By Kristen Friesen
For The Independent

But the real motivation for such organization is the very person who has the most to gain from it their 9-year-old son, Chad. Among other things, structure keeps Chad anchored, calm and secure despite his recent diagnosis of attention deficit hyperactivity disorder.

"Structure's the big thing," Jane said. "That's really important for kids with ADHD. It makes them feel safe. And that's something my son really needs."

The diagnosis

Prior to discovering Chad was dealing with ADHD, he was struggling in school.

"He had a really bad school year last year. He couldn't concentrate and focus and was always distracting other kids and always in the principal's office," Jane said. "That made me wonder right there because Chad is brilliant. He's a very bright kid, but it doesn't show at school. The two things are like oil and water. They don't mix very well."

At home, Chad's grief over missing his own mother who lives in another state was manifesting itself in anger and, specifically, in his refusal to listen to Jane.

"Chad and I had a really good relationship. I wasn't the person giving him the discipline," Jane said. "But then it was kind of mixed up with everything Chad has gone through with the divorce and remarriage. He has problems with his temper. A lot of times, with children, sadness becomes anger."

Ironically, it was Jane's position as "stepmom" that enabled her to step back and view the situation a little more objectively than if she were his own mother.

"I kept saying to his dad, 'I really think he's ADHD and I really think you need to look into that because I think that will really help him,'" she said. "It runs in my family and I have it. I have adult ADHD. So I'm kind of familiar with it and can recognize it in kids, I think, because of that. And then I read articles in family magazines and stuff like that. It just kind of jumped out at me."

And, according to John Flaherty, a licensed independent mental health practitioner in Grand Island, Jane was right on track.

"I always encourage parents to do a lot of reading to become smart, if not smarter than their therapist, on the issue," he said, "because I consider parents to be the most knowledgeable experts on their children."

So Rick and Jane got busy and pursued answers to their son's behavior. They started with Chad's teachers, who thought it was definitely worth pursuing. Then they went to their own family doctor and a psychiatrist, giving the school regular updates as they continued.

But getting the official diagnosis was not the answer to all their problems. An explanation for behavior does not help a child (or adult) cope with it. On the home front, a monumental effort is required to maintain stability for a child with ADHD through appropriate discipline, advocating on their behalf in both educational and social settings as well as in making informed decisions regarding medical treatment.

"Parenting these children can be a 25-hour-per-day job," Flaherty said. "Parents are going to teach these children how to live. It's a day-by-day-by-day sort of job. Because ADHD affects a child's ability to self-regulate, parents may find themselves being the only source of regulation a child experiences for many years. You can imagine how difficult and stressful this can be on the entire family."

Flexibility, tolerance and discipline

As a specialist in home-based therapy, Flaherty counsels parents to "create a routine for them (their children) that they can follow and then enforce the routine," he said.

"But expectations need to have some flex to them," he added. "Flexibility and tolerance are two important concepts that parents need to keep in mind as they go through life with ADHD children."

Rick and Jane, who are also clients of Flaherty, present flexibility and tolerance when they compassionately and lovingly help their son deal with his temper.

"John (Flaherty) works on him (Chad) and talks with him about what he calls the 'fireball,'" Jane said. "There are two things you can do for a fireball: You can listen or ignore."

And they discipline carefully and consistently. In social settings, it is more difficult to follow through, but necessary for Chad's sense of security. On the first offense, Chad has to sit out of the activity.

"That's embarrassing for him. He's a very social person," Jane said. "If that doesn't work, we go out to the car. And, if that doesn't work, we leave. But most of the time we don't have problems in social settings because he's a social kid and he does well. He loves meeting people and he learns their names right away and doesn't forget them."

According to Flaherty, in fact, most children with ADHD would do well to be involved in social activities outside of school.

"I encourage parents to get them involved in sports or activity-based events," he said. This provides a social setting that is particularly important in cases where "their behaviors have negatively affected their relationships with their peers."

The decision to medicate

A tough decision with big implications that must be made by parents is on the issue of medication.

"We (Chad's parents) talked about it all last summer whether we would medicate him or not," Jane said. "You hear these horror stories about kids who are overmedicated. And it was hard for him (Chad's dad, Rick) to keep going if we'd try a medication and it didn't work. It's so hard to go back and try again because you're so discouraged and you don't want to put your child through anything bad."

And, as if that wasn't enough, they faced a lot of criticism when they needed support.

"We got so much backlash from people we knew about putting him on medication," Jane said. "So we had to really stand our ground that we were doing what was best for our child."

Parents as advocates

Parents, as advocates for their children, encounter plenty of obstacles when their child suffers with ADHD.

"Children with ADHD are going to run into difficulties and prejudice in our society," Flaherty said. "The more 'out in front' of the situation the parents are, the better it is for all of them."

Aside from choosing medical, psychiatric and/or counseling services, parents must be their child's voice in the educational system. And, while it's a big job to keep in close communication with a child's educators, Flaherty has never worked with any families who've home-schooled.

"I think parents look forward to getting those kids to school even though they know school will create its own set of problems," he said. "Anywhere there's more structure for them is better."

Rick and Jane are thankful Chad is in a smaller school where the teacher and principal are both available to keep close tabs on him. Almost every day Jane touches base with Chad's classroom teacher and his teacher, in turn, often sends notes home in Chad's backpack.

"The teachers and principal we're working with are excellent," Jane said. "But you have to be prepared because there are people who will treat your child differently when they know about the diagnosis. But it's not like you have to be a pit bull."

In Flaherty's experience, each school system has its own way it approaches conditions such as ADHD.

"Some are more tolerant and willing to work with families and some have a more hands-off approach," he said. For families who need more support, teachers and therepists will be able to provide more resources.

A family affair

At the end of the school day, children with ADHD are often exhausted from their efforts to stay in line. But siblings seldom take that into account.

According to Flaherty, "ADHD affects everyone in the family, so family treatment is important. If there's a need we'll bring in siblings and address their feelings as well. It can be very frustrating to live with someone who constantly is in need of direction or correction. Sibling relationships are intense enough as it is without the added stress of the ADHD condition."

For Rick and Jane, the chart on the refrigerator keeps them on task and family meetings help keep the peace.

"We don't say, 'This is for Chad.' We say, 'OK, you guys, we need this for our family, and so this is how it's going to be.' And we sit down and have a family meeting with them whenever there's a change so that they know about it," Jane said. "My husband is very good about it, and the kids love it. They get to say their thing and we say our thing and they're happy about it."

Future prognosis

And despite the effort and energy it takes the entire family to pull together, Rick and Jane's hopes and dreams for Chad's future look a lot like their hopes and dreams for their other three children.

"I don't think about him as being different. That doesn't occur to me at all," Jane said. "He's just a kid. He likes to play and have fun. Sometimes he doesn't like school, and that's just like many other kids."

And the good news is that, if Chad is like 80 percent of children with ADHD, he'll not only grow through his symptoms as he matures, but very likely will be a successful adult.

"I don't know if their (children with ADHD) intelligence level is higher than anyone else's, but there is a correlation to having that energy level and being successful if their energies are directed. That's why the routine and structure is very important for the family because, if they (parents) can create structure and re-direct the energy into positive activities and habits, they can help their child become very successful," Flaherty said.

Coming up:

In Monday's Independent, Edie Humiston takes a look at ADHD through the eyes of the medical community and explores treatment options including various types of medication; Your Health, page 1-B.

In Tuesday's Independent, Robert Pore talks with John Street, director of the Central Nebraska Support Service, to see how schools deal with students with ADHD; Next Voice, page 1-B.