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Now to understand why this disorders why these impairments would
continue into adulthood
we need to go back and understand that its a dish
order a self regulation and it's a quantitative deficit so
that begs the question: how far behind is dis child
and so the rule that I have talked for years in our clinics to families and it
remains a very good
rule of thumb is the average ADHD child is 30 percent behind their age
some are even more but on average across all ADHD children it looks to be about
30 percent so here's what I want parents to do
if your child is 10 yes the self control of a seven-year-old
that is how long he can persist that's how long he can remember that is how
long he can go without supervision
his ability to self organize
is that a seven-year-old now what would you do for a seven-year-old
how would we arrange homework what else would we be doing around chores around
social functioning
around independence from parents you would be doing as much as you would with
a ten-year-old
you would not allow as much responsibility as much freedom
as much independence so I want parents to be
lowering their expectations to the child
executive age what
is his self regulatory age 30 percent younger
art that's what you can expect in if you're expecting more than that
you're my problem because you're causing the conflict
you're like a parent of a dyslexic child demanding normal reading
you're like the parent of a mildly retarded child demanding
normal self sufficiency normal cognitive village or my problem
because you just don't get it so I watch it get it
it a 30 percent lagged that's where they're at
that's what you can expect if you're asking for more you're going to have to
do something
to rearrange that environment to allow them to show what they know
but if you don't do anything they're going to be about 30 percent behind
so what does it mean at sixteen about giving kids a license
are you out of your mind
you just gave an 11-year-old a motor vehicle
and your shot to see the driving consequences are
you may have an 18-year-old who is one of the few that's gonna go on to college
he's 12 that is executive age
how would you have to design a campus if twelve-year-olds were showing up to go
to school
those exactly are the accommodations you have got to make on that campus for this
person
pretender 12 more hand holding
more accountability more reporting to student services
you're gonna get more curriculum materials you gonna study
in groups with older more competent students you gonna be in a
substance-free dorm
and you're going to be accountable to student services four times a day for
the work you doing
in other words when treat you like a 12
and then you might just get through but what do we do not we send you off you
feel the first semester and everybody brings their hands vol what we gonna do
we're gonna have to change the campus will have to change the environment to
suit the executive level
not the chronological level so you need to understand the thirty percent rule
because it applies to everything
I have a 14-year-old daughter with ADHD should should be allowed to babysit are
you crazy
me this is a nine-year-old being given care oven infant
Knoll way I don't care she finished the Red Cross babysitting course
I don't care she's got a certificate we don't let nine-year-old
attend three month old babies on
supervised and that is her executive age
you think this is hypothetical we have legal cases
the people even into their early teens and twenties
who have killed babies out over anger
out of impatience outta immaturity have not knowing
what to do when the baby got upset and then their emotion comes to the
forefront
so we don't want to go there so you should be looking at
all love these avenues have independent and applying the thirty percent rule to
them
and that's what you allow and if you are going to give the more you better be
doing something to see that they can handle it
okay we want you as a parent to understand that every treatment plant
has to have these four components
or it's not going to work component number one you got to get
a good evaluation you have got to see inappropriate knowledgeable
professional it doesn't matter whether it's a developmental pediatrician a
child psychiatrist a child psychologist or a behavioral neurologist as long as
they are well-trained
and knowledgeable about ADHD that's the trick
it's not the degree it's the knowledge it's the training if the experience to
do they see lots and ADHD kids and families for adults
so we need an evaluation because eighty percent of these people have another
disorder
and that's going to need to be treated as well next
families need to educate themselves will talk more about that
but you need to become an expert about ADHD or you're not going to know how to
deal with attending this afternoon has been a big step in that direction
third you need to understand that medication is the most effective thing
we have
and not doesn't matter to me whether you like that or not
that as a statement a fact we have no
more effective interventions that these medications which is why the last decade
we have moved them
up in our priority abusing them it used to be that we would try
everything else under the Sun first and only if they feel go to medication well
guess what eighty percent of them failed
and we went to medication anyway and we should've started with to begin with
because it would have made a more minimal and more susceptible to the
other psychosocial
educational programs we were trying to do so don't be surprised to learn that
up to eighty percent ADHD children will be on medication
at some time in their developmental period whether that is childhood or
adolescence
because there are times in places where you cannot Institute psychosocial
treatment
if your child is driving home from the homecoming
last night which was over the Delta hotel by the way I checked in and
there's a problem going on
you can't be there handing out tokens for following the speed limit you know
this is
idiotic to think the behavioral interventions are as good as medications
they're not
where they're done when they're done they're good but there are places where
they can't be done
and now what do we do the medications feel the homes
gaps so that's why we use them and that's why you're seeing medication
on the increase in both our countries and it is completely irrational to do so
then we make accommodations
that's what I meant by altering the point to performance using goes by
strategies we talked about
externalizing information you need to create prosthetic
devices in these places to help them show what they know