Friday, May 20, 2005

Preparing for Summer / Funky Frontal Lobes

Yeah, yeah, I know: Wherethehellyabeen.

Just crazy busy is all. The past week or so has been an astonishingly busy blur, but largely devoid of anything particularly blog-worthy. My aunt and uncle from Connecticut flew in last Friday for a long weekend visit, so we had a little bar-be-que/drinking fest at our place to welcome them to town. Saturday was spent largely recovering from said drinking fest, having some brunch, then going to my son's final t-ball game of the season. Sunday was a trip for the entire family to Inner Space Caverns -- lots of fun, there. Then, lunch in Georgetown (awful) and dinner over at my brother's place (I made penne with a vodka cream sauce, topped with smoked salmon and chives -- delicious). Lots of wine was consumed and karaoke sung. Fun fun fun!

Then on Monday my in-laws arrived -- they're staying with up for most of this week, and will then be moving into a condo they have rented out on the lake for the next few months. This is going to be fantastic as a) they will be nearby, which means we have babysitters who LOVE to babysit our kids whenever and b) they are not staying with us. They've only been in the house for 4 days and my wife and her mom are at each other's throats. Same shit every time. Sigh. Tuesday was work work work followed by getting together with my aunt and uncle for their last night in town (yummy delicious ice cream, wine and conversation at mom's after).

Then Wednesday Christine and I had a follow-up meeting with a neurologist regarding our daughter's ADD/ADHD evaluation and testing.

Oh, we could talk about that I suppose. The last month or so has been very informative on that front.

Briefly, my daughter has been doing great in school, but has been showing lots of warning signs/red flags/what have you for potential ADD/ADHD behaviors and her teacher (who we adore) suggested that we might want to look into getting her evaluated before any of these issues become a real problem for her. So far, the main issue that's been caused is her inability to enter the accelerated/creative learning program they offer because they haven't been able to get her to sit still long enough to take the tests necessary for admission, so it hasn't really impacted her yet.

Anyhow, we had a meeting with a neurologist that was recommended to us by some very respected friends where we discussed Miranda and did the whole parental Q&A thing. The entire screening process is designed to identify a broad range of behavioral, psychological, and neurological issues that can fall under the ridiculously non-specific umbrella of ADD/ADHD, so the first step is to meet with the parents, get their view on things, examine family history, and so on.

Then, a week or so later I brought Miranda in for her testing. Pretty much a full-day affair, where they do all sorts of tests and interviews to evaluate motor skills, conceptual and cognitive function, IQ, and psychological and emotional state. It was quite an adventure for her, actually -- she had a lot of fun with the tests and enjoyed being the center of attention (obviously -- I mean, she is my daughter after all...) . I took her out for ,lunch to give her a break and then picked her up a few hours later. After that, she kept me company while I gave blood, which was an ... interesting ... experience for her. She was alternately intrigued, freaked out, bored, and grossed out by the entire process. But it was definitely something new and interesting for us to do together -- I figure it's good for her to see her parent's doing things that might not seem like fun, but that are for good reasons anyhow.

So, Wednesday Christine and I met with the neuro to follow-up and discuss the results of the testing. Long story short: While she has absolutely no sign whatsoever of any learning disabilities or emotional/psychological issues, the frontal lobe of Miranda's brain is wired a bit differently than the "typical" brain, and as a result she has some problems focusing when other stimulants compete for attention, with basic impulse control, with emotional control and with long-term information retrieval. The testing couldn't have been more precise in diagnosing this -- she hit every criteria for it.

The "problem" is fairly minor, however, especially because the testing also demonstrated that Miranda is exceptionally bright. Her IQ registered at about 120 (91st percentile), but the neuro said that that is actually lower than her "actual" IQ, since the problems she has with focus and paying attention interfered with some of the IQ testing procedures, causing her to leave some sections incomplete. So yeah, she's brilliant, which has prevented the attention deficit from affected her scholastic performance and development thus far -- she's at least 1-2 grade levels ahead in nearly every area for which she was tested.

Of course, the trouble is that in time, as the difficulty and amount of school work increases, she will almost certainly eventually hit a point where suddenly the attention problems become an issue, which is why it's good we got involved in this process early. Plus, this stuff can lead to some serious social issues for kids, especially for girls. Kids who have these problems tend to have trouble judging proper behavior in specific social situations, and it can really jam them up over time -- especially girls, apparently. Since girls, particularly in the early grades, tend strongly toward "social ruler" roles, other girls who don't play along, or who more precisely gets the rules "wrong" can really get ostracized. Not that I want my kids to be followers -- far from it -- but being independent is different from being forced to be an outsider. Take it from me: I know.

