Therapeutic Boarding Schools: What Happens to Poor Kids?

One of the things that makes me squinty-eyed about the therapeutic schools-struggling teens deal is that low-SES families surely are in need of these services, but there's not much available.  There are programs -- like the Oddfellows program  that has over a century of history -- but....well, read a story about the Rebekah Children's Society (Oddfellows and the female side, the Rebekah lodge, are one of the many friendly societies that were so common in American life in the 19th century, and have to a large part, fallen away.)

Learning to focus--Tuesday, March 15, 2005--By Melania Zaharopoulos

William Vazquez was a consummate under-achiever. At least, that’s what his teachers consistently said as he was growing up, but that statement couldn’t be further from the truth. Swirling in the boy’s mind was a small cosmos of ideas waiting to burst forth from the chaos, and what his teachers didn’t know at the time was the name for that chaos.

Attention deficit disorder and attention deficit-hyperactivity disorder was what gave Vazquez, now 45, an uncommonly high energy level. Unfortunately, it also limited his attention span, and by college he was struggling academically.

ADD and ADHD, so commonly associated with childhood, don’t go away as the years progress. Instead, sufferers learn to cope. Adults with ADD’s hyperactive component are known as “high energy,” creative and sociable people.

“These are the folks who can work two jobs no problem,” said Susan Barton, founder of Bright Solutions for Dyslexia in San Jose and a regular speaker on the topic of ADD/ADHD. “They make great scientists or engineers because they can think outside the box naturally and as adults they’re generally engaging and funny. If you have a dull committee meeting, all you have to do is bring in an ADD adult.”

Of course, the very same personality traits that work for an ADD sufferer as an adult work against him or her in childhood.  These sufferers are plagued by what Barton calls “good day, bad day” cycles of concentration, odd sleep hours, high distractibility and low impulse control, not to mention disorganization, frequent mood swings and attention issues.

“Their mind is so active,” said Barton. “Kids with ADD are highly distractible. Their mind is so busy and creative that as soon as the teacher gets a little boring, they take a mind trip. And whatever is going on in their mind is usually a lot more interesting, so they sort of check out. I had one adult student who told me her nickname in school was Princess LaLa because she was always in la la land.”

As a child, society makes allowances for this behavior, and although some parents cry ADD at the first sign of restlessness or learning issues, the disorder is somewhat overdiagnosed, according to Mazhar Khan, a pediatrician based in Gilroy.

For those who do have the disorder, there are also a variety of other issues and conditions that can overlap the problem, said Khan.  “The child may have a hearing problem or a little bit of mental delay,” said Khan. “Some kids have learning disabilities. Those can go hand in hand with ADD.”

Indeed, about half of all ADD sufferers also have some form of dyslexia, said Barton, a learning disability that, like ADD, is inherited. Other issues that can come with the territory include depression, bipolar or anxiety disorders as well as obsessive-compulsive disorder and Tourette’s, all of which can drastically impact a child’s life.

As adults, ADD sufferers often have difficulty maintaining relationships and jobs, have trouble with the mundane details necessary to run a business and tend toward addictive behavior, said Khan.  Vazquez, who is currently going through his second divorce, works to help children overcome the same obstacles he dealt with the hard way.

As a residential counselor at Rebekah Children’s Services in Gilroy, he helps to give children the support they need to overcome the social barriers of severe ADD behavior. It’s a last chance for kids hand-picked by probation officers and social workers, two sets of professions many severely ADD kids run into as they reach the volatile teen years and begin acting out in frustration.

After Rebekah house, a teen’s options are limited: Juvenile hall or a lockdown mental facility.

“You try to get them to grasp these things like thinking before they speak,” said Vazquez. “You can learn adapted behavior in order to function. You’ll never fully think that way or be that way, but a lot of times you work to adapt to the society you live in.”

For ADD students, particularly those Vazquez works with, the classroom can be the most challenging place because they are surrounded by distractions they’re mentally unequipped to block out.

“With ADD, if teacher is talking and a butterfly enters the room, you’re on it, and what they say can’t get through,” said Vazquez. “And with 30 kids in a room, you’ve got distractions like that everywhere.”

Stimulants often help to calm and focus ADD sufferers in this range, having what doctors call a paradoxical effect on them, said Khan.

“My grandma was the first to notice that if I had coffee with grandpa in the morning, it kind of took the edge off,” said Vazquez. “I’ll drink a pot and sleep like a baby.”

