ADDHD: CCHR —Labelling Normal Kids "Mentally ill"

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 ADDHD: CCHR —Labelling Normal Kids "Mentally ill"

https://www.penguin.co.nz/books/understanding-adhd-2001-revised-edi...


Special Thanks to 9-year-old skater, Logan Cogswell
Film credit: Austin Dodson

 

 

UNDERSTANDING ABOUT ATTENTION DEFICIT DISORDER...

By Vlada Mikahl Schoon

Attention Deficit Hyperactivity Disorder - it's a mouthful to say,and an even bigger handful for parents whose kids are afflicted by the condition that turns little angels into absolute terrors in many peoples eyes...

I'm going to use a few case histories,along with name changes & altered here to explain what this is all about as I really don't have full permission from the named person's to pass this information along out of work place,nor do I like to go into my own personal experiences with this condition,so read between the lines please..

Though it shames her to admit it,Terresa used to hate her son,"By the age of four he was out of control as far as she was concerned and nothing made a difference"..."He was constantly throwing what she saw as tantrums - getting hysterical and kicking and punching.

I would turn my back on him to put shopping in the boot,then find him scratching other people's cars with my keys. He just wouldn't listen to reason,so I thought it was because I was a terrible mother.

"Then Terresa's second child was born.

"Once she reached the age of two,I realised that my sons behaviour had not been normal. By then he was at school,where he was constantly in trouble and falling behind in his grades. He was diagnosed with ADHD and put on medication.

The change was dramatic even though I hated to think a pill was all that did that,it gave me a rest for a while and as this drug was none addictive or had adverse side effects I thought for a short time it was of benefit and Id take him off it later when he had matured a bit.

Anyway within weeks,he was no longer destructive and I was able to reason with his actions and knew he was taking in what I was talking to him about to take responsibility for his actions.

For the first time he willingly did homework and sat still to eat his dinner to" We've all seen kamikaze kids defying frazzled parents on buses and in bank queues. In the past,they would have been in constant contact with the wooden spoon..

Today,however,children who are chronically hard to handle are being diagnosed with Attention Deficit Hyperactivity Disorder [ADHD] - an epidemic that appears to be sweeping our playpens and schools. [The name of the condition - formerly Attention Deficit Disorder or ADD - was changed several years ago to include the hyperactive component of the condition] Health professionals estimate that up to 5 per cent of New Zealand & Australian children have ADHD.

The 2010 National Mental Health Survey of New Zealand Youth suggests the figure may be higher - with up to 11 per cent of children between six and 17 showing clinical signs of the condition.

The symptoms of ADHD are a recipe for chaos: Poor organisational skills,short attention span,inefficient short-term memory,impulsive or aggressive behaviour,and delayed development.

"One can joke that these behaviours apply to all of us at times,but in ADHD children they are extreme and chronic" say Dr's and heads of the Child Development Units at the Children's Hospitals. "

The art of diagnosis is increasing,because we are better at recognising the condition these days and can use alternative formats to manage without medications.

That's a good thing,because if we don't catch these children early enough they experience years of failure,which lowers self-esteem,as well as academic,vocational and social competence"

The full-out can be long term. A large scale study in the Psychiatric Institute in the US has been tracking two groups of boys since the 1970's.

By their early 20's the hyperactive boys in the study were nine times likely to have been in prison.

Although the cause of ADHD is not yet fully known,its thought that the problem occurs in the brain's frontal lobe,where some receptors don't respond to dopamine,a hormone-like substance which aids brain function. This tendency seems to be passed through families.

Research of more than 1000 twins has been conducted over the past 10 years, "We have found from this that if one identical twin has ADHD,the chance of the other having the condition is 80 to 90 per cent",

"this strongly suggests that this is a genetic condition". The effect on the child's brain of this inattentiveness can be shown through imaging,which maps electrical activity.

"When children without ADHD do a 'thinking task',the frontal lobes [involved in planning,organisation and impulse control] becomes very active,"

When children with ADHD do the same task,they don't show that same increase in frontal brain activity"

 THE DRUG DEBATE...

The medical teams have found that a single dose of ADHD medication can kick-start greater frontal lobe activity in some children,but not all. However,medicating children for behavioural or concentration difficulties still causes great controversy,and so it should,its sometimes not the right thing nor an easy fix solution either.But it can be a blessing to a client for a short period to get some schooling completed at least..

The drugs most commonly prescribed to control ADHD are Dexamphetamine and Ritalin,which are in the same family as street class A amphetamines or speed [equivalent to LSD] The demand for these drugs is on the increase to.

