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I'm Stuart Segal.
I am the director of Services for Students with Disabilities
and one of the sponsors of today's talk.
And I wanted to welcome and thank you all for coming.
It's just been sort of overwhelming to me
to watch this event grow as the years go on.
The person that I get to introduce is actually one of the
one's that we can really thank for this and when I introduce
her I think she deserves a, a very big round of applause.
But I also wanted to let you know that that during next year
Services for Students with Disabilities will be celebrating
its 40th anniversary on campus.
And that we will be having a year long celebration in the
forms of a series of talks and workshops,
and that I hope all of you will give some consideration
of coming to these events.
It will be culminated in an all day conference on
disability issues in October of 2014 and
you'll be getting more information about that,
as well as the list of speakers and talks.
So without any further ado
I do want to introduce Dr. Geraldine Markel.
Dr. Markel is currently in private practice as an
educational therapist and academic coach, is a nationally
renown speaker and author, also has been an old,
I shouldn't say old, but a previous faculty member
in the School of Education, and was the last director
of the Reading and Learning Skill Center.
Something that's desperately needed on campus today,
that's my own editorial comment.
And the reason for this event and the, the great audience
that we have in the way that this is sort of advanced
over the years is really due to the hard work and effort
of Geri and I would like to congratulate and applaud her.
[Applause]
Well welcome to all of you.
What a great turnout.
Each year we started out with 15 people in a small room at
the Union and then because of Maureen Candy and her wonderful
PR, we you know graduated and got into the ballroom of the
Union and then the amphitheater here, and now the auditorium.
I don't think we're going to make it to Hill.
[Audience laughing] But we've got great, great hopes.
Say hello to your neighbor.
It's always nice to you know be friendly.
If you want put a card and pass it down to the aisle.
We want to get a good mailing list for next year.
There's also a clipboard outside,
so we can get a good roster.
Next year we already have one person
on the event planning team.
He is a fabulous entertainer, songwriter, musician.
He was a featured person at the recent ADD conference in Detroit
and so he'll be a headliner, that's Jerry Mills.
This year the awareness event is part of a national effort.
The adults with ADD ADDA group, children and adults with ADD
the CHADD national group, the ADHD Coaches Association,
and Attitude Magazine.
They are the national sponsors.
And this year we have some additional sponsors and because
of that we're able to videotape the presentation.
And the, it will we on the site for Services for Students
with Disabilities and the Depression Center,
and perhaps some other ones.
If you're interested in finding out more information,
you can write to Geri, G-e-r-i, @managingyourmind.com.
So we have a wonderful roster of sponsors and if you know anybody
else who you think might be interested for next year,
please them know or let me know.
First of all Services with, for Students with Disabilities,
Rackham Graduate School, Counseling and Psychological
Services (CAPS), the School of Information,
the School of Dentistry, the Office of Student Services,
the Neuropsychology Section in
the Department of Psychiatry at the Medical School.
And our new sponsors the University of Michigan
Depression Center, the Methylphenidate and AD/HD Study,
and CHADD of Washtenaw and Western Wayne County, and the
Language and Literacy Program at the School of Education.
Of course, the special thanks go to Stuart Segal, the director,
and Maureen Candy, the office coordinator for Services of
Students with Disabilities, our IT specialists,
Rackham facilities and staff, Michigan Media,
and of course our interpreters.
Well you wonder why there's an ADHD event and
that's because we're trying to increase awareness.
There's still many myths and misinformation, and so we're
looking to increase awareness and get more services.
And we're very lucky this year
to have Dr. Thomas Fluent as our speaker.
He is a clinical assistant professor and serves as the
Medical Director for Ambulatory Psychiatry at the University of
Michigan Hospital and Health Systems.
He's evaluated and treated child, adolescent,
and adult patients, and families with ADD
across multiple settings for over 20 years.
His topic, Shifting Faces of ADHD: A humbling journey
from psychiatrist to dad and back again.
Help me welcome Dr. Tom Fluent.
[Applause]
Hello.
Is this working?
You know what, I think I'll just use this.
Good afternoon everyone.
I'm technologically challenged, so.
Thank you Geri for the introduction.
I, I couldn't help but notice that during the introduction
I want to be honest that when you asked me to do this,
I thought that it was going to be about 15 to 20 people
in a small room in the League.
[Laughs] And so the idea that I floated out about talking about
our family journey was based on that belief.
So, this is a little bit more than I bargained for.
I'll, I'll tell you right up front
I'll, I'll try desperately to be appropriate.
I have struggles with that sometimes.
I've also spent many, many years in the Navy and been in a lot
of different places, so life has humbled me to a point
where not that much bothers me.
So, it's hard to hurt my feelings as this point, so.
