Interview with Sterling

So Sterling…Why did you decide to write a book about parenting children with ADD?

When I first set out to write a book I intended it to be an adventure novel based on my travels throughout the world. What came out instead was the story of my very ADD youth. What I gained from writing that book was a vision that I could use my experiences growing up with undiagnosed ADD and raising kids with ADD, to help others.

I digested book after book on ADD and how to deal with it. I also started to reach out to the people I hoped to help. I joined an ADD support group sponsored by CHADD and listened to what those and other parents were struggling with. Most of the parents I talked to where frustrated about the information and help they were getting from the professional community. It seemed that no one was talking or writing about what I considered to be the two most important steps in helping children with ADD. I decided to address those two steps by writing Pudd’nhead Parenting.

The first issue is identified in my book’s sub-title: Forming a Positive Working Relationship with a Child with ADD. Building that relationship has to be the initial focus for these parents. In Pudd’nhead Parenting I outline three vital steps for accomplishing that. I then address the next important issue: how to repair and protect their child’s self-esteem. Low self-esteem is the most devastating side-effect of ADD. It empowers a child with ADD to contribute to their own solutions. With those two elements in place parents are ready to coach their child through what I outline in my book as the Process of Forward Motion.

What makes you an authority on ADD?

I would like to say that I know everything there is to know about ADD, about parenting, and about children, but I obviously don’t. What I can say is that through my experiences growing up with ADD, as a parent of children with ADD and through my continual studies I have a unique combination of knowledge in all three areas. Not only do I understand what kids and parents are going through, I understand it at both an emotional and technical level.

I have been a corporate trainer for the past twenty years and now have a passion to use that talent to educate parents. My mission is to help them avoid some of the struggles I experienced because of my lack of understanding and enjoy some of the successes that have come as I have gained perspective and learn a better approach.

Is ADD real? What is really going on?

I have first hand evidence that ADD is real. I was the youngest of six kids. All my siblings were straight A students, but when I got to first grade I was unable to focus. When my teacher, Mrs. Butterfield, placed a worksheet on my desk I would write my name at the top and answer the first few questions before drifting off into some daydream or being distracted by other things going on in the classroom and out on the playground. All through school I was able to learn the material but was unable to complete or turn in assignments or homework.

A few years back I got a glimpse at what was really going on inside my brain through SPECT scans. They showed areas of my brain that were fairly inactive compared to the normal brain. The more I tried to concentrate the more inactive they became. When I say inactive, I’m talking about the flow of electrical signals from one neuron to the next. Those signals are carried by the neurotransmitters dopamine and norepinephrine. If those chemicals are mishandled by the brain or the brain doesn’t produce enough of them, the control center of the brain does not communicate well with the other parts, particularly the frontal lobe. The result is a lack of concentration and difficulty planning, prioritizing, managing time, managing emotions, starting tasks, competing projects, etc.

Is ADD over diagnosed?

You may be surprised to hear this coming from an ADD advocate, but the answer is absolutely yes.

Of the 4 million kids diagnosed with ADD an estimated 1.8 million actually have it. The rest have one of the various ADD look a like’s. Anxiety, depression, bipolar disorder can all demonstrate ADD symptoms. Even environmental factor such as allergies, mal-nutrition, a chaotic home life, divorce, abuse, and yes even just plain bad parenting can exhibit behavior that looks like ADD to the untrained eye.

It may seem like a complete contradiction but ADD is also under diagnosed. We miss the mark in both directions. An estimated 1 million children have ADD but still don’t have an accurate explanation as to why they are struggling at school, at home or in social situations. This is the group I am the most concerned about. These children are experiencing their ADD the same way I did in the sixties when no one knew anything about it. These days that doesn’t need to happen. One of my goals is to see that it happens less.

What are the dangers to a kid when their ADD is ignored?