Though these statistics are old the Federal Health Department figures showed that back in 2006,an estimated 9900 scripts for Dexamphetamine were filled,compared with 248,300 scripts in 2011. In the same five year period,Ritalin prescriptions soared from 13,400 to 96,600. About 1 percent of New Zealand children taking stimulants every day.

Potential side effects include poor weight gain,slow growth,stomach pains,insomnia,even hallucinations. "Fortunately,such problems can usually be minimised by getting the dose right", "The medication is successful,improving information in 70 to 90 per cent of children who take it." Diagnosis of ADHD is made by paediatricians,psychiatrists to a questionnaire asking them to determine behaviours,each case is assessed on a individual basis,and not always is medication given and more management of behavours is the first option.

IS ADHD ALWAYS THE CAUSE....

Not according to Dr's at the Medical Association Council of General practise. I'd question whether some children have other,overlooked problems,ranging from vision,hearing or actual learning disabilities,other neurological disorders included right through to emotional problems such as depression,anxiety or difficulties at home,even some parenting techniques,or child abuse etc.

Boys are diagnosed with ADHD at four times the rate of girls.

Could we be medicating them for behaviour that 50 years ago would have been seen as boisterous or just simply naughty?

"In some cases I think we are,the problem is three-fold: boys have less contact with men due to family breakdowns and more solo parenting, long working hours,so their role models are now action heroes,they have energy to burn but,due to stranger danger and computers,often finish the school day and then sit indoors.

There is also an indication that boys learn better by rote,so current changes to the curriculum disadvantages them,thereby encouraging failure and acting out,This may be misdiagnosed as ADHD." ..

Two years ago,Margaret Prescoll,44, became aware that her then seven-year old son Mathew was not being attentive at school work "the next thing I knew,the school psychologist was diagnosing him with ADHD" she said incredulously she disagreed with the diagnosis and so did Mathew's teacher.

"I would rather accept that he learns at a different pace to other children" ...

Could another form of treatment help him? I certainly think so,and so do others in my field of work,my superior has specialised in perceptual motor dysfunction.

"The 30 percent of children with these movement difficulties behave in exactly the same way as an ADHD child " she explained

"but their problems is actually a delayed development of kinesthesis,which is the feeling of movement. [Kinesthesis] is not fully developed until age 12, but our educational curriculum here unhelpfully demands it be developed much earlier.

Those children who can't keep up either act out or withdraw into their own world.

Through simple exercises,however,such as teaching a child to look at the target when they throw a ball,the majority improve and can be successfully weaned off medication after three to 10 sessions".

Other treatments include neurofeedback - computer games to help stimulate brain waves that assist concentration. Despite parents concerns,there is no evidence that such games worsen or cause ADHD, in fact,early evidence suggests that the right computer games used therapeutically during 20 to 40 half-hour sessions of neurofeedback can be as effective as stimulant drugs.

The benefits of medication are also being explored through a program being plotted,children aged 10 and under who have been diagnosed with ADHD will be taught concentration-enhancing techniques,such as lying still,visualisation and repeating affirmations.

The team are also researching whether supplementation with the fatty acids found in fish oils can help children by affecting the nervous system.

What about cutting out junk food? its shown little evidence to support this as a treatment for ADHD, however,some supplementary practitioners swear by its importance.

"Allergies or nutritional deficiencies due to poor diet can lower a child's immunity,then children may develop sensitivities to chemicals in food,such as sugar,additives,colourings,gluten in wheat and lactose in milk.

Its been known to cure many children of their supposed ADHD symptoms through a low-allergy diet and supplements that include vitamins such as B,C and E,in minerals such as zinc.

Some parents of children with ADHD believe a change in diet is effective they say cutting out foods such as chips and soft drinks,sugar etc but found that diet made no difference,so its debatable but worth looking into regardless..sugar in particular has been known to be infused with other ingredients that can act like parasites in the human body,see the video below that explains this..

 Other children's behaviour..

Trish Walker 37 whose 10 year old was diagnosed with ADHD at age eight.. said without Ritalin,her son is a extremely aggressive child,He's been expelled four times,and each time we have later realised he had forgotten to take his medication that day. Yet my immediate family insist my husband and I are just not firm enough with him. Blaming parents for the behaviour of children with ADHD causes them heartache and embarrassment,its common for these parents to have two or three other children who are fine and only one child with ADHD - so it is obviously not a parenting issue,Yet we point a finger and add to their duress. It can also be stressful trying to find a school willing to take a child branded as difficult. The increase in ADHD diagnosis has caused some schools to take an anti-medication stance. In our schools we dont enrol children on ADHD drugs said one continental area director of applied Scholastics,an organisation that oversees independent schools and learning groups.. "Their view is that medication is simply a cover-up for other problems" the organisation feels schools use visual and tactile stimuli,and children are never pushed into learning new skills prematurely. 