I, I did think I, I worried a little bit about sort of
opening up our family experience like this
in this way and, but I've sort of come to believe
that it's very important and that it's helpful to people
to find out that most of us are a lot more
like one another than we think we are.
And most folks are having similar struggles,
it's not just related ADHD, but just life in general.
So, anyway I'll get off the podium here and move on.
But the point being I'm hoping this will be
relatively informal.
I'm just going to basically share our family journey with
you and I hope that in some way it will be helpful for ya.
Okay?
And let's see if I can master the slides.
All right.
So first, I want to go ahead and acknowledge my son, Nick, who
when you know I decided that I was willing to consider doing
this, obviously I chatted with him and in usual Nick fashion
he kind of shrugged his shoulders and I don't care.
And at that point we decided we'd go ahead with it and again
before I get started, this really was a family project
so my wife, my daughter, even Nick,
everybody sort of contributed to this.
So this really is as much about the family as it, as it is me.
All right, so let's get rolling.
So this is the agenda.
What I'm going to try to do is, is cover what we call a pre-Nick
personal/professional impressions of ADHD.
Obviously then Nick arrives on the scene and we get to
experience it first hand, again several year, multi-front battle
ensues, and then hopefully near the end we can chat about things
that at least we've found helpful.
I, I really want to be clear that this is our, our story.
It may not be applicable or helpful to other folks.
It's very much our, our story from a personal standpoint.
So I'm really up here more as a dad today
than I am as a child psychiatrist.
All right.
So pre-Nick.
So for me my parents are pretty extraordinary people.
There was five of us, biological kids, but they also took
in multiple foster kids over many years.
I quite frankly don't know how they did that, but they did.
And several of those kids had struggles and so
I had a certain impression of ADHD at that time,
but again it was really primarily
I saw it sort of similar to just a learning disability.
It may have been there, but I don't recall much
mention of ADHD in medical school.
During my residency training at Portsmouth Naval Hospital, which
is up there in the corner, built in 1830, I found that a large
percentage of sailors that were coming to see us generally in
the context of behavior/performance troubles,
would just mention that they had taken meds as they were a kid or
mentioned ADD when they were kids.
Again, the general impression was that these weren't like
bad kids, but they were folks that were struggling,
oftentimes considered to be under-performing,
sort of doing things that didn't make a lot of sense
I guess would be the way to say it.
Again, at that time my impression was in residency and
then even moving into fellowship that the emphasis was really
predominantly on inattention and hyperactivity.
Again that it was seen as primarily a childhood disorder.
During my fellowship at Walter Reed I, I think I became
somewhat more nuanced and sort of began to appreciate the idea
that again these diagnoses have both a categorical element in
terms of a certain number of symptoms, but also a dimensional
quality where, where one would consider developmentally
inappropriate inattention or distractibility or impulsivity.
There's, there's a certain arbitrariness to it.
I also became much more aware of the overlapping symptoms,
meaning that obviously all that is inattentive and distractible
and impulsive is not ADHD, that there's lots of multiple
alternative explanations that might explain the same symptoms.
I would have to say though that in my fellowship the, the focus
really did remain on the more medication responsive symptoms.
There was certainly some talk about behavior management or
parent training, mostly kinds of behavioral strategies
to manage kids.
Not necessarily different than what would be usual parenting,
but again there was a recognition that these kids
presented more of a challenge on the parent front.
I would also admit, and again I apologize there's parents
out there, I'm just trying to be honest here.
I also had a growing sense of
what in the heck is up with these parents?
Good lord these people are unhappy.
And they presented frequently sort of frustrated, angry,
and some of the stuff that would come out of their mouths
[Laughs] would take my breath away.
And doesn't care, he's lying, no self-discipline, and I found
that it was really a struggle to get folks into some sort of a
middle ground, meaning it seemed like folks, depending on the day
or the moment, were either you know none of this is about ADHD.
This is just this kid needs more discipline versus
the other alternative, which was the pretty much
all bad behavior was explained under the ADHD.
And people would struggle to hold the kids accountable
for even reasonable kinds of things.
You know you hit your sister, it's the ADHD.
You didn't get the homework, it's the ADHD.
And of course the problem is is that there's sort of kernels of
truth in all those things, but again I would just say that
at that point my, I had a certain belief set about
the parents that was probably a bit less than generous.
So at this point in time, I would say my informed view of
ADHD parents was somewhat again no wonder
the kid's struggling for god sakes.
[Audience laughing] Acorn doesn't fall far from the tree.
[Audience laughing] I mean given what we know about the genetics,
there may be some element of that.
Tired, cranky, again at least some sense
that they may be part of the problem.
All right.
So this is a summary.
I basically said all these things.
I'll move quickly through here.
But as I left my residency and my fellowship,
my overall impression was that this was primarily
a disorder of inattention and hyperactivity.
