intolerance for mistakes may be misunderstood to be signs of Obsessive-Compulsive Disorder or Obsessive-Compulsive Personality Disorder. In some sense, however, giftedness is a dual diagnosis with Obsessive-Compulsive Personality Disorder since intellectualization may be assumed to underlie many of the DSM-IV diagnostic criteria for this disorder.

Dual Diagnoses
Learning Disabilities and Giftedness. Giftedness is a coexisting factor, to be sure, in some diagnoses. One notable example is in diagnosis and treatment of learning disabilities. Few psychologists are aware that inter-subscale scatter on the Wechsler intelligence tests increases as a child's overall IQ score exceeds 130. In children with a Full Scale IQ score of 140 or greater, it is not uncommon to find a difference of 20 or more points between Verbal IQ and Performance IQ (Silverman, 1993; Webb & Kleine, 1993; Winner, 2000). Most clinical psychologists are taught that such a discrepancy is serious cause for concern regarding possible serious brain dysfunction, including learning disabilities. For highly gifted children, such discrepancy is far less likely to be an indication of pathological brain dysfunction, though it certainly would suggest an unusual learning style and perhaps a relative learning disability.

Similarly, the difference between the highest and lowest scores on individual subscales within intelligence and achievement tests is often quite notable in gifted children. On the Wechsler Intelligence Scale for Children - III, it is not uncommon to find subscale differences greater than seven scale score points for gifted children, particularly those who are highly gifted. These score discrepancies are taken by most psychologists to indicate learning disabilities, and in a functional sense they do represent that. That is, the levels of ability do vary dramatically, though the range may be "only" from Very Superior to Average level of functioning. In this sense, gifted children may not "qualify" for a diagnosis of learning disability, and indeed some schools seem to have a policy of "only one label allowed per student," and since this student is gifted, he/she can not also be considered learning disabled. However, it is important for psychologists to understand the concept of "asynchronous development" (Silverman, 1993), and to appreciate that most gifted children show such an appreciable, and often significant, scatter of abilities.

Poor handwriting is often used as one indicator of learning disabilities. However, many and perhaps most gifted children will show poor handwriting. Usually this simply represents that their thoughts go so much faster than their hands can move, and that they see little sense in making writing an art form when its primary purpose is to communicate (Webb & Kleine, 1993; Winner, 2000).

Psychologists must understand that, without intervention, self-esteem issues are almost a guarantee in gifted children with learning disabilities as well as those who simply have notable asynchronous development since they tend to evaluate themselves based more on what they cannot do rather than on what they are able to do. Sharing formal ability and achievement test results with gifted children about their particular abilities, combined with reassurance, can often help them develop a more appropriate sense of self-evaluation.

Sleep Disorders and Giftedness. Nightmare Disorder, Sleep Terror Disorder, and Sleepwalking Disorder appear to be more prevalent among gifted children, particularly boys. It is unclear whether this should be considered a mis-diagnosis or a dual diagnosis. Certainly, parents commonly report that their gifted children have dreams that are more vivid, intense, and more often in color, and that a substantial proportion of gifted boys are more prone to sleepwalking and bed wetting, apparently related to their dreams and to being more soundly (i.e., intensely) asleep. Such concordance would suggest that giftedness may need to be considered as a dual diagnosis in these cases, or at least a factor worthy of consideration since the child's intellect and sense of understanding often can be used to help the child cope with nightmares.

A little known observation concerning sleep in gifted individuals is that about twenty percent of gifted children seem to need significantly less sleep than other children, while another twenty percent appear to need significantly more sleep than other children. Parents report that these sleep patterns show themselves very early in the child's life, and long-term follow up suggests that the pattern continues into adulthood (Webb & Kleine, 1993; Winner, 2000). Some highly gifted adults appear to average comfortably as few as two or three hours sleep each night, and they have indicated to me that even in childhood they needed only four or five hours sleep.