Children with ADHD can be talented in areas such as the arts, Kurt Cobain who I'm a huge fan of by the way,influential lead singer of the band 'Nirvana',was diagnosed with ADHD and placed on Ritalin from age four. This caused him insomnia,so he was prescribed sedatives,Another side effect of Ritalin was stomach pain, which,when he was older,Cobain anaesthetised with an alternative drug Marijuana and then moved to Heroin,his drug dependency was said to be linked to his suicide at only 27yrs of age sadly, what a loss of pure talent in my eyes,when his condition could have been placed under better control and management and he'd still be here today,pumping out the awesome wacky cool tunes he's famous for.

In which case is the risk that taking stimulant medication will lead children[and adults] with ADHD to greater experimentation with drugs?
Well no according to the research,in fact it suggests that children with ADHD who are on medication are at less risk of substance abuse in adolescence,because they don't need to self-medicate to try to treat their problems.
If you give a child a drug to help them improve their grades and behaviour,you risk teaching them that drugs are a quick-fix solution to problems. We need to be more inquiring about the underlying causes of behavioural problems. If not,we'll never be sure the children diagnosed with ADHD are not crying out for some other form of attention which has a cause that's been overlooked and lead to disaster and loss of lives..

OPPOSITIONAL DEFIANT DISORDER..

WHAT IS IT..

ODD is a psychiatric disorder that is characterised by two different sets of problems..These are aggressiveness and a tendency to purposefully bother and irritate others.. It is often the reason that people seek treatment,When ODD is present with ADHD,depression,tourette's,anxiety disorders,or other neuropsychiatric disorders,it makes much worse than ADHD alone,often enough to make people seek treatment. The criteria for ODD are:

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

* 1. Often loses temper

* 2. Often argues with adults

* 3. Often actively defies or refuses to comply with adults requests or rules

* 4. Often deliberately annoys people

* 5. Often blames others for his or her mistakes or misbehaviour

* 6. Is often touchy or easily annoyed by others

* 7. Is often angry and restful

* 8. Is often spiteful and vindictive

The disturbance in behavour causes clinical significant impairment in social,academic,or occupational functioning.

HOW OFTEN IS OFTEN?

All of the criteria above include the word often..but what exactly does that mean? 
Recent studies here have shown that these behaviours occur to a varying degree in all children. 
These researchers have found that the 'often' is best solved by the following criteria..

Has occurred at all during the last three months -

*8. Is spiteful and vindictive
*5. Blames others for his or her mistakes or misbehaviour

Occurs at least twice a week -

*6. Is touchy or easily annoyed by others
*1. Loses temper
*2. Argues with Adults
*3. Actively defies or refuses to comply with Adults requests or rules

Occurs at least four times per week -

*7. Is angry and resentful

*4. Deliberately annoys people

What causes it?

No one knows for certain. The usual pattern is for problems to begin between ages 1-3.. If you think about it,a lot of these behaviours are normal at age 2,but in this disorder they never go away. It does run in families. If a parent is alcoholic and has been in trouble with the law,their children are almost three times as likely to have ODD. That is 18% of children will have ODD if the parent are alcoholic and the father has been in trouble with the law.

HOW CAN YOU TELL IF A CHILD HAS IT?

ODD is diagnosed in the same way as many other psychiatric disorders in children. You need to examine the child,talk with the child,talk to the parents,and review the medical history. Sometimes other medical tests are necessary to make sure it sis not something else. You always need to check children out for other psychiatric disorders,as it is common the children with ODD will have other problems,too.

WHO GETS IT?

A lot of children! & Adults to!..This is the most common psychiatric problem in children. Over 5% of children have this. In younger children it is more common in boys than girls,but as they grow older,the rate is the same in males and females.

ODD RARELY TRAVELS ALONE.

It is exceptionally rare for a physician to see a child with only ODD. Usually the child has some other neuropsychiatric disorder along with ODD. The tendency for disorders in medicine to occur together is called comorbidity. Understanding comorbidity in paediatrics psychiatry is one of the most important areas of research at this moment.

COMMON PATTERNS OF COMORBIDITY

ODD Plus ADHD

If a child comes to the clinic and is diagnosed with ADHD,about 30%-40% of the time the child will also have ODD..Here are some examples of how this looks across ages..