It primarily was an academic issue.
It responded to the meds.
I really didn't see it as particularly impairing or
impactful long-term.
It wasn't clear to me is it overdiagnosed, underdiagnosed,
overmedicated, undermedicated, probably.
You know I really didn't have strong feelings about it to be
honest and I just didn't see it as a major player
in the world of child psychiatry.
I just didn't see it like depression or anxiety or autism.
And I did have, as painful as this is to admit, some sense
that maybe the parents were at least part of the problem.
So, 1997/98, very big year for the Fluents.
So we head off to Russia to adopt Comrade Nick.
[Audience laughing] My wife who's sitting here decided
that my Navy career was over and uh...
[Audience laughing] A decision was made to join
the University of Michigan and so that was my decision
and I turned down Beaumont for a lot more money and
so both of us live with both these decisions, okay.
[Laughs] [Audience laughing] And are still haunted by them, so.
Additionally we were moving back from D.C.
We've been gone for probably 10, 11 years and were coming back
home to two very big, very intrusive,
somewhat crazy loving families, okay.
And this picture here,
that's actually our first meal as a family.
That was on Thanksgiving Day in the orphanage
where we adopted Russia, Nick sorry.
We didn't adopt Russia, just Nick.
[Audience laughing] Yes.
Perhaps we should have adopted Russia.
[Audience laughing] All right.
So there is Nick's passport picture,
a rotund little fellow to be sure.
So I had actually been doing as a child psychiatrist in D.C.,
I had done a lot of prescreenings,
I don't know if folks remember at that time,
but there was a lot of overseas adoption and
I did a number of the sort of prescreenings of the video.
Myself and the peds neurologist we would screen these things
and, so I'd looked at a number of those and based on that,
we had an expectation, we talked with Natalie, our daughter,
about sort of he's going to come.
He's going to be very quiet and sweet.
We're going to have draw him out.
[Laughs] And you know it's going to take time and patience.
So that was not the Nick that showed up.
So the Nick that we got was two and a half,
right in the middle of his terrible twos, loud, demanding,
stubborn, very active in some ways, but also
used to sort of having his way, interestingly enough.
So our first fight actually was him, we had like four steps
to get up into our house in Maryland, and he basically
stood there for an hour refusing to walk up the stairs.
And I thought, wow.
This, this is going to be fun.
[Audience laughing] So, all right.
So we again begin to experience our own Bolshevik Rev,
now you again, you look at him, how,
you know it looked, could he look sweeter?
No way.
And so, so after about a week, our Natalie, who was seven at
the time and who'd you know basically been queen of the nest
for quite sometime, comes to me very serious, sober, clearly
you know like I don't want to do this to you and mom, but
I've thought a lot about this and you need to send him back.
[Audience laughing] [Laughs] And, and so, and she had again
things, she's very organized and obsessive, and so she had
her three points, does not do what I ask, he's too loud,
he never stops talking, and he won't stop touching my stuff.
And so, you know again this is sort of like DCM4, right.
I mean of ADHD.
So she saw it coming.
I explained to her that he was far too expensive to return,
however. [Audience laughing]
And that we were all going to have to get along.
So however this is no exaggeration,
within the first month with had him,
we had the fire department to our house three times.
And the first one, we put him in time out.
He was throwing a tantrum, you know, I'm a child psychiatrist,
I know how to handle this.
I put him in his room.
He's screaming in there.
It gets quiet and then I hear a click.
And I go to open the door and
he's locked the door from the inside out.
And it's on the second floor.
We can't get in from the window.
So he's basically locked in the room.
And [Laughs] I was going to like break the door down,
didn't know what to do.
So we ended up calling local fire department,
because they were like four or five, just, just like a couple
blocks away, thinking they'd send a few folks over.
Well in like five minutes, a whole truck comes pulling up,
the sirens going.
[Audience laughing] The guys are in their full outfits.
[Audience laughing] Well he sees, Nick sees this out just
as the guy walks in the front door in his fireman outfit,
I hear the click come off, and Nick runs out.
[Audience laughing] To welcome the firemen.
[Audience laughing] Within the same week,
I put him into the van.
We weren't used to having, you know Natalie was very compliant.
She would sit where you put her.
I put him in the van.
Started the car.
Got out of the van.
Click.
He locks the door with the car running.
Marie, anyway.
Back come the firemen. [Audience laughing]
And so at this point, I really was starting to wonder
about child protective services being involved.
But we were not so fortunate.
[Audience laughing] So.
Anyway, so we move on.
This is a summary slide of Nick.
I call this Daily Life with Nick, and it's just,
I love that picture because it speaks to that age with him.
So then preschool years we started to notice
things were a little different.
Again, when reading he, he really was more into the action,
the reading part of it, rather than the actual story.
