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ADHD and Junior High
Q: My daughter is 12. She was diagnosed with ADD in 3rd grade but was never medicated, and she was always manageable. She is having a terrible time in junior high. She is distractible, can't stay on task, and is totally unorganized. I pulled her out and started home schooling after Christmas. This is going well, but I don't want to do this forever. What can I do? I hate to medicate her now. We made it so far. She went from an A/B student to D/F. At home if I stay on top of her she's A/B again.
A: Sometimes children have ADHD (the formal term for this condition), but do not exhibit symptoms of hyperactivity and do not have management problems. This is more often true in young girls than in boys, and for this reason, their problems might be missed or misdiagnosed in the early grades. They don't act up or act out, but may seem a bit "spacey." But since they are good kids, teachers like them and give them lots of "breaks." This is really not doing them a favor, since a lot of these girls who haven't had any effective intervention (that would have helped them be better organized) have significant problems when they enter middle school or junior high. Here the demands for organization are much greater than they were in elementary school: lockers with combination locks; amazingly brief transitions between classes; multiple teachers and teaching styles, lack of consistency in the expectations of teachers, courses which may have little or no relation to each other, etc. And all of this heaped right on top of adolescence! It's no wonder why these kids have such difficulties.
By pulling your daughter out of school for home schooling, you intuitively simplified the multiple demands of junior high. You are exposing her to a style of teaching and learning that is probably more connected and organized than the program she encountered in junior high. Medication may be helpful, and while your daughter is at home with you, you're in a great position to measure its effectiveness by observing her behavior -- particularly her ability to organize herself and her materials. You may feel more comfortable about medication if you get additional information from your pediatrician or a pediatric psychopharmacolgist.
If your daughter returns to school, she will benefit from a study skills program that will teach her how to be better organized and more efficient and effective as a learner. She will also benefit from having someone (like the person who diagnosed her as having ADHD) explain the condition to her in terms she can understand. Unless this happens, she may blame her inefficiency on herself, rather than her condition, and this can quickly erode self-esteem.
If your daughter returns to school, she should have a full evaluation by professionals in the special education program. She may need to have an individual educational plan (IEP) or a "504 Plan" written to insure that teachers and other specialists are providing the kind of modifications and programs she needs to achieve her full potential. She may need to be in smaller classes with teachers who are themselves very organized.
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Jerome (Jerry) Schultz is the founding clinical director of the Learning Lab @ Lesley University, a program that provides assessment, tutoring, and case management services for children with learning challenges. Schultz holds a Ph.D. from Boston College, and has completed postdoctoral fellowships in both clinical psychology and pediatric neuropsychology.