WHAT HAPPENS TO CHILDREN WHO HAVE THIS WHEN THEY GROW UP.

FIRST: There will be some lucky children who outgrow this..The exact number is not clear,but probably not the majority. The aggressiveness is very stable. That is aggressive 2 year olds are likely to be aggressive 20yr olds. Only IQ is more stable over years than aggression.

SECOND: ODD may turn into conduct disorder[CD] This usually happens fairly early. This is,after a 3-4 years of ODD,if it hasn't turned into CD,it wont ever. What predicts a child with ODD getting CD? A history of a biologic parent who was a career criminal,and very severe ODD.

THIRD: The child may continue to have ODD. Recent work suggests that this is probably the most common path. If you look at a group of preschool boys who have ODD and check out two years later, about 75% still have something wrong. Sometimes ODD at that age changes into something else,but that is rare. More often ADHD and ODD just continue on. The more common thing that happens is that children with ODD develop signs of mood disorders or anxiety as they get older. By the time these children are in the end of elementary school,about 25% will have mood or anxiety problems which are disabling. That means that it is very important to watch for signs of mood disorder and anxiety as children with ODD grow older.

WHAT CHILDREN WITH ODD END UP AS CRIMINALS?

Probably not unless they develop conduct disorder even then many will grow out of it. Life may not be easy, People with ODD who are grown up often do best if they can work for themselves and stay away from alcohol and drugs. However their tendency to irritate others often leads to a lonely lifestyle.

WHAT IS THE DIFFERENCE BETWEEN ODD AND ADHD?

ODD is characterised by aggressiveness,but not impulsiveness. In ODD people annoy you purposefully,while it is usually not so purposeful in ADHD. ODD signs and symptoms are much more difficult to live with than ADHD. ADHD sometimes goes away,but ODD rarely does. ODD is not characterised by poor social skills either. Children with ODD can sit still.

WHAT DIFFERENCE DOES IT MAKE IF YOU HAVE ADHD OR ADHD PLUS ODD?

A lot! Children and adolescents with AHDS alone do things without thinking,but not necessarily aggressive things. An ADHD child may impulsively push someone too hard on a swing say and knock the child down on the ground. She would likely be sorry she did this afterward. A child with ODD plus ADHD might push the kid out of the swing and say she didn't do it,and then brag about it to her friends later. ADHD plus ODD children and adolescents are in a lot of trouble as their impulsiveness and hyperactivity often lead to fights,rough play,and huge temper tantrums.

MY CHILD HAS BEEN DIAGNOSED WITH ODD. I DON'T LIKE TO SAY THIS,BUT NO ONE CAN STAND HIM. IS THIS COMMON?

Unfortunately,it is quite common. In comparison to ADHD alone,children and adolescents with ODD plus ADHD or just ODD are much more difficult to be with. The destructiveness and disagreeableness are purposeful. They like to see you get mad. Every request can end up as a power struggle. Lying becomes a way of life,and getting a reaction out of others is the chief hobby. Perhaps hardest of all to bear,they rarely are truly sorry and often nothing is their fault. After a huge blow up,the child with ODD is often calm and collected. It is the parents who look as they are going to lose it,not the child. This is understandable. The parents have probably just been tricked,lied to or have witnessed temper tantrums which know no limits.

MY FATHER IN LAW SAYS THE WHOLE PROBLEM IS MY HUSBAND AND I. MY DAUGHTER CONVINCED HIM THAT SHE IS A VICTIM OF UNCARING PARENTS. HOW OFTEN DOES THIS HAPPEN?

Too Often! Children and adolescents with ODD produce strong feelings in people they are trying to get a reaction out of people,and they are often successful. Common ones are:inciting spouses to fight with each other and not focus on the child,making outsiders believe that all the fault lies with parents,making certain susceptible people believe that they can 'save' the child by doing everything the child wants,setting parents against grandparents,setting teachers against parents,and inciting the parents to abuse the child. I frequently see children with ODD in which teachers and parents and sometimes others are all fighting amongst each other rather than with the child who is causing all the turmoil in the first place.

CONDUCT DISORDER

In some ways,conduct disorder is just a worse version of ODD. However recent research suggests that there are some differences. Children with ODD seem to have worse social skills than those with CD. Children with ODD seem to do better in school. Conduct disorder is the most serious childhood psychiatric disorder. Approximately 6-10% of boys and 2-9% of girls have this disorder. Here is the definition..

A. A repetitive and persistent pattern of behaviour in which the basic rights of others or major society rules are violated. At least three of the following criteria must be present in the last 12 months, and the least one criterion must have been present in the last 6 months.

