9.1.3 What to Do About Planning and Organization Problems: How to Cope with Being Distractible in a Behavioral Sense It is important to separate the high-speed motor activity of ADHD from the meandering, wandering distractibility of ADD. Sometimes they can look the same if there is the addition of anxiety. Anxiety and distractibility will make these people look as if they are on a high-speed chase going nowhere. Dis- tractibility that is behavioral in nature will differ for ADD with and without hyperactivity. Both groups can appear to always be on the go, moving from one unfinished task to another and evidencing either mental or physical rest- lessness or both. It is important to distinguish anxiety as the differentiating factor, i.e., whether the restlessness is due to anxiety or the motor hyperactiv- ity of the ADHD individual. These are ADHD children and later adults who are seen as running, not walking. Both groups can evidence impulsivity, but for different reasons. The ADHD person is impulsive due to low frustration tolerance and for the ADD without hyperactivity person it is due to exhaus- tion and being tired of trying. The distractibility can result in difficulty com- pleting tasks alone (without a monitoring system) and can impact follow through as well. Planning and organization problems may occur as a result of the distractibility and confusion of the ADD without hyperactivity or it could be due to a true planning and organization problem from the frontal processes being problematic, which relates to ADHD. One coping mechanism for the behavioral tendency to become distracted as well as for the problem of planning and organization, is the use of a plan- ner. Setting goals with times and dates can will oneself to complete tasks in a timely fashion. All of the tasks the individual needs to complete, e.g., dates, appointments and so on, are placed in this planner for the person to reference on a continual basis. Ironically, another problem common for ADD individu- als is to misplace things — including the planners. Ritualizing the habit of consulting the planner daily helps people not only by reminding them of what they need to do but also by instilling the importance of the book so they are less likely to lose it. In lieu of a planner, ADD individ- uals may have some sort of a backup method for task completion, such as encouragement and/or assistance from a parent, spouse, or office manager. However, they may tend to become overly dependent on that person for planning and task completion. For example, I have had individuals who called me daily to report on what they are going to do for that day as a means to plan and organize. A daily assignment sheet that goes from school to home helps ADD children with task completion, ensures that they know what they are supposed to do, and fosters good communication between home and school. Tasks can be broken down into smaller units and these people can teach themselves to develop task completion skills. It is critical to lay out all of the materials needed for task completion and to clear away materials not needed. ADD without hyperactivity can self talk themselves through a task until it is done by using internal statements, such as “just keep going until you finish,” © 1999 by CRC Press LLC 0-8493-????-?/97/$0.00+$.50 © 1997 by CRC Press LLC 10 How To Tell Your Child About ADD: What It Is and Isn’t and Why Take Medication 10.1 Discussing ADD With Your Child: The Facts, Just the Facts This phase is extremely important if for no other reason than to stop the end- less folklore about ADD. If you have read this far in this book, you are aware that far more is unknown than known about ADD and that this cumulative field (psychology, neuropsychology, medicine, education) is changing so quickly that “current” information does not stay current for long. Thanks to recent development in research methods involving QEEG-, PET-, and CAT- scan studies, MRIs, and breakthroughs in pharmacology, important informa- tion is constantly discovered. Unfortunately, your local library is probably one of the last places to start learning about ADD. By the time a “current” publication (yes, this one included) makes its way to the library shelf, the information is often outdated. Therefore, start your own ADD research project at the bookstore and choose publications with a current (relatively speaking) copyright date. Another good source of information is the nearest university library, department head, or media specialist. The local C.H.ADD (Children and Adults with Attention Deficit Disorders, headquartered in Plantation FL) chapter or support group generally has a keen eye for note- worthy, credible information. Deliver the facts to your child. Report what you know, not necessarily what you think. There is a vast difference between when we were trained and worked as schoolteachers in both general and special education, We were “taught” our professors’ biases and folktales about ADD. Clear, spe- cific, direct information was at a premium and too often just not available. We then passed those biases on to other professionals and nonprofessionals and contributed to the growing amount of folklore, certain that we spoke only the humble truth dispensed to us from one of the assistant gods. When discussing ADD with your child, use your knowledge and understanding © 1999 by CRC Press LLC © 1997 by CRC Press LLC 11 Adolescence and ADD: A Class by Itself 11.1 Introduction One needs to remember, when dealing with adolescents, that they are in a continual state of turmoil. Emotional, social, hormonal, cognitive, and growth issues are all coming together at once. The brain is peaking in its abil- ity to perform abstract thought and the body is growing in spurts. While this is an exciting time, it can also bring with it some negatives. Blood-sugar levels bounce, which can lead to symptoms of hypoglycemia and irritability, fol- lowed by exhaustion after eating. Teen eating habits are notoriously poor. When they don’t eat, the body reacts by signaling its lack of proper nourish- ment with a low-blood-sugar reaction. When they do eat, they eat everything that is not nailed down and the body responds with exhaustion. If the adolescent is ADD and taking medication, the required dosage will vary frequently in this period of constant change. We have found that Ritalin does not work as well in times of stress, which often impacts the way medica- tion is metabolized in the body. Adolescence is also a time that high stress and changes in medication levels can add to the emotional instability. Teenagers react to everything and see everything as a big deal. They are often confused and dizzy, not knowing which end is up. Stimulant medications and low blood sugar can enhance this effect. Therefore, at times, they can scarcely think ahead because their heads are clouded. For ADD people, all of their issues are height- ened. There is anger, questioning, and depression due to the emotional changes that are occurring. They question who they are, where they are going, and what they have done so far. In short, a life review occurs. Teens attempt to seek their own degree of truth — what is truth for them. They really don’t want to give away secrets or show any kind of emotion, as this would provide clues as to what they have been doing or where they have been while they are still rehearsing. It is like looking at the artist’s painting before the artist is ready to show it. They don’t want anyone to see them before they are “done.” Thus they show a “deadpan” of emotions, and rarely show excitement about anything. There is a fear regarding their ability to perform. They are unsure that they can do something and unsure that things will happen the way they want. They © 1999 by CRC Press LLC . Thanks to recent development in research methods involving QEEG-, PET-, and CAT- scan studies, MRIs, and breakthroughs in pharmacology, important informa- tion is constantly discovered. Unfortunately,. irritability, fol- lowed by exhaustion after eating. Teen eating habits are notoriously poor. When they don’t eat, the body reacts by signaling its lack of proper nourish- ment with a low-blood-sugar. information is the nearest university library, department head, or media specialist. The local C.H.ADD (Children and Adults with Attention Deficit Disorders, headquartered in Plantation FL)