Multiple Personality Disorders and Giftedness. Though there is little formal study of giftedness factors within MPD, there is anecdotal evidence that the two are related. The conclusion of professionals at the Menninger Foundation was that most MPD patients showed a history of childhood abuse, but also high intellectual abilities which allowed them to create and maintain their elaborate separate personalities (W. H. Smith personal communication, April 18, 1996).

Relational Problems and Giftedness. As one mother told me, "Having a gifted child in the family did not change our family's lifestyle; it simply destroyed it!" These children can be both exhilarating and exhausting. But because parents often lack information about characteristics of gifted children, the relationship between parent and child can suffer. The child's behaviors are seen as mischievous, impertinent, weird, or strong-willed, and the child often is criticized or punished for behaviors that really represent curiosity, intensity, sensitivity, or the lag of judgment behind intellect. Thus, intense power struggles, arguments, temper tantrums, sibling rivalry, withdrawal, underachievement, and open flaunting of family and societal traditions may occur within the family.

"Impaired communication" and "inadequate discipline" are specifically listed in the DSM-IV (1994) as areas of concern to be considered in a diagnosis of Parent-Child Relational Problems, and a diagnosis of Sibling Relational Problem is associated with significant impairment of functioning within the family or in one or more siblings. Not surprisingly, these are frequent concerns for parents of gifted children due to the intensity, impatience, asynchronous development, and lag of judgment behind intellect of gifted children.

Health care professionals could benefit from increased knowledge concerning the effects of a gifted child's behaviors within a family, and thus often avoid mistaken notions about the causes of the problems. The characteristics inherent within gifted children have implications for diagnosis and treatment which could include therapy for the whole family, not in the sense of "treatment," but to develop coping mechanisms for dealing with the intensity, sensitivity, and the situations which otherwise may cause them problems later (Jacobsen, 1999).

Conclusion
Many of our brightest and most creative minds are not only going unrecognized, but they also are often given diagnoses that indicate pathology. For decades, psychologists and other health care professionals have given great emphasis to the functioning of persons in the lower range of the intellectual spectrum. It is time that we trained health care professionals to give similar attention to our most gifted, talented, and creative children and adults. At the very least, it is imperative that these professionals gain sufficient understanding so that they no longer conclude that certain inherent characteristics of giftedness represent pathology.

References
Clark, B. (1992). Growing up gifted: Developing the potential of children at home and at school, (4th ed.). New York: Macmillan.Diagnostic and statistical manual of mental disorders, Fourth Edition. (1994). Washington, DC: American Psychiatric Association.Jacobsen, M.E. (1999). Liberating everyday genius: A revolutionary guide for identifying and mastering your exceptional gifts. New York: Ballantine.Seagoe, M. (1974). Some learning characteristics of gifted children. In R. Martinson, (Ed.), The identification of the gifted and talented. Ventura, CA: Office of the Ventura County Superintendent of Schools.Silverman, L. K. (1993). Counseling the gifted and talented. Denver: Love Publishing.Webb, J. T., & Latimer, D. (1993). ADHD and children who are gifted. Reston, VA: Council for Exceptional Children. ERIC Digests #E522, EDO-EC-93-5.Webb, J. T. (1993). Nurturing Social-Emotional Development of Gifted Children. In K. A. Heller, F. J. Monks, & A. H. Passow (Eds.), International handbook of research and development of giftedness and talent (pp. 525-538). Oxford: Pergamon Press.Webb, J. T. & Kleine, P. A. (1993). Assessing gifted and talented children. In J. L. Culbertson, & D. J. Willis (Eds.), Testing young children (pp. 383-407). Austin, TX: Pro-ed.Webb, J. T., Meckstroth, E. A., & Tolan, S. S. (1982). Guiding the gifted child: A practical source for parents and teachers. Scottsdale, AZ: Gifted Psychology Press (formerly Ohio Psychology Press).Winner, E. (2000). The origins and ends of giftedness. American Psychologist (55, No. 1), 159-169.

Oops - My own ADD kicked in

Well, my own ADD kept distracting me from keeping this updated and it just feel off of my radar after a while. I hate that because now I don't remember how I felt about everything from April til now.

I don't know if Joey is handling his ADHD better yet. I think I will find out soon though. He starts the 3rd grade in two days.