He really started to struggle with unstructured environments.
We had put him into a Montessori school and
it, I don't think it lasted a week.
It was a disaster.
Terrific trouble settling down once he got revved up.
So like if other kids were revving up, he really struggled.
We were encouraged at that time by very experienced
daycare providers to hold him back for another year.
However, my lovely wife was equally stubborn
and said no way are we doing that!
And so we started him in school and again early school years
certainly not a bad kid, but very quickly earned
an invitation to attend the handwriting club.
He was inattentive, mildly disruptive and very quickly
we were introduced to, I don't know if you've seen this term,
the, I don't want to swear on tape here, but a certain
type of sandwich where the feedback gets sort of buffered.
So here's some, kindergarten, Nick is a great kid,
enthusiastic, and helpful.
Remember to follow the class rules.
Needs to work on following directions.
These are all taken from Nick's school reports.
And again, you know you get this impression not a bad kid,
but a kid that's struggling.
At least is, is seen as mildly disruptive.
All right.
We move to the open face sandwich.
[Audience laughing] We lose a bun.
[Audience laughing] All right.
And now we don't have the top.
So occasionally I have to remind him to control himself,
stay on task, needs to continue to work,
you'll, you'll notice these themes of "needs to".
Needs to work on whole-body listening.
I'm not sure what that is.
[Audience laughing] But again, enthusiastic and positive.
This quickly morphs into a lettuce wrap.
[Audience laughing] All right.
Now we're, there's no longer positives, right.
This is just lots of "needs to".
And you can, I think you can sort of as a parent you read
these things, and you can start to get a sense that
this is starting to irritate this person.
Like he's starting to get on their nerves.
And you can sort of start to read it in the, in the language
and in the comments, and again, it, when you're not used to
sort of seeing yourself in that light,
it's quite upsetting you know.
And it's very difficult not to start feeling some irritation,
both with your child and also with the teachers
who again are trying to juggle 25, 30 kids.
I think at that point we started to be aware too
that this wasn't just inattention, distractibility,
there was really starting to see some backlash
in terms of social struggles.
So again, this is all kind of very subtle,
but sometimes not so subtle.
That play dates aren't necessarily reciprocated.
You hear about a birthday party you weren't invited to.
And, and again, when you're around it wasn't like this
social difficulty was dramatic, but of course in that world
it doesn't take much, very subtle and that's all
it takes to be on the outside looking in.
And so, as a parent it was very difficult you know I mean it's,
even though you know it's ridiculous it's hard not to see
your kids as little narcissistic extensions.
And so it puts you in some awkward spots because
you certainly, you, you know you're kind of damn if you do
and damned if you don't in terms of intervening and, and such.
Particularly in social situations, because you can see
where it could quickly kind of backfire around you.
But what we noticed is that it was very, you, you were sort of
in this mode of constantly needing to game plan,
constantly trying to set up "play dates", and
constantly trying to stay on top of the homework issues.
It just a sense of like you're swimming upstream basically.
And it was difficult not to get angry and frustrated.
So by third grade, things were starting to not feel good.
So as it has been my custom,
I left on a deployment at that point in time.
[Laughs] So.
[Audience laughing] I'm out of here!
So anyway, so I was gone.
Marie was managing this on her own.
And it started to become fairly clear
that school was not much fun.
You know this is just not a place of success for him.
And you could see, you could feel as much as see,
he wasn't just looking for to it.
And again, you're in contact with the school.
You can kind of sense their growing frustration.
So at the end of third grade, he was seen by a colleague of mine
and the diagnosis was made, and he started on medicines.
He also began to see a tutor, Mrs. Montebella,
who was terrific.
And that really helped.
You know obviously not everyone is so fortunate.
I mean we're blessed.
We were reasonably secure financially, so again bringing
somebody else in to help with some of these things
who didn't convey this sort of visceral sense of frustration
and you know I want to kill you.
[Audience laughing] I think made the work easier for him to do.
So this was the end of third grade and these are
all comments right taken from the report card.
I thought this was a particularly interesting slide.
[Laughs] Because I made it.
But also because you could see the comments are shifting a bit.
So these, I, I sort of want to spend a little bit of time,
does not take initiative or work independently,
does not organize time, use it wisely.
Does not work toward personal best.
What was interesting is you could see how the medicines now
were in fact benefit, he was not disruptive anymore.
So there's no mention of being disruptive, keeping his hands
to himself, you know so we sort of like quietly not getting it.
Does that make any sense?
But it's quite dramatic when you look through, I mean
this was very interesting for my wife and I to do this.
You could really see how this, how the comments shifted.
The, the problem is right the struggle continues okay.
[Laughs] In some ways it's worse,
because it's quieter somehow.
Anyway, so homework.
