Monday, January 25, 2010

My ADHD Story Part 5 - Northeastern University (Almost done!)

In my final years at UMass, I got my Emergency Medical Technician certification. This turned out to be my only job prospect upon graduation. That summer, I rented out a room for the summer at Kappasig and got a job for Cataldo Ambulance in the Greater Boston area.

Things were bad, I eventually rented a small room in the fall. The door could only open ¾ of the way before hitting the twin bed on the opposite wall. My EMT credentials were going to expire so I needed to figure out what I was going to do. While in a police-supply store in Somerville, I was contemplating dropping an entire pay-check to buy a bullet-proof vest. (They don’t often need ambulances in safe neighborhoods.) I told myself, “You have a freaking degree. Do you really want a job that pays so little to get puked on by junkies?” I put the vest down and knew that something needed to change. Being a college student in Boston rocks, but being broke in Boston sucks! I barely remember that year because there was nothing worth remembering.

Right around that time, the evening news had a special about local cheerleaders going to the Atlanta Olympics to be in the opening ceremony. It was the Northeastern University Cheerleaders. I recognized some of the from NCA summer camps when I was at UMass. I remembered how happy I was cheering, so I showed up and asked if I could work out with them. They were very gracious and let me hang with them.

I took an accounting class at NU hoping it would boost my chances of getting a business job. No luck. To make more money, I ended up getting a job at Chili’s with some folks on the squad.

Let’s rewind for second… I switched jobs from saving lives to serving burgers FOR THE PAY INCREASE! That is a scary thought. I made significantly less money saving lives (or trying to save them) than I did at Chili’s. I think that is a sad commentary on our nation’s priorities.

Then it happened. The one phone call that put my life back on track.
Her name is Lorrie Wright, and she was the cheer coach at NU.
(pausing to get choked up…)

I don’t remember the details, but somehow Lorrie knew that I was investigating the School Psychology program at NU. I remember her calling me and giving me two people’s contact information. I was to ask one person about applying to the program, and I was to ask the other about a grad assistant-ship.
(If you know Lorrie, you know that she didn’t ask me my feelings on the matter. She knew what I needed, and she told me what to do.)

I don’t know what happened, but I have seen Lorrie help other students out. That is just who she is… I don’t know what I did to get on that list… None of that matters. I just know that, sometime in my life, I need to Pay It Forward one day. Regardless, after that moment, my life started to come together in fast forward. By day, I was a graduate student on my way to great career. At nights and weekends, I was a Captain of the Northeastern Cheer squad. I lived my life at the speed of my ADHD.

The only bad thing about cheering in graduate school is that I did not spend enough time networking for a job in the very tough Massachusetts market. My only job offer was in California. I felt horrible moving, as I could have cheered another year because I was still taking fieldwork advisories for another year.

I left to California, by myself, looking for a fresh start.

Eric was on his way to becoming Dr. Beam.

I need to finish with one and only one thought.
Thank-you Lorrie!


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Thursday, January 21, 2010

My ADHD Story Part 4 – UMass, Diagnosis, and graduation

I was the first person to ever transfer from MIT to the University of Massachusetts, Amherst. I know this because EVERY person involved in my transfer told me. It was also the rationale as to why they had to review every class credit transfer on a case-by-case basis. In this review, the difference in MIT’s system (1/2 the classes per sequence, but twice the curriculum per class) and the UMass system meant that I lost 1 credit for every 6 that should have transferred. Because you cannot get a 1 credit class in Biology 2 or Organic Chemistry, I was stuck taking the whole class over. This now cost me another semester. If you are keeping tabs, this is one semester of MIT Tuition and one semester of UMass tuition lost to undiagnosed ADHD.

Taking an entire semester of classes that I had already managed to pass at MIT sucked the life out of my self-esteem. I was no longer living with brothers at MIT, but in a dorm at a state university of some greater than 20,000+. I was pretty much another face in the crowd. I remember sitting in Biology lab. Instead of enjoying the attractive and smart lab partner who was making an effort to socialize with me, I was wallowing in self-pity thinking, “I should be TEACHING this class, not taking it.” I was too socially inept to notice if she was flirting, trying to be friends, or just a nice lab partner. She was self-conscious about her hearing aids. Maybe not noticing things helps sometimes?