Which is what's been most interesting in all of this. As we've done the reading and research and spoken with the neuro, well, a lot of things have become much clearer. There's a very, very strong genetic corellation with this sort of neurological development, and, well, let's just say this apple didn't fall far from the tree. Christine and I both were just like this when we were kids -- oversensitive, easily frustrated, very bright but socially awkward and impulsive, odd kids. We both carry a lot of baggage as a result of this, because when we were kids they didn't call this ADD or work with parents to try to identify the issue and come up with ways to work around it -- they just said we were "dreamers" or "flighty" or "easily distracted" or "lazy" or "weird" and moved on.

But, more interesting though, we are just like this as adults. We've just learned some strategies to work around the problems our oddly wired little fore brains present. Keeping lists, multi-tasking, avoiding emotionally charged situations if they are not comfortable for us, forcing ourselves to think before saying something impulsively, etc. For example, anyone who knows me knows I'm a crier -- give me a good sad movie and I'm wiping furiously at my eyes at the end. I'm fine with this, because I'm lucky enough to not be uncomfortable socially and I don't particularly care what people I don't know think when they see some big 220 pound guy sniffling and wiping his eyes. But I also know that if I am going to be somewhere, around people I do know and respect, where emotional outbursts aren't OK (such as work, for example) I need to keep a certain emotional distance on what goes on around me or I won't be able to control myself or my emotions at all.

Coping strategies. That's all. And judging by our experience, our lives thus far, that's all it takes.

So, it's been interesting. Basically, we stacked the deck on this kid (and almost certainly on our son as well -- he's certainly showing some of the usual tell-tale signs as well and I have a strong feeling we'll be doing this whole process all over again in a year or so...) but we also know that she's super bright and that bright people find their way through these things. We both managed to do it, without much in the way of assistance or help (since 30 years ago this stuff was all just being figured out). Our kids will do just fine, and wuill probably do better than we did because at least we know what we're talking about and what to watch for.

As for medication, we're avoiding it if at all possible and will only consider it if things start looking bad school- or social-wise. But one of the things we learned form the neuro is that the meds actually address precisely the sort of issue that Miranda (and me, and Christine...) have, which is that they stimulate the frontal lobes of the brain and thereby enhance the patient's ability to focus and screen out distracting info for a brief period of time. One of the reasons these meds have gotten such a bad rep is that they were prescribed to every kid who had any sign of anything ADD/ADHD related. Our culture is so keep on the quick fix, the magic pill, so that's what we do. Still, we're going to avoid them if at all possible -- they are a Band Aid, not a solution.

So next is reading and study. We need to bone up on techniques to help Miranda learn how to keep her thinking and activities more ordered and structured so that the neurological issues don't interfere with her ability to learn and develop socially. So that'll be interesting.

Side note: Just a moment to brag. As we were going over Miranda's tests, we went through the emotional/psychological portion, which was essentially a series of "fill in the blank" type questions. One of them was "I feel safe when..." and Miranda finished the sentence "... my Daddy holds me in his arms."

OK, misty-eyed now. Damn funky frontal lobes.

Mood: Beat
Now Playing: Gorillaz, "Demon Days"


Karl Elvis said...

That whole story could have been mine. Olivia, who's 11, is brilliant and sensitive, and absolutely cannot sit still or concentrate on anything for more than a few minutes. Her school started talking about ADD and meds, and we got her into testing and some counciling.

The result - yes, she's ADHD, but you know what? WIth the right environment, and some careful attention to what she's eating (Gregg, watch out for food coloring - the red is muder for ADD/ADHD kids, it makes it much worse), she's at the top of her class in a very tough private school.

...And like your story, I'm exactly like she is. Full on ADHD. Mom is ADD. Olivia's got it on both sides.

The bottom line is, ADD/ADHD can be a real challenge for parents, but some of the world's most interesting people are that way.

Gregg P. said...

Yeah, that's exactly our take on it. As I said, medication is strictly a last resort sort of thing -- it would be something we'd consider only if Miranda were having a VERY hard time -- grades falling rapdly, self-esteem taking a serious beating as a result, etc. -- and it would be a temporary measure to get things under control while we worked on additional behaviorally-based approaches to fix things.

One funny outcome in all of this is how it explains so many little things that I've found frustrating about my wife, or my self, or Miranda. It's so much easier to not get worked up over something when you know, without question, that the person isn't "ignoring" you or purposely leaving things undone or whatever: they just can't help themselves. If nothing else, that's been a really good result of the testing and discussions with the neuro.

And thanks for the heads-up about food coloring -- I mentioned it to Xine and she said you're the third person who's mentioned that to her! I had no idea....

Karl Elvis said...

We learned the hard way -- Olivia would get wired and then miserable every time she has a slurpee. I scoffed. No way, I said. But it's true; we tested several times. White slurpees, only the normal sugar buzz. Red ones, wired then weepy. Olivia's now trained to read labels for food coloring and won't eat any candy or drink any drinks with red 40.