Aggressive to people and animals..

Often bullies,threatens,or intimidates others
Often initiates physical fights
Has used a weapon that can cause serious physical harm to others[a bat,bricks,broken bottle,knife,gun or others]
Physically cruel to animals
Physically cruel to people
Has stolen while confronting a victim[mugging,purse snatching,extortion,armed robbery]

Destruction of property..

Deliberately engaged in fire setting with the intention of causing serious damage.
Has deliberately destroyed others property other than by fire setting.

Deceitfulness or theft...

Has broken into someone else's house,building or car
Often lies to obtain goods or favours or to avoid work
Has stolen items of non trivial value without confronting a victim[shoplifting,forgery]

Serious Violations of rules...

Often stays out at night despite parental prohibitions,beginning before 13yrs of age.
Has run away from home overnight at least twice without returning home for a lengthy period.
Often skips school before age 13yrs

B. THE ABOVE PROBLEMS CAUSES SIGNIFICANT IMPAIRMENT IN SOCIAL,ACADEMIC,AND OCCUPATIONAL FUNCTIONING.

SO HOW ARE ODD AND CD RELATED?

CONDUCT DISORDER AND COMORBIDITY

It has been common in the past for people to think that conduct disorder is just the beginning of being a criminal. Up until the last few years,children with conduct disorder were often 'writtenoff'. It is now clear that this is true only with a minority of cases. It is very easy to focus on the management of the CD child and forget to check the child out for other neuropsychiatric disorders. A careful examination of children with CD almost always reveals other neuropsychiatric disorders. Some of the most exciting developments in this area of medicine involve understanding this phenomena. It is called comorbidity,that the tendency for disorders to occur together. It is very common to see children with CD plus another one or two neuropsychiatric diagnoses,by far the most common is CD plus ADHD,between 30-50% of children with CD will also have ADHD,anotrher common combination is CD plus depression, CD disorder plus substance abuse is also very common,also common are associations with learning disorders,bipolar,tourettes syndrome & asbergers.It is exceptionally rare for a child to present for evaluation by a paediatrics psychiatrist to have pure CD,here are some examples of the comorid presentations.
Looking for comorbid disorders in every child with conduct disorder is absolutely essential. Many of the treatments of these children depend on what comorbid disorder is also present.
CD plus substance abuse,sadly,this is very common,in our clinic,every child with CD is assumed to be abusing substance until proven otherwise. This is certainly the most common comorbidity and often goes along with the ones below...

DIAGNOSIS...

Conduct disorder is diagnosed like all things in paediatrics psychiatry. The child and the caregiver will be interviewed together and separately to go over the history and check out all other possible comorbid conditions. Usually there are school reports too,The child is examined to look for signs of many disorders,this usually includes some school work and or teachers reports,recommendations,interventions tried so far etc. some parts of the physical exam,and getting the child's perspective on things,occasionally,there are lab tests and Xray's to do to. There is no lab test that shows these problems..

PROGNOSIS AND COURSE OF CONDUCT DISORDER

Perhaps about 30% of conduct disorder children continue with similar problems in adulthood. It is more common for males with CD to continue on into adulthood with these types of problems than females. Females with CD more often end up having mood and anxiety disorders as adults. Substance abuse is very high,about 50-70% of ten year olds with conduct disorder will be abusing substances for years later, Cigarette smoking is also very high,a recent study of girls with CD showed that they have much worse physical health,girls with it were almost 6 times more likely to abuse drugs or alcohol,eight times more likely to smoke cigarettes daily,where almost twice as likely to have sexually transmitted diseases,had twice the number of sexual partners,and were three times as likely to become pregnant when compared to girls without CD.
Looking at this from the other direction,by the time they are adults,70% of children no longer show signs of CD,are they well? Some are,but what often happens is that the comorbid problems remain or get worse. That is a girl with CD and depression may end up as an adult with depression,but no conduct disorder. The same pattern can be true of CD plus Bipolar disorder and other disorders.

FAMILIES AND CD

It is not unusual to see signs of stress in the parents and other siblings when a child has CD,one of the hardest questions is figuring out whether or not difficulties in the family are causing CD or whether the stress is causing family problems,often it is impossible to determine this or there are reasons to suggest both the CD is causing the family problems to live with,it would be very unusual to see a family where it was not causing grave distress. This obviously needs to be addressed in any treatment plan. Some of the things parents have told me about their conduct disorder child are noted below...

