Driven to Distraction (Revised) Read online

  Theresa finished the story as follows: “This was September-October when we first brought them to you. I had decided I could not control their behavior at home anymore—it was so unsafe, and so many accidents had happened. I remember someone came to my house one day and Danny had been doing cartwheels for one and a half hours in the room we were in. I didn’t pay attention to it because it was always the way life was for us. The person visiting me was a nurse and she said, ‘Theresa, you know, I don’t mean to say anything about Danny, but don’t you think it’s a little strange that he has not stopped doing cartwheels for the last one and a half hours?’ And I said, ‘Yeah, but that’s the way he is, you know, he’s just very active.’

  “But it did get unsafe. They were being unsafe with each other and somebody was going to get hurt. I had decided that it was time to try something different. I had given Danny and David that year to be free, to see where they were going.…

  “I came to see you and you started them on medication. And over a period of two weeks to a month their response to Ritalin was phenomenal. The teachers were amazed at the fact that these children, who had been so disruptive to the classroom, now could sit in their seats. David, who could not sit at his desk for longer than five minutes without flipping the desk over, well, all this sort of thing stopped. It all stopped.

  “They were both mainstreamed, with a resource room available to them just in case something happened.

  “They’ve had their problems, like any other child has problems in school. Their behavior is not always appropriate, it is not age-appropriate still, and my assessment is that their behavior will never be age-appropriate, that there will always be a lag—a lag physically, a lag mentally—there will always be a lag time because they lost too much time the first three years of their life. But we can handle that.

  “They are now in fourth grade. In a matter of two years they have accomplished four years of school. They went from being told they would never get out of a Point Four classroom, they went from being told they would never amount to anything, to doing four grades in two years. On their most recent report cards nothing is unsatisfactory with their work. David has had some problems this semester, occasional fighting and those issues, but both kids are considered very bright by their teachers and are very well liked by most of their peers. They get along. It’s a tough school. The teachers have told us that it is a tough school and Danny and David are the only new children there. All the other kids have been together for four years, four to six years.

  “Danny and David started taking piano lessons about a year and a half ago. The assessment by their piano teacher is that Danny is playing at the level of a high-school student and they are both at least six years beyond where she would expect them to be. Danny and David play and listen to Bach, Beethoven, Mozart, Tchaikovsky, all the great composers. That’s who they listen to, that is what they play. They are exceptionally talented on the piano. They also take karate. They have taken it for three or four years. Last year both of them won awards in sparring. They have done exceptionally well. Karate has really taught them a lot about focusing and discipline and all the things they have needed to learn.

  “They are fantastically athletic. They can basically pick up any sport that they want to and do well at it. They both take ballet and have been in a recital already. They both take tap, too. They’ve had their recital and are the only two boys in the entire school to have done that. Matt and I do not push them to do these things. We have had a lot of conversations where we have sat down and said, ‘Listen, this is too much.…’ Because besides doing these things they also work out three to four hours a day in karate and they take gymnastics. They are considered natural gymnasts. In addition, they play soccer, which I actually took them out of last year. That was a very big disappointment to their coach because they were the stars of the team. We’ve sat down and said, ‘You guys, this is too much, you have too much homework to do, you have too much working out to do—you cannot do everything every day of the week.’ They cried. They didn’t want to take anything out of the schedules. I mean, financially, we are in ruins because of them! But they won’t give anything up; they want to stay in everything. Danny thought that ballet was for girls but he loves it now and is waiting for his recital. Both of them are stars of the ballet recital that is going to be coming up, because again, they have a natural ability. And what they have done in karate helps them in ballet because they are as flexible as can be.

  “I’ve had a lot of concern.… I’ve worried a lot that we were pushing them, asking too much of them, that they were doing these things only for me. But they won’t drop anything. I would like them to stop some of these things! (Laughs.) Because I would like to not have to spend so much money! It costs a thousand dollars per month for their activities and that doesn’t include tournaments and all the things they go to, and costumes.

  “But it is worth it. With their ADD, they have to put all that energy somewhere. We want them to be ready for adolescence. And so we are trying our hardest to make sure that they do not get with a wrong group of children. I worry. I worry because Danny especially continues to be very, very impulsive, and you just don’t know.

  “These children are … I mean, had we had these children in the appropriate place when we first got them, they probably would have been child prodigies in something. Instead, we were led to believe we had adopted severely disturbed children. We thought, Oh my God, what have we got ourselves into? Here are two kids who we are going to have to support when they are thirty-five. That was what we were told back then. Our belief now is that these kids have the world open to them. They could do anything that they want to do.

  “And let me say something else. I want to say something about the issue of a parent who goes through this experience and finds out later on that the child has been misdiagnosed and could have been treated years before.

  “The guilt is incredible, as a parent. Especially as a professional who works with children every day and has let this go on. You feel like you have … I mean, I feel responsible for the fact that for three, four, however many years, I let Danny and David down, that I didn’t give them the proper care that they should have been given. They could be much further ahead than they are now—although I don’t know how much further ahead these two could get!

  “The guilt that you feel—all I can say is that it is incredible. Matt feels it, too, but not as strongly as I do.”

