Thursday, September 27, 2001

Distracting reading

Is Ritalin falling out of favor?

On the one hand, judging from some of the e-mail lists I'm on for adoptive and special-needs parents, medication for kids with attentional problems is as popular as ever. Detailed discussions take place on the amount and the timing and the transitions involved in various medications, and while admitting that the medication of children is not an exact science, many parents seem pretty committed to it.

Then, too, my kids both brought home memos from the school nurse announcing general guidelines regarding the distributing of medication at school, and I don't think she was talking about allergy pills and aspirin. There must be a sufficient number of Ritalin-taking kids to make a schoolwide announcement more practical than individual notification.

But then, on the other hand... Looking at the best-sellers in the category of Parenting Special-Needs: Hyperactivity on, I can't help but notice that of the top 10 books, six are specifically anti-medication, and two more stress behavior modification. Signs of change? A turning of the tide? Or is it just in the nature of self-help books to offer something different from the norm, and in the nature of self-help-book buyers to seek that something? Take a look at these titles and judge for yourself (quotes are from publisher's descriptions unless otherwise noted):

1. Talking Back to Ritalin: What Doctors Aren't Telling You About Stimulants and ADHD by Peter Roger Breggin.
"Millions of children take Ritalin for Attention-Deficit Hyperactivity Disorder. The drug's manufacturer, Novartis, claims that Ritalin is the "solution" to this widespread problem. But hidden behind the well-oiled public-relations machine is a potentially devastating reality: children are being given a drug that can cause the same bad effects as amphetamine and cocaine, including behavioral disorders, growth suppression, neurological tics, agitation, addiction, and psychosis. Talking Back to Ritalin uncovers these and other startling facts and translates the research findings for parents and doctors alike."

2. Without Ritalin by Samuel A. Berne.
"We spent 373 million on Ritalin and its generic counterparts in 1996; today, some 4 million children are taking the drug daily. Is it any wonder that parents are searching for safe, nontoxic, drug-free alternatives? In Without Ritalin, Dr. Samuel Berne explains the approach with which he has successfully treated more than 3,000 ADD/ADHD-diagnosed patients, including information on detoxification, nutrition, and developmental learning programs and activities."

3. Taking Charge of ADHD by Russell A. Barkley.
From Book News Inc.: "Empowers parents of children with ADHD by giving them a step-by-step plan for behavior management, hard data on diagnosis and treatment, strategies for helping children succeed at school and in social situations, and information on advances in genetic and neurological research that enhance understanding of the causes of ADHD. Includes an annotated list of books, organizations, and Internet resources."

4. Transforming the Difficult Child: The Nurtured Heart Approach by Howard Glasser and Jennifer Eastley
"Children are fascinated by bigger reactions and children who are a bit more needy or sensitive or intense are particularly drawn to bigger reactions. Some children literally feel invisable unless they are doing the things they know will get their parent or teacher going. ... The secret is in strategically energizing successes instead of accidentally energizing failures. The good news is that this is extremely easy to turn around. Instead of trying to make the child's intensity go away through expensive treatments and the use of medications, the intensity becomes an asset. Children very quickly begin to use their intensity in beautiful ways. It's truly amazing. ADHD children are actually the easiest to 'transform' completely to a new and fully successful way of life."

5. Helping Your Anxious Child: A Step-by-Step Guide for Parents by Ronald M. Rapee (editor).
"All kids get scared, but some fears can escalate into paranoias with long-term ramifications. This step-by-step guide tackles the why, how, and what now of anxiety disorders. Written in everyday language, it describes in detail strategies and techniques parents can combine into a comprehensive self-help program for managing a child's worry while building confidence and self-control." (No, I don't know why this is on the hyperactivity list either.)

6. Women with Attention Deficit Disorder: Embracing Disorganization at Home and In the Workplace by Sari Solden.
From the author: "Many women experience great shame when they are unable to conform to our society's degrading 'job description for women.' With exercises, self-talk and stories I help women dismantle their self-images as "slobs" or "space cadets" and enjoy a new cycle of success on their own."

7. Ritalin Is Not the Answer: A Drug-Free, Practical Program for Childrena Diagnosed with ADD or ADHD by David B. Stein, Ph.D.
"How parents, teachers, friends and family can rescue their children from the widespread and extremely dangerous use of an amphetamine (speed) called Ritalin to control 'normal but inconvenient' behavior."
8. The Care and Feeding of Indigo Children by Doreen Virtue, Ph.D.
"Doreen explores the psyche of these special kids and offers alternative solutions to Ritalin based on her extensive research and interviews with child-care experts, teachers, parents, and the Indigo Children themselves. Read the accounts of these remarkable children as they explain why they act-out, are aggressive or withdrawn; and what they want from the adults in their lives."

