Tales of Stress and ADHD: High School

Written by Dr. Jerome Shultz | 7 years ago

Clinical neuropsychologist Dr. Jerome Schultz is the author of Nowhere to Hide: Why Kids with ADHD and LD Hate School and What We Can Do About It and is an expert on stress, learning disabilities, and ADHD. In the following three scenarios, he takes you inside the brains of a parent of a teen, a high school student, and a high school teacher as they attempt to cope with ADHD- and stress-related challenges. At the end of each scenario, he offers his expert take on the situation and follows up with tangible (and at times out-of-the-box) tips that parents and teachers can apply.

Scenario #1: The Student

Devon, 16: I tell my parents I study a lot. I tell them I’m all caught up with my work. Neither is true. I may spend a lot of time in front of my books, but I’m attracted to everything else around me. I’m emailing, sending text messages to my girlfriend, and cruising the internet. I’m pulled in by just about anything interesting, fast, flashy, and loud—and all I have to do is hit the enter key to find more of it. Having to read a chapter in my history book or write an essay about my take on a poem written by some ancient guy who’s impossible to understand can’t compete with all the other stuff that gives me instant satisfaction. I don’t feel good about lying to my folks. I’m really a good kid, but I know they have high hopes for me, and I don’t want to look stupid in their eyes. Lying is my camouflage. It’s my way of trying to make my AD/HD go away. But it always catches up with me in the end.

My take on this: Devon is a kid whose intelligence and talents are buried in the fog of his ADHD. He finds it nearly impossible to escape the sticky web of sights, sounds, and content of the electronic universe that surrounds him. They have a gravitational pull on him, like magnets carrying him away from activities that are, in contrast, boring and dull.

Devon is competent, and he cares about what his parents and others think of him. He sees no way out of the dilemma that is his distractibility (or “attract-ability”). He deals with it by lying; lying hides the problem, puts the shame at bay, and helps him maintain his image of the “good kid.” The result? He’s using up his psychological energy to save face—energy that could be better spent doing the tasks that challenge him.

My advice: First of all, let’s address Devon’s guilty feelings. Getting a better handle on time management can help this thoughtful young man be more upfront with his folks. Parents should take part in his plan, too, so they can share in his accomplishment.

In order for Devon to make better use of his time, his parents could encourage him to create a “no-screen zone,” or a space where he totally shuts down his electronic universe for one or two hours a night—preferably a computer-free room. This is similar to the advice I’d give someone who finds it hard to resist drugs or alcohol—don’t hang out with users or dealers, and just say no to keg parties! He might not be addicted to technology, but he’s awfully close. Devon might have to start with 15-minute blocks and then increase the time off-screen. He can also use a timer to mark the passage of time. Remember, however, to use a kitchen timer and not, for instance, a cell-phone timer—that would make it too tempting to “just do a quick check” of email or slip away into Google Land. If he needs to use assistive technology, like a text reader, use “restricted” technology—software that’s loaded on a device (like a Kindle or e-reader) and has no internet connection.

Here’s another strategy Devon’s parents can encourage him to attempt. Before Devon starts on an assignment, he should use a 1-to-5 scale to predict the difficulty level of a homework assignment. He can put this number (e.g., 5 = “wicked hard”) on the corner of his paper, along with how long he thinks the assignment will take. When he’s done, he should do a reality check of these numbers to see if he’s been realistic. This mindful approach to time management can lead to better planning and hopefully keep him from running out of time in the future.

Another idea: If that “GF” (aka, girlfriend) he’s texting really loves him, she might be brought in as a partner by promising not to text Devon between 7pm and 8pm, rewarding him with non-stop texting from 8pm to 8:15pm, and then sending him back to work. If the girlfriend strategy puts too much strain on a budding relationship, then Devon or his parents might consider hiring a “brain coach.” Athletes know how valuable a coach or trainer is in helping them achieve their “personal best.” For some students, this reality makes the idea of a homework coach acceptable and sensible.

Bonus Tip! Some adults with ADHD have difficulty maintaining emotionally health relationships with significant others. Working jointly on a task with Devon’s girlfriend may be a good rehearsal for future relationships (with this girl or another lucky lady later in life) that are made more solid by a better understanding about his ADHD, how it gets in the way, and how both members of a couple can work as a team in a way that pulls them closer together—and not farther apart by the ADHD.

Scenario #2: The Parent

Through a dad’s eyes: It all comes out when my sophomore daughter gets stuck on a homework assignment.The other night I walked by her closed bedroom door and heard her sniffing and sobbing. She had her ear buds in, so she didn’t hear me when I tapped on the door. I opened it slowly and she looked up, teary and embarrassed. She screamed “Get OUTTA here!” and I retreated like a rabbit. She reset, though, when she saw the look on my face. Suddenly it was dad and his little girl again—just like that. “What’s going on, Sweet?” I asked. “This homework is so, so hard, Dad!” she exclaimed, “and so stupid! Why do they make us do this stuff? I’ll never need it later, and I sure don’t need it now!”

Her teachers tells us that our daughter, a sophomore, seems to be “getting it” at school. She’s getting B’s and some C’s on her report card. They say, “Well, that’s not bad—it’s a very challenging curriculum.” They tell us (and her) that she should “speak up more in class and join the discussion.” The smart, happy little girl who got mostly A’s all through elementary school and most of middle school tells us that she just can’t keep up with the intense flow of words and ideas she’s confronted with every day in high school. She has ADHD, inattentive type, and her medication hasn’t fixed this problem.