This was actually a hidden blessing. I knew this curriculum. I sequenced DNA and RNA at MIT, and they want me to learn to use a microscope!
Then, I bombed my mid-term.
WHAT THE F-_-K!
My self-esteem took another hit, but the scientist in me had firm data. Something was wrong. An F was not a valid representation of my understanding of the curriculum.

I don’t remember the details, but I ended up telling my story to someone at UMass Student Services. I ended speaking to an intern at the Berkshire Assessment Team, now called Counseling and Assessment Services.

I do remember her parting words after one session.

You sound like a text book case for learning disabilities and/or ADHD screening. It would be inappropriate for me to make any predictions based on this visit, but we have a two-tier approach. You will get an initial screening to look for obvious rule-outs or determine if you fit the profile for more rigorous testing. This may take some time, so I STRONGLY encourage you (wink, wink) that you research the study skills recommendations for student with ADHD.

At this point, my understanding of ADHD was an occasional joke or newscast about Ritalin. But I would be damned, how was it that every single case-study in these flyers and books were about me?

I bought the book and audio-book for Driven from Distraction. I read the book and listened to the audio-book so much that I wore the audiotape clear through. I don’t remember learning anything concrete from these—not that there was not good information. I was listening from too emotional of a state. I just knew that there was a name for my problem, and, more importantly, a plan to overcome it. I cannot explain the joy, relief, and uncertainty that I experienced. A diagnosis is just a label. There was still a lot of work ahead.



In time, I received a world-class assessment and diagnosis. (In retrospect, probably overkill. I bet some interns needed practice on some assessments. Glad that I could help.) Like I have said, in my 12 years in the field, I have not yet run into a discrepancy as large as mine. My deepest thanks to the folks at UMass. That is how you do Student Services correctly!

I also got a proper prescription for Ritalin. I still take methylphenidate in the form of Concerta today. However, that is the topic for another post. I will tell you that I tested myself then, and confirmed again this year, that my productivity from medication improves by a factor of six. This means that one hour of work on medication yields the same product as 6 hours without medication. I remember packing snacks and a lunch for a days worth of homework… only to be done by 11:00 am. What did I forget? Spanish, done. Biology? Chemistry? Holy Cow.



SOCIALLY

For the most part, I was a lost soul at UMass. Even with diagnosis and my academic turnaround (GPA before Diagnosis was a 2.7 and a 3.7 after diagnosis and services.) I was still obsessed with my academics and my situation. By the time I was diagnosed, I “should” have been graduating from MIT and choosing what medical school I was going to. A co-worker at the Greenough Snack Bar told me about how excited she was to get accepted to Tufts School Psychology program. Until then, I have never heard of school psychology. Thanks Eden!

It is not surprising that I had not made much social progress considering the fact that I was so self-absorbed in finally coming to terms with myself, focused primarily on academics, and completely clueless to my social issues. I did not want to make lifelong friendships, I wanted my damn diploma!

This does not mean that I did not run into great people at UMass. I became involved in competitive cheerleading. I was not that great, but I loved it. Organized sports help amazingly. I burned energy. I had an external structure to my life. I was surrounded by great people that provided support. I know most stereotypes that people have about cheerleaders, but the ones that I know are great people. They are the most kind-hearted that I have met. They are true athletes, and, in fact, lack the legal protections that NCAA-sanctioned athletes enjoy. They are not just academic achievers, but they also have the social skills and connections to be very successful. In fact, former cheerleaders are some of the happiest, if not most successful, people that I know.

I did get my diploma, but I was so focused on my immediate problems that I had no plan for life after a Bachelor’s in Psychology. I was in debt, had no job prospects, and no true support system unless I moved back home. I was way too proud to move back home after proving my dad’s worse fears true. I had a degree in psychology, but what would that get me?


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Tuesday, January 19, 2010

Communication and Assistive Technology

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I will take some time away from talking about myself to answer one of my first questions.

Q: What are your thoughts on Assistive Technology (AT) for non-verbal/mostly
non-verbal kids? (Doesn’t have to be Autistic specific)
A: My first step would be to look at the student’s functioning and ask, “What is the big goal?” I want to know if my goal is to increase community involvement and interaction.
If it is, I am a fan of Least Restrictive Environment --- even for AT devices (Also commonly called “Alternative and Augmentative Communication” or AAC).

1. Is there a low-tech answer?

2. If you go tech, can you use something that is commonplace in work or school technology? It is amazing what you can find on your everyday laptops that no one knows about.

