NOWHERE TO TURN?

Why It's So Hard to Get the Help Your Child Deserves and What You Can Do about It

"The doctor means well, but his advice just isn't practical."

"The school says it is 'not their problem' because ADHD is not a school's responsibility but a medical problem."

"My husband thinks the 'real problem' with our child is that I am a pushover and 'just not firm enough.'"

"I never would have known how much my daughter could have done on long-acting medications, because my insurance company would not pay for them."

The fact that you're reading this book probably means you've run into some of the same obstacles as these parents. Despite repeated efforts and a firm commitment to helping your youngster with ADHD, "the system" just seems to stand in your way. Maybe it's the insurance company that won't cover the latest medication even though it's the only one that really seems to help your child concentrate at school. Or it could be your local school system, which just doesn't have enough funds to give your child extra help while letting him remain in a regular classroom, where you're sure he'll thrive—if only he could be allowed extra time for tests and be offered methods to help him stay on task. Perhaps "the system" is your own family—a spouse who "doesn't believe in ADHD," as one mother reported, relatives who shun your admittedly disruptive child and therefore your entire family unit, or siblings who are falling apart from the conflict and neglect they are suffering because the kid with ADHD needs so much time from you.

Far too often, the systems in place to help children with chronic illnesses like ADHD fall short, largely because the unique problems of an individual child require costly, time-consuming attention and the number of individual kids needing such care simply exceeds the capacity of the available resources. But sometimes the system can work for your child, if you know how to push the right buttons and pull the right levers. The trouble is, by the time you've piled up what feels like a lifetime of frustration over the system's shortcomings, you may have very little sense of what's gone wrong, much less what to do about it.

Most likely, you have already read other books on the topic of ADHD, you have consulted with your child's doctor, and perhaps you even have sought the advice of a professional counselor or therapist, such as a child psychologist or psychiatrist. Almost certainly, you have had repeated discussions with your child's teachers, and you may also have sought advice from family members and friends. So, given all the effort you have put into getting your child help, why are things still so difficult?

The short answer is that the task before you is one of the toughest any parent—and person—ever faces. As a parent of a child with ADHD, I can personally attest to a lot of trial-and-error, hit-and-miss attempts to do the right thing, only to realize later that I made yet another mistake ... despite undergraduate training in psychology, four years of medical school, and extensive training in child, adolescent, and adult psychiatry! Creating a good life and crafting a promising future for a child with ADHD is incredibly complicated. Lest you've gotten so down on yourself for "failing" that you've forgotten what you're trying to accomplish, let me remind you how high the bar has been set for you: You have to convince an underfunded school system that may be understaffed with undertrained educators to learn and use new classroom and homework systems to ensure that your child has the same chance to learn as the dozens of other children under its tutelage. You have to work with a doctor pressured by managed care to treat patients faster and more cheaply in finding medication that will calm your child down and help him concentrate, without keeping him up at night or causing other intolerable side effects. You may very well have to negotiate with your insurance company with the skill of an experienced arbitrator to get coverage for therapy, medications, and even visits to the prescribing physician. You and your child's other parent have to set aside philosophical differences and marital conflicts to form a united front to help your son or daughter with ADHD. And you have to take on these time-consuming, exhausting tasks without neglecting your other kids, harming your own health, or going broke.

Not so short an answer after all, is it? Now for the long answer.

WHY MEDICAL FACTS ARE NOT ENOUGH

What has often surprised me is that while my training has definitely been helpful, it is my experiences as a parent (including my many mistakes) that have been most valuable in assisting parents to develop workable solutions for their child with ADHD. In fact, my experiences as a parent tend to keep me honest.

I am often aware that the simple, typical medical advice I dispense in the comfortable surroundings of my office isn't nearly enough to send a parent off knowing exactly what to do at home. The difference between what I can read in any medical textbook and what works in the "real world" lies in the particulars of adapting the advice to the given circumstances of that child and family, and in debugging the tools and techniques to be applied to the many problems that get in the way.

On a Personal Note ...

To show you what I mean, let me give you one of my own trial-and-error experiences. As you might expect for a child psychiatrist, I spent no small amount of time in graduate and postgraduate training learning how to apply behavior therapy, a special form of treatment that relies on so-called rewards and consequences—point systems and the like—to help a child with behavioral problems such as ADHD, oppositionality, and aggression. Just in time, too, since my...