Dr. Devon MacEachron\'s Blog

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Are you familiar with the 5 stages of grief?

They describe the stages people go through when they learn they have a serious illness, or have lost a loved one, or have gotten divorced or broken up with a significant other. I find these stages helpful in understanding how parents may feel after their child receives a diagnosis of learning disability, ADHD, Asperger’s, and even giftedness.

For many parents there is a natural “mourning period” – a period of time in which they eventually let go of the image they may have harbored of a “perfect” child with idealized characteristics, and accept the child they have instead been given – for all his or her unique and wonderful differentness. It’s natural for parents to have expectations and dreams about the child they will have one day. And it’s natural to be shaken up when one’s expectations and dreams are threatened. That’s where grief can come in. Parents may go through “stages of grief” as they “mourn” the loss of the child they thought they’d have before accepting the child they do have.

Stage 1 is Denial. The first reaction for some is denial. This stage can serve the function of providing emotional protection from being overwhelmed with the idea all at once. Parents may believe the diagnosis is incorrect or mistaken, and try to cling to a false, preferable reality of a “perfect,” or “normal” child. Second opinions may be sought. Symptoms may be dismissed as “developmental” or attributed to generalities like “boys will be boys.” The assessment report might be filed in the wastebasket. Of course it is possible that the diagnosis is inaccurate, and parents should challenge it if it doesn’t seem right. But at some point – if the shoe fits – it is in the child’s best interest for parents to stop denying it. It is very important that the professional charged with first explaining the child’s profile to parents do so with empathy, recognizing and pointing out the child’s many strengths, and providing recommendations that address strengths as well as areas of weakness. No child should be defined entirely by weaknesses, deficits, or disabilities.

Stage 2 is Guilt. As the shock wears off, it may be replaced with pain and guilt. Parents may feel it is their “fault.” Mothers may wonder if it was that one glass of wine they had when they were pregnant. Should they have embraced a more structured parenting style and told their toddler “no” more often? Should they have used organic baby food? Should they have asked their future spouse for a genetic screening test before they accepted a proposal of marriage? I find the guilt stage to be particularly prevalent among mothers who work outside of the home.

Stage 3 is Anger. Some parents may become angry and frustrated, especially at proximate individuals like school staff, teachers, and spouses. They struggle with “Why my child? It’s not fair!”, “How could this happen?”, and “Who brought those genes into the family anyway?” They may go to war with their child’s school, focusing their anger on trying to get the services he or she needs. They may hire an advocate to accompany them into battle. Often this is a good thing and results in the child’s needs being met. But sometimes parents get stuck in this stage and spend years locked in battle. This may not be the most beneficial thing for the child, who is waiting in the sidelines for services, and can create a “battle zone” mentality which is not conducive to a happy home life. Marriages may suffer, especially if one spouse is in the anger stage while the other is still in denial or guilt.

Stage 4 is Depression. A period of sadness, loneliness, and hopelessness may come next. Parents may feel a sense of despair that their child might not be able to lead a normal life, go to college, find a partner, and have a successful career. Sleepless nights may ensue. Parents may isolate themselves from relationships with others (e.g. friends with children who appear to be thriving in school) who they feel can’t understand what they’re going through. This stage can be particularly difficult for parents who feel they are in it alone – single parents and those whose spouses do not “buy in” to the diagnosis and plan of action.

Stage 5 is Acceptance. Acceptance is the final or “goal” stage. Acceptance means that parents bury the expectation of the perfect, normal, idealized child (whatever that means) and accept the wonderful child that they have – in all his or her uniqueness. Acceptance means realizing: “It’s going to be okay;” and maybe even: “It’s going to be great!” Equanimity comes with acceptance. Equanimity involves the ability to be calm and maintain composure even in a difficult situation.

As the parent of two twice exceptional children with learning disabilities and ADHD I’ve been through these stages myself. Disbelief and denial that there could be anything “off” given how bright my children seemed. Guilt that maybe this wouldn’t have happened if I’d parented with more structure or had them assessed when they were younger. Anger that their schools seemed unwilling to address their disabilities or their giftedness. Isolation, sleepless nights. Friends and relatives who didn’t “get it.” And finally…acceptance. And pride and joy that my children are unique and fascinating individuals with strengths they probably would never have had if they weren’t wired differently.

I’m still working on the equanimity bit. Calm and composed? Too much to expect!

Many parents wonder if their child will grow out of the problems that plague them as a child: their dyslexia, math disability, writing challenges, weak executive function, ADHD, or Asperger’s. I’m asked this question quite often by successful adults who are initially surprised their children are struggling, but when interviewed carefully about their own early years admit to having experienced similar challenges. But now they are a successful adult, so they must have grown out of it. Right?

