Where My Parents Got It Right

As most of you already know, my wife teaches a 5th grade gifted education class at a local elementary school.  She has about 10 years of experience teaching in a variety of classroom settings ranging from "inner city" to "suburban privileged."  She has truly enjoyed and appreciated seeing the broad spectrum of educational settings and has come to appreciate her current position very much.  As you can imagine, she has also seen the spectrum of behavioral issues including what likely represents the entire range of children with ADHD from mild to wild.  As you would imagine, some of those experiences have been difficult and some have been quite rewarding.  She has seen children go from barely functional to fully integrated into the classroom setting due to the miracle of modern medicines.  Unfortunately, she has also seen a considerable number of children who seemed to have no improvement on medications but the parents were still convinced they were necessary and efficacious although there was no tangible evidence to support that.

As nearly all of you know, I am a physician working towards specializing in both Internal Medicine and Pediatrics.  I have certainly seen no shortage of parents bringing their children into the Pediatric Clinic for evaluation of possible ADHD and have been involved in managing ADHD enough to have some degree of comfort with it.  I have seen and evaluated children that I felt undoubtedly had signs and symptoms consistent with a diagnosis of ADHD.  I have prescribed medicines for some of those children and have gotten reports back from parents that the medications were helping immensely.  As you can see, I believe that ADHD is a real diagnosis/condition.  I choose those words carefully, though.  I feel that ADHD is not a "disorder" but rather is on the spectrum of normal behavior with a tendency towards the extreme end.  I believe strongly that it overlaps with a number of true psychiatric disorders in many cases and that is unfortunate because it leads to negative stereotyping and labeling of children afflicted with the condition.  I believe strongly that it is extremely over-diagnosed and that medications are thrown at a number of children/families in haphazard fashion. 

We live in a world today that demands a diagnosis for every subtle nuance in behavior or any deviation from "normal" whatever that may mean.  This has led to an explosion in the number of diagnoses for every type of condition ranging from seasonal allergies to autism spectrum disorders to restless leg syndrome to fibromyalgia to, yes, even ADHD.  Many things that would likely have resulted in a stern "talking to" or a swift swat to the bottom in days of yore now result in a diagnosis and prescription.  This is a little unfortunate because it has alleviated the need for a lot of children today to take responsibility for their own behavior.  It prevents children from adapting to their personal shortcomings and devising ways to enable them to be functional and successful human beings without the need for pharmacologic or social assistance.  I'd like to relate one particular example of this happening.

One of my wife's students this year carries a diagnosis of ADHD and is on medicine.  OK, more than one but for the purposes of this story one in particular.  He is undoubtedly a talented and intelligent child as many children with "ADHD" are.  He has qualified for the magnet gifted education program in the area where we live and by my wife's account has been a more than capable student even in the competitive environment that exists in the gifted education program.  Unfortunately, his grades have suffered to some extent as a result of his ADHD type behaviors.  He has missed several homework assignments because he has neglected to write down the assignments and so he didn't know what they were when he got home and therefore could not possibly complete them.  Of course, his parents are highly concerned about this and scheduled a meeting with the school principal and his primary teacher (my wife).  At the meeting, his parents requested that each of his teachers help out by writing down his homework assignments for him and sending them home so that the parents could then prompt him to do his homework.  On the surface, this may sound like a reasonable request but when thinking about it more deeply I take issue with it for a number of reasons.  First, it is an unreasonable demand to make for the teachers.  Why should it be the responsibility of the teacher to write down his assignments for him?  Isn't that part of the assignment - learning how to be responsible enough to write it down and then remember to do it?  Secondly, where does that responsibility end?  Each of the three 5th grade gifted teachers at the school where my wife works has roughly 30 students.  Should they each be responsible for writing down the assignments of 30 students to help them remember?  Thirdly, doesn't it give him an unfair advantage if he has someone helping him remember his assignments and reducing his need to be responsible?  As if that wasn't enough problems with this request, I have still more.  I wonder when exactly these parents are going to decide to teach this child how to be responsible.  I wonder when they are going to let him develop his own adaptations and overcome his shortcomings.  I wonder when they are going to let him fail so that he might learn from that failure.