I was not able to get any medication for him. The doctors are convinced that he will be fine without it. Well, they are not the ones dealing with a son that comes home crying all the time and constant notes from the teacher. I am going to try to believe the doctors for a while though and see how the year starts. Of course, I would rather Joey not have to take anything but if everything falls apart in the next few weeks - I believe medication is definately worth it. I'll have to prove it to the doctors.

I haven't wrote "the letter" to Joey's new teacher yet. I'm talking about the letter I always have to write to tell them all about Joey and his ADHD and why he acts the way he does. I am wondering if I should write it before Monday or wait and see if Joey blends in first. I've tried that before though, and it never works.

Parent Training #4 - Homework

For homework, I am supposed to keep on doing the previous assignments and then add on some more. The additional things I need to do are:

• play games with Joey that will help him understand some social cues. They gave us a list of a lot of silly games we could do. They seemed fun and like something Joey would like.
• find groups of kids for Joey to try to join in playing. Practice talking to him beforehand about things he could say and how he should react if they say no.
• we already are in an organized sport, so I need to begin trying to make friends with the other parents. I thought I was going to make friends with one of the parents at the first practice but I must have done or not done something right. She sat at the other end of the line of parents when she arrived to the next practice. Prof. Mikami suggested that I make some treats and bring them for everyone. I might consider that. I need to think of something I can make or buy that would be "normal"...if only I knew what normal is. I think I have more problems than Joey!

I need to do some special times with Joey this week. I pulled out a box of cake mix today and was going to see if he wanted to do that with me but then I put it off until it was too late in the day. I will try again tomorrow or another day.

I will still try to do the attentive listening. I probably earned a "B" on that yesterday. I did manage to stand still and listen to him for a little while but then I noticed that I would be late to the parent training if I did not hurry the heck up! I could tell his story was not going to end so I interrupted him and said, "okay. I need to go now but you can finish telling me about this when I get back." He seemed fine with that.

I will also look for a good time to talk to Joey about a secret signal before Tuesday. I think it will be a good conversation if I can just find the right moment.

AND I need to practice game playing skills with Joey by playing some board games with him. He does really good when he is playing with me though. It is when he plays with others that he might lose control and throw a fit when he gets frustrated. Hopefully, us playing together will open up more opportunities to talk to him about how other kids like to play.

I am continuing to praise Joey every chance I get. I started a notepad on Monday where I have been writing down everything he does good for each day. He seemed happy when he saw it. I told him I wanted to remember all of his good things he does and I wanted him to write down any good things that I forget about. I thought it might help him to see the long list of things he did right for the day and for the week. It also helps me remember the good things because I forget those little things too quickly and then forget to praise him when I see him again.

Parent Training #4 - 4/1/08

Topics covered:

• Difficulties picking up social cues commonly seen in children with ADHD. Failing to notice when peer is bored or when peer is upset or uncomfortable. We discussed some games that parents could play to help the child understand how to know when their friend is bored or uncomfortable.
• How children join others at play. ADHD kids just rush in and try to jump right into playing with the other kids. Joey does this and is so excited to play with someone but he is rejected a lot and is always heartbroken and can't understand why they won't let him play. We talked about some ways to encourage our kids to try to join in and ways to react when other kids say no.
• We talked about how we can encourage our child to join an organized activity/sport to meet new friends. We also discussed how organized sports and activities can often be difficult for ADHD kids. We should not pressure them into participating but it is good if we can find a good one. It was suggested that we the parents try to make friends with the other parents so that our kids would be invited to events and be included in playdates. This concept intimidated a couple of us. I am not good at making friends myself and usually end up making things worse. However, I will try anything for Joey and I plan to make a better effort. (I wish there was a friendship clinic for ME - haha)

**at the beginning of this session, I arrived early and was able to speak with Prof. Mikami and Casey for a while without the other parents. They told me that the last playgroup went well and they thought that Joey seemed very receptive to the feedback I gave him during the session. They said I was doing good. That almost made me cry since I always seem to feel like I'm failing somehow. I am not a good judge of how I am doing. After all that was said, I started thinking..."I wonder if they are just praising me to encourage me like I'm supposed to be doing to Joey?? I wonder if they would even tell me if I needed to do a lot better??" Hopefully, I am just being too hard on myself.