9. The Difficult Child by Stanley Turecki, M.D.
"Temperamentally difficult children can confuse and upset even experienced parents and teachers. They often act defiant, stubborn, loud, aggressive, or hyperactive. They can also be clingy, shy, whiny, picky, and impossible at bedtime, mealtimes, and in public places. This landmark book has been completely revised to include the latest information on ADHD, medications, and a reassuring approach to all aspects of childhood behavioral disorders."

10. The ADD Nutrition Solution: A Drug-Free Thirty-Day Plan by Marcia Zimmerman.
"The A.D.D. Nutrition Solution provides groundbreaking information on the nutritional deficits, food allergies, and hereditary and environmental factors that can cause attention deficit/hyperactivity disorder (AD/HD), a condition that afflicts more than 17 million people in this country today. Drawing from her 10 years of research, counseling, and lecturing on nutrition and AD/HD, certified nutritionist Marcia Zimmerman clearly explains why what we eat affects how we think and outlines an easy-to-follow 30-day dietary and supplement plan shown to decrease or end AD/HD symptoms completely."

Tuesday, September 25, 2001

Tattoos for tots

My son's got a thing about tattoos.

I don't know when it started, I don't know why, I don't know what about the things fascinates him so greatly, but it's entered the top 10 of his conversational repertoire, with a bullet.

It's bad enough when he asks me if he can get a tattoo. What I want to do, of course, is scream "over my dead body!" but we enlightened parents of the '00s don't want to prejudice our kidlets against the personal choices of others. So I just tell him no, kids can't get tattoos. I don't know if this is true. It had better be.

I try to deter him with the explanation that getting a tattoo involves being stuck with a needle, a lot, and if he doesn't like getting a shot he won't like getting a tattoo. He ain't buying it. He wants to know: Is it good to have a tattoo? Why do people have tattoos? When can he get a tattoo, too?

Never, never, never.

What's worse, though, is when he sees someone with a tattoo and feels compelled to point that out. Loudly. Like in church this weekend, in the quiet of prayer time, suddenly pipes a little voice saying: "Look, Mama, that man in front of us has a tattoo! Why does he have a tattoo? Is it good to have a tattoo?"

So far, the tattoo-bearers so pointed out have not turned to listen to my answers to those questions, and have taken no notice of the small boy asking them. Perhaps tattooing imparts some sort of hearing impairment, and for that I am grateful.

In the meantime, I suppose I'll have to look into some of those rub-on tattoos to distract the little guy from the real thing.

Do they do that heart with the word "Mom" on it design in the temporary variety?

Monday, September 24, 2001

Trauma deficient

Everywhere you turn these days, there are articles and supplements and TV shows to help you talk to your kids about the terrorist attacks of Sept. 11. The impression one gets is of a nation of hurting children, frightened, drawing pictures, talking to school-provided counselors, imploring their parents for insight. It makes sense that the most vulnerable among us would feel most vulnerable after such a disaster.

So what does it mean that my own personal kids couldn't care less about it?

Is it because of their neurological impairments? I wonder. Certainly, they have enough work to do just to get through each school day without raising their eyes to take in disasters unrelated to their own personal universe. Abstractions are pretty impossible for my daughter to grasp, and unless I take her to ground zero, it's unlikely that planes crashing into buildings is going to be anything but. Most adults have trouble grasping the reality of it.

Maybe they would have more awareness of this terrible event if I had let them watch it on TV more. I specifically didn't, because the images were so upsetting. But that has rendered this mostly a word-of-mouth phenomenon for them, and language processing being the iffy thing it is in our house, that may have put it out into the never-never land of book plots and math story problems. Neither of them is exactly up to speed in the emotional development department, either; they have taken the death of extended family members with relative stoicism, so it may be unrealistic for them to have any response to the deaths of strangers, even thousands of them at once.

At any rate, I find myself in the awkward position of feeling that they should know more about this and feel more about this, but unsure how to make that happen without actually browbeating them. How many times can I sit down and explain it? When everybody is working to keep their kids from being upset, should I be working to upset them? Perhaps I should just shut up and count my blessings.

Wednesday, September 12, 2001

Tragic Tuesday

I remember a few days ago, looking at pictures of Catholic schoolchildren in Northern Ireland walking to school under protection of riot police and feeling embarrassed at all the fuss I make over little things at my kids’ schools, instructional aides not in place, IEPs not sent out, teachers not informed, forms not delivered. I make of these things a disaster, when in other parts of the world children are facing violence and terror.

Now, of course, I don’t even have to look to other parts of the world to put these things into perspective. I just have to look out the window.

We live close enough to New York City to see the cloud of smoke rising where the World Trade Center used to be, close enough that some of my children’s classmates will likely have lost loved ones in the tragedy. As of Tuesday afternoon, the attack was still a thing of rumors and mishearings. My daughter had heard from a girl in the lunchroom that there had been a plane accident; my son’s special-ed teacher had told his class only that there was a fire in New York. The teacher told me that she felt it was the parents’ job to explain the situation. Thanks. How do we do that exactly?

