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The ADD Label

Children and adults associate a wide variety of images and feelings with the diagnosis of attention deficit disorder. It might surprise you to know that some contradict others. I've had parents and children say they were relieved. Others have said they felt restricted. Still others have said that the ADD diagnosis gave them a sense of having safe boundaries established, although there were those who said they viewed ADD as an excuse.

Relief is a very common feeling associated with the ADD diagnosis. For many people it helps to have an explanation for the frustrating behavioral symptoms that have been disrupting their lives. Parents often say, "If there is a name for it, there must be a cure for it." And children with the ADD diagnosis often remark, "Well, now at least I know I'm not crazy." For families, the diagnosis can mean an end to blaming and the beginning of treatment.

For some, labels such as ADD are seen as providing a welcome clarity. Finally they can define their child's success or failure within the accepted ranges for the disorder. If the parents understand that ADD children have short attention spans, they can accept without frustration or guilt that their ADD child won't be able to focus as long as other children. The downside is that a parent or child may decide that the ADD diagnosis is a convenient excuse for accepting limits and then resist treatment efforts as useless.

I call this the "lost keys" syndrome. Once you find your car keys, you stop looking for them. If you are searching for the reason your child can't master basic math, you might be tempted to stop searching once he is diagnosed with ADD. If the child hears, "You are disabled and you will always have trouble in math," he may give up too. The child can legitimately ask why he should continue trying to learn math if his disability prevents him from ever mastering it. But the parent, teacher, or counselor can legitimately respond, "You can improve your skills well beyond what they are now"--by finding new ways to learn that take into account the impact of ADD on traditional learning processes.

Labels can also distort a child's view of the world. A child labeled as ADD might tend to see everyone else as smarter or more worthy. It's understandable, but it is also a distortion. ADD is a limitation, but so is poor eyesight or dyslexia. Both can be overcome and neither limits true intelligence. Even if a teacher tells a child that, he may refuse to believe it because other children seem to have an easier time with their studies. Some children may take on a victim's mentality or develop anger instead of accepting the challenge of treatment.

Sadly, the damage we do to ourselves with these imprecise labels can outweigh the cognitive problems caused by the affliction itself. Human beings are capable of overcoming extraordinary challenges. We scale mountains, we explore the bottom of the ocean, we've walked on the moon. The most serious limitations many have are those they place on themselves unnecessarily. Auditing for Labels
For every individual who has accepted false limitations because of a label, there are ten who've gone on to achieve wonderful things. I've known hundreds of individuals who accepted the ADD label and then defied any limitations associated with it. They've gone on to full, rich, and authentic lives. They are courageous warriors who eagerly take on life's challenges. They chart their own destinies in spite of the labels put upon them.

When I begin working with a child with an ADD diagnosis, I find it useful to assess her perceptions of the disorder and its symptoms. The audit that follows is a tool that can help you identify your child's self-perception and some of the restrictions that may have resulted from the label of attention deficit disorder.

These questions have open-ended responses. Encourage your child to write down the answers or have your child dictate them to you. Save them, because we'll refer to them for a later comparison. Honest responses will benefit your child the most. Approach this as a learning experience that will help your child break free of boundaries and limitations.

Ask your child:

1. If you had to describe yourself as an animal, what animal would you choose? Why did you choose it?
2. Describe three strengths of your animal.
3. If you had to describe yourself as a vehicle, such as a car or airplane, what would it be?
4. Name three characteristics of that vehicle.
5. Select a heroic figure that you identify with, such as a comic book hero like Spider-Man or a historic figure like Eleanor Roosevelt.
6. Come up with three characteristics of that hero that you would like to have.
7. Has anyone in the family or a friend ever called you something or described you in some way that has made you feel different about yourself, either in a good way or a bad way? Write down what they said.
8. List five characteristics that you feel you have. Include attention deficit disorder if you've been told you have it--and if you agree that you have it.

   Note: The parent should now compare the labels that the child mentioned in 8 with those mentioned in 1 (animals), 3 (vehicles), 5 (heroes) and 7 (family labels). How are they the same or different? List them.

9. Have you observed how friends, family members, or others have labeled themselves? Do you see any ways in which those labels have limited them? (Examples: "I am just a kid. I am just an idiot. I am just an eighth-grade student.") List some.
10. Do you recall any examples of labels such as ADD that have affected your behavior or attitudes? List them with explanations of how you have been affected.

This audit can also aid in broadening the self-concepts of the whole family. Remember that labels like mother of an ADD child and sibling of an ADD child can be restrictive too.

Consider all the adjectives and descriptions you or your child have used anywhere in the above exercise, and circle them. Compare the ones that are associated with ADD or other limiting labels. Determine the limitations imposed upon yourself or your child by these labels. Most important, which labels does your child recognize as important and want to retain, and which ones does she wish to release? Start a list here. Feel free to come back and add to this list as you read further. Action Plan to Break the Bonds of Self-restriction
There are experts who understand diseases, works of art, and mechanical processes, but it is difficult to find a person who claims to truly know him- or herself. It doesn't help that modern consumer marketing creates labels and then does its best to channel people of all ages into marketing categories. They do this in an attempt to convince us that we need to purchase certain consumer goods and brands. Those labels are derived from the popular culture, and we are almost powerless to stop their insidious intrusion into our daily lives.

The point for parents of a child with ADD to understand is that there are multiple forces at work that affect their child's attempt to forge an identity. Recognize that your child may buy into any one of those influences, consciously or unconsciously, and that her behavior will reflect that.