Not necessarily. The short answer to whether most children grow out of these challenges is: probably not. At least not completely. But the demands in the world around them (their day-to-day environment) do change, and as they move through school and career they can be more selective about the kinds of things they choose to do, electing to do things they’re good at and avoiding things they’re not. So their dyslexia or ADHD or Asperger’s might not negatively impact the quality of their life very much as an adult, and may even become an advantage. But they still have it.

Adults diagnosed with dyslexia as children, even if they benefit from years of reading and writing remediation, tend to remain poor spellers and slow readers. I see this every day in my dyslexic husband who reads one book to my ten, though we spend the same amount of time reading every day.

For ADHD, some of the research suggests that children with ADHD simply have delayed brain maturation (by 3-5 years), but that they will eventually catch up with their peers. Unfortunately this may not happen until well past puberty and into college. I get dozens of calls every year from families of college freshmen with ADHD who are spinning out of control in the area of executive function. I often feel that students with ADHD would benefit from being “redshirted” to give their frontal lobe a chance to catch up with their peers’. Redshirting is a practice used most often in athletics of postponing entrance into kindergarten of age-eligible children in order to allow extra time for physical growth, making the children bigger and stronger thus more competitive athletically than their grade-peers. But it would be hard to “redshirt” our ADHD children for 3-5 years!

Anyway, rather than completely growing out of it, it seems that most children with ADHD grow up into adults with ADHD. The American Academy of Family Physicians reports that two-thirds of children with ADHD continue to grapple with symptoms (at some level) throughout adulthood. Their symptoms may present significant challenges, or they may not – depending on the circumstances. Some adults with ADHD only demonstrate impairing symptoms when they are anxious or depressed. Or when they’re hurrying. Or when they have to work on a long-term project. Or when they haven’t been getting enough exercise lately.

The environment and the individual’s physical state are both critical factors determining whether symptoms will be problematic or not. This is true for other medical conditions as well. If you have Type-II diabetes how you eat influences whether your symptoms manifest and whether your condition will appear to be dormant or you will have to use insulin for treatment. Adults with ADHD can try to choose careers (environments) that are well-suited to their needs. I can’t imagine either of my own children functioning very effectively if they were required to sit quietly at a desk all day doing routine work. Fortunately, they’ve gravitated to the fast-changing worlds of tech and media start-ups. In these environments they find it easy to stay attentive and focused. They can get up and move around. And they’ve learned that they’re more focused when they take care of their physical states by exercising, meditating, getting enough sleep, and eating right.

Children with Asperger’s still retain autistic brain differences as adults and gravitate to professions that fit their profiles. Hans Asperger wrote: “We can see in the autistic person, far more clearly than with any normal child, a predestination for a particular profession from earliest youth. A particular line of work often grows naturally out of their special abilities.” The adult with Asperger’s working as a physics professor or in Silicon Valley may be perceived as eccentric, but not necessarily as having a “disability.” The right environment can bring out the best aspects of a unique profile and downplay the worst.
Even during the school years, a child’s symptoms may manifest differently depending on the demands of the environment. A dyslexic child may experience significant challenges in elementary school when they have to read written text, hand-write responses, and are marked off for spelling errors. But when they’re in high school and can listen to text through voice software, type responses, and use spell-check, things can get a lot easier. A child with a math disability who struggles to recall math facts and has slow math calculation fluency may have a lot of trouble in elementary school when math is mostly about arithmetic. But when they reach high school and college when it’s more about problem-solving and fluid reasoning, they may excel.

So, children don’t usually grow out of it, but they may not be troubled by the different way their brain is wired when the demands of the environment change. In fact, having a differently wired brain may confer distinct advantages.

Books like: The Dyslexic Advantage: Unlocking the Hidden Potential of the Dyslexic Brain by Dr.’s Brock and Fernette Eide; The ADHD Advantage: What You Thought Was a Diagnosis May Be Your Greatest Strength, by Dale Archer, M.D.; and The Way I See It: A Personal Look at Autism & Asperger’s by Temple Grandin, M.D. point out the advantages that being wired differently can confer. This is not just “feel-good” pop-science – there is some serious research uncovering real strengths in thinking associated with each of these diagnoses.

If orange is the new black, maybe having a “disability” is the new superpower.

If your child has ADD or ADHD, or you think they might, do you worry that it will affect their life and future in only negative ways? Distractibility, disorganization, hyperactivity, interrupting the teacher, not completing assignments, poor time management, underachievement – the list goes on.