Parent Training #3 - Homework

Assignments:

• Attentive Listening
• Constructive Feedback
• Effective Praises - lots of them
• Special Times
• Create Secret Signal
• Play Games and practice skills
• Talk to Joey about dealing with teasing

Joey was out of school on spring break all this week. It has been a rough week. I haven't done much of the homework. We've been too grouchy with one another.

I will write more later...

For this week I only managed to do a few things right. I did try to listen attentively a few times. I probably only did it completely right once. He was extra talkative this week. I gave him some nice constructive feedback, but also quite a bit of yelling feedback (I get an F in that). I remember giving him some praises but they were harder to say this week just because I was grouchy.
I ended up forgetting all about the game playing assignment. I was going to talk to him about bragging and then come up with a secret signal but he was not ready to hear anything about him bragging. I just dropped it and decided to wait until a better day. I didn't really need to talk to Joey about his bullies this week. He is starting to do good with that. We talked about ignoring his bully a few weeks ago and he has enjoyed making the boy mad each day. He sees that it is working some but he is getting impatient that the results are not immediate.

Playgroup #2 - 3/30/08

The researchers had the four boys play a problem solving game where they had to figure out how to get from one spot in the room to another using folders for stepping stones and without touching anything in the room. We the parents were instructed to help our kids follow the rules and help them in making friends. That wore me out! Joey did fine and all the kids were good but I tend to get worked up myself when there are adult voices talking everywhere and boys flying around the room like a swarm of bees. The other parents jumped right into instructing their boys but I think I just sort of shut down for the first 15 minutes or so. After I had time to process it I was able to walk over to Joey and give him some feedback. I could tell that all the chaos bothered Joey as well. It did not seem to bother the other boys at all. Joey got frustrated when he couldn't get anyone to hear him trying to say his ideas for the game but he only is very upset for about a minute and then snaps back into normal mode.

I was thinking that it would be helpful if there was a time when the researchers could actually coach the kids or help them understand more about ADHD and how to handle it when making friends. I believe that Joey hears my voice so constantly that he is immune to it and it doesn't break through the chaos to get into his thoughts. I wonder if other adults talked to him about all these things if he would listen and be more receptive.

After the problem solving activity, the boys could choose board games to play with each other. Joey picked the Guess Who game that he seems to like the best. He got quite frustrated at times when he didn't feel like he was doing really good at the game. He won the first round and is always a great sport when he wins. I am proud that he will not brag and he always says something nice to other players, such as "good job!". On the second round, Joey lost the game and he got a little upset. He is not such a great loser. After that game he played Jenga briefly and I played it with him before leaving for home.

The hour long playgroup goes by really fast. I really wanted to talk with the other parents there and get to know them but there wasn't time for that.

There will be one last playgroup on May 4.

Parent Training #3 - 3/25/08

At this session, we talked about "Helping Your Child Improve Game-Playing Skills", "Common Mistakes in Conversational Skills Made by Children with ADHD", and "Dealing with Teasing".

For game playing we are to play games with our child and practice skills. We can let them win long enough to learn the game and then start challenging them. During the game, we should address issues as they arise and use effective praise and constructive feedback.

From what I have seen, I think Joey's main mistakes in conversations with friends is unknowingly bragging about himself, frustration when others don't believe what he is saying, and talking nonstop. Joey compliments other kids a lot but the research indicates that this doesn't actually make much difference. He has to deal with his problems in conversations in order to maintain friends. Homework is to create a secret signal with Joey that I can do whenever he is unknowingly doing one of these behaviors. That way he won't be embarrassed by me saying stuff while he is with his friends and the immediate correction will help him tremendously.

In dealing with teasing, we can talk to our child about how it may work to ignore it. If that doesn't work, then make fun of the tease. He can find other friends to play with. Also he should try not to tattle to the teacher about the bully unless they are hurting him physically or something dangerous. He should continue to tell me about it though so we can talk through the situation.