If a kid doesn’t get the right explanation for their struggles and failures, they will come up with one on their own. Actually, they will accept the explanations the adults around them come up with. Those explanations normally fall into the category of moral defects such as lazy, unmotivated, uncaring, and uncooperative. Those explanations erode a kid’s self-esteem, without which kids stop believing in accomplishing their dreams. They instead start to focus on being accepted by their peers and not feeling so miserable. They start to cope with life in self-destructive ways such as tobacco, alcohol, drugs, and eventually crime. Someone has to be there to build them back up and shore up their feelings of self-worth, or their choices can trap them in some tough situations.

A recent study showed that 40% of prisoners had ADD as a child. Of those 93% were never diagnosed. I wonder what the percentage would have been if those people had understood as a child what the true source of their struggles was. The statistics for kids with ADD are quite alarming. They are two time more likely to abuse drugs, four times more likely to be arrested, and eight times more likely to become involved in a teenage pregnancy. Another alarming statistic that came out recently from the Center for Disease Control stated that children with ADD are five times more likely to die by the age of twelve. My experience with kids with ADD tells me that those statistics are at least in the ball park. I believe that if helped in the right way, kids with ADD can not only beat those odds but the odds for kids in general.

Why does ADD look so different in different kids?

When it comes to ADD one size does not fit all. Parents need to understand the unique way ADD manifests in their child. To begin with researchers have identified up to six sub-types. Depending on your child’s sub-type they may have tendencies toward being hyperactive, impulsive, inattentive, irritable, worrisome, depressed, inflexible, aggressive, restless, etc.

Which ADD sub-type your child demonstrates may be influenced by various other factors such as their temperament, sex, age, sibling order, diet, and yes, even parenting style. The more we understand how our child is experiencing ADD the better chance we will have of helping them.

How do parents know if their child is struggling with ADD or something else?

It is a challenging task for a psychologist or psychiatrist to arrive at an accurate diagnosis for ADD and rule out the look a likes and masking conditions. So many times ADD exists but is accompanied by a co-existing disorder such as a learning disability, obsessive compulsive disorder, anxiety disorder, bipolar disorder, tourette’s syndrome, or narcolepsy. These can exist with or without ADD.

The key to a good diagnosis is having an experienced clinician who specializes in ADD and its related conditions. If someone observers your child for a while and asks you a few questions and is ready to give you a diagnosis, don’t accept it. Find someone who insists on doing more. The most important element of the diagnosis will be an extensive family and personal history for your child. They will want to gather observations from teachers and others who interact with your child on a regular basis.

Be patient in this process. An accurate diagnosis is more than likely the most important thing you will get from your mental health care professional.

What are the first things parents should do when they learn that their child has ADD?

My vote is for them to learn. Before everything was solid state, I used to love to take apart some appliance or device that wasn’t working and see if I could fix it. The more I knew about the device the more likely I was to get it back together without making it worse. The more you know about how your child’s brain works the more likely you are to help them instead of making things worse.

Who can parents get help from when trying to help their child with ADD?

I have two general criteria for knowing who to get help and guidance from. The first qualification is that they have a firsthand experience with what you are dealing with. I wouldn’t get advice on publishing a book from someone who has never published a book, or help with parenting from someone who has never raised a child.

The second qualification is that they have helped someone succeed at what I am looking for help with. Even though Wayne Gretzky and Michael Jordan were the best at their sports they weren’t the best of coaches. Sometimes the best coaches are those who had to figure out how to get there, so they know how to explain that process to others.

Why do mental health providers often struggle to help children with ADD?

I love mental health professionals. Some people have accused me of bashing them a bit, but I understand that in many ways their hands are tied. Mostly they are influenced in the type of care they offer by the type of care insurance companies will pay them for. In most cases this includes a less than extensive diagnosis, a couple of prescriptions and a few follow up visits to adjust medication. Most of the very thorough practitioners work outside the confines of insurance, which makes them too expensive for the normal middle-class family.

Their hands are also tied by liability insurance. In order to lower their premiums, which are exorbitant, they must promise not to do and say certain things that will make them responsible for their patients’ outcome.

