ADHD

Last Wednesday I went to a presentation on “ADHD – A Clinical and Research Update". The DMC ( Developmental Medicine Center ) Forum Committee - Children’s Hospital Boston, hosted the presentation.

Leonard Rappaport, MD, MS is the Chief of the Division of Developmental Medicine, Children’s Hospital Boston Director, and Developmental Medicine Center of Children’s Hospital in Boston . In the introduction, the person stated that the doctor directs one of the world’s primary centers for the identification and treatment of children with assortment of developmental, behavioral, and learning disorders. He is an author of numerous research reports, chapters, and reviews. In his lecture, the doctor talked about current understanding of ADHD.

Dr. Leonard Rappaport explained to the group, the various symptoms that maybe associated with ADHD such as; impulsivity, distractibility, poor selection, impersistence, insatiability, poor monitoring, and attention in motivation dependency, inconsistency, and hyperactivity. In his speech, he emphasized that these are negative words! He told parents to recognize what our child’s strengths are and to emphasize upon them. Every child with ADHD is unique and there may be different signs that vary with each child. The most important comments I thought he made was for parents to look at those negative words a different way and to implement “Behavioral Management Strategies”. If your child has ADHD, a parent should have parental training in behavioral management strategies. A parent learns how to work with their child and learns helpful behavioral techniques. Some of the “Behavioral Strategies” are using rewards, praising positive behaviors & ignoring negative ones, time outs, communication and so on. This would begin with small steps and over time, the steps increase. Parents must be consistent in order for these strategies to work.

In a slide presentation, the doctor spoke about each negative word associated with ADHD and next to the negative word, he had the opposite meaning:
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Impulsivity - Productivity
Distractibility – Creativity
Poor Selection – Alternative Thinking
Impersistence – Knowing when to move
Insatiability – Ambition
Poor Monitoring – Getting things done

Dr. Leonard Rappaport spoke about how important it is to reward our children when they do anything good. Parents should set up an award system for their children when they accomplish a simplest task, or the simplest positive behavior. He also pointed out that children with ADHD thrive on rewards because of the dopamine (neurotransmitter) in the brain. My sister has used this method in her parenting and it seems to work for her children. It especially works for her middle daughter – she has ADHD. My sister has a fun box and she fills it with play jewelry, candy, games, and crafts. At the end of the day, if they behave or did a good deed she rewards them with a star. When her children reach 10 stars then they go ahead and pick a reward from the fun box.

Finally, the doctor spoke about medication for children with ADHD. He said that the decision to medicate a child with ADHD should be an agreement between the child, the parent, and the physician. He also spoke about finding the right stimulant medication for your child. The doctor stressed the importance of monitoring your child’s behavior and performance once the medication begins because of the effects of the medication. I disagree; it is my belief that the choice to medicate a child with ADHD should be solely up to the parent. In my daughter’s case, she has a rare medical condition and is already on so many medicines. No one honestly can tell what the side affects could be in the future for her. In addition, I would be worried of the possible interactions with her other medicines.

The next speaker was John Gabrieli, PhD Harvard-MIT Division of Health Sciences and Technology (HST), Department of Brain, & Cognitive Sciences Massachusetts Institute of Technology. In his introduction, the person noted that he is the senior author of over 200 papers published in peer-reviewing scientific journals, including publications of Science and Nature. He spoke about the structure of the brain of a child with ADHD. It was very interesting but I found it to be a little complicated. I have to admit, I lost interest, and I found myself focusing on something else. It was then when I realized that it was easy for anyone to have a short attention span, especially when the topics are hard to comprehend. Now just imagine how easy it is for a child with ADHD to lose focus at school. We as parents should try to live one day in our child’s shoes with ADHD.

In conclusion, I found it to be a rewarding presentation. I learned a lot from what Dr. Leonard Rapport spoke about and I know that I will implement some of it. For example, I will help my daughter to learn to be familiar with and adjust to her difficulties, while recognizing her full potential. I will also set up a fun box for my daughter, so that I can award her for good behavior and good deeds.