Also for homework, we are to continue special times, attentive listening, and effective praises and feedback.

Parent Training #2 - Homework

Yesterday, I tried to be an active listener when Joey got off of the school bus. He talked for a good 10-15 minutes non-stop. It was actually harder than I thought to stop doing my own things while I was listening. It was hard for me to sit still and look at him as he talked and rambled. But it seemed that when I did that he didn't talk as long as he USUALLY does. He seemed satisfied enough with the talk to go on happily about his business and play his games and watch tv. Normally, I am probably giving him the impression that I really want him to stop talking and am not really listening. So, he talks more and more trying to get my attention.

Maybe I'm not such a terrible mother after all! haha

We also baked cookies together last night (which was also part of special time that I was supposed to do with him LAST week) - oops! It went well though and I remained calm and let him have fun.

I praised Joey last night because he went ahead and started putting his pajamas on when it was time for bed and I did not have to tell him to do that. I was specific and when I told him thank you for doing that, he replied by saying, "I like to make you happy, momma". Now I feel like crap because I probably make it hard for him to make me happy some days. I need to be better and not so hard to please.


... I hope to have more things to write about as the week progresses...

Parent Training #2 - 3/18/08

At this session, we talked about how to communicate more positively with our ADHD children. We practiced the art of "Active Listening". I need to listen actively to Joey when he is trying to tell me about his day or something that happened. Usually I will get bored after a couple of minutes and start doing my own chores around the house while only half listening. And sometimes I will jump in and try to give a solution before he is done talking. I need to stop all of that, stop what I am doing and just listen. I feel like an idiot that I didn't even notice I was doing this. I hate it when people do that to me and I have been doing it to him!

We also learned about how to give our child corrective feedback while not being so negative or hurtful. We should also be specific when we give praise and always find something to praise them about. I think Jonathan and I have been pretty good at the praise part for Joey. I think we give him praise quite a bit even when we don't feel like it. I will still make an effort to be better at it and try to notice more things that he does right. I also need to make sure I am giving him at least 4 praises for every negative comment.

Our homework is to practice attentive listening, giving praise and corrective feedback.

Parent Training #1 - Homework

I managed to catch Joey at a good time and we played his interactive DVD game, "Planet Earth". We ended up playing this for 30 minutes or more. It was a very nice time together. I was glad I did it. Joey seemed very happy also. Our quality time has been greatly reduced since the end of my pregnancy last fall and then especially after the birth of the baby.

It was hard to not say "parent-like" things while Joey and I played. I slipped once and said, "Okay...be quiet now so I can hear the questions". He didn't even seem to pay attention to what I said anyway so I don't think I ruined it. I was good for the rest of the time and fought the urges to say things. It actually was very peaceful to just let the little things go and not have to argue and battle over them. I know Joey appreciated it.

For the 2nd special time, we hid Easter Eggs. Again, we spent about 30 minutes or more since 15 minutes seemed so small. Joey was so happy. It made me very happy to see him so happy. I was mad at myself for not doing this sooner. It seems like it would've been so obvious to me that this is what he wanted from me and if I took the time with him, he would be happy. Sounds so simple! I believe that I thought that if I started doing anything with Joey that he would get upset when I had to stop no matter how long I spent with him. I didn't want to go through the battle, so I just never started. He didn't do that to me though. It all went just fine.

I was going to bake cookies with him for the 3rd special time before the next training session, but then the baby decided it was HIS special time to be grouchy. We ended up baking the cookies tonight though. Again, it went much better than I expected. It probably really does go so well because I make a conscious effort to not instruct, correct, or say anything remotely negative. I just let him "be" and try to be the perfect friend for him for a while. He really enjoyed it. I don't remember any difficult times with him this evening. He once whined about his DVD not working right and one time I caught him wearing his heelies in the house. He knows he's not supposed to wear them in the house. But I just calmly told him to take them off and he just did it.

