Withdrawing from School, crisis management

Parents Forum
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<p>In May of 2010, we moved Son out of his freshman dorm room at the end of the semester.His roommate had left the school after first semester, so he was alone in a double. He was in the choir that sang after graduation, so he had to stay on campus several days after his last final…with nothing to do but pack.</p>

<p>We arrived to find that the extent of the packing was a few clothes thrown in a duffle bag. His room looked like one from one of the Hoarders shows (only with just a few months of mess insead of years.) I am not exagerating to say that I am traumatized by the experience two years later. It was such a window into his utterly disorganized mind, into how things are for him when left to his own devices.</p>

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<p>It is classic Executive Function Disorder. Lack of the ability to initiate - such a severe form of procrastination - is a hallmark.</p>

<p>What I have found is that it is easy to get a diagnosis, but the constructive next step is elusive. Kind of like being an alcoholic…okay, pretty easy to tell when someone is an alcoholic, then what? The diagnosis is not the cure. And of course, with both conditions, we know that there is no cure.</p>

<p>My heart just breaks for all of the adults out there with Executive Function Disorder…with no name to it…just a life time of being “lazy” “irresponsible” “procrastinators” “screw ups”. Negative character qualities ascribed to a neurological condition. There is so little help out there for adults.</p>

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<p>^^yes, yes yes…The dx of ADHD was timeconsuming but definitive. But there is no next step. He isn’t seeing a therapist, just a PA who oversees the meds. We’ve tried without success to find a coach, and quite frankly, pouring more money into providers when there is not a lot of buy-in seems counterproductive. It’s not that S2 doesn’t want to be different, or doesn’t understand the issues — it’s like most adult ADHD patients, at that specific moment of action, he usually chooses to pass. He started a webclass and clearly was overwhelmed and panicking after reading the syllabus. I literally held his hand and said, you only have to tackle one day at a time. Just one day.</p>

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<p>If you can at all afford it, try to get good professional help, and it’s not cheap. You may even have to pay out of pocket for effective help. If you can at all manage it, I recommend it.</p>

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<p>Greenbutton and MissyPie,</p>

<p>How did your sons do in high school? Did you have any indication of their inability to be organized?</p>

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<p>But it is so difficult to find effective help. I was so excited when a therapist who was an “executive function expert” finally had an opening. Nine months of “therapy” with the guy just reinforced the traits…okay, so Son realizes that he is disorganized, horrible with money…now he owns it, affirms it…okay…where’s the fix? There was no “this is how you can be better with money”. It was “you shouldn’t handle money.” This approach might work with alcoholics…a person can live his entire life without alcohol. But a person can’t live his life without handling money, without buying food, etc. That particular therapist definitely made things worse.</p>

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<p>Mitch Nagler told me that in high school, the parent is the coach, without realizing it.
In high school you go to meet the teacher night and get the syllabus for the class. The parent can email the teacher and she responds. The parent can ask for a meeting with teachers and they come. Grades are posted online at least every 3 weeks and the assignments are listed for the whole grading period. If the student skips class, the parents get a call. </p>

<p>Presto chango, they turn 18, they go do college. Teacher aren’t allowed to talk to the parents or share grades or attendance, even if they are willing. Doctors can’t even share information. </p>

<p>You have a child who has benefited from a lot of structure and accountability and over night they are transported to an environemnt of little institutional structure and no immediate accountability. I feel like a voice calling in the wilderness, because I know why so many students don’t do well in college.</p>

<p>Helicopter parents are blamed…we didn’t let them fail in HS, we did too much for them. But people with Executive Function Disorder may always need some sort of a coach. And left to their own devices, when it’s sink or swim, very often they will sink and never swim. And again, they will be accused of being lazy or of partying too hard, that’s why they didn’t do well in school. In reality, they need a whole lot of structure that college does not provide.</p>

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<p>I worry about this for my son (well, both my older sons but my oldest is headed to college in the fall 3,000 miles away). His room is a disaster, though when he has time, he does love to organize. I often have to remind him to put things on the calendar, to call/email someone, etc. He’s really bad at administrative type things. As a homeschooler, I’ve done most of that. He’s a top student (though I’m guessing he’ll experience failure since he’s headed to MIT) but I just see him dropping the ball on deadlines for non-academic things. </p>