"If you have a child with CD,everyone will initially assume it is your fault,you will be blamed by everyone for what the child does. You may know all about family and children services,probation,youth court,residential homes,RCMP procedures,and Mental Health Services"
"You will often have the feeling that no one knows what they are doing with your child and they are just trying to pass the buck to someone who does"
"You can end up divorced,depressed,alcoholic,hopeless,or all of these from dealing with such a child,it will often make or break your faith in yourself and your spiritual belief even"
"You can see yourself where the child's problems are leading,but can be unable to do anything about it or find anyone who can do anything about it.helplessness"

DON'T GIVE UP! there is a lot to that can be done!..

~OP-POSITIONAL CHILDREN AND ADOLESCENTS NOTES FOR PARENTS~

1. Op-positional children have an obvious problem and a not so obvious problem.
The most vivid of their difficulties is their defiant and confrontational
behaviour. The less obvious problem afflicting these children is that they are
growing up too fast,they are not functioning completely as children but,to
one degree or another,are carrying adult emotional responsibilities.

2. One reason that op-positional children are such trouble is that the traditional
approaches of parenting often don't work,and cures that work well with other
children only seem to make matters worse. These children are not mean spirited 
evil or bad -they just perceive confrontation differently.

3. Op-positional children perceive conflict different from most other children. The
child appears to purposefully seek confrontations with adults,especially
parents.
The children are often unusually skilled at "pushing the buttons so to say" of 
adults. It is therefor important that adults do not feel guilty for their child 
being oppositional in nature. Firstly because the child will pick up on the 
guilty feelings and use the guilt to their advantage. During the 
confrontation,the children appear unusually stubborn and unwilling to back down
or take responsibility for their behaviour. The child is unusually vociferous in 
demanding their rights and may demand equal relationship from adults.

The child tends to be empowered by these confrontations. In particular,the child
tends to be process oriented - to be more empowered by the process of
confrontation that the outcome of confrontation. In other words,the argument is
more important to the child that what is being argued over [although the
child would dispute this also]

The parent and other adults are resentful of the child and feel that there is a 
power struggle going on that they,the parents,are loosing. Although the parents 
feel resentment they also feel love towards the child and desperately want to
help him or her.

In more serious forms,the children become 'power and control hungry' in all 
their relationships,including their peers. There appears to be confusion between
love and interpersonal control. If children maintain a pathologically powerful
position in their social system long enough,their abilities on an emotional 
level to feel their parents love is inhibited. In other words,it is difficult 
for the child to simultaneously occupy the position of an adult and feel on an
emotional level loved as a child. The children will make statements that suggest
that they do not think that their parents love them.

Once the situation progresses to the point where children become confused
between the expression of love and control and where the children have 
difficulty perceiving love from their parents,the behaviour usually turns 
abusive and the child is often given the label of a conduct disorder.

In more severe cases which are not properly treated,there is starting in
adolescence an exaggeration of the process orientation,by which the argument is
more important than the outcome of the argument. In this extreme form,whose 
side you are on is more important than what the reality of the situation is.
At this stage,the person is often labelled as having a borderline personality 
disorder.

4. To solve the problem of oppositional behaviour,I suggest change must happen
in two major areas:

a. Parents and others involved adults must respond differently to the child's
provocations.

b. The adult portion of the children's emotional burdens must be changed so
that they may function in age appropriate ways.

THE SEQUENCE OF OPPOSITIONAL BEHAVIOUR

During confrontations:

1. Who determines the timing of confrontations

2. Who determines the topic and direction of confrontations

3. Who determines the mood of confrontations

If your answer is that 'your child' to the above questions,then it is likely that your child is oppositional in his/her behaviour.

Parents view power as the outcome of an argument and oppositional children view
power as determining the way the argument went.

OPPOSITIONAL BEHAVIOUR IS HARMFUL

The first problem with severe oppositional problems is that they cause children to
grow up too quickly. One of the saddest handicaps that a soul can be dealt is growing up too fast. Childhood is supposed to equip us with lightness and gaiety,with wonder and a sense of peace. People who grow up too fast are often 
short-changed when it comes to these qualities.

The second problem with severe oppositional problems is that the child most likely to be abused is the one with oppositional behaviour.

Third problem with severe oppositional problems is that they sometimes interfere with schooling. The kids that teachers have the least patience with are these kids and not uncommonly these children develop negative attitudes towards the classroom. This is not always the case as some children only show the oppositional tendencies with the people they are the closest too - family and friends.

Fourth problem is the amount of family tension and unhappiness often surrounding severe oppositional behaviour. Parents often feel like failures and are actually hating the kid.