Again, my, my wife contributed to this slide
and so did Natalie.
You know it really became something that was really,
it just was not pleasant, and it was every night.
And, and these problems with planning, organizing,
prioritizing, anticipating, all the -ings,
he really struggled with.
And the amount of parental involvement that was required
to get the work done was sort of breathtaking.
I mean at least from our perspective.
Of course, the complication too was a lot of time
you'd work for hours to get the homework done,
he wouldn't turn the damn thing in, you know.
And then that would even make it worse, you know.
So, and sometimes I never said
mean regretful words, but my wife did.
[Audience laughing] She's right there.
[Audience laughing] So, as a trained [Laughs] ya.
As a trained clinician, I would never use such language.
[Audience laughing] So I, I think though too what was,
it was very frustrating for my daughter as well.
I mean think that you know it, it was not fun.
You know it was sort of like,
it felt like Nick was always in trouble.
Massive energy sink.
It affects the tone of the household in a big way,
and I think she struggled and even with "all my training",
you really struggled with why doesn't he just do
what he's supposed to do for god sakes.
It's not that hard.
It was, so even knowing those things, I was struck at how hard
it was to translate it into the day.
I mean I'm not proud of that, but that's the truth.
So, so moving on to fifth grade.
Again, it seemed, we kind of like moved into
sort of an unpleasant, uncomfortable comfortableness
where we're kind of getting through.
Again, I say mothers' perhaps distorted observations.
I, I think clearly there was a sense
that he was slipping through the cracks.
I think the impression the school doesn't care
too much is no question unfair.
I mean, I, but that's, it's very difficult not to feel that way.
You know, so I'm saying this is very much the impression,
because you're sort of feeling guilty about it and you know
that they're busy and you, you dread the idea that
you got another contact with them.
And so I think in some ways part of the defense is to go oh
they don't give a damn, they're part of the problem too.
It's, it's just very difficult not to be
seduced by that if you will.
So again, I just want to be clear, this isn't,
this is not necessarily reality.
This is coming from sort of what it felt like.
Does that make sense?
All right.
Frustration grows.
So things came [Laughs] this is, this is one of
Marie's interventions, that we call these
are less than proud parenting moments.
We have several of these.
We actually have a book on them.
I love this though.
Did you receive failing grades on your last report card?
Yes.
So Nick would have to fill this out.
Do you want to pass sixth grade?
Yes.
Do Mom and Dad want you to pass?
Yes. Spelled with two s's.
Okay.
[Audience laughing] I mean...
Did you make a rule there'd be no TV and no Internet?
Yes.
Did you check your email?
Yes.
Did you watch TV after rule #4 was made?
Yes, I did.
[Laughs] Nick, lie son.
This is one of those times you should lie, right?
[Audience laughing] Did you write in your log today?
Nope, I didn't.
Did you, did you practice your French?
Nope, I didn't.
I love this one.
Bonus, on the back of this page write down
everything you can think of that people have done for you
to help you succeed in school.
[Audience laughing] This is, so my wife and
I are both raised very Roman Catholic.
This is sort of part of our genetics, right.
The whole guilt economy.
And uh... [Audience laughing]
Obviously, it was not as successful
as we would have liked.
So, so again, right at this point in time,
Tom leaves for another deployment.
[Laughs] So I'm out of there again.
And Marie made the decision
to move him to a small private school.
And again, we're fortunate that
we were in the position we could do that.
You know I get that and not everybody is,
but the opportunity for the smaller class size.
It, it was really at a point where he was starting to dread
going to school and we felt like at the smaller schools
he might have a better chance to be on a sports team,
be part of a club, whatever.
Interestingly, the teachers didn't see him
as having social struggles at school.
But my sense of that was, is that part of that's because
the smaller classrooms they're able to basically
regulate the social milieu much tighter than
you can with a class of 25, 30 kids.
So again, the comments sort of shift a little bit.
We're back to the first sandwich where we're getting
some positives on the top and positives on the bottom.
I think though that they did a nice job of helping
Marie and I start to reframe some
of the behavior in a more positive way.
I think what happened at least for me was that really
when the rubber meets the road, all your "clinical training"
sort of goes out the window and
you revert back to what you grew up with, you know.
Which is, you know my, we managed, my grandpa managed,
we managed conflicts among myself and
my foster brothers with boxing gloves.
That's, that was the solution.
Put the gloves on Tommy.
You guys let me know how it goes.
So this is, was not [Laughs], I mean it was loving and
nurturing, but there was no,
there was no quarter given I guess.
And so I could feel that coming out in myself,
just do it for god sake.
And I think this school was sort of true to their creed.
So they, they helped us a great deal.
Even the framing, you have more to offer than we've seen so far.
It's a much different language than needs to X, needs to Y,
test preparation is a goal for next, it, it felt different.