Let me be clear about ADHD and me.  There is no doubt that if I was growing up in today's world I would be labeled as having ADHD.  I displayed all the characteristic behaviors early on in life.  I was a handful for my teachers not because I wasn't capable but because I was disinterested and easily distracted, a "troublemaker" or whatever you want to call it.  I made mostly good grades up through high school not because of my diligence but because I was intelligent enough that I didn't really have to do much work to keep up.  I got easy A's in classes that could hold my attention and nearly flunked those that didn't hold my attention and I didn't really care either way.  I got a "D" the first semester of my freshman year in high school in a typewriting class (yeah, we used real typewriters) because I just wasn't interested in the class and decided to talk to my friends and be disruptive because that was more fun.  I got a "C" in high school Chemistry because I didn't like the teacher and wasn't all that into it at the time.  I got a "B" in 8th grade Science class even though I had A's on every assignment because I didn't turn in my folder of all my work.  Not turning in folders was a recurring theme in many of my classes and I lost a ton of easy points because it was a lot of work for a kid with "ADHD." Keeping up with a lot of papers was difficult and I reasoned that it didn't really reflect any level of intelligence anyway so I just didn't even attempt to do it.  That really drove my parents crazy.  And let me be the first to say I absolutely never did homework in junior or senior high school.  I managed to get through high school relatively unscathed in spite of myself.  I then landed in a small college for undergrad.  I didn't really apply myself there either for a number of reasons.  When I felt like it I could do relatively well but I rarely felt like it.  I preferred to party my way through school, hanging out with friends and having fun and very infrequently studying.  I did start doing some homework but just enough to get by.  But still no one was forcing me into performing well in school and that was probably a good thing.  By that time, my mom had passed away and my dad was relatively hands off with directing my life (again probably a good thing).  Eventually I would graduate with a less than stellar GPA and a Bachelor's Degree in Business Administration.  I ended up working for a few years before deciding to truly get my life together (maturing?).  Eventually I would develop some coping mechanisms in part due to a number of activities I was involved in and life experiences and probably the aging process itself.  I then decided to go back to school and got a Bachelor's Degree in Chemistry and gained acceptance to Medical School. 

I am truly thankful for my parents approach to all the problems I gave them.  Rather than cajole me into doing every little assignment and having my teachers write down my homework assignments, they were able to practice enough restraint to let me learn from my mistakes.  And they did let me make plenty of mistakes.  And it did take a long time for me to get myself together.  I know it was VERY hard for my mom to sort of stand on the sidelines and let me find my way all while her health was dwindling.  I know very well that if I had managed to listen to her and do all those things she said I should do that I would have been a few years ahead of schedule from where I am today.  And, yes, my folks were right a lot of the time.  But the place they got it most right was in having the patience to let me find out for myself how to do things, to develop my own coping mechanisms, to let me find my way and even to fail when necessary so that I might learn what that is like and how to keep it from happening when it really counts. 

I wonder how kids like the little boy in my wife's class are going to turn out.  How can we possibly expect him to mature when he has no reason to?  How can we possibly expect him to figure out a way to remember to do his homework if his parents get the accommodation they are requesting and his teachers have to write down his assignments?  Is it even a big deal if he gets a "B" or God forbid a "C" in 5th grade because he forgets to do his homework?  Isn't that the best possible place to learn that responsibility?  I mean, who really cares about this kids grades in 5th grade?  In the grand scheme of things, they are absolutely meaningless.  They're not going to prevent him from getting into college, right?  Is his ego so fragile that he can't handle a fail here and there so that he can have the opportunity to make adjustments and learn from those mistakes?  Are his parents being too overbearing?  And for that matter, should he even be on medicine if he was smart enough to qualify for gifted classes without the medicine?

I think we as a society are expecting too much out of our kids.  If they somehow don't perform perfectly, we are searching for a diagnosis and a medicine to make them better.  We expect them to get straight A's and conform to our unrelentingly high standards.  We freak out if they miss an assignment.  I think the lesson we need to learn most is that it's OK to fail and sometimes the best learning is born from that failure.  If kids never have to pick themselves up and dust themselves off then try again to do better, how can we expect them to be able to persevere and become functional adults capable of dealing with all the stresses that life can throw at them?  I guess the bottom line is that I am incredibly thankful that my parents were OK with letting me fail and even fall on my face from time to time.  And I am incredibly glad they were there to help pick me back up and encourage me to try again until I got it right because without them I wouldn't be prepared to deal with the life I have to lead now.  I wouldn't be able to see the inevitable failures and be able to not only deal with them but find the motivation in those failures to do better and overcome them.  And for that I am incredibly thankful.  I can only hope that I am blessed with the same patience in dealing with my children so that they too may learn how to deal with life.  One fail at a time.