Is It Lying Or Is It ADHD?

Just because it’s not the truth doesn’t mean it’s a lie.

Huh? Try that again.  Let’s back up a bit.

 

In the course of a busy day, filled with details and information and social cues, the child with ADHD can be anticipated to:

  • lose focus
  • become distracted
  • not hear an instruction
  • not copy the full assignment before it is erased from the board
  • not remember a message that didn’t seem important or relevant at the time.

When directly confronted, the child feels embarrassed, upset at being caught and ashamed to be judged as inadequate.  It may seem to the child that the most expedient solution (not the best solution) is to quickly make something up, to create a plausible answer as an excuse.  Is she lying to gain some advantage or reward? Not necessarily. The instinct for self-preservation is a fundamental human survival mechanism.  And sometimes, impulsively making up an answer is the child’s rudimentary attempt to save face.

Peter Jaksa, Ph.D. points out that “for children with ADHD, lying is often a coping mechanism, albeit a counterproductive one. A lie may be a way to cover up forgetfulness, to avoid criticism or punishment, or to avoid dealing with feelings of guilt and shame over repeated failures.”

Uncontrolled ADHD can often masquerade as dishonesty.

Dishonesty often manifests as a coping mechanism used by children with ADHD.  These are the kids who typically get in more trouble due to impulsive speech and behavior.  In addition, future consequences are just not on their radar, as they exist in the world of ‘now’.  They are always trying to catch up on life (missed instructions, missed assignments, missed chores, missed messages, missed next step, missed social cues).

ADHD does NOT cause lying, but lying can be part of the fall-out caused by uncontrolled ADHD.

Does any of this give permission to the ADHD child to lie? Absolutely NOT!  Parents and teachers should help these children become attuned to the situations where a made-up answer is likely to erupt and together develop strategies that can help minimize the opportunity for such behavior. 

Often the choice of words used by the adult sets the tone for the rest of the conversation.  Consider that sometimes rephrasing the question can help ameliorate the child’s inclination to make-up a reply.

Tommy consistently does not complete homework assignments.  He believes that he copies instructions correctly from the board, but in reality does not.  Instead of asking (accusing) him, “Didn’t you copy the assignment?” try telling him to check what he copied.  This gives him a chance to find his mistakes

Any student, ADHD or not, may balk and lie at what may be perceived as a ‘gotcha’ moment.  If you already suspect that the copied instructions were inaccurate, perhaps due to:

environmental distraction

haste looking back and forth from board to paper

slow handwriting

challenge shifting focus of attention,

CHADD recommends that it may be more instructive to ask, “Did you have enough time to see what was on the board?”  You avoid the lie and instead get to the root of the problem.

Before branding a child as a liar, consider that one of the roots of ADHD is the disruption of executive function skills.  This results in impaired organization, record keeping, and sense of time. Children with ADHD are notoriously forgetful. They also have difficulty understanding instructions, especially if these are given quickly and involve several steps. This may lead to misinterpretations.

ADDers look like everyone else. There is no physical feature to distinguish them from others not thereby impaired. As a matter of fact, ADD’ers will go out of their way to appear normal.  In some cases, children might lie in an attempt to hide their symptoms. But lying does not automatically come with ADHD.  On the other hand, misunderstanding, misinterpreting and forgetting, are all common traits in these children.

Not telling the truth, when confronted with a ‘gotcha moment’ is still not OK, but it is understandable.  In this context, the ADHD child is NOT exhibiting signs of moral failing, nor giving evidence of a compulsive lying condition or oppositional defiant disorder.  This child requires our compassion and our guidance in ways that help him or her get to the crux of the cause for the protective lie being told.  We, and by that I mean parents, educators, physicians, counselors, therapists, coaches, all should hear the ‘misspeak’ as the child’s juvenile attempt to cover up the shame and embarrassment of uncontrolled ADHD symptoms.

Professionals at CHADD remind us that getting to the source of the reason the child has lied is essential. The adults who teach and nurture children with ADHD must understand that these children will frequently not perform as well as their peers and that, unless there is an additional disorder, they are neither lazy nor willfully defiant, and they are just as likely to want to succeed as their peers.  

Lying is not acceptable behavior even if it is to protect the self from embarrassment or punishment.  Reward honesty, it is always the best policy.  When children hear an adult tell a ‘white lie’ they become confused, so be an honest role model yourself!   