WHAT CAN PARENTS DO

1. Resist being drawn into confrontations. Bring up topics later when it suits the
parent rather than at the timing of the child. Parents must choose the battle.
In order to do this,the parent must feel all right about making strategic
retreats from the child. Parents should think about how long they can 
reasonably expect to withstand a verbal onslaught before they complete a 
strategic retreat. Parents also need to complete the retreat before their
endurance runs out,they should plan what they will do when their patience runs
out also.

2. Parents should strengthen their connections with other adults,so that the
child knows there is a difference between adult-adult and adult-child 
relationships. Parents should be openly affectionate to their adult loved ones
and go out with friends on a regular basis. Parents also must initiate intimacy 
with the child on a regular basis in a loving way - ask how they're coping with
a certain problem,listen to the child rather than give advice. Parents-inspired 
intimacy with the child is the most important source of parental authority.

3. Parents need to maintain a loving attitude themselves to actively attempt to 
change the child's mood from a negative to a positive state. The child must be 
dis-empowered in a gentle and loving way. The child's interest in power is a
loving attempt to become the parent of the parent,i.e. to have more power than 
the parent. Respond in an empathic,non-reactive,optimistic,and firm fashion.

The main goal is to get the child to seek help in a positive way from the
parent when the child realises that their mood is off. Ask the child about
something that might really be bothering them and therefor is more worthy of 
conversation,particularly as oppositional behaviour can sometimes occur to 
avoid discussing sensitive topics.

4. Clear up any past family secrets - oppositional children are sensitive and will
have awareness of these issues.

5. Bring back into the family all extended family that doesn't have a good
relationship with the parents. Family and friends often fall away,frustrated 
that their advice that works with 90% of all children,doesn't work with the
the oppositional child. The parents need to establish the family network on
positive issues rather than the behaviour of the oppositional child. The family
network needs to see the parent as the expert,as they have had a lot of
experience with their child,can read their moods and help other family members 
learn how to cope with the child's behaviour.

6. Make sure that you do not get drawn into an unhealthy triangle with other 
adults - i.e. where one adult becomes the rescuer in confrontations and sides 
with the child some times and with the adult other times. Children with is 
disorder know how to manipulate these situations.

7. Learn safe physical restraint but only used if truly necessary - it should be
done safely,benevolently and non-aggressively.

8. Dis-empower the child gently with love using some of the following ideas.

* Use non-confrontational punishments and consequences that do not depend on
the child's many ways to not comply. Taking away something the child owns is
a punishment that requires no cooperation from the child. Cooperation with a
compliance-dependant consequence can be achieved with a two-tier punishment
system. What two-tier refers to is that there is a second consequence given 
<font ">until the first consequence is completed. For example: until the leaves are 
raked,the television will remain locked in a closet. Note the second 
consequence,the second tier,does not require the cooperation of the child.
* Chose your own timing for giving consequences, 'tagging' events to be brought
up later. It is only appropriate to tag bad behaviour if it seems to the 
adult that the conditions to control his or her own mood through a 
confrontation. Parents should announce punishment at a time when they feel
centred,calm and in control. It also helps if you have another adult to back
you up and ensure that you keep calm,team work.
* Schedule regular positive parent-child times regardless of the child's
behaviour. Use positive reinforcements for good behaviour. Choose a few
behaviours you want to reinforce,like when the child backs down from an 
argument or controls their emotions.

10. Don't be surprised if your child hates going to therapy and hates the 
therapist to. Do not be overly concerned as this approach is designed to work
without the cooperation of the oppositional child. While the child's behaviour
can make them intensely unhappy at times,the child sees the world through 
ideas of power and control,so will not give up these behaviours easily,they 
remember they have warrior spirits are true little troupers and so imagine if 
they were on your side on the battle field they would serve you well and never 
back down in defeat its in their DNA and they cant change this but they can be
taught how to manage this trait within them,love them for that as they are 
unique for a good reason.

A CLASSIC EXAMPLE OF THEIR CHARACTER YOU AS AN ADULT HAVE TO AT LEAST LAUGH AT...

A 12 year old boy noticed a girl was leaving class to go to the bathroom.
Upon the girl's return,the teacher over heard the oppositional child 
light heartedly say to her:
"When you came back in, you should have slammed the door,then everyone in
the class would have laughed at you and the teacher would have said something
nasty to you and you could have said something smart and cleaver back and we
would have all laughed some more and you would be sent to the principal's 
office,but then after school we would have come up to you and talked to find
out what had happened when you were there that's more cool aye you should do 
that next time what you recon".....

