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Date:         Fri, 13 Nov 1992 10:38:30 -0500
              <PSYCGRAD@UOTTAWA.BITNET>
From:         Jeff Kline <egkline@BEFAC.INDSTATE.EDU>
Subject:      Neural development and TV

Kathy Morgan writes:
>I am also afraid that this label (ADD) is being >applied in
>some cases willy-nilly by frustrated high school guidance
>counselors at
>a loss for "treatment" of repeat problem students.  I am worried
>that
>some of the students that I see in my classes don't have ADD, but
>rather, are just plain motivationally or intellectually impaired.
>I
>know I'll be drawn and quartered for this, but how can you tell the
>difference, and what are the implications, if any, for higher
>education
>and equal opportunity? Just adding more fuel to the fire,

I agree with you I read/heard/saw somewhere that most of the ADD dx
is being made by GPs and Family docs. When there DX was compared to
neuropsychological assessments (supposedly more accurate) the
differences were astounding with Family Docs giving more DX of ADD
than the Neuropsychs.   I feel strongly that this dx is made too
often without properly consulting and exploring the whole range of
family/interpersonal dynamics that come into play in a child's
behavior.

When I hear about a child with a dx of ADD I always wonder if the
child's behavior does not derive from a need of the family's. Some
of the children that I have worked with show a great deal of
awareness of the family dynamics, and at times it almost seems that
their behavior serves the purpose of distracting the family from
some real issues that underly the family structures. I sometimes
wonder if these  children do not carry these active, purposive
behaviors into their classrooms.

This is probably best exemplified by an example. A young child was
seen in a clinic that I was connected to. Only child about 5 years
old, begining to have problems in school, poor discipline at school,
acting out, could not attend to any tasks (in an age appropriate
manner) and was always getting into trouble at home and at school.
Parents were sitting in the therapy discussing some issues while the
child QUIETLY played in a corner. The parents were providing
background info about their family. The parents began to discuss
some of the stressful stuff happening in their marriage. Their
voices were quiet and not particularly tense, their words were
carefully chosedn, yet when the subject was broached immediately the
child jumped up ran over and started being obnoxious, totally
interrupting and derailing the parents discussion. Nothing about the
stressful topic was said, just a quick glance and the child reacted.
It was observed through a number of sessions that the child reacted
whenever the parents discussed one or two particular subjects. The
child's ability to figure out the tension in the family was uncanny.
This was not isolated, it was very noticeable in a number of
families and is consistent with years of clinical experience of the
senior staff. It seems that in at least some families children
behave in a purposive manner, attempting to derail tension and
stress.

Maybe our problem children's classroom behaviors need to be taken in
the context of the environment and there purpose for both the child
and the system (this is my Adlerian side leaking out).

Just a thought and I realize that this is not a statistically
siginificant study just clinical judgement, but it certainly seems
to fit.

p.s. exscuse the shorthand DX = Diagnosis

Jeff Kline

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              *               Jeff Kline                 *
              *        Indiana State University          *
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              *               "TANSTAAFL"                *
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              *        egkline@Befac.indstate.edu        *
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              *              Egkline@indst               *
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