Wednesday, August 20, 2008

Accomplishment and Self-Esteem

AD/HD is frequently characterized by an inability to stay focused on a task—repeatedly and significantly. The Sunday, August 17 issue of the New York Times featured an article on Michael Phelps, “AD/HD Didn’t Keep Phelps From Finding His Focus—On the Gold.” Teachers throughout his early school years observed that Michael could not focus to achieve goals. Yet, no Olympian has won more medals than Michael.

My son Andrew is 17. First identified at age 11 months as having developmental delays, Andrew has always had significant trouble staying focused on the task at hand. And he still faces attention challenges. Yet, this summer, he obtained and succeeded in his first paid job. His self-esteem has increased while mastering what the world expects—gainful employment. No Olympic medals, just modest but meaningful goal attainment. To Andrew, his mother, and me, these are significant.

Robert Brooks, PhD, has emphasized at CHADD conferences over the years the need for each of us to have and use our "islands of competence." As Andrew grows and matures, his islands of competence continue to expand. He is still very anxious, still socially awkward, still has learning challenges, and still has major doubts. But he is succeeding.

It’s interesting to read the many stories about Michael Phelps. Teacher after teacher told Michael’s mother that he could not focus, he could not stand still, he could not be an academic success. But he was academically okay and his island of competence was swimming—and now he is the greatest swimmer of his generation and holds the most ever Olympic medals. It’s important for people living with AD/HD to pursue interests they enjoy and at which they excel. Phelps’ success demonstrates that being a part of a supportive family, setting goals, engaging in enjoyable activities, and receiving positive feedback are all important in building self-esteem. Phelps is clearly an exceptionally talented athlete and a source of pride for the millions of people affected by AD/HD.

Andrew’s goals are much more modest. This summer he participated in a summer school program where in the mornings he focused on getting ready to pass “No Child Left Behind” state standardized exams so he can graduate next year from high school. In the afternoons he assisted the school’s IT director—for pay—by loading new software on school and faculty computers. Loading computer software is now an island of competence. In the late afternoons and evenings he enjoyed field trips, including attending four minor league baseball games.

Those who know us and those who have read my previous blogs know that Andrew and I share a passion for baseball—for the Baltimore Orioles, for the Boston Red Sox, and for the two major league players we have met through CHADD who are connected to AD/HD, Scott Eyre and Jeff Conine. This summer Andrew took his passion and joy for a sport and turned it into paid employment. Through friends at church, Andrew applied to the Bowie Bay Sox—the Anne Arundel County affiliate of the Baltimore Orioles, ten minutes from our home. This weekend Andrew began his employment as a main gate ticket taker. He has to arrive an hour before the gate opens. He has to help set up the gate area. He has to get organized to retain the ticket stubs after taking them. He has to be patient and friendly. His work is done by the top of the fourth inning, and he gets to see the last five-plus innings of the game. It’s not Olympic gold, but it is normal life and attainment of a life goal—paid employment in an arena that he enjoys.

With support, focus on a goal, and effort, people with AD/HD can succeed. Some receive New York Times coverage. Some are worth a good feeling inside and hope for the future.

As you struggle with your own AD/HD or as you struggle with your family member’s AD/HD, be satisfied with every little step toward success and happiness.


Tuesday, August 12, 2008

Dealing with Health and Educational Disparities

For the fifth consecutive year, CHADD was actively involved in the annual convention of the National Medical Association. CHADD’s mission is to improve the lives of people affected by attention-deficit/hyperactivity disorder and related conditions. NMA’s mission is to advance the art and science of medicine for people of African descent.

At this year’s NMA conference, CHADD hosted a dinner for the NMA section on psychiatry and behavioral sciences, offering presentations about AD/HD that covered the lived experience, public attitudes, and special education placement. CHADD also hosted a community forum on AD/HD at an African-American church in Atlanta.

The success of the dinner typifies CHADD. The event was a perfect example of professionals and family members educating each other and sharing their experiences. NMA psychiatry section chair Diane Buckingham, MD, who also serves on CHADD’s professional advisory board, served as emcee. The featured speaker was Karran Harper Royal, a mom from New Orleans and former member of CHADD’s board of directors. Karran spoke movingly about the experiences of her brother and her two sons, all of whom live with AD/HD.

Here are some points to ponder:

Disabilities occur at a higher rate among individuals who are African American (19.2 percent) and Hispanic/Latino (26.1 percent) than among Caucasians (18.9 percent).

African-American children are under-represented in treatment for AD/HD when compared with Caucasian children.

For African-American children with Down syndrome, life expectancy has not kept pace with increases in life expectancy for Caucasian children with Down syndrome.

African-American children with autism are typically diagnosed five years later in life than Caucasian children with autism.

Something is clearly wrong here.

With the March of Dimes, CHADD co-chairs an advocacy coalition working to convince Congress to appropriate $5 million to address racial and health disparities in health outcomes for the special populations served by the Centers for Disease Control and Prevention. Health disparities are defined as the differences in the presence of disease, health outcomes, and access to health care across groups.

As CEO, one of my commitments has been to engage in meaningful and respectful outreach to the African-American community. This has been demonstrated through CHADD’s relationship with the National Medical Association, the roughly forty community forums that have been held since 2001, and my efforts as co-chair of the workgroup on health-care disparities.

Economic times are tough and CHADD’s revenue is down. It is harder to continue this work. But we are committed to continuing our work in the coming years. If you can provide financial support to help us continue this work, let us know.