30 Essential Ideas you should know about ADHD, 5B ADHD is a disorder of self regulation
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30 Essential Ideas you should know about ADHD, 5B ADHD is a disorder of self regulation

So I would want parents to understand that that is a very profound disturbance
in a person’s behavior but it arises out of Neurology Internet X and out if this is going to come a
very important view of what to do about this disorder the first thing this
is going to mean yes to stop teaching so many damn skills because you’re approaching this child is
if you stupid right although he doesn’t have any
friends I guess who doesn’t know social skills so we’ll
take another local clinic and we’ll roll in a 12-week social skills camp about
which will probably pay fifty to a hundred dollars a session or we’ll send em to the Upper Peninsula
Michigan where there’s a nice summer social skills camp that was advertised
in Chad attention magazine there is probably a very nice camp I
don’t mean to belittle it I’m just telling you what will do no good rent well now let’s understand I might want to
send a child to camp just to have fun right it’s hard to the quality of life
goal have a nice summer but if I’m sending you to camp with the
belief that you’re going to come back a person with better social skills
you’re sadly mistaken so we have got to stop putting all the
eggs in the skill training basket because
that’s not where the problem is we have got to spend more time changing the point a performance the point
performances were you should be using what you know and you’re not and the only way to treat
a performance disorder is to change that point this means that all treatment if it is going to work at
all must be at the point performance the
place in your life where you’re not using what you already
know and if the intervention isn’t done there it’s useless and has been a major
finding the last decade the only treatments that work are
treatments that modified those natural points in the environment
where the problems are occurring enough those are modified nothing done
away from that site will do anything so you can do pull ups
services you can go to summer over to a social
skills camps you can go to a special ed you can come
and see me for once a week for psychotherapy and everything I just said we’ll have no
generalization maintenance well go anywhere won’t even leave this
room Howard a pic of Tulsa beautiful story the social skills group B ran on
the day they covered anger management and sharing he open the
door to the room in there was a fist fight in the hall by the elevator over who is going to push the button so much for your anger management she see what happens
you were focusing on knowledge oleg d teach you how to share and
cooperate any missed the point this is not
information deficit disorder this is performance deficit disorder so you gotta change those point to
perform it if he has no friends on the playground you’re gonna have to do
something at that school if you have trouble with
homework at the kitchen table honey it’s not my office we need to rearrange
where the home work is being done to help them show what they know as I’ve already said this point of view
also then makes us look very differently in psychopharmacology as a form of neuro
genetic treatment now everything I’ve just said could be
used by any parent to come up to me and say much I got thrown out of school
yesterday for some misbehavior would you please go to school and get
him reinstated he should not be held accountable for these consequences right because after
all can you just say to your genetic disorder so let me help you understand something
about what I just said ADHD does not cause a problem with
consequences the problem is with time it was the
delaney to the consequence the disabled you
which means that I’m going to do the opposite up
with this mother is asking increase accountability not decrease it increase the frequency immediacy the salient and the timing
have consequences people with ADHD need more
accountability not no accountability in fact this view Ave
DG is an executive disorder would tell you that if you argue for no accountability you will
make this disorder worse not better because the problem is the delay and all natural
consequences %uh any importance are delayed what does that mean we are going to have to use behavioral
treatments the beam on programs that opens the church the cards the smart
stickers whatever what is their purpose their purpose is
not to teach that is a missed nomer if you will their purpose is to sprinkle artificial consequences
into these two ladies in the natural environment in order to
increase your accountability so they’re not teaching anything they
are making up for the accountability deficit disorder be
mine does not teach anything to eat each the
children really what it does is improved the motivation
to show what you know by making you more accountable more
often around you you have less ADHD by excusing from the consequences you be
more ADHD so what you understand something there
are two reasons why we would tell you as a family to do behavior
modification one is instructional this is why we
teach families have artistic and mentally retarded children be remote
application to teach their children things they
don’t know but the second purpose you would you be
much for has nothing to do with instruction its motivational to make up for the
motivation deficit disorder that this disorder produces and so if you do be marred for its
motivational value you can’t stop it because if you pull it
you pulled the motivation if you do be moderate instructional
purpose you can pull it because once they’ve acquired the skills
to use the skill and you don’t worry about it anymore now do you see a a contrast you most
parents in nearly all teachers I deal with
believe that be mired is for instructional value that’s why we
do it for ADHD which is why when are you going to a school in you try to teach a
teacher to set up a token system the first question out of his mouth is
how long do I have to do this when we internalize the program and my
interest never choices in your class you will have to
rearrange artificial consequences to replace the delayed once and if you
don’t do that he will not work for you so I want you to think about token
systems and star charts and all behavior modification as being equivalent to a ramp that comes
into this building that ramp is there to make people who are physically disabled less moto
wrigley impaired they can get into the building in their
wheelchairs or whatever other devices they’re using but would you ever say to such a person after 30 days are venturing this
building successfully using the ramp you know with you know the punchline right can I take
the Riverway have they internalize the ramp of course not the ramp was never for
teaching right the ramp is a prosthesis a prosthesis is an artificial means I’ve reducing the disabling consequences
a few disorder it is not to train you up into anything
no amount of using a ramp is going to take the ramp away and no
amount to be modest going to take to be modded way these individuals will always need more frequent consequences around them
then we’ll other people in order to perform at the same level it’s just a general corollary have ADHD
so we don’t have we learned about ADHD well if all treatment is at that point
to perform internet at that point performance I’m trying to arrange a
prosthesis a prosthetic environment to reduce the
impairment from the disability right then it means that the caregivers
are the most important people in the treatment plan the parents and
the teachers it is their compassion for disabled people and their
willingness to make these prosthetic accommodations that is the heart any successful
intervention and absent that compassion no amount of quality in a good professional or
therapist is going to change that you have to make those people
stakeholders you gotta get them invested and if they’re not you’re in trouble it doesn’t matter how
good a clinician you are so it’s best to look at ADHD I would be
telling these families in my office like we look at diabetes largely a
chronic disorder and our goal is to manage it to create a reduction in the symptoms the purposive which is the avoidance of
secondary harm we do not treat diabetes to get rid of
it we treated to prevent what happens to
you if you don’t manager diabetes because you will go blind and your heart muscle atrophy and you
are at risk for sudden death and you will get gangrene and you may
have your toes or fingers are other appendages eventually amputated if we do not manage your insulin levels
that is what we try to prevent but no amount of treating diabetes as
ever designed to get rid of the diabeetus and I think a DH is a very good analogy
I think we manage adhe to prevent the secondary harms what I’m about to show
you we don’t manage ADHD to get rid of it we
manage it so that you don’t experience those more genus consequences