It is our job as caring adults to make sure that ADHD children receive the help that they need, be it therapy, medication, executive function coaching.  First and foremost we should educate ourselves about the causes and symptoms of ADHD, and the fall-out that often accompanies the disorder.   Start here with these links specific to the issue of dishonesty employed as a coping mechanism by ADHD children:

Two great articles by Peter Jaksa, Ph.D.  http://www.additudemag.com/adhd/article/882.html  and  http://www.additudemag.com/adhd/article/5705.html  as well as an article by Jerome J. Schultz, Ph.D.  http://school.familyeducation.com/add-and-adhd/lying/42736.html?detoured=1

The National Resource Center on AD/HD can be reached at their website www.help4adhd.org  This website features What We Know information sheets and additional links for resources.  Parenting a Child with AD/HD (WWK2):  http://www.help4adhd.org/en/living/parenting/WWK2 is a good place to begin.

www.CHADD.org and the archives of  www.ADDITUDEMAG.com are both great places to find information.

Remember this is a marathon, not a race.  Spend the time necessary to build your team of supporters.  Share resources with others whom you feel could benefit from the knowledge.  People who have “the lived experience” and professionals who work with these children understand that parenting and classroom strategies for children with ADHD are based on a different paradigm than the typical child.

Best wishes for a Happy New Year,

Debbie

The TAGLESS Shirt

Step away from the Computer and no one will get hurt!

Attention Debbie Dear

To Medicate or Not to Medicate

Here we go again…To Medicate or Not to Medicate.  Nobody is neutral on this.

One week ago, an article arguing against the use of ADHD medication was published in the New York Times.  Appearing in the Sunday paper, the Opinion article submitted by L. Alan Stroufe, a professor emeritus of psychology at University of Minnesota, opened up fresh wounds for many and potentially turned the clock back on the tremendous advances that have been made over the past four decades regarding our understanding of the causes and treatment of ADHD.  In the face of families struggling with the decision about whether or not to include medication in their child’s ADHD treatment plan, that article could be waved like a flag by those who are opposed to the use of medication.  Despite the documented work of experts in the fields of medicine, psychology, education, and parenting, there are still some for whom the specter of doom raised by contrarians in the 1970’s still resonates.

Loving parents don’t wake up one day and cheerfully announce, “Today is the day I will drug my child.”  More likely is the scenario of absolute frustration and feeling of helplessness, when a child’s pain outweighs a parent’s biases, prejudices, and fears.

So many factors come into play when making the decision whether or not to include medication among the arsenal of strategies and interventions. ADHD is a spectrum syndrome. Some children respond to added structure, consistent directions, organizational tools, change in diet, improved sleep hygiene, or added physical exercise.   All of these can be beneficial

But when they are not enough, the right medication can help that child access the part of the brain that will allow those techniques to be implemented.

The child’s team made up of parents, physicians, counselors, and teachers can benefit from another player.  That’s where medication comes in; not to replace all of the important teamwork, but to enhance it.  It is still the child’s responsibility to ‘own’ the ADHD challenge and take responsibility for actions and words.  Medication doesn’t replace any of the hard work to which each child and family must commit.  But it can make it possible to succeed.

Here are four fabulous responses that appeared in social media this week.  Each author approaches the issue from a unique perspective (science, medicine, psychology, parenting, culture, experience) and is worth reading and sharing.  The first two are Edward M. Hallowell, a psychiatrist who specializes in ADHD and is the author of several ground-breaking books on the subject; and Harold Koplewicz, M.D. president of Child Mind Institute located in New York.  Following those two responses, I am also including a column written by Judith Warner for Time; and a post by KJ Dell’Antonia writing for Motherlode.  The NYT Opinion article by L. Alan Stroufe which is the basis for the cavalcade of responses can be found here as well.

Every family’s journey through the world of ADHD requires parents to make choices as they examine all possible options for their child. It’s tough enough without complicating their path with off-ramps leading backwards.

Remaining hopeful,

Debbie

P.S.   Ruth Hughes, PhD, CEO and fearless leader of CHADD joined the fray today 2/7/12.  Her passion as an addvocate for children and adults with ADHD is unsurpassable.  Please click here to read her response.