<p>He also has a hard time saying no to anything. He loves to do everything but he just can’t do that when he gets to college. I think I’ll look into EF coaches for the summer. Even if he could learn a few simple skills, that might help-maybe something as simple as learning to use his smart phone for reminders of deadlines would be helpful. And I guess he should plan on being a minimalist when he packs for college.</p>

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<p>I have severe executive functioning issues and would like to share a story, and a strategy.</p>

<p>My biggest issue in school was taking a list of X number of things, and figuring out how to divide my time in such a way to accomplish all X number of things in one day. I completely lacked that skill going into senior year of college and was just not eating or sleeping to compensate. Shortly before I started working with my coach, the boy I was dating at a time tried to give me a set schedule for the day to follow for each thing I needed to do… we tried this for a few days. The first day, he forgot to schedule my lunch. I couldn’t eat lunch that day, because if I derailed my schedule to eat I wouldn’t have had the skills to put the train back ON the rails again-- the rest of my day would have collapsed around me. The second day, I had an unexpected appointment in the morning… and the rest of the day was a wash. Either I tried and tried and tried and couldn’t get everything done, or I worked so hard I burned out in the middle and couldn’t get everything done, or I got overwhelmed and panicky and got nothing done. This is beyond normal lack of discipline, I literally did not possess the skills to FUNCTION.</p>

<p>I had much better luck while working with my coach, and that is how I’ve managed to get to a relatively good point today. The BEST thing about her was that she had a limitless imagination for coming up with new organizational strategies for me. The thing with ADHD is, if you try one strategy and it doesn’t work, trying to hand hold or force your son into complying with that strategy is like asking him to repeatedly beat his head against the wall-- his problem is most likely not that he lacks the discipline to follow through with organizational strategies, by 22 we usually know in THEORY how to take care of ourselves, the question is whether we have the skills to actually consistently follow through without help. Unless there are underlying discipline issues on top of the ADHD (which sometimes there are, but often by age 22 maturity kicks in and there isn’t), that strategy is probably never going to work if it isn’t at least kind of working from the beginning. </p>

<p>So if my coach tried to color code my folders and after a week that wasn’t working for me, that strategy was out and we tried something else. Eventually, through trial and error, we found strategies that worked for everything I needed to do. I still struggle as an adult but I can make it on my own now, and I am no longer skipping out on things to vomit in the bathroom like OPs S-- and yes, I’ve been there. The trick is not to fall into the trap of thinking, “okay, I showed him how to do it, NOW WHY WON’T HE DO IT?” Giving one strategy is showing WHAT to do, not HOW to actually do it, which is something you can’t teach… you just have to find the strategies that work with the way his brain with wired. Go with the grain, not against. You will never, ever win going against.</p>

<p>For an example of the above, I keep track of things I need to do with a whiteboard on the wall. I have a large pad of paper on the wall of my cubicle at work, too, now that I am no longer a student. Give me a day planner and that is a one way ticket to disaster… it will NEVER work for me, no matter how simple it is. Coach threw out the day planner and we tried other things until something clicked.</p>

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<p>Terrific post, Ema.</p>

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<p>For those of you who do not have executive function issues yourself or are not living with someone who does: if you suggest that someone buy a day planner and they absolutely jump down your throat, it is because that person has heard the same suggestion 20 times a year since 4th grade. Day planners are for some reason seen as the Absolute Panacea but for many, they are not.</p>

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<p>We tried the day planner, tried index cards, tried a whiteboard, tried a calendar, tried voicemail, tried not trying. Tried baskets, bins, files, folders. Tried minimalist uncluttered look. Tried color coding, tried iPod apps. Trying meds. Trying phone/iPod in a locked drawer. Trying no icons on laptop. Trying positive reinforcement for the victories, because I completely understand that it is not his nature to know how, and that he will never form a habit, but can develop a discipline. He certainly doesn’t lack effort! But how do you tell the difference between it isn’t going to work, and it isn’t going to work YET? Emaheevul, can you recall how you would decide how to try another strategy?</p>

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<p>Thanks, missypie.</p>

<p>And a P.S… if you take the head-banging-against-the-wall out of the equation, your S will not burn out and descend into panic so quickly. That sense of being stuck in a loop of failure just flips a switch in some of us and we self-destruct immediately. We need to keep moving forward with new strategies and never get stuck in that loop to begin with.</p>