The answer to this is the same as with normal health care. We must be responsible for our own care and arm ourselves with information and explore all the options. We must view health professionals as providers of services, not necessarily solutions.

What can parents do to help their children besides giving them medication?

This is the best question of the day. People often express to me their concerns that kids with ADD are over medicated. I also have that concern; however, my bigger concern is that they are undertreated in other ways. When someone goes to the doctor for high blood pressure they may get a prescription, but they should also change their eating habits, start an exercise program and learn to manage their stress.

The same is true when treating ADD. With or without medication parents should look at changes to diet, environment, and daily routine. They should help them look for strategies to overcome obstacles and accomplish what they need to do in life. They should also help their child develop habits and structures that will support them the rest of their lives.

Just like with high blood pressure, if enough other things are done, some patients can discontinue taking that pill every day. I’ve seen some ADD kids progress to the point where they can succeed without medication. Not all can, but either way the other things they do will be essential to their happiness and well being.

What adjustments should parents make when their child has ADD?

A question I often get from parents is, “My child’s room is knee deep. Is that something I have to accept because they are ADD?” or “My child is often rude to the family. Is that something I have to accept because they are ADD?” My answer is always an emphatic no.

We have to accept a lot of things about our ADD child. We may have to accept that they will make more mistakes and that they may make the same mistake over and over before finally getting it right. We may have to accept that it will take them longer than the next kid to form a new habit or reach a goal, and that their path to that goal may be unique.

We should never accept lower standards or limited goals. Standards such as cleanliness and courtesy, honesty and punctuality are essential to a happy life. Giving up on them is sentencing them to unhappiness. You will have to be patient and prioritize on a couple of issues at a time, but never send them the message that these things are not important.

What are the two biggest road blocks to good parenting?

A lot of different things can get in our way of being the kind of parent we really want to be. Some that come to mind are financial and health problems, marital or emotional problems. Although all of those are real issues and should be addressed, we can still do a pretty good job as a parent if we can avoid the pitfalls of pride and fear.

Pride and fear can make us do things as parents to avoid embarrassment or to impress the neighbors. As long as we are driven by those two factors we will tend to make decisions to avoid short term consequences but that may have lingering effects on our children’s self-esteem.

Sometimes we have to let our children make their own mistakes and learn from them, even if it doesn’t reflect well on us. That trust may allow us to help them find a better way. It will certainly give them room to grow.

Why is low self-esteem so common and so dangerous for kids with ADD?

In my book I talk about something I call the inner-critic. It has several forms of false logic it tries to get us to buy into. The nature of ADD makes kids especially vulnerable to the inner-critic’s logic. For example one of its arguments is comparative thinking. It tries to convince us that if someone else is better than us we are bad. ADD kids may hear things like, “Why don’t you just turn your homework in like your sister.” They may see their siblings being praised for good report cards and make a judgment about themselves.

Each form of false logic the inner-critic feeds us has ways to detect it and ways to combat it. Comparative thinking can be reversed by focusing and even tracking individual progress. If last week they forgot their homework three times and this week only twice, then that is a reason for them to feel good about themselves, regardless of what anyone else does.

What can parents do to rebuild and protect their child’s self-esteem?

The biggest boost to your child’s self-esteem is when they realize you understand and accept them and empathize with what they are going through. From there you can help them gain confidence through focusing on what I call superpowers and sweet spots. As you help them put the necessary strategies in place and make even small incremental progress to their goal they will start to believe that with the right approach they can accomplish what they are meant to accomplish in life.

In my book I list ten specific things you can do to boost their self esteem. For example quieting your own inner-critic will help them master the language of self-esteem. Taking the steps to help someone else always makes us better people. The steps in Pudd’nhead Parenting are no different. As you accept your child’s strengths and weaknesses you will accept your own. As you work to raise their self-esteem you will naturally start to value yourself more. You will also learn to be patient with yourself as a parent as you exercise more understanding and patience for your child.