ADD and CAPD

[jvigrl]

I have a 13yr who has ADD and CAPD.  He is falling way behind in school and now doesn't even want to go.  His grades are awful and honestly I don't think he cares.  He refuses medicine.  Which his doctor said he is old enough to make that decision.  I was considering homeschooling him, but not sure if he would even try.  Anyone with any advice would help. thanks

[Rebecca Resnik, PsyD]

Hello,
    age 13 is such a tough one for boys, particularly when they have a disability. I would be very surprised if he truly does not care that he can not be successful in school and make you proud of him--take that pre-teen bravado with a BIG grain of salt. Kids with ADHD and learning disabilities often choose to fail on purpose because they worry that they are too dumb to learn. To a teenage boy, being seen as a rebel can be a lot more attractive than being seen as dumb.

     Medication is a touchy issue at this age, and I often expect to hear about adherence problems in teens. While you can not force medication down his throat, I wonder if there are other options than just discontinuing all medications. You may wish to try a different medication with side effects that he can tolerate, or perhaps make it part of his behavior plan to take his meds. It depends on how much benefit vs discomfort he gets from them if you decide this is an issue worth making a priority.

    Unless you are a teacher or even better a special educator, then home schooling is likely to be very difficult. Children with ADHD are tough to teach, and even very experienced teachers need all of the tricks up their sleeves to meet their needs. Additionally, withdrawing him from school and his friends will deprive him of valuable relationships with peers and mentor teachers. Most children this age respond better to instruction from people outside the family, because the whole parent-child dynamic is not present.

    So in terms of what you can try, first I would seek some guidance from a pediatric psychologist, not just your pediatrician. A psychiatrist has much more training and experience in managing medication and symptoms of ADHD. Then I would ask for a referral to a psychologist, licensed counselor or behavior specialist who can help you put him on a positive behavior plan. You want to get him back on track with doing tasks such as homework, studying and organizing, and these can be very challenging goals to achieve without professional help. Seeking professional help can also help you avoid the temptation to try to punish and threaten him into changing, which is likely to backfire and make things worse. Here are some resources that may be helpful to you as well:  www.ldonline.com, www.chadd.org
Dr. Larry Silver's Advice to Parents of ADHD by Dr. Larry Silver
The Kazdin Method by Dr. Alan Kazdin
Taking Charge of ADHD by Dr. Russell Barkley

Best wishes to you in trying to help your son
Rebecca Resnik

[jvigrl]

thanks for your advice...He is a very stubborn child and would probably never agree to see a psychologist.  I couldn't even get him to go to his regular doctor's visit.  
I'll keep trying though!
thanks again