Is It Lying or Is It ADHD?

Just because it’s not the truth doesn’t mean it’s a lie.  Huh? Try that again.  Let’s back up a bit.

In the course of a busy day, filled with details and information and social cues, the child with ADHD can be anticipated to:

  • lose focus
  • become distracted
  • not hear an instruction
  • not copy the full assignment before it is erased from the board
  • not remember a message that didn’t seem important or relevant at the time.

When directly confronted, the child feels embarrassed, upset at being caught and ashamed to be judged as inadequate.  It may seem to the child that the most expedient solution (not the best solution) is to quickly make something up, to create a plausible answer as an excuse.  Is she lying to gain some advantage or reward? Not necessarily. The instinct for self-preservation is a fundamental human survival mechanism.  And sometimes, impulsively making up an answer is the child’s rudimentary attempt to save face.

Peter Jaksa, Ph.D. points out that “for children with ADHD, lying is often a coping mechanism, albeit a counterproductive one. A lie may be a way to cover up forgetfulness, to avoid criticism or punishment, or to avoid dealing with feelings of guilt and shame over repeated failures.”

Uncontrolled ADHD can often masquerade as dishonesty.

Dishonesty often manifests as a coping mechanism used by children with ADHD.  These are the kids who typically get in more trouble due to impulsive speech and behavior.  In addition, future consequences are just not on their radar, as they exist in the world of ‘now’.  They are always trying to catch up on life (missed instructions, missed assignments, missed chores, missed messages, missed next step, missed social cues).

ADHD does NOT cause lying, but lying can be part of the fall-out caused by uncontrolled ADHD.

Does any of this give permission to the ADHD child to lie? Absolutely NOT!  Parents and teachers should help these children become attuned to the situations where a made-up answer is likely to erupt and together develop strategies that can help minimize the opportunity for such behavior. 

Often the choice of words used by the adult sets the tone for the rest of the conversation.  Consider that sometimes rephrasing the question can help ameliorate the child’s inclination to make-up a reply.

Tommy consistently does not complete homework assignments.  He believes that he copies instructions correctly from the board, but in reality does not.  Instead of asking (accusing) him, “Didn’t you copy the assignment?” try telling him to check what he copied.  This gives him a chance to find his mistakes

Any student, ADHD or not, may balk and lie at what may be perceived as a ‘gotcha’ moment.  If you already suspect that the copied instructions were inaccurate, perhaps due to:

  • environmental distraction
  • haste looking back and forth from board to paper
  • slow handwriting
  • challenge shifting focus of attention,

CHADD recommends that it may be more instructive to ask, “Did you have enough time to see what was on the board?”  You avoid the lie and instead get to the root of the problem.

Before branding a child as a liar, consider that one of the roots of ADHD is the disruption of executive function skills.  This results in impaired organization, record keeping, and sense of time. Children with ADHD are notoriously forgetful. They also have difficulty understanding instructions, especially if these are given quickly and involve several steps. This may lead to misinterpretations.

ADDers look like everyone else. There is no physical feature to distinguish them from others not thereby impaired. As a matter of fact, ADD’ers will go out of their way to appear normal.  In some cases, children might lie in an attempt to hide their symptoms. But lying does not automatically come with ADHD.  On the other hand, misunderstanding, misinterpreting and forgetting, are all common traits in these children.

Not telling the truth, when confronted with a ‘gotcha moment’ is still not OK, but it is understandable.  In this context, the ADHD child is NOT exhibiting signs of moral failing, nor giving evidence of a compulsive lying condition or oppositional defiant disorder.  This child requires our compassion and our guidance in ways that help him or her get to the crux of the cause for the protective lie being told.  We, and by that I mean parents, educators, physicians, counselors, therapists, coaches, all should hear the ‘misspeak’ as the child’s juvenile attempt to cover up the shame and embarrassment of uncontrolled ADHD symptoms.

Professionals at CHADD remind us that getting to the source of the reason the child has lied is essential. The adults who teach and nurture children with ADHD must understand that these children will frequently not perform as well as their peers and that, unless there is an additional disorder, they are neither lazy nor willfully defiant, and they are just as likely to want to succeed as their peers.

Lying is not acceptable behavior even if it is to protect the self from embarrassment or punishment.  Reward honesty, it is always the best policy.  When children hear an adult tell a ‘white lie’ they become confused, so be an honest role model yourself!