  I asked Theresa how it had affected their marriage.

  “This is a general statement about children with ADD, particularly ADD with hyperactivity like Danny and David have, and, in my case, coupled with the experience of going through the therapeutic-school problem and dealing with DSS. Beyond being destructive to a marriage, and it probably destroys a lot of marriages, it creates issues that will never, ever be able to be resolved. There were too many people hurt. There were too many fights, too many hard feelings between husband and wife about what happened and what didn’t happen, what should have happened and what should not have happened. In our case our marriage will never, never be the same. Had we not had Danny and David, if we had not made the commitment to stick with them, Matt and I would not be with each other now.”

  The story of Danny and David teaches many lessons, but one of the most important is just how significant diagnosis really is in psychiatry. How dangerous and damaging it would have been had these boys never been treated for the right condition.

  Theresa and Matt are both strong, devoted parents who lived through a nightmare and are now finding ways of steadying their lives. As the interview with Theresa points out, the problems did not end once the diagnosis of ADD was made and treatment begun. The management of ADD is really a lifetime undertaking.

  If there were ever poster children for ADD, Danny and David would be good candidates. It is hard to believe how well they have done, considering what they were up against. I see them now about once a month. They come bounding into my office, usually in full, colorful
karate regalia, and start playing games right away—asking permission first, of course. They are involved in all the activities Theresa spoke of, and to listen to these crew-cut, karate-robed “tough” kids talk about Mozart (pronounced mo-zaht) and Bach is to appreciate the marvelous.

  While Danny and David had relatively severe cases of ADD, there are many moderate cases that frequently are not diagnosed until adolescence. The following case concerns a boy who came from a very stable, loving family. Will had all the advantages in his early life that Danny and David did not have—including the attention of excellent teachers in two fine schools. Yet his ADD was not diagnosed until after he graduated from high school. Here are actual excerpts from his teachers’ comments beginning in nursery school and moving through the twelfth grade.

  Notice in the comments what the teachers couldn’t recognize because they were unaware of the existence of such a syndrome: the thread of ADD running throughout. Listen in the comments for signs in Will of distractibility and impulsivity, high energy and creativity, enthusiasm and inconsistency. Look for signs of risk-taking, for erratic academic performance, for underachievement. Note how many times reference is made to Will’s not paying attention or to his being disorganized. Hear how much the teachers like Will, how imaginative they think he is, but how exasperated they become over time at his difficulty in getting on track:

  NURSERY SCHOOL, 1975: Will is an active, imaginative, and friendly boy. He enjoys people and school. Most of his time is spent in dramatic play with his best friend—usually acting out some superhero escapade. This involves imaginary, daring physical feats.

  KINDERGARTEN: Will enjoys an enviable position in kindergarten. He is loved by everyone.

  Will has a real flair for imagination, fantasy, and dramatic playacting. This skill can be used to advantage; it can also be a distraction for him.

  FIRST GRADE: Will’s ability seems to exceed his performance in terms of the amount of work he produces. He is a good reader, writes interesting, usually humorous stories, and has good reading comprehension. However, he dawdles over simple board work and work sheets and takes longer than expected to complete questions on his books. While his expression of ideas is sophisticated, his speech is immature.

  At times Will can work well independently, while at other times his conversations with friends interfere with his work. He gets into long discussions that distract others as well as himself from work. He is not careful with his materials or the appearance of his work. He needs to learn to more accurately follow directions.

  THIRD GRADE: Will has been unable to take full advantage of the opportunities offered in workshop, as social relationships have occupied a good deal of his time and energy this term. He has had some difficulty organizing his ideas, and needs to develop a step-by-step approach. Will would gain greater satisfaction from results if he were more committed to his work.

  FOURTH GRADE: Will started out the year doing lovely work based on the concept of the straight line. He came up with an original solution. This together with previous experiences made me aware that Will has artistic potential.

  On the other hand, all his other work has been sloppily executed and his general behavior very poor. His mind cannot focus on his work, and he does not give his talent a chance to come out. I would like to see Will make an effort to settle down in class.

  SIXTH GRADE: Will has not yet completed many projects.…

  Will seems to bring a sense of fun with him to the learning environment.

  His [lack of] organizational skills continue[s] to slow down his academic progress.

  At this point Will moved from one school to another, entering the new school in the seventh grade.

  SEVENTH GRADE: Will is a satisfactory to excellent student. With more consistent effort, he could probably do very well in all subjects. He must try to minimize the times when he lets himself become distracted during class.

  Will could be doing much better work in Latin if he would only establish a regular routine of home study.… It is up to Will whether or not he is satisfied with just passing work or whether he settles down to achieve good results.

  EIGHTH GRADE (January): This has been a year of improvement and development for Will. His biggest problem now will be to maintain the level of intensity needed to carry on this good record and not to rest on his laurels or get careless. During the last few weeks he has begun to enjoy himself more in his classes, which is good if he doesn’t let this relaxed attitude keep him from paying close attention.