3. If no to #1 and #2, then consider the fancy stuff.

I really try to stay in 1 and 2 for kids that have the possibility of employment and/or more integration in society. If communication is completely halted to the point that there is no interaction with the community, then you can consider the big technology.

The problem with high-tech for community interaction is that the community is not used to using or interacting with the device.

Whereas, a low-tech system like PECS (Pictures), can be used by the McDonalds trainee.
The fast-food joints all have picture menus... Those are really just a cousin of a PECS system.

"Oh, that looks like our picture menu. Let me see. You need to find the bathroom? Over there, sir."

Also, fancy technology fails. What happens if the battery dies or there is a technical glitch (and your local Best Buy is not going to be able to repair it)?

Going low-tech or common-tech whenever possible reduces the probability of bad things happening, and it increases the likelihood that the community will be willing to interact with them.

Now, if the lack of communication is 100% of the current obstacle, all of those points are moot, and we need to be able to tap into what is going on in that head.

Just be wary of the fact that AT companies have REALLY good marketing presentations. You need a really good, INDIVIDUALIZED assessment from someone that does not make any money off of the sale. A fancy device that is not consistently being used is worthless. Don’t be impressed by an AT device that looks like something that would be installed in James Bond’s car. You only need the options that your student will be using. Once it is set up correctly, you probably won’t use 95% of the other options. Once the settings are tweaked to the individual, you want it to be reliable. Do not underestimate the importance of battery life (both holding a charge and number of recharges before it is dead) or local maintenance versus needing to ship it to Bangalore.

Like most things, this is individualized. Therefore, you have to look at the quality of process and people that are helping you. Can they explain their recommendations with rationale and evidence in plain English?


Dr. Eric’s randomness – Because I have ADHD and it’s my blog.

Check out my fraternity brother’s blog on management in the tech sector. My favorite post so far is when he compares management to his days on the MIT Blackjack Team.

If you are not familiar with the MIT Blackjack Team, there is a book on them that inspired the fictionalized account in the movie 21.


Monday, January 11, 2010

My ADHD Story Part 3 – MIT

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Academics
“Getting an education at MIT is like trying to drink from a fire-hose.”

Man, they loved repeating this quote during orientation. I am at MIT, away from home for the first time, a small-town 17-year-old with a nasty case of undiagnosed ADHD.

First and foremost, the best thing that ever happened to me at MIT was that I pledged the Gamma-Pi Chapter of Kappa-Sigma Fraternity before I started classes my freshman year. Whatever stereotypes you have of fraternities, it gave me an immediate support system and linkages to some of the best guys I know. It is a complete shame that freshman are no longer allowed to pledge.

Many freshmen have a hard time adjusting to MIT. Kids smart enough to get into MIT can usually get through high school on natural talents. As a result, they do not necessarily develop the study skills necessary in college that other students already have started developing in high school. In addition, most classes at MIT were graded on a curve. I remember one 8.02 Physics exam where the test was so hard, I earned a “B+” with a 28% average – all partial credit; I did not correctly answer one question fully. Now, the fire-hose simile makes more sense. All freshmen at MIT were graded pass/fail. It gave us a year to transition and to develop those skills. Well, I did not transition or develop so well.

Student Support Services at MIT failed me, BIG TIME. I had many contacts with them: my fraternity pledge program, self-referral, and when I was on academic probation. Their response? The same worthless, canned, and crappy time-management spiel and a one-page weekly organizer. I could have presented their spiel. A copy of this “planner” is now available online. I guess PDA’s or Smartphones are too high-tech.


In addition, they “helped” me by waiving their own rules and letting me stay an extra semester. They based this on my academic advisor’s comments that I was, “capable of doing far better than my grades suggested.” SOUND FAMILIAR? People with ADHD are used to hearing things like this. Only this time, it cost me an extra semester of tuition that my family really could not afford. My self-esteem may have felt differently, but I wish they would have followed their own rules and kicked me out instead of letting me stay (and fail) another semester until I left on my own.

Now, the professionals in the business should know that MIT has no legally liability. In higher-education, identification and advocacy for students with disabilities are the student’s responsibility… the responsibility of the undiagnosed teen-ager with poor self-awareness and self-esteem who has not yet heard of ADHD or Ritalin. Would it really have been too much to expect more from MIT than the same crappy time-management lecture and a “not legally negligent” quality of service?