Parent Training #1 - 3/11/08

I was surprised to find that there were different parents at this session than was at the playgroup session. I immediately got along with all of the other parents though. I found out that we were all ADHD ourselves! I was happy to find this out. I immediately felt like they would understand and accept me better than any other friends I've tried to make in my city.

We talked about our kids and their issues. It was such a relief to hear other parents saying similar things as myself. For once, I wasn't surrounded by the seemingly "perfect supermoms" who have everything all together and look down on me for being "weird" and having a son who doesn't fit the mold. The hour and a half went so fast. I wanted to stay and talk all night.

Our homework was to have 3 special times with our sons, each being 15 minutes long. During these times we are to use a style of interacting called, "Attending". I would have to be a very active listener with Joey and not argue, instruct, correct, or do anything parent-like. I just needed to be a good listener and friend for 15 minutes and have good positive times with him. This sounded hard to do. But at the same time I was relieved that someone was giving me "permission" to have some good times with my son and stop being so mom-like for a while. I always thought that I HAD to correct everything and never let anything slide even once or I would have to start back at square one. I never liked being that way but I had been told by other parents and books that this was "the way" to be a good parent.

I also was instructed to observe Joey playing with a friend and check his behaviors on the handout.

Playgroup #1 - 3/2/08

For the playgroup session, we all met in the same room as the intake session and there were three other mothers and their sons present. My first thoughts after meeting them was that they seemed like such great and positive parents. I felt like I probably wasn't doing as well as they were in the parenting department.

Joey played very well with the other boys though and I felt proud of him.
They boys were instructed to work a maze together as a team and they had decide among themselves who would go first, who would go second, third, and last. The last person to make a line on the maze and finish it would be the winner and would get to choose which toy to play with first. After hearing those instructions, I got very nervous. I thought a genuine "Joey coniption" was inevitable. I figured they would be getting some very useful footage today! To my surprise, Joey was quite nice and polite with the other boys. They didn't argue too much with him though, so I'm sure that had a lot to do with it. I was RELIEVED that Joey won the maze game. I knew I'd have a huge battle and embarrassing moment if Joey lost. I was lost for words, however, when Joey tried to say that he himself did not win, but instead "everybody won". He was trying hard not to brag or be a bad winner. I had never seen that side of him. I was so happy I wanted to cry.

The rest of the session was pretty uneventful. I really was expecting much more drama, but the boys were very friendly and accepting of each other and Joey just fit right in. I couldn't help but wonder if this was supposed to happen this way. It seemed like it didn't really accomplish much but I know that the research team knows what they are doing. I'm looking forward to seeing how all of this plays out. I'm sure that I will be happy with the end results!

At the end of the session, a researcher took Joey to another area and asked him how the playgroup went and some other questions. I don't know exactly what they were. I would love to know what Joey said! I'm sure it was entertaining.

After that, they took me and Joey to another room alone and told me to talk to Joey about the session for 4 minutes, ask him if he liked the other boys, and tell him some things to improve on. Those 4 minutes felt like 10 minutes. I asked him some questions but he didn't seem to want to talk much. He acted silly and just didn't seem interested in what I had to say. I believe it was videotaped... I wonder if I will be used as a "good parent" example or a "bad parent"! haha

Intake Session - 2/3/08

It was superbowl Sunday I remember... because Jonathan was slightly aggravated that I planned this at a time where he would miss half of it. I really didn't think about that at the time but it ended up not being anything great that we missed.

We were 10 minutes late to the intake session because we couldn't understand our directions that I printed from mapquest. UVA gave me directions but I thought I would be able to follow the mapquest ones better. Guess I was wrong. I felt so bad being late!

When we walked into the room that we would be in, I immediately recognized Amori Mikami from her picture on the internet articles. I almost felt like I had met a celebrity for a moment.

Joey sat at a big table with a couple of young adults who asked him lots of questions. They performed an IQ test. I can't wait to see what the results were! They asked Joey all about his friends and everyday life (I think). I know that Joey loved all the attention and the many opportunities to talk.