I agree there are significant challenges associated with having ADHD, and certainly being the parent of a child with ADHD is not easy!

But today let’s look at the flip side of the coin – the positive aspects. I’ll use the term ADHD because our diagnostic manual (the DSM-5) groups all of these attention disorders under Attention-Deficit/Hyperactivity Disorder (ADHD), allowing us to specify predominantly inattentive, predominantly hyperactive/impulsive, or combined presentation subtypes.

Recently, research has been focused on uncovering the strengths associated with being wired differently. Dyslexics have trouble with sounds and language (housed in the brain’s left hemisphere), but they are often great at visual spatial thinking (housed in the right hemisphere). This may explain why we have so many successful dyslexic architects, engineers, and artists. Individuals with Asperger’s may have difficulty thinking at the “big picture” level (this requires a broad network of neural connections), but are better than most people at narrowing in on a specific topic. This may be why the Israeli army recruits people with Asperger’s into an elite intelligence unit dedicated to interpreting aerial and satellite photographs. They can see details that others can’t.

It makes sense, doesn’t it, that if your brain is weak in one area that another might pick up the slack? In her book The Autistic Brain,  Temple Grandin explains that some areas of her brain are smaller than normal, and others are larger. Dr. Grandin is brilliant at visualizing how things work, and she feels this is because the volume of axons (the pathway) projecting from the area of visual object information to her frontal and motor cortex is 10x larger than most people’s. Being different need not always be a bad thing.

Let’s look at the strengths associated with ADHD. The hunter/farmer hypothesis proposes that ADHD was an evolutionary advantage to nomadic hunter-gatherers who could both hyperfocus and were better able to sense and respond quickly to predators. It is only as agriculture developed and people became farmers that these behaviors – so useful hunting mammoths on the plains – became maladaptive in environments like the modern classroom. Maybe ADHD was an advantageous variation in human evolution. Could it still be?

In an article I wrote for CHADD a few years ago I touched on this topic: Looking for Silver Linings in the ADHD Playbook.

Here are the top ten benefits or “superpowers” associated with having ADHD in modern society:

  1. Creativity
  2. High energy, enthusiasm, curiosity, zest for life
  3. More sensitive/attuned to environment, 360-degree awareness
  4. Interpersonal intuition/emotional sensitivity (e.g. strong radar for other’s feelings)
  5. Entrepreneurial drive and talent, willingness to take risks
  6. Innovative, willing to explore, invent, think differently, fresh perspective, divergent thinking
  7. Holistic thinking coupled with ability to make quick thought connections
  8. Ability to multi-task
  9. Sense of humor
  10. Spontaneity

Doesn’t sound so bad, does it?

My favorite strength, and the one with the most evidence to support it, is creativity. Why would ADHD support enhanced creativity? Because weak ability to inhibit distraction and lapses in attention facilitate divergent thinking and the generation of random thoughts and ideas. Also a wider attentional span allows more elements and ideas to be combined, generating novel and original ideas. And the willingness to take risks is one of the core underpinnings of creativity. Researchers at UConn recently published a study about Engineering Students with ADHD, finding they possess “unparalleled creativity and risk-taking potential.”  They can draw on the kind of non-traditional divergent thinking essential for making radical technological breakthroughs – just the kind of thinking that moves society forward.

Forbes magazine describes ADHD as “the entrepreneurs superpower”. Sir Richard Branson, Ikea founder Ingar Kamprad, and JetBlue founder David Neelman are exemplars. Success magazine reports that “some of the most successful entrepreneurs credit their attention-deficit/hyperactivity disorder for their accomplishments.” Creative people in fields from acting to politics attribute their success to their ADHD (actors Justin Timberlake, Channing Tatum, and Ryan Gosling, swimmer Michael Phelps (the most decorated Olympian of all time), political strategist James Carville, and others).

I’m a big believer in nurturing the strengths and interests of every child, not just trying to “fix” their weaknesses and make them be like everyone else. A strengths-based approach is especially important for students diagnosed with a disability. Yes, we need to help the child with ADHD get through school by addressing the challenges associated with their profile. But to help them fulfill their potential and become happy and productive members of society, we need to place an equal or perhaps even greater emphasis on helping them discover and celebrate their unique abilities.

Look for the ADHD “superpowers” in your child, and help them become the successful adult they have the potential to be!

If you’d like to talk with me about how to reinforce and develop the strengths of your child with ADHD, please e-mail me to plan a time to chat. I can be reached at: dm@drdevon.com.