So, again these are our impressions.
I mean for us and for Nick this was good, a good fit.
I think they helped us reframe things in a more positive.
I think because there was less kids,
it was easier to communicate with the teachers.
And I think because of the, the different relationships,
Nick was-- this was something
I really never appreciated until this day.
Very difficult for him to ask questions.
You know I think this idea that you kind of part of the reason
you sort of delude yourself into thinking that they don't care is
because it's too painful to think that they do.
You know what I mean?
So I think the kids start to get this what looks like
really cavalier attitude and they're not reactive.
And in some ways, it's hard not to collude with them.
Because it's just too painful to go there
when at some level they really do care and they do notice
that they're not keeping up, and they do notice
that they need to ask more questions and such.
So anyway, all and all, it was a very positive mood.
I, I think this was also a time that we started really
recognizing that it was real, very easy for this
to start to define him and who he was.
And so we really started looking and trying to find other places,
other activities to help sort of round out this identity, okay.
For us and again I know it's not for everybody,
we, we're really, really fortunate.
The scouting group around where we lived,
it was terrific, absolutely great gentlemen.
They helped a lot, especially with all my time away with
the military, I mean we're, we're really indebted to them.
They also really stressed this whole idea of responsibility
and accountability, which I think is absolutely crucial
for everybody, but even more so with these kids.
So we, again candy bar gate, Nick had some eating issues
as well, and he, he would sometimes not be truthful
even when it made absolutely no sense to lie.
Like it wasn't like it got him anything,
but I think it was this impulsivity.
So again, in the land of Fluent,
there is nothing worse than a liar.
Those are like fighting words.
And so he had I think lied about a candy bar.
And of course, Marie, "Nick I'm giving you one more chance
to be honest," of course she'd already found
the wrapper in his backpack, right.
So I'm going to give you one more chance to be truthful
about this honey, and I really want you
to think hard about this before you answer.
[Audience laughing] Of course, he doesn't.
And so he was going to lose this scouting weekend,
I think it was a winter campout and again,
I'm embarrassed to say, I was deployed.
And this is a good example,
Mr. Brigham there who looked sort of like Father Time.
[Audience laughing] He, Marie called him and said I'm afraid
Nick is, you know that Nick's not going to be coming on
the campout, and he, he I think very wisely said, you know
Mrs. Fluent I would love the opportunity to talk with Nick
over the course of the weekend about how important it is
to be truthful, particularly with your mother.
And, and, and you could see by Nick's face there,
so Mr. Brigham had several such discussions
with Nick over the years.
And, and I think that made a lot sense at the time you know.
So, and I think Marie was smart enough to recognize that.
So again, the importance of bringing in other folks
and family and friends and such to help you
get perspective with this.
This was another one of our solutions that
didn't work very well.
I will not lie.
I should know better.
You see the first 16 of these that went on for quite sometime.
Did not seem to be particularly effective.
[Audience laughing] All right.
I think we also became better at this point in trying
to recognize that life is a lot, about a lot more
than academics and how you do in school.
I mean that seems so ridiculously obvious,
but when you're in the, in the heat of the battle
it oftentimes doesn't seem so obvious.
And I think it can convey a really not so good message
to the kid in terms of what you value most in them
and what they end up valuing.
So I think we were able to start to shift that obviously
it's important that you're an honest young man,
that you're a good friend, that you're where you want to be
with your faith and your family and your friends.
The idea that, not that academics aren't important,
but it certainly doesn't define who you are.
I know this sounds preachy and it seems maybe obvious,
but I can tell you when you're in the,
the fray it sometimes isn't so obvious.
And of course, we're fortunate Nick has a lot
of terrific strengths.
He's great with animals, lots of episodes that we would hear
from people of him defending other kids on the playground.
He had a real sense of justice and he wasn't very big,
but he, he was very willing to step in and stand up for kids
who were being picked on and such.
And obviously that's an extraordinarily terrific trait.
And at times, you'd get stuff like this.
"Mom thank you for everything you have done for me,
"like putting me in AACS.
"You have stuck with me through all my troubles
and helped me through the hard times."
I mean come on, how, how sweet is that? [Laughs]
And, and so again, this sort of ongoing battle but also
those kinds of moments of little mini victories.
So we graduate successfully from middle school.
Parents decide [Laughs] victory is ours.
The ADHD has been vanquished and has left the field,
back to the public school.
No more tuition, no more commute, not a good decision.
And so Nick went back to the public schools
for ninth/tenth grade.
[Laughs] Tom leaves for Afghanistan.
And things did not go so well again.
Similar sorts of things.
So the grades were really declining.
He was on the wrestling team.