19 thoughts on “30 Essential Ideas you should know about ADHD, 5B ADHD is a disorder of self regulation

  1. but they may have missed some skills because of being inattentive when they were younger… but he's right about point of performance

  2. so funny my daughter was in a rage this morning after i was watching this i started the chart. she screaming out of her room and said this guy is stupid….the work got done for the first time so there must be something to this .

  3. But Russell Barkley, how will they do in the adult world if they are reliant on the prosthesis token sysytem. If we have made them a consistent immediate token system, how will they adapt without one as an adult.

  4. I suffer from untreated ADD and lack of immediate consequences in childhood, no discipline, and no accountability has totally messed me up…

  5. This particular one is so absolutely dead center for me, it's unreal. I've been trying to alter my environment for years, instinctively at first and then in a semi-organized manner, knowing how profoundly I'm dependent on the environment to succeed. (Clearly medication is not handling it.)

  6. Maybe if people got diagnosed earlier it would save people the heartache of going to drugs and alcohol or food and treatment centers

  7. A low carb or zero carb diet can completley mitigate diabetes, even somewhat reverse it. So…do that for ADD

  8. This is really enlightening. When I was in cadets or a strict high school, I did pretty well, but college and home life was so laid back or at least lacked short term consequences, so I got nothing done.

  9. I've been thinking lately about consequences and punishment. It's seems to me that it doesn't have to be a very unpleasant conscience for it to work. In fact a very unpleasant consequenc may probably make the situation worse because it may add some negative emotions that will stick with the memory and make or minds less clear. And i think we got it all wrong how this works. With consequences that just a tiny bit uncomfortable it is not about the brain learning to do the right thing because it wants to avoid the discomfort. It is almost the opposite. Why do you think enjoy amusement parks, why is there such a thing as SM, what about movies? Our brains love this stuff as long as it is not to serious, or too painful. So our brains sees this more as a reward if the emotional if it is done under the right conditions so that you feel safe and the pain is not to much. What it does is that it wakes up our brains a little more enabling us to make the necessary corrections in a calm and easy way.

  10. I have watched some of Barkley's lectures. Here are my impressions:

    1. Barkley is clearly threatened by newer perspectives on ADHD based in evolutionary psychology that may, in fact, help explain why this difference, which appears to have a strong genetic basis, continues to exist in such large numbers in the population. He is disparaging and rather arrogant in his treatment of others' ideas on the subject in person, making jokes at their expense which I was appalled that other psychologist appeared to find humorous.

    2. In person, he also makes jokes at the expense of children with so called ADHD. He does not appear to have empathy for those with this difference; his empathy appears limited to those who must "deal" with this difference in others, be it parents, teachers, employers, etc. Again, I was appalled at his crass attempts at humor targeted at individuals with ADHD during the seminar I attended. It was akin to making "fat jokes" at a medical seminar on obesity, although Barkley seemed oblivious to the lack of propriety of such jokes, and furthermore, did not appear to believe that anyone in the educated audience he was addressing could suffer from ADHD.

    3. He is so married to his own theoretical views, which have made him a "renowned expert" in the area of ADHD that many of his attacks on other theoretical viewpoints are clearly defensive in nature and aimed to protect his career and status in the field. His disdain for Thomas Hartman was quite apparent at the seminar, for example, although there is now some evidence that Hartmann's idea (it's not quite a theory yet) that individuals with ADHD were adaptive in past cultural environments is quite possible and supported by evidence concerning other conditions that were once protective in different physical environments (i.e., sickle cell anemia and its protection against malaria).

  11. Diabetics is always treated by injecting insulin, but recently people find out that low carb food and keto helps diabetics. While ADHD and ritalin can be used in the same statement, one must aware that our environment is not changeable like diet. Yah ADHD symptoms can vanished by not talking with people, not having things to be done, not having any responsibilities, no need of driving, and where people expect you to be self-disciplined and perform self-care. Somehow makes drugs sadly seemed to be the only way. Although that environment is not totally changeable, we must still alter it to suit our needs, having less sweet stuff in diabetics may not affect the need of injecting insulin, but it definitely helps with the disease. Environment changing helps ADHD into an extent, but meds is needed like injecting insulin.

  12. You can actually get rid of diabetes It's called a keto diet. Not "manage" it. In that respect.. I wonder if you can "get rid of" ADHD. Hmmmm…

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