She says she doesn’t speak up in class because she often has no clue what they’re talking about. “Better to be silent than dumb,” she says, as if she’s rehearsed this line before. She seems to get sadder by the day. She’s tired, has little energy, and is perpetually plugged into her music, which consists of some pretty dreary and depressing tunes. She’s drifting away from her friends, after-school activities and, most sadly, from us, her family. We’re worried.

My take on this: This girl is really behind the ADHD eight ball. This is a classic example of a teen who managed to handle the school demands in early grades—possibly because elementary school teachers are less driven by the need to “cover the curriculum” than their counterparts in middle school and high school—but, now that she’s in a fast-paced, challenging academic environment, is hitting a wall. She’s having trouble receiving, filtering, and storing the information she’s bombarded with throughout the day. Her executive functions are malfunctioning. She’s having trouble making decisions about what’s important and what’s not, and everything feels out of control as she drowns in a sea of facts, words, directions, complex social demands, and organizational challenges.

When kids don’t feel in control, they get stressed, which has a negative impact on the parts of her brain that she needs most—the parts that help her remember and organize. We can see how this is a double deficit: she can’t process because she’s so stressed, and she’s stressed because she can’t process.

My advice: Something has to be done to break this cycle of fear, frustration, and failure. If someone is drowning in the deep end, we intuitively lead that person to the shallows so they can get their feet on solid ground. That’s what this girl needs. In a busy, noisy high school, “the shallows” can often be reached by:

  • providing kids with smaller classes,
  • having them take fewer courses,
  • or getting them more help in the courses they do take.

This might result in having to make up courses in summer school or staying on for an extra semester after senior year—commonplace adjustments in colleges that are, unfortunately, a hard sell in high schools. Some kids need to be told that they don’t have an option. Slowing down or reducing the course load may help a teen gain the stability needed to move ahead with confidence.

If a child is immensely overwhelmed by the stimulation and demands of a large high school, it might be time to consider another smaller and perhaps more specialized school. Building a firm foundation for learning in high school will help to assure success later in college, so now’s the time to take action.

And, yes, if the medication isn’t working, it’s time to check in with your physician about the medication type or dosage. Some kids need their meds adjusted when they get older and bigger.

Scenario #3: The Teacher

View from the classroom: I teach Honors World History. I move at a fast pace and cover a lot of ground. I take pride in the knowledge that I’m thought of by students and parents as a teacher who is “good and fun…but tough.”

I’ve got a boy in my class, George, who at time seems to know history better than I do. He’s addicted to the History Channel and can go into great depth about a number of topics. He’s the kind of kid who might one day become a historian (or even a history teacher!).The problem is, though, that this boy simply can’t resist the urge to call out what he knows before other kids get a chance to answer a question—and sometimes even before I get the question out of my mouth! If I were his private tutor, I could handle this. But since this is a class, he’s posing a major management problem. His classmates are upset by his impulsive style. They roll their eyes when he blurts out an answer, and I know they’re thinking, “Mr. B., why can’t you handle this kid?” And I get it.

One of my students told me she’s stopped raising her hand in class because, as she puts it: “It’s hopeless. George knows like everything, and I never get a chance to talk in class. It’s so annoying!” I brought this situation up at the Student Assistance Team meeting at school and got some pretty good ideas from my colleagues. They suggested talking to him outside of class about the need to let others have a chance to talk and telling him I wouldn’t call on him unless his hand was raised. All good ideas that I’ve tried, but the problem persists. I really respect this kid’s knowledge and even his desire to share it, but I’ve got to get my class back on track!

My take on this: Mr. B is obviously conscientious and cares for this very talented student, but he also cares about the rest of the kids in his class. He has an exuberant, bright boy in class whose outbursts are creating a negative atmosphere. The teacher feels like he’s losing control, which is apparently an unfamiliar situation for him. He’s sought out consultation from his well-meaning colleagues, but he’s still grappling with this dilemma. What to do?

My advice: I would ask for a consultation with the school’s behavior specialist. This person is a professional who’s trained to look for patterns in kids’ behavior and identify the motives of that behavior. The specialist might identify that his disruptive calling out signals or is symptomatic of one or a combination of the following items:

  • the student’s need for attention;
  • his desire to show what he knows in order to reinforce his feelings of self-importance;
  • his attempt to compensate for feelings of inferiority in other parts of his life;
  • his lack of empathy when it comes to understanding the impact of his behavior on others in the class and on his teacher; or
  • impulsive-type ADHD in an extremely gifted and well-educated teen.

Observation and data analysis should help the behavioral specialist come up with a systematic plan that would match the behavior assessment. The teacher might then be encouraged to schedule private seminars with the student, which would allow the student to have high-level academic discussions with the teacher in private. In exchange, the student might be more inclined to restrain himself more class. Here are a few more ideas for Mr. B to explore, either on his own or with a nudge from the student’s parents:

  • The student could be given a notebook or an iPad and be asked to write down what he would say if he were called upon, and then later confer with the teacher on whether or not his answer was correct.
  • The teacher could give him an “advanced” assignment that would allow him to display his knowledge in a written essay or in a creation (play, poem) of some kind.

Mr. B could also put kids into learning dyads or teams—what I call “learning success partners” (LSPs). Once a teacher asks a question, each pair of LSPs discusses what they think the correct answer is and then, once the partners agree, are allowed to respond to the question. The teacher, of course, is in charge of choosing which team member shares the answer with the class.

This kind of strategy does several things: It puts the teacher back in the driver’s seat; it encourages positive social interaction and collaboration; it slows down and channels the impulsive behavior; and it gives all kids a chance to contribute at the micro (team) and macro (class) levels.