He was sort of not quite eligible and I had just
gotten back from a, a fairly challenging
ten-month deployment in Afghanistan, so I'm, I'm using,
I don't normally use that, but I'm going to use it here,
I wasn't at my best clearly.
[Laughs] So I, and when I saw the grades and I saw kind of
what had been going on, I said I'll use some
motivational interviewing techniques that I've used.
Basically, my impression was that he liked wrestling more
than school and so being a kind and empathic father, [Laughs]
I thought I would, if you don't get your grades unless,
you're not going to be wrestling and you're going to be going
to some small school or blah, blah, blah.
Anyway, so we're driving along in the car and
I'm sort of ranting in a not very, not in a way that
I would be proud of at all, and Nick sort of shocks me.
He, he looks at me and says, you know Dad, I think you're right.
I think I need to be in a school that's a little smaller where
I don't feel embarrassed to ask questions and you know
I, I just think that would be a lot better for me.
And of course, I really wasn't expecting that
on several levels.
I mean, but clearly it was one of those again, I'm not giving
the whole story, but I think that what, it was one of
those painful moments where he kind of revealed
I actually do care about how I'm doing.
I actually do feel crappy and just because I don't act like it
and I try to act like everything's fine, it's not.
So I was really you know, let's just say that the shame
and humiliation was really me, you know.
I mean I felt terrible so anyway.
So at that point then we made a pretty quick decision,
how I'm doing time-wise?
Oh goodness, I got to hurry.
All right.
So we go back to the public school,
I mean we go back to a small private school.
And this is where we really kind of, I, I had a, by then I had
sort of broke down and started really learning more about ADHD.
And as I'm sure many of you in the room already know,
know the, it's very sobering.
I mean when you actually start reading the literature,
it's sobering, man.
I mean comorbid depression, comorbid substance abuse,
vocational problems, school problems, divorce, car,
it's a sobering literature.
And so I by this time, I had sort of broken through
my last remnants of denial and said, you know Marie
this thing could go south, not south in an
oh this is challenging way, but big time south.
And of course in my practice I see it all the time.
So that reality was really staring me in the face,
that you know we need to do what we can do.
So we really sort of implemented
the full court press if you will.
He got a tutor in math, but really what was particularly
helpful, we, we, and again I know we're fortunate
to be able to afford to do this,
we basically hired a homework coach.
And, and man did that make a difference.
So she really worked with him on organizing his time,
on how to structure his study time.
It really allowed us then to move more
into the parent role and be supportive.
She was very helpful in telling us to back off.
And so we sort of stopped the nightly badgering,
which again I don't know if I...
the routine of you know do you have any homework?
Do you have any tests?
Do you have any projects due?
No, no, no.
Then you find out at 11:00 that night, yes, yes, yes.
[Audience laughing] And, and now you're off to the races.
You're up till late.
Everybody's tired.
Again, just this horrible pattern.
And at that point, things started really turned
fairly dramatically for the good.
So again, I get we're, we're fortunate, we were able to do
this, but the smaller classroom and the smaller school
I think was just a great fit for him.
I think between the homework coach, the small school,
and other things, you know we started to develop
some positive momentum and, and we as parents were able
to be more parents, which was terrific.
[Laughs] My good friend, my good friend Joe Himley came up,
he said Nick's the most improved kid in Washtenaw County.
[Laughs] [Audience laughing]
And we just, I think that's hysterical.
And so, again we laugh, Nick was employed in the movie industry,
basically swept Quality 16 popcorn, and such.
Participated in sports, mission trip, singer in the Praise Band.
He earned his Eagle Scout which again
I'm not a great scouting dad and so he did that
with a lot of help from some other terrific men.
Again, applications to college, did, did very well,
has had a terrific summer experience with a camp,
Sancta Maria in ***, every year.
So a lot of people I guess and activities
that have contributed to this.
Again, here's graduation.
There's his Eagle Scout.
These, these are some of our thoughts
and I've covered most of these.
The, the small school for him was a big deal.
I think it really allowed him to ask questions in a way
that he wasn't just able to do in a larger classroom.
The extra academic supports.
Us backing off.
I think trying to get his sister and you know
our son in-law who have been terrific.
The extended family and friends,
and for us the faith piece was, was big.
I know that's not, you know I don't mean that for everybody,
but for us, it was a big, it was a, it was a very positive thing
in terms of helping to define him in a broader context.
Big time team, that's his principal
at Livingston Christian, Mr. Nast, terrific gentleman.
So this is also Team Nick.
This is up, I guess I can, well, doesn't work.
Anyway, point being really a group of folks in his corner in
a way that the ADHD seemed to shrink in terms of size somehow.
And yet it was all being very actively addressed.
Nick end up, we ended up deciding on Ferris State.
It was primarily Nick's decision.
And really most, there were other campuses he liked better,
but he really was impressed by the level of academic support
at the school and the smaller class sizes
and the readily available tutoring.
