On Sunday night, January 23, Let’s Get Real With Coach Menachem featured Rabbi David Becker, LCSW-CCSP, Adjunct Professor at the Wurzweiler Graduate School of Social Work of Yeshiva University, and psychotherapist specializing in ADHD.
Rabbi Becker began with a story that illustrated the frustrations and challenges faced by children and adults with ADHD. He said 11% of children in the United States have this diagnosis and 4.4% of adults. “If you have ADHD in childhood, there is a 90% chance you will carry it into adulthood. Though we tend to associate ADHD with hyperactivity, he shared that boys tend to have the hyperactive component, and girls tend to be inattentive but they don’t generally have the jumpy component. People with ADHD have difficulty determining what to focus on. Adults with ADHD are generally not as hyper as children who have ADHD.
Someone asked how to help her son who complains that school feels like jail and he needs to move around. Rabbi Becker said that first we need acknowledgement and awareness. The rebbe needs to find time to read up on ADHD. Then he should give her son frequent breaks. It’s important to keep these children moving. They had difficulty sitting still and listening. This was the origin of the fidget spinner. It helps kids be more centered as they keep their body moving. He recommended bouncy bands, which can be placed on the legs of the chair and the child can wiggle his feet on them while he is seated.
He then detailed several ideas to help a child who is struggling with ADHD in school. There can be daily report cards from the rebbe and the morah. This can help the child to feel good about himself. The rebbe and teacher need to understand what is going on. Seating in the classroom needs to be planned. The child should not sit near windows or anything that is a possible distraction. He added that there is the medicinal option as well.
Someone asked how you know if your child has ADHD. He explained if it impacts your child’s functioning and being able to cope with his environment.
He shared that people with ADHD tend to be creative and out of the box, sensitive, and many of our leaders have it.
Other conditions can mimic ADHD. These include trauma and brain injury. With ADHD, executive functioning is involved. “ADHD is a neurological disease. Poor parenting cannot cause it.” He explained how in people with ADHD the prefrontal cortex of the brain thickness is delayed by three years. So kids with ADHD are three-to-five years emotionally delayed. ADHD is often concurring with another diagnosis like anxiety. There is a 30% chance of having anxiety if someone has ADHD.
To determine if a child has ADHD, there needs to be a report from the rebbe, the teacher, the principal, and, if the child is able, the child himself. It could be that the child has a sensory processing disorder or a learning problem. It’s important to get the right diagnosis.
ADHD is a point of performance issue. Someone asked how to deal with a spouse with ADHD. Rabbi Becker said that a spouse needs understanding, but he will never totally understand what the other one is dealing with.
Someone asked about medication, and he said that finding the right dose takes work and the right dose should have minimal side effects. He added that you can have ADHD and use it to your advantage. The symptoms wax and wane in adulthood.
He noted that sometimes ADHD medicines can increase anxiety, so you need a competent prescriber, and CBT therapy works well for anxiety. Someone asked about biofeedback, and he said that there isn’t enough research on that yet. He said the first line of intervention is medication, and that combining it with behavioral therapy works best. Family working together with teachers is also helpful and brings about the best results.
He then spoke about the big three, which include sleep, exercise, and diet. Sleep is critical, as so many executive functions are guided by having enough sleep. Exercise is critical, as the movement really helps, and a healthful diet helps, as well.
He stated that “ADHD is not a problem of knowing what to do. It’s a problem of doing what you know.” He added that visual prompts can be helpful. A woman couldn’t convince her husband who had ADHD to drive safely. So she put a picture of someone in jail on the steering wheel and that changed his behavior.
By Susie Garber