Encourage your child by recognizing her assets and strengths. Play the cheerleader for your child so that she learns to recognize her value and potential. The greatest power comes from within, but parents instill that power--they fuel it by helping a child build a strong foundation of security and confidence.

Parents should never mislead a child or give a child false information, but it is certainly better to follow the advice of the old tune and accentuate the positive rather than dwell on the negative. A child who is shorter than his classmates and not likely to ever be more than average height certainly should be encouraged to look beyond height as a measure of his worth. In the same manner, once your child has been diagnosed with attention deficit disorder, you should stress that thousands of men and women who share the symptoms have achieved success in their lives.

If you want your child to be successful, you have to help him find the tools to create his own success over a lifetime. You can't create it for him. You can only prepare him for success by helping him learn how to learn in the most effective manner. Some people learn best by trial and error, some by rote memory, others by rational reasoning.

I am always inspired when I see the innovative methods devised by successful people to overcome their limitations. Texas had a governor in recent years who had such a reading problem that he had all of his notes written on large cards with broad black one-inch-high letters. A well-known opera singer could not read the words on the score and had to memorize each note and word by listening to her coach repeat them. One very wealthy businessman still does not know the order of the alphabet.

I have observed CEOs of major organizations develop specific strategies, such as acupuncture, massage, and music, to prepare for important staff and board meetings. Professional athletes use rituals and creative imagery to prepare for each event--to remove specific obstacles in their thinking or focus to ensure success and high achievement. A Three-Step Action Plan to Achieve a Goal
We have heard of twelve-step, seven-step, and even five-step action plans. It's time to step up with the three-step plan. I want your child to step faster than others. My mother used to say, "Inspiration without perspiration makes you a fan, not a player." So I'm putting your child to work so he can get in the game too.

Step One: Identify a Goal
Labeling usually occurs when we confront a challenge en route to a goal. The operative word is a goal--not many goals or all the goals for your child's whole life. For this exercise, the entire family must participate. Your child with ADD shouldn't be made to feel like the family project. If everyone participates, then everyone can gain empathy for the demands of the exercise. More important, participation shows that this is as much about family unity as it is about the ADD child.

Call a family a meeting to define one goal for this exercise. Some examples:

• Read a book, one chapter per day. (This helps extend attention span and develop good study habits.)
• Memorize a poem, book passage, speech in a play, or short story. (This helps develop memory skills.)
• Learn to sing a song with all the verses. (Believe it or not, this can help stimulate the brain as well as induce healthy breathing patterns.)
• Dig a ditch or take a ten-mile hike. (The physical act of performing even a monotonous task for an extended time stimulates the brain to pace itself.)

Step Two: Identify Inner Dialogue That Limits Your Ability To Pursue Goals
As Yoda might say: This is inner homework, Jedi trainee.

Your child might fight it, but it is important to show him how his inner thoughts can be reprogrammed for more positive results. After you have identified the limiting inner dialogue, write down some healthy alternatives. Talk to your child about the importance of finding positive options both for his inner dialogue and for his actions.

What follows is an example from the family workbook of one of my patients, named Bobby, containing family members' thoughts on a goal--digging a ditch in the backyard:

Thoughts	Alternative Healthy Thoughts
Bobby's Thoughts: This is dumb.	I am just scared of doing something else stupid, but this might help me improve my abilities to focus on a task.
Father's Thoughts: I don't want to dig another ditch. I did enough of that in the army.	This might help my relationship with Bobby.
Mother's Thoughts: This is his problem, not mine.	I am kind of proud of what I have done, and it does help the garden.
Younger Sister's Thoughts: Not another thing to do for my big brother.	I can see that my family would help if I needed it. I like my family better.

Step Three: Assess Your Child's Experience
Step three is an ongoing process that requires that your child look within himself in the context of the experiences. How does your child feel about his self-concept? Did the exercise lead to any changes in the family's perceptions of themselves?

Bobby's family experiences:

1. Bobby: I learned that it feels good to do something physical once in a while, and dumb as it seems, you can at least see you have done something.
2. Bobby: It was strange that once I got into it, I could think better after digging for a while. I got some pretty good ideas while I was working.
3. Bobby's father: I did not like digging, but I liked the activity with my family. We had some fun.
4. Bobby's mother: I liked getting my hands in the dirt, and for the first time we were doing something together.
5. Bobby's sister: I thought it was cool, and I could see how this was more fun than I thought it was going to be.

It is helpful to discuss what positive behaviors or attitude changes became visible to the group. These can be valuable for validation, especially since someone with ADD rarely gets positive support. Some of Bobby's family's thoughts about each:

1. Bobby: I saw my family trying to help me instead of preaching at me.
2. Bobby's father: I saw Bobby want to give up a time or two, but he kept at it. I was proud of him.
3. Bobby's mother: Bobby worked hard, and he tried. That is all that I asked--that he would try.
4. Bobby's sister: I was surprised that Bobby did it, and he seemed to appreciate me pitching in. That made me feel good. So I appreciated him back.

The critical accomplishment is not that your child digs a good ditch or likes the book, but that he recognizes that there is a process involved in doing instead of stagnating.

A Special Note About Failure
The major complaint I hear from kids, especially teenagers, with ADD is that everyone focuses on the failures, and they already know about the failures. The worst things a parent can say to a kid who screwed up is: "Look at what damage you have done. Do you see what you have done? You have wrecked your mother's car." Of course he sees what he has done. He desperately needs you to tell him what to do next. He is a child, after all.

Instead of waiting for the next teacher visit or counseling session, begin working now with your child on the three-step action plan. Choose one activity and focus on how it feels.