  NINTH GRADE (February) Ecology: Will is selling himself short in this course. He is not keeping up with his note-taking, does not take advantage of opportunities to make up poor tests, and did not maintain his test average on the exam with a grade of only 67. This laziness has been much more apparent in the latter half of the term. Will could be doing better! Grade C+

  (April) English: His writing doesn’t show his good insight because it is underdeveloped—urge him to take care with it: his ideas are worth the effort! Grade: C+

  (April) Ecology: Will must take his work more seriously and use the good ability he has. Grade: D

  TENTH GRADE (November) French: Will’s knowledge of France and his sense of humor make great contributions. He just needs to focus his mind a little more.… Grade: B

  (November) Biology: Will has the ability to do as well as he pleases in biology. To date, he has seldom put forth a full effort. He is the first to admit that with more effort he could be doing better, yet he is often the first to conduct himself poorly in class. I get very frustrated with someone like Will who has the ability to do very well and only does average work. Grade: C

  (January) Biology: The improvement in Will’s attitude and effort has been absolutely amazing. At midterm I mentioned that Will seldom put forth full effort. This statement is no longer true.… A little extra concentration will be beneficial. Grade: B

  (April) French: This may be a long spring for Will. A 20 on a quiz is typical of the type of nosedive that plagues him. I am also troubled by the difficulty he sometimes has paying attention in class. All this is offset by his good humor.… Of course, his innate ability can help him too, if he applies it a little more. Grade: C+

  (April) Biology: Will is the type of student that you very much enjoy having in the classroom because he is always energetic and keeps the class alive with interesting questions. Will is also the type of student that can frustrate the heck out of a teacher because at times he is just not into what he is doing and does not work to his potential. Grade: B

  (April) Math: Wow! A student emerges! As of late, Will’s work has been excellent. I hope success will breed success and Will will finish the year with a flourish! Grade: B+

  (June) Math: The student disappeared. I don’t know why Will worked hard at times and at times did nothing. The last month he spent more time worrying about the dress code than doing math. Grade: C

  (June) English: I very much enjoyed teaching him—he’s bright and enthusiastic. And with his Klinger version of civil disobedience [relating to the dress code], he showed that he knows how to apply abstract knowledge in the moral world. I was pleased.

  ELEVENTH GRADE (January) English: Will’s exam was the best in the class, and a recent story he wrote was also outstanding. Perhaps as he continues to mature, he will achieve consistency. He obviously has intelligence and skill. Grade: Exam, A–; Semester, B–

  (January) Science: Will seems to have academic moods that show a wide variation of productiveness. There were times when he literally held out and then he would show a burst of energy and do some fine work. This stop-and-go approach to learning greatly dilutes Will’s learning. Grade: B

  (June) English: … I was greatly impressed with his articulate discussion of how what we do does not discount the basic goodness of who we are. Grade: B–

  TWELFTH GRADE (January) Physics: Will remains extremely unpredictable, yet managed to squeeze his average forward slightly with a recent makeup exam on the dynamics of motion. Will
must continuously overcome chronic tardiness, missed classes, haphazard organization, and lapses of attention during class, and still manage to concentrate on the specific topics at hand. Unfortunately he will not receive as many chances for redemption in the future.… Grade C–

  (January) Philosophy: Will is an eloquent and often impassioned participant in our discussions in class. His essay on the imprisonment of Japanese-Americans was insightful, although very late. Grade: C

  (April) Physics: I have only praise for Will’s improved overall efforts in physics thus far. His punctuality and consistent attentiveness have improved, and he is handling himself responsibly.

  (April) French: Will is not making any perceptible effort. I don’t want to put him on the defensive, and he may be making some effort that I can’t see.…

  (April) Good and Evil: Will is an eloquent and impassioned participant in our class discussions … but I hope to see more consistency.…

  (April) Ceramics: Will is capable of producing nice work when he wants to but often becomes distracted by friends.

  Varsity Squash: Will had a good season. Despite injuries and having to play our best player every day in practice, Will maintained a very positive attitude. As in soccer, what Will lacks in talent he more than makes up for in spirit.

  Will’s story is, unfortunately, very common. The picture of a young child who starts out well and then gradually sees his school performance tail off while teachers grow increasingly moralistic in their explanations should always suggest the possibility of ADD.

  I let Will’s teachers’ comments tell his story because they do it so well. They show us the cute, creative little boy who as early as kindergarten was getting distracted easily and distracting others. They show us the exasperation of teachers who knew Will could do better if only he would try harder, as they said in so many different ways. They show us the boy that “you very much enjoy having in the classroom,” who at the same time can “frustrate the heck out of a teacher because at times he is just not into what he is doing.” They show us the Will who can be impassioned, articulate, committed to some cause we hear about involving civil disobedience and the dress code, and they show us the Will who can seem not to care at all. They show us Will the inconsistent. As one teacher put it, “I get very frustrated with someone like Will who has the ability to do very well and only does average work.” Just as one teacher is giving up on him, stating almost biblically, “Unfortunately, he will not have as many chances for redemption in the future,” Will comes through, leading the same teacher months later to state, “I have only praise for Will’s overall efforts.” But then, as another teacher is praising him, cheering, “Wow! A student emerges!” Will’s performance deteriorates, leading the same teacher to comment, months later, “The student disappeared.”