And that was his, the ultimate decision.
I was stunned.
That's not what I was looking for in a college.
So it was, it was impressive to see him start to develop
some ownership over the disorder.
Again, this is some thoughts from Mom
I think you can read those things.
She obviously was the primary parent
involved in this due to my absences.
So she bore the overwhelming brunt of this and I feel again
that we would both say it was a humbling journey to be sure.
And so the idea of sort of backing off, looking for success
experiences outside of the academics, downtime, and again,
really trying to be aware of all the positive things that are
going on as well, which can be very hard to keep your eye on.
So this would be my revised view of ADHD.
I know that's a, a busy slide and there's lots of words on
there, but I think the data supports very strongly and
certainly our experience was this is really a condition
that will kick your butt. [Laughs]
And it can really play out in big time ways
in a number of venues, academically, socially,
certainly psychologically in terms of self-esteem
and mood and worry about school.
The difficulties with organizing, planning,
what, what people will term the executive functioning
can just be devastating.
I think is as kids age that, that clearly becomes
the more prominent struggle than just
the inattention and the distractibility.
Treatment at least from where I sit is,
really needs to be a multimodal team approach.
What we found was and I think this is common, I've seen it
in practice and we experienced it firsthand,
that it's very tempting to think that you beat it
and that you're through it and that you've got it licked.
And what happens then frequently is once you back off
on the support, things can decline quickly and
I think what's particularly treacherous about that
is it can be easy at that point to say, look, you showed us
you can do it, why aren't you doing it?
You, you can really sort of twist what was a positive thing
into a negative thing in a way that clearly isn't helpful.
So in the parenting piece of it, again I've beaten on this until
the mule is dead, but it really does impact all levels of
your household in terms of relationships and the tone,
is very, very easy to feel inept,
frustrated, defensive, [Laughs] angry.
I call it scramble the planes mode where it just feels like
you're constantly being surprised by things.
And so the challenge I think is to somehow embrace
the seriousness of the illness, but to try not to let
the illness define the child and define the family.
So certainly, we've been humbled.
We laugh a lot, probably at inappropriate times.
[Audience laughing] And, and really the idea that this really
is a partnership and it's not, it's not a sprint you know.
I mean this thing is, it continues to be
sort of a big part of his life and our life.
And this is sort of a take home point, this sounds a little bit
harsh, but I think it's an important thing to acknowledge
because I have the same discussion with kids coming back
from combat deployments you know, and PTSD.
I mean I know this area very well and I can tell ya,
at the end of the day no one, no one really, no one really cares
why you're acting the way you do, okay. [Laughs]
So you might have been deployed three or four times,
at the end of the day you're responsible.
And I feel like that's something we've, how to sort of gently
and consistently and firmly get across the idea
that this is yours to own, okay.
And, but I think it's critical that you do, because otherwise
it can set up a dynamic that's going to be problematic once
they get out of school, once they enter the real world.
It might, again this is a quote,
this is as Nick and I were driving to Ferris. [Laughs]
It might not be fair Nick, but you're going to have
to do things differently to be successful.
You, you can't do the late nights
and study at the last minute.
That's not your deal.
It might, you know I'm sorry I wish it was, but it's not son.
And so I think that trying to maintain that balance of again
a helping hand with the well timed kick in the britches,
that's, that's really the delicate dance.
I also think this sort of this multidirectional impact
of successes is really important to,
to sort of get your arms around.
What I mean by that is that you know success in a,
you know a computer camp or a horse camp or,
it can really drive improved academic performance.
It all starts to flow together in a big way.
So you know having success in either activities or peer groups
or whatever, I think can dramatically impact
the academic piece and vise versa.
So really the, the model that I embrace, I didn't,
I don't want to get clinical here, but again there's sort of
a chronic care model, sort of like diabetes or hypertension.
Really the idea is that the individual needs
to become the expert on their disorder.
It's their disorder.
And they need to take responsibility
and ownership for it and manage it.
Lots of folks out there that can help them with it,
but at the end of the day it's theirs to own.
And so that's, that's the approach that I now take,
not just, we take with Nick, but even in, in my clinical work,
and it's different than what I, I don't see the med, I'm not,
I'm, I really, really shy away from
this treatment being done to you, you know.
That's really seductive and it sort of
lets the kid off the hook, you know.
It's really got to be: look, we're, this is a partnership
and you've got responsibility and I've got responsibility.
And those, so those discussions about divvying that up,
I think end up being very useful.
So I know I kind of moved pretty quickly through these.
I hope that in some way this has been helpful for you.
I'd be, I'd be glad to answer questions,
because I think this is my last slide. [Laughs]
It is. There we go.
So there's young Nicholas right there and uh...
[Applause]