Socially –


MIT was a time of extremes for me. Socially, I found a great group of guys who took me in, called me brother, and let me develop from a sheltered, small-town teen to a young man in Boston. Of course, I ended up leaving prematurely under difficult circumstances.

Dating and relationships are an entirely different situation. I was still an undiagnosed, un-medicated train wreck. On one hand, I was able to get dates. This was great for both my self-esteem and social skill development. However, dates very rarely turned into anything. I quickly got categorized into “not serious” or “just a friend” material. (No, I will not be writing anything about the possibility of “Friend with benefits.”) Of course, this is my side of the story. If my evaluation of my past relationships is completely wrong, doesn’t that just prove what they say about people with ADHD and relationships?

I can say with confidence is that I did a lot of stupid things back then. Have the parents of kids with ADHD ever, while completely dumbfounded, ask, “What were you thinking!?!?!?” I had to ask myself that question a lot back in those days. I thought about giving some specific stories, but I have chosen not to for many reasons.
• I don’t need a catalog of stupid things that I have done on the internet.
• I am not big into regrets… or whining.
• Being happily married while analyzing what happened 15-20 years ago is REALLY weird!

I think that this brings up a serious question. Is ADHD a condition that I have, or is it part of who I am? At work, I am very politically correct and work with the label, “Student with ADHD.” For myself, I don’t really see the difference. If someone reads this and asks me for an overdue apology, I would never say, “Sorry, but it wasn’t me, it was the ADHD.” The adjectives that people would use to describe me back then are very likely the same adjectives that could be used to describe the condition.

I will revisit that question at a later date when I talk about people who know Eric versus those that know Dr. Beam. Until then, off to being the first ever transfer from MIT to UMass.

Thursday, January 7, 2010

My ADHD Story Part 2 – Early years through high school.

I graduated from high school in 1990. It is important to note that our understanding on the diagnosis and treatment of ADHD is a whole lot different now than it was back then. I won’t give you my whole bio, but here are some key points.
• A lot of my first memories involved trips to the emergency room and scars that I still have now. Coincidence? I think not. I consider myself lucky. Our family doctor was also the state medical examiner.
• I wish I had a word-for-word transcript of my Spanish teacher’s explanation as to why I was a good student, but she could not write me a college reference after the week I gave her. It would have been a perfect summary of what a smart student with ADHD looks like. I do remember something like, “You will get an A, but I cannot have you do that to the other students.” There might have also been an incident with me leaving class, participating in French 5 (I was in Spanish 5 and French 1 at the time.), and then giving the French Teacher a Good-Bye hug in the middle of class to return to mine. Did I mention that this French Teacher did not know me? I could not find an email address for Sra. Reiter. I wanted to send her a link to this post… and an apology.
• I would have been in contention for valedictorian, but I bombed World History. It is amazing what completely forgetting the highest-weighted grade, a term-paper, will do to your average.
• Social skills? My classmates could comment on that better than I. Let’s just say that I did not have any bonds that lasted after I left for college.


My parents:
I love my parents, and they did so well for what they were dealing with. Both of my parents were intelligent enough to go to college, but life’s circumstances prevented them. This is significant, as children of college graduates have serious advantages in their prospects of going into college. Regardless, it is amazing how far hammering the same two points can really get you.
1. If you are getting poor grades, work harder.
2. Your one and only job is to get good grades and go to college. College is the ticket to a life we never had.

Why did I go to college? I did not know that I had a choice at the time.

I hope that I thanked them enough on each of my graduations. I hope to pay it forward to their two grand-children.

Here are my key memories from my parents:
• I still remember my mom ripping up my 5th grade report on the Praying Mantis. “You had 3 weeks to do this, and you threw this garbage together at the last minute? Explain to your teacher why I ripped it up, and ask him what your options are.” This could be viewed as traumatic. For me, it was a lesson in tough love, high standards, and not making excuses – even if you have a challenge.
• Instinctively, my parents knew to keep me busy. What trouble would I have been getting into without a day like this?
o 7:15-2:15 School
o 2:15-3:15 Play rehearsal.
o 3:15-4:35 Swim Practice.
o 5:00 Mom picks me up from practice with a sandwich and drives me to 1-3 hours of Karate.
• I have the lecture from my father for every time I got a bad grade in a test or project memorized.
Listen. It is not that this is the most horrible grade in the world, but I know you are much more capable of this. If all you were capable of was a B, C, or D and you met your potential, I would not be upset. But you are clearly smarter than this.
• There was a slight variation of this when he reviewed his concerns with my school choice. I chose to decline a free placement to the Air Force Academy and a partial academic scholarship to Villanova.
It is extremely expensive, but we will do whatever we can to send you. Here is my concern: We will make the sacrifice if you are truly serious, but how is anybody with your study habits going to make it at a school like MIT?