It is our job as caring adults to make sure that ADHD children receive the help that they need, be it therapy, medication, executive function coaching.  First and foremost we should educate ourselves about the causes and symptoms of ADHD, and the fall-out that often accompanies the disorder.   Start here with these links specific to the issue of dishonesty employed as a coping mechanism by ADHD children:

Two great articles by Peter Jaksa, Ph.D.  http://www.additudemag.com/adhd/article/882.html  and  http://www.additudemag.com/adhd/article/5705.html  as well as an article by Jerome J. Schultz, Ph.D.  http://school.familyeducation.com/add-and-adhd/lying/42736.html?detoured=1

The National Resource Center on AD/HD can be reached at their website www.help4adhd.org  This website features What We Know information sheets and additional links for resources.  Parenting a Child with AD/HD (WWK2):  http://www.help4adhd.org/en/living/parenting/WWK2 is a good place to begin.

www.CHADD.org and the archives of  www.ADDITUDEMAG.com are both great places to find information.

Remember this is a marathon, not a race.  Spend the time necessary to build your team of supporters.  Share resources with others whom you feel could benefit from the knowledge.  People who have “the lived experience” and professionals who work with these children understand that parenting and classroom strategies for children with ADHD are based on a different paradigm than the typical child.

Best wishes for a Happy New Year,

Debbie

new guidelines, new book, new outlook

Extra! Extra! Read All About It!  AAP Updates ADHD Guidelines for Children ages 4-18

Until this month, parents of pre-schoolers who ‘knew’ that their family needed help were simply told that it was not possible to identify ADHD in a child that young.  They were told that all children develop at different paces, all special in their own way, and that even the American Academy of Pediatrics (AAP) didn’t recognize ADHD in children under the age of 6!  They were admonished to be “better parents”, to be more organized, more disciplined, more consistent at home.

Previous AAP guidelines published in 2000 and 2001 covered children from only ages 6-12.  Parents who lived with a hyperactive or daydreaming pre-schooler knew what the experts wouldn’t yet confirm, until now, that indeed AD/HD is observable in children as young as 4 years old.   Now, thanks to new guidelines released this month by the AAP, parents seeking help for their children from ages 4-18 can be provided with the tools and become part of the team along with pediatricians,therapists, and teachers who can follow the newly formulated guidelines for assessment, diagnosis and treatment of ADHD.

Parents of pre-schoolers were previously advised to eliminate foods, get excercise, get sleep, set more routines, give more hugs. These are all noble suggestions that can benefit any busy young family.  But parents of ADHD children know that they can talk ’til they are blue in the face, and if their child’s brain chemicals aren’t zinging in response, there’s no end to the battles that can ensue.

While no one is reccomending an automatic jump to medication before trying behavioral interventions first, especially with the very young child, it will be a welcome relief to the parents of pre-school aged children to at least be able to acknowledge that there is a reason for their child’s disposition and behavior.  Just knowing that their child is not deliberately behaving in ways contrary to the parents’ house-rules can have an enormous impact on that family.  Being able to say, “It’s the ADHD” instead of  “she’s such a bad kid, and is totally disrespecting my parental authority” can lighten the family’s load, and at the same time change the tone of the messages that the child infers about herself from being constantly re-directed.

The new guidelines are part of a report being published in the November 2011 issue of Pediatrics, whose lead author Mark Wolraich, MD, FAAP
says, “Treating children at a young age is important, because when we can
identify them earlier and provide appropriate treatment, we can increase their
chances of succeeding in school.”  Dr.Wolraich also offers for consideration that, “Because of greater awareness about ADHD and better ways of diagnosing and treating this disorder, more children are being helped.”

Information for parents is available at www.healthychildren.org/adhd and
a new 2011 edition of the book entitled ADHD: What Every Parent Needs to
Know
can be purchased from that website.

Pediatricians have lots of children’s health issues to keep up with.  If your pediatrician hasn’t heard about the new ADHD guidelines that include children as young as 4 years old, you may suggest that s/he contact the AAP to request the newly revised and updated ADHD toolkit for healthcare providers that is being released to concide with the latest research report published in the November 2011 issue of the AAP journal Pediatrics.

Debbie

~Debbie