We said that bad people had driven planes into buildings. We said that many, many people had been killed. We said that the people who are trying to find out why think that the bad people hate our country, and wanted to hurt us. I don’t know if we said the right things, but we tried to say them calmly. We tried to keep the TV off. How many pictures of collapsing buildings, falling bodies and bloodied survivors do children need to see? Zero would be good, I think.

Today, life is going on. I have a meeting with my daughter’s teacher this afternoon to request the necessary accommodations, and with my son’s teacher tomorrow to gather information for his twice-yearly neurological appointment next week. The school principal still owes us a promised spare set of textbooks to keep at home. My son’s IEP is still MIA. The message I left at the special-ed office about the errant instructional aide has still not been answered. There’s homework to be done, tests to study for, after-school programs to look into, administrators to harrass. But it’s hard to muster my usual sense of outrage over these minor hassles. It’s not, as they say, the end of the world. The end of the world is across the Hudson.

Thursday, September 06, 2001

Committed to memory

My daughter is the flash-card queen. If you can put it on a flash-card, she can learn it. Math facts, vocabulary words, the continents of the world or the planets in the solar system, rote memorization is the name of her game.

Spontaneous thinking and comprehension, not so much.

We’ve given her a fair amount of remediation for reading comprehension and abstract thinking, which she has taken amiably enough but not acheived any blazingly successful results at. She just plods on, getting what she can, not getting what she can’t.

I’m coming to feel that, rather than throwing more time and money and effort at her weaknesses, we should be helping her use her strengths to compensate for them. But how? There are tons of books and classes and resources for improving your reading comprehension, but nothing to tell you how to effectively pretend like you understand. Maybe an acting class?

Maybe, if she rote memorizes the whole book, word for word, she’d have something to say about it?

Maybe not. She can memorize addition facts but stand slack-jawed in the face of a story problem. If she memorized the book and was then asked a question about it, she’d be stuck spouting lines, and they’d likely be the wrong ones.

There should be a way, though, shouldn’t there? Many people go through life without a proven ability to think on their feet; shouldn’t you be able to go through elementary school?

Flash cards. What we need here are more flash cards.

Tuesday, September 04, 2001

Age ain't nothin' but a number

It's probably not a common practice, but it's certainly not unheard of for parents adopting children from Eastern Europe to legally change their child's age, generally to make them younger. There are all sorts of noble reasons for doing this, ranging from contradictory paperwork putting the original age in doubt; to bone age and other tests indicating that the original age is impossible; to a conviction that the child's small size or developmental delays would be less noticeable and traumatic if his or her age was in closer accord.

We did not choose this path for our kids, although our son's size and behavior are still substantially delayed, and our daughter is now in a class two years behind her age level, and different ages would certainly appear to fit them better in some ways. I always worried about this idea of age-shifting, though: What happens when the kid finds out? What happens if the kid has a growth spurt that makes the new age ludicrous (as indeed, my daughter did -- if we had adjusted her age down, she would now be freakishly tall; as it is, she's on the big side for an 11-year-old)? What happens if the developmental delays catch up more quickly than the parent had anticipated, and the child is trapped in a much lower age group and school class than his abilities warrant? What if, on the other hand, the delays get worse, and the child can't get help because, although she is severely delayed for her original age, she's not bad enough at her adjusted one? And of course, what happens if the child grows up to work in a field where the tabloid revelation of his or her older original age could be highly embarrassing?

Now, of course, I have another worry to add: What if the child's Little League team wins big, and Sports Illustrated starts digging through Russian birth records?

I don't mean to imply that the motives of adoptive parents and the motives of the father of Danny Almonte -- who pitched a perfect game in the Little League World Series and led his Bronx team to a third-place finish only to be revealed to be 14, not 12 as falsified documents had asserted, and too old to play -- are the same, but on some level all are trying to give their child the best possible chance. Unlike Almonte's father, adoptive parents aren't lying to give their child a specific advantage in a specific situation; they likely see it as giving their child an age that's closer to the truth. But folks, the truth is slippery. Tests are fallible, and sometimes contradictory. Children develop in ways and at rates we can't predict. And they often develop unevenly, with emotions at one level and cognitive functions at another and physical attributes at another. The original date may be wrong in some cases; but any attempt to adjust it is going to be the roughest guesswork.

It seems to me that what age-changing parents hope to do is eliminate all future problems their children may have with one simple bureaucratic act. The humiliation of being too short for your age, the embarrassment of acting immature, the pain of not fitting in -- gone! with a minor adjustment. But does anybody believe it's going to be that easy? A mom can hope, that's true. She can be a mama bear and do what she can, even if there's risk, even if snotty Web site writers disapprove. And she can call Little League headquarters and make sure that changing a child's age at the time of adoption for physician-approved reasons is not a violation of some developmental-difference-unfriendly rule or regulation.

Giving the rest of us hope that the Danny Almonte of tomorrow won't be named Sergei or Sasha.