<p>ETA: OP, it’s difficult to recall… I have been out of school a year now and work is a lot easier than school was. But I think the way we knew was when I sensed that feeling of being stuck in the loop of failure coming on… when it got to the point that I was failing at it repeatedly over and over and my stress level was rising, it was time to try something else. For me, that can happen in a day, but it’s usually more like a week or two. Your S may be different. </p>

<p>My coach was also helpful at judging when my stress level was reaching a point that it was no longer productive to continue on that one course. If he panics and shuts down, you’re not making any headway with that strategy. Though, if he is still all wound up from his “failures” at school and is getting upset and overwhelmed very quickly, he may need some time and a therapist to help him cope with the anxiety side of things, too… that can become a whole other issue which complicates matters, as I’m sure you’ve witnessed. Anxiety and executive function disorders feed off of each other, in my opinion. I don’t think you can fix one without fixing the other. If he is still feeling very bogged down by his lack of success at school, I think he will struggle with anything he tries.</p>

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<p>To find a good expert, try talking to area elementary school counselors. They deal with young kids with the issue and find out who is effective. Try calling a number of elementary schools, including private and parochial. Some experts are not effective at all. A really good one may not take any insurance, but is better than years of an ineffective therapist covered by insurance.</p>

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<p>Ema – very helpful post. </p>

<p>Are there some tests that specifically indicate Executive Function issues? Or is it more an “I know it when I see it” thing?</p>

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<p>I would not even be considering sending him back to school in the fall. He needs time to work on his issues. </p>

<p>This may sound like it’s out of left field, but I would have him do a sleep study at a hospital with a sleep center. There often are issues related to nighttime sleep / daytime sleepiness which can affect the daily functioning and can go completely undetected without such a study.</p>

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<p>He is registered for the fall, but our private thought is to see how he is then. He would commute from home, so there’s a lot of security and support, and he’s only registered for 2 classes (which might be reduced to one, we are in no hurry here). </p>

<p>I work in an elementary school, and haven’t yet found a therapist who specializes in adult adhd. But today, S2 found out about a student adhd support group that will start up in August, so that would be something useful for him.</p>

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<p>Interesting that I came across this thread just as I am about to discuss with my ADD college junior son the implications of his not taking his Concerta this past school year. What he has told me is that he didn’t take it because it makes him lose his appetite and feel weird. We have discussed that many medications have side effects and that dosages/types can be adjusted to minimize them. He admits that the Concerta does help him focus. He had a psychologist specializing in ADD that he saw for about a year and then had a couple visits with a psychiatrist to get the meds when therapy alone wasn’t making a significant difference. But the meds are surprisingly ineffective when they are not actually swallowed.
So far my plan is to require him to make an appointment with the psychiatrist to discuss all this with him. And maybe to have him resume therapy with his psychologist, depending on what the psychiatrist says.
My son has managed a B- average so far, majoring is psychology (ironically). But I know he got a D or F in one class this semester, even with just 12 credits. And I don’t think the rest of his grades are A’s and B’s :slight_smile: I think now that he is taking all upper level classes, the techniques that got him through the easier classes aren’t cutting it. He is adamantly opposed to working with an ADD coach.
Sorry for the long post; my heart goes out to the OP and everyone one else dealing with this.</p>

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<p>delamer- I go through that periodically with my son too. We go up and down on dosages. But have stayed on the same meds. It is really frustrating, isn’t it?</p>

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<p>My daughter needs a coach at college, but we cannot afford one. Coaches charge at least $100/hour, often much more. Any ideas on affordable coaching? Right now, I’m the coach.</p>

<p>Love the comments on day planners.</p>

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<p>Vlines -it is hard for me to understand why he wouldn’t want to try to get a dosage that he is comfortable with, when he acknowledges that it helps. I suspect that while intellectually he knows that ADD is a medical condition, just like high blood pressure, emotionally he feels that there is a certain stigma attached to it.</p>

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<p>my son too. And that he is “weak” or “cheating” if he uses meds. </p>

<p>He decided to stop all meds end of junior year. He got to be unbearable around here. It’s not just with school work, but just being around him is difficult sometimes when he is that scattered! Even a really low dose helped to calm just enough that he could enjoy himself, and the people around him could enjoy him!!!</p>

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<p>I haven’t been around my son enough to see if he behaves differently when he is on meds. He isn’t hyperactive, which is one reason it took until he was in college to be identified as ADD - no H. He is a bit loud and talkative; I am not sure how I’d feel if that disappeared…</p>