Wow! Hindsight is 20/20. Off I go, to college, undiagnosed.


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Tuesday, January 5, 2010

My ADHD Story – Part 1 Self-disclosure and Ethics.

First and foremost, I am not a fan of professionals who self-disclose too much. However, this is my blog, and it is for educational purposes. I hope my story helps.

I am a school psychologist with Attention Deficit Hyperactivity Disorder (ADHD) - SEVERE ADHD. This is something that I very infrequently disclose to my parents or students. If/when I do, it is with much reservation and deliberation on whether the disclosure is to the student’s benefit or my own. Unfortunately, I disclose too freely to my co-workers. They disclose to whomever they want. For some reason, anyone that has met me off of my medication (methylphenidate) figures it out without being told.

Many parents and teachers think that it is great when a professional has a personal issue with the topic at hand, and they readily dismiss anyone that is not in the club. Ask any school psychologist without children how many times they have been told, “You may have the degree, but don’t tell me what it is like to raise a child.” Guess what? None of the research or my advice have changed since I became a parent.

To some folks, all of the credentials and experience mean nothing. They will listen to the folks at the beauty salon over the professional. Then, they find out that I have ADHD, and I get immediate Street Cred. This would seem a good motivator to disclose more often. Why not?

Too many people get attracted to a helping profession because of their own issues. Do an informal survey. Ask every drug counselor you meet about their personal experience with drugs/alcohol. Scary. I know a lot of crazy mental health professionals.

Do I, “know what it is like?” Yes, I do. I know what it is like for me, but that is my point. I know what it is like for me, but it is not about me. Other people don’t have my genetics, parents, support systems, upbringing, etc. In that regard, I am lucky. Most people with ADHD are not like me. When I was assessed and diagnosed, I had about a 5 standard deviation discrepancy between my baseline ability (measured un-medicated) and attention/impulsivity. That is 3-4 times more than necessary to be considered “significant” in the State of California. It is also very rare. In fact, I would love for someone to look up the statistical probability on a 5 standard deviation discrepancy.


It is my job to assess and help the unique individuals that I serve. There are trends, research, and best practices. It always goes back to the individual. My own personal emotions, history, and biases stand to do more harm than good.

I have seen this happen. I have seen a school psychologist (and parent of children with Autism) try to diagnose every kid with a flat affect or social problems with an Autism Spectrum Disorder – even if they were 17 and stoned. I have also seen a rape crisis counselor almost yelling at a client because she stated, “The Christian in me needs to forgive him so that I can move on with my life.” We never saw her again.

This does not mean that having a learning challenge in my profession is all bad. (My employees may disagree on this one.) I have a motivation to help students with learning challenges that few people could rival. I am also a believer, in part, of the “Gift of ADHD” in terms of thinking outside of the box. There are times when personal experience can help… more on that later. It just requires vigilance and checks/balances.

I think that we do a great job of addressing counter-transference and personal bias in most graduate programs and internships. However, once licensed and in the working world, I think we forget to re-visit those extremely important issues - which is why I spent all of my time talking about disclosure and ethics, and little on actually self-disclosing.

WELCOME!

One day, I envision that this becomes a Question and Answer blog. So please ask me a question! Even if you do not have a specific question, please give me ideas for a topic.

One day, I envision that this becomes a Question and Answer blog. So please ask me a question! Even if you do not have a specific question, please give me ideas for a topic.

WHO IS MY INTENDED AUDIENCE?
Everybody! My biggest pet peeve is when groups cater to one audience. For example, there is one parent advocacy group… that will remain anonymous for now… that loves to paint all educators as evil. There are also some trade groups that like paint parents in a constantly negative light. That is not my style. I love to help and educate. I don’t care who I am helping… students, parents, other professionals, the more the merrier!

If we were all on the same page, wouldn’t our results be better?
I also hope that I will appeal to people that want to cut through the B.S. and politics - and everybody, including me to some level, has a political agenda!