11 Tornadoes in One Month!

“Phil, he had 11 tornadoes for the month of April,” Becca told her husband.  Phil had no idea what she was talking about.  “What, are they studying the weather?” Phil asked.  “No,” Becca fired back, her face snarled.  “The teacher has a chart at the front of the room with every child’s name on it.  They get a daily grade for their behavior. Most kids get a ‘partly sunny’ every day, with the occasional shower. Our son had 11 tornadoes in April.  There were only 14 days of school that month because of vacation.”

Phil, who was called “motor mouth” in first grade, did not immediately share his wife’s dire concern.  “Did he have any hurricanes?” Phil asked with a chuckle.

“You never take our son seriously.  He’s already starting to feel bad about himself.  I told you he needed more discipline.  He just doesn’t know how to follow the rules, and that’s your fault.”

“Maybe he’s just bored.” Phil said, his humor starting to turn to irritation.  “You want him to be a little robot of conformity, but that’s not our son.  He’s different.  No, he’s unique.  He has a
dress-up corner in the basement and puts on plays for his family.  He does funny voices, and at 5-years old does a great British accent.  Yes, he has trouble sitting still, but can play army men by himself in the basement for hours at at time.  I think he’s gifted, and yes, he is a tornado of creativity.”

“But we’re not teaching him how to fit in,” Becca said plaintively.  “That’s one of our main jobs as parents,” she continued.

“No, it isn’t.  Our main job is to support and nurture him to be true to himself.”

This vignette is a true story.  Phil and Becca are friends of mine and they came to me for my opinion and advice.  While my sympathies obviously lie with Phil, especially since Connor is a lot like me, I understand Becca’s position.  These negative, school-generated messages will take root in him, sprouting self-doubt, self-sabotage, and slowly marginalizing Connor at school, and maybe beyond.  Becca is right to be afraid.

It was only at the end of the school year that I learned of their predicament.  I have made a few recommendations for this upcoming school year.  First off all, I will be meeting with Connor’s teacher and educating her about ADHD in general and Connor specifically.  I will inform her of the incredible power she has, a power that could turn a creative mind into a force for innovation and positive change. Conversely, I will be compelled to share with her the destruction to his sense of self-efficacy that her reactions could cause.  I will certainly educate her on the ADHD brain in the hope that she will not take Connor’s distracting behaviors personally, and that she will understand the need to use creative means to fully engage him.  I am also going to ask her to use a new technique.  I will give her several CDs that play a chime at irregular intervals.  With this device, she will instruct the class that the chime is a signal to take a few seconds to make sure that “you’re on task” and behaving according to expectations.  There are several CDs with the chime played at different intervals.  This method is most effective when no one knows exactly when it’s coming.  Simple modifications like this not only help ADHD students; they help the whole class.  I am always on the lookout for teaching  methods that allow teachers to more effectively reach all students.  With so many students, they really need to use their energies as effectively as possible.  The chime method does that and also decreases the potential for ADHD students to feel “different” and thus marginalized.

However, in Connor’s case, the boy is different and his parents and future teachers need to continually find ways to celebrate that fact. I see him as an actor, artist, or even social activist.  He has an uncommonly developed sense of justice and fairness.  With proper guidance and positive messages about himself, Connor is one of those ADHD movers who can go on to change the world.  These early years are crucial along that path.  Frederick Douglass said, “It is easier to raise strong children than to fix broken adults.”

ADHD, Substance Abuse, and Impulsivity

A  recent study from the journal Nature Neuroscience suggests that teens who struggle with substance abuse and those with ADHD have somewhat different cerebral profiles, specifically in terms of impulsivity, a feature of both conditions. Both groups exhibit impulsivity, but that trait appears to derive from different areas of the brain. Among the teens who had tried alcohol, cigarettes or other drugs, like marijuana, brain scans showed different patterns of brain activity in the right inferior frontal gyrus and in the orbital frontal cortex compared to teens who had not touched these substances before. These differences showed up in self-control tests during which activity in their brains was monitored. Prior research has found that the right inferior frontal gyrus is involved in the ability to control, or inhibit, impulses. People with head injuries that damage that area of the brain have problems with inhibition. The orbital frontal cortex has been known for years to be involved in drug use.

What’s interesting is that the ADHD teens who were administered this self-control test also showed difficulties with controlling impulses, but their patterns of brain activation were quite distinct. The teens with ADHD exhibited differences in the bilateral frontal lobe and the basal ganglia, both of which are known to play a significant role in ADHD symptomology. So the same end behavior, impulsivity, appears to be linked to different parts of the brain.

The reason this study is important is that ADHD people have a significantly increased risk for substance abuse. The data from this research effort strongly suggest that atypical functioning of certain cerebral networks, those involved in impulse control, underlies addiction.  But impulsivity in addiction, as opposed to ADHD, appears to be a different animal. The study did not examine ADHD people who also were substance abusers. What will be interesting to see is if ADHD people with substance issues look more cerebrally similar to the ADHD group or to the substance abuse group.

Overall, this study shows us that the brain is an incredibly complex organ that we are just beginning to understand. Also, we see that impulse control does not always indicate the presence of ADHD. While it is easy to judge others who show what appears to be a lack of “willpower,” this study points to the underlying biology that is involved, and thus invites us to consider addiction as a bona fide disease.

With ADHD and addiction, many people who are not afflicted presume that a lack of willpower is to blame. “I know when to stop,” they will righteously declare. “They just need to learn their limits.” This scientific information gives us reason to pause and reflect, and perhaps reevaluate how we view both ADHD and addiction, and to consider having more compassion for people who deal with these challenging conditions. So many people presume expertise when dealing with mental health conditions. If you really want to understand mental health, go to school on the brain. I recommend the following books to help you in that endeavor:
1.  Howard, P. (2007). The Owner’s Manual for the Brain. Austin, TX: Bard Press.
2.  Nigg, J. (2006). What Causes ADHD?: Understanding What Goes Wrong and Why. New York: Guilford Press.
3.  Stoehr, James D. 2006. The Neurobiology of Addiction. 1st ed. Philadelphia: Chelsea House.