Problems With ADD - Illogical Thinking

Problems With ADD

A third common defensive reaction that is very closely linked to the polarized response is to become involved in illogical thinking, making up reasons for the child's behavior, subscribing to a theory that relieves the parent of responsibility. For example, a parent may have seen a program on TV or read an article that talked about something odd in the water or food chain. Latching on to this issue, a parent can then attribute the child's behavior to that arbitrary factor and cling to it, even though there may be no evidence that it is affecting children in this way. Many parents of children with special needs of any kind are understandably anxious and so eager to search for a remedy that they can become fixed on a single explanation instead of looking at the complexity of factors.
 

Rather than trying to help the child learn to set limits, focus, or calm down, or trying to improve family dynamics, parents may overfocus on a single cause, which could be food additives, the school environment, or even the content of TV shows the child watches. Problems With ADD
 
Blaming the Other Adult 

ln addition to illogical or polarized thinking or lashing back at the child, another common response is to focus on another "culprit" in the family. Who does the child take after? Is it Daddy, Mommy, Grandma? When a child shows problems, it's very easy for the adults in the family to blame one another. Then we have additional family tension and conflict - sometimes a lot of arguing, even fighting.
 
Parents of children with special needs have a hard time hanging in there together and working out their problems. You'