For this reason, most ADD treatments are actually derivatives of methamphetamines, the same drug sold on the street as speed.

“I saw a video about a guy who was really ADD, and he and his girlfriend started getting into cocaine,” said Vazquez. “The weird part was, as they got into it, he started getting more focused, started to become more responsible and could hold a job. Things were going so well, they decided to get off the cocaine, and as the cocaine went out, so did all that organization and responsibility, and his ADD returned.”

Abuse of ADD medication is part of the reason doctors are reluctant to prescribe it, but the other lies in the fact that some children with ADD do better if treated in a non-medical manner, said Khan.

“The milder forms probably will not require medication, but the more severe forms may always require medication because they are causing social distraction,” said Khan, who bases his prescriptions for ADD medication on both the child’s symptoms and his perception of the parent’s threshold for controlling the child. “It all depends on the attitude and tolerance of the parents and the teachers.”

But while medicine focuses its attention on children with socially disruptive behavior, Barton cautions parents not to overlook the symptoms of ADD in a child who is not overactive.

“People think of ADD and they think of hyperactivity, but there are two types of ADD, two flavors if you will,” said Barton. “There’s a type of ADD called ADD, Primarily Inattentive, and these are the kids who are usually missed. Instead of hyperactivity they have hypoactivity - they’re underactive. They’re not wiggling, and they generally sit in the back of the room and don’t make eye contact, but these kids are generally lethargic, slow moving … the space cadets.

“These are the kids who are very, very hard to get up in the morning, slow to get dressed, slow to eat their breakfast. They’re the last ones to walk in the door and they’re the first ones to check out.”

Barton recommends that parents monitor their child’s school progress, and resist the temptation to become angry if problems arise. It could be ADD rather than laziness. She also cautions against immediate use of prescription drugs to calm the storms of ADD.

Instead, she recommends kids with the disorder get at least 45 minutes per day of heavy physical activity - something that makes them sweat- and that parents do their best to create a highly structured life for the child.

“The child needs to know what’s expected every day and have clear rules and consistent routines,” said Barton. “They don’t adapt well to instant changes or to the rules from yesterday being different today. Structure here does not mean punishment. It means a consistent routine that will help them learn to get through their daily life.”

Warning signs of ADD

Here are a few of the warning signs to look for if you think your child may have issues with ADD or ADHD, courtesy of Susan Barton, founder of Bright Solutions for Dyslexia in San Jose and a regular speaker on the topic of ADD/ADHD.

Parents and educators are not qualified to make diagnoses that result in the prescription of behavior-modifying medication. For a true diagnosis, parents should consult a child therapist who specializes in ADD/ADHD as well as contact their child’s pediatrician for a referral to a neurologist or other mental health professional.

For those whose children have already been diagnosed, Barton offers monthly seminars in the San Jose area to help parents better understand the work patterns and needs of their children. For more information, call (408) 559-3652 or log onto www.BrightSolutions.us.

Comments

[Lisa]

Many of my kids who take Ritalin or a similar type of drug now will probably be big coffee drinkers as adults and go off their medication. That's fine -- I'm a big coffee drinker too, and it definitely helps me focus.

I'm always a little peeved when I see people making a big deal of the chemical similarities between stimulants for ADHD and hard street drugs such as cocaine. It implies that taking Ritalin is drug abuse, or leads one to drug abuse. Actually, some studies have found that people with diagnosed ADHD are LESS likely to abuse street drugs if they take doctor-prescribed medication, simply because they do not need to self-medicate. ADHD is also associated with risk-taking behaviors, and taking illegal drugs would certainly fall into that category.

I don't think stimulants are the answer for every person with ADHD -- I've met many kids who do not respond to them or who respond better to other things -- but I really dislike the way that people attach a social stigma to those medications, as though they were morally suspect.

[Lisa]

I was diagnosed at 31, of having ADHD. Once I started my medication (Adderal) my life changed a complete 360 . I am now a recovering addict, with 4 1/2 years clean. Finding out what a root problem to my addiction and taking care of it has helped me in every area of my life. I just completed a two year college, graduated with honors and now I am at a University working on my bachelors in Human Services. I have excelled in my job, going as far up to management in a restraunt. Being able to finally focus and follow through has made my life so much easier. Also to be multi-task is a plus. My life is beyond my wildest dreams. The whole stigma about medications being a drug problem, is "crap" to put it bluntly. Medication has saved my life mentally, physically and spiritually!