Jonathan and I went into a smaller room and filled out lots of questionnaires and talked to a researcher about our own assessments of Joey's behaviors. It was kind of nice to talk to other people who understood what we were talking about and for once I didn't feel like someone was thinking I was just not parenting good enough.

I was really looking forward to the next steps of the study...

I think I'll write it down

I thought that it would be a good idea to keep something like a journal of what I learn and discover during this Friendship Clinic for Joey. So here we go...

My first email asking to participate in the study

This is the email I sent to Professor Amori Mikami the day I found out about the Friendship Clinic.


Tue, 26 Jun 2007 16:28:17 -0700 (PDT)

Dear Professor Mikami,

I found several articles on the internet that talked about your research on ADHD children and how difficult it is for them to make friendships. The Friendship Clinic sounds wonderful and EXACTLY what ADHD children need. I wanted to see if you would possibly have room in your research/study for my son and his parents (my husband and I). Or if you have completed your study, then would you have any helpful information or programs you could direct us to? I happened upon your articles by searching the internet for some kind of help in this area. My 7 year old son has ADHD and right now his number one problem is friendships. About two hours ago, I picked him up from summer day camp and he greeted me in tears again (a common event). Apparently, he spends his entire day having emotional meltdowns over the most trivial things, such as losing a game, not getting to be first, etc. These emotional breakdowns happen every single day. My son cried all the way home despite anything I had to say and he was clearly heartbroken that he can't get along with other kids. I know exactly how he feels since I was much like him at that age (I also have ADHD).

My husband and I have tried all we know to help our son. We discipline, encourage when he does positive things, role-play situations to help him learn how to act, etc. Apparently this situation needs an expert such as yourself. I have searched my city for resources and asked for help from the school guidance counselor but I continue to get responses such as, "he'll grow out of it", "stop letting him have his way" (which we already do), and of course there's the medication. We use medication (Adderall XR - 5mg) but this does not solve our son's social and friendship issues. The medication helps him get straight A's in class. However, I would trade those A's for F's if he could not grow up feeling rejected as I did.

I'm sorry this is so long. Please... is there anyway we can participate in the Friendship Clinic?

Thank you so much for your time,

Andrea Graham
Lynchburg, Virginia


I was excited to get an almost immediate response...


Tuesday, June 26, 2007 8:01:57 PM

Dear Andrea,

Thank you for writing and sharing your experiences. Many families are going through the same thing, which has motivated my work.

Unfortunately (as you have guessed) we don't have anything going on outside of the Charlottesville VA area. The study requires many visits (up to 12 over a 3 month period). 4 of the 12 are easy to do on the weekend. The only problem is that if you do get assigned to the weekly treatment group (which is a 50% chance, but I assume something that you would clearly want), these 8 sessions of groups are really best held in the evening on a weekday after work (e.g., 6:30-8p.m., for example, on a weeknight that is not Friday). We do have some parents who commute from Richmond and Lynchburg-- but it is not workable for most families unless you have a very unusual job situation

We are also running a waitlist right now for boys, although I think there's a reasonable chance that your son would get in sometime over the next school year.

Please let me know if you think the distance and travel is workable or not.

In the meantime, I usually also recommend to parents a book by Fred Frankel called "Good Friends are Hard to Find". It's written for parents of kids ages 6-12, is not specific to ADHD, but it's a good book and easy to read with lots of practical advice.

If you are not already aware of it, I would recommend the group CHADD(Children and Adults with ADHD), an advocacy and support organization. Youcan find their website at www.chadd.org They have a lot of information,referrals, and such about ADHD and it is a great group. You might also likethe factsheets about ADHD at http://www.help4adhd.org/en/about/wwk which areaccurate and written for families about different aspects of the disorder-- including co-occuring disorders with ADHD, and ADHD in adulthood.

Thank you again for writing. I wish you and your son the best! If you have thoughts from your experiences about what is useful for social problems in this population, and/or you try some of these suggestions and have comments about what worked and what didn't, please do write me and let me know-- I value your input.

best wishes,
Amori

Amori Yee Mikami
Ph.D.Assistant Professor of Psychology
University of Virginia