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Section 3
ADHD Rating Scale

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On the last track, we talked about the five Idiosyncratic, Unique Patterns of children with ADHD. The five Idiosyncratic, Unique Patterns of children with ADHD are good social skills, a high IQ, shyness, no siblings or one-on-one preschool situation with parents, and ADHD without hyperactivity.  We also talked about the misdiagnosis of ADHD for Learning Disabled.

On this track... we will talk about how education about ADHD and counseling for children with ADHD and their parents can work together. We will look at three main examples of education and counseling combined. Those three examples of combined education and counseling are 1. the "no-fault" notion about cause, 2. the Symptom Rating Scale, and 3. self-esteem reevaluation.

The "No-Fault" Notion about Cause
Billy, age 11 diagnosed with ADHD, displays many of the symptoms common to children with ADHD. At dinner one night Billy was in a bad mood and slow to join his parents at the table. His mother said, "Fine, we’ll just eat without you." When Billy finally sat down, he listed a string of complaints about the meal. The tension at dinner mounted, and Billy’s father finally jumped up from his seat and roared at Billy. Billy left the table very upset and wondering what was wrong with him. Meanwhile, his parents’ dinner was ruined as they, too, wondered what they had done produce such bad behavior in Billy.

With Billy and his parents, I used the first example of combined education and counseling, the "no-fault" notion about cause. I stated, "ADHD probably has a hereditary base to it that no one in the family could have changed. Billy, it is not your fault that you have ADHD, and Mom Alice, and Dad Tony, it’s not your fault either." This "no-fault" idea has two major implications. The first implication is that the parents do not need to crucify themselves with guilt over how they are responsible for their ADHD child’s bad behavior.

It will likely take continued counseling for parents like Billy’s to learn, practice, and reinforce correct ways of thinking, but those ways of thinking will become habitual. The second implication of the "no-fault" idea is that the ADHD child did not grow up with the intention to make his or her parents miserable. For example, Billy did not intentionally let his ADHD behavior get out of control to ruin dinner. However, the "no-fault" idea should not be used as an excuse by the child for his behavior. Billy needs to be disciplined for his dinnertime behavior, but he and his parents need to have realized that the ADHD is no one’s fault.

Think of parents you are counseling. Would the reinforcement of the "no-fault" notion be beneficial in your next session?

Using the 'Symptom Rating Scale'
The second example of combined education and counseling in a session is a technique called the "Symptom Rating Scale." As you know, ADHD does not affect all children the same way. ADHD comes in different forms and degrees. The "Symptom Rating Scale" allows parents and children to realize which ADHD symptoms they will have a harder time dealing with.  The "Symptom Rating Scale" will also allow them to realize that there are some ADHD symptoms that will be mild or even nonexistent.

To do the "Symptom Rating Scale,":
Step 1 - I first asked Billy and his parents to rate on a scale of 0 to 10 the degree that they felt Billy manifested each of the eight ADHD symptoms explained on the first track.
Step 2 - I asked them to do this rating individually without consulting one another.
Step 3 - Once they were done, they then compared their ratings.
-- Each had rated symptoms like inattention, impulsivity, and hyperactivity fairly high at 8 or 9.
-- Other traits, like social problems and disorganization, were low on in their ratings, around 4 or 5.

Through this exercise, Billy came to a better understanding regarding how his ADHD affected him. Alice and Tony also had a better idea concerning what to expect regarding Billy. Does the Symptom Rating Scale sound like a technique that might be helpful for your ADHD client?

Self-Esteem Reevaluation
Finally, in addition to the "no-fault" notion about cause and the "Symptom Rating Scale," the third example of combined education with counseling is self-esteem work. As you know, people commonly overemphasize their faults when doing self-evaluations, but this overemphasis is even more common in ADHD children and their parents. Parents will often feel guilty because of repeated irritations with the ADHD child.

In Billy’s case, Alice confessed that she sometimes feels like she doesn’t even like Billy. I encouraged her to think of all the work she does daily for Billy. I stated, "Think of things like going to staffings and seeing counselors like me. Or even think of the mundane things, like cooking, washing clothes, and buying necessities like toothpaste." Realizing all the things she did for Billy helped Alice to improve her self-esteem a bit.

I stated, "Reorganizing the way you think about yourself can be very helpful to maintaining your self-esteem at a reasonable level." Think of your Billy and his parents. Would any of them benefit from a self-esteem boost by recalling the numerous tasks they do for and cope with regarding their ADHD child?

On this track... we have talked about three main examples of combined education with counseling for children with ADHD and their families. Those three main examples of combined education and counseling are 1. the "no-fault" notion about cause, 2. the Symptom Rating Scale, and 3. self-esteem reevaluation. If you feel your client needs education in any of these three areas, would it be beneficial to replay this track for yourself as a review prior to the session? Or, strongly consider actually playing this track during the session.

On the next track, we will discuss three types of counseling for children with ADHD. The three types of counseling for children with ADHD are individual counseling, self-control training, and social skills training.

Peer-Reviewed Journal Article References:
McKeague, L., Hennessy, E., O'Driscoll, C., & Heary, C. (2015). Retrospective accounts of self-stigma experienced by young people with attention-deficit/hyperactivity disorder (ADHD) or depression. Psychiatric Rehabilitation Journal, 38(2), 158–163.

Overgaard, K. R., Oerbeck, B., Friis, S., Biele, G., Pripp, A. H., Aase, H., & Zeiner, P. (2019). Screening with an ADHD-specific rating scale in preschoolers: A cross-cultural comparison of the Early Childhood Inventory-4. Psychological Assessment, 31(8), 985–994.

Patros, C. H. G., Tarle, S. J., Alderson, R. M., Lea, S. E., & Arrington, E. F. (Mar 2019). Planning deficits in children with attention-deficit/hyperactivity disorder (ADHD): A meta-analytic review of tower task performance. Neuropsychology, 33(3), 425-44.

What are three examples of combined education and counseling in a session for children with ADHD and their families? To select and enter your answer go to Test


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