√ℓἇ∂ἇ...

[ënagualí~ᏉLAᗪἇ ኔጡ።]

Inattentive and overwhelmed: The rise of ADHD in women

Karen Nimmo is a clinical psychologist

“I’m all over the place,” my client said.

In her early 40s, she described problems with inattention and overwhelm, disorganisation and forgetfulness. She constantly missed deadlines at work.

“If I’m honest,” she said, “I’ve always been this way. I’m known for it. So I’ve been doing some research. Could I have ADHD?”

 

No surprises with the question. People often seek assessments for psychiatric conditions when they recognise clusters of symptoms in themselves. Or, commonly, they start to self-assess after their kids are diagnosed with atypical patterns of thinking or behaviour.

But ADHD-specific queries are rising, particularly from women trying to get to the core of difficulties with inattention, focus and restlessness. It’s led to more women being diagnosed and a predictable increase in prescriptions for ADHD medication.

The simple explanation is girls have long been underdiagnosed with ADHD. One theory is that the disorder presents differently between genders, with boys more likely to show hyperactive symptoms, and girls inattentiveness.

The other reason is gendered notions in medicine. Traditionally, where the unruly behaviour of hyperactive boys led to an ADHD assessment, inattentive girls fell through the cracks as they were labelled as daydreamers, chatterboxes or “away with the fairies.” But now, as more women recognise their lifelong struggles may be due to neurodiversity, they’re wanting answers.

What is ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders of childhood, and refers to differences in brain structure, connectivity and function.

In the ADHD brain, the frontal lobe – the area responsible for filtering/controlling attention, emotions, motor control, judgment and executive function (planning and organising) – is slower to develop. This delay means performing frontal lobe tasks is harder and more mentally taxing.

Psychologists tend to diagnose under the three common subtypes – inattentive; hyperactive and impulsive; and a combination of both. In childhood, symptoms often overlap with those on the autistic spectrum. The cause isn’t clear, but contributing factors may include genetics (there are often strong family links), environment or problems with the central nervous system during development. Childhood trauma has also been linked.

Like most psychiatric conditions, ADHD symptoms lie on a continuum, from mild to severe. Obvious struggles with hyperactivity and distraction are often picked up in childhood. But many – particularly women it seems – reach adulthood having had these problems for years, always feeling like their brains are “differently wired”, but not knowing why. Many learn to cope or compensate in creative ways but the difficulties can flare with the increase in work or life stress.

People who struggle with ADHD symptoms can be harsh self-critics, labelling themselves lazy or lacking motivation. They may struggle with self-doubt at work, feeling intellectually inferior, particularly as they rise up the ranks and take on more responsibility.

ADHD does not reflect intelligence – it’s a brain wiring condition. Plenty of brilliant, inventive minds have had ADHD, so it needs to be viewed as a difference rather than a liability. People on the continuum are often energetic, creative, highly intuitive, sensitive and fun. They are frequently experts in their fields.

Adults with ADHD describe persistent concentration, distraction and organisation problems. They may have difficulty storing and recalling information, be restless and struggle to switch off. Many report sleep problems (there’s often a history of insomnia) and deep fatigue when mentally taxed. They may become frustrated easily, but cool down quickly. A desperate drive to be physical can trigger impulsive behaviour.

Lesser known symptoms include:

• “Time blindness” – always late, or way too early to avoid being late. Difficulty estimating how long a job will take, leading to over-promising and over-committing.

• Chronic procrastination: missing deadlines or leaving them to the last minute. Get lost figuring out where to start larger projects.

• Hyperfocus – can fixate on an activity for an extended period of time . Become so engrossed you block out everything else.

• Depression, anxiety and addictions often coexist.

If you find yourself nodding, you may be a candidate for ADHD. However, there can be multiple reasons for these symptoms, including other mental health problems, hormonal changes and life stressors. The constant use of phones and screens can make relaxation difficult – particularly for those prone to anxiety – and the chaos and uncertainty all around us can compromise coping and make it harder to self-manage.

If worried, a clinical diagnosis can help you make sense of what’s driving your difficulties. Therapy (including lifestyle assessment) can help; medication too. But it’s also important to stocktake your world, look at your lifestyle and identify what you could change.

• Do I have too much “noise” in my life? If so, how can I reduce it?

• Do I have reliable go-to ways of resting and relaxing?

• Have I learned at least one de-stress breathing technique?

• Do I regularly practise being content by myself?

Remember, no matter what’s going on for you, getting to know who you are is important. But learning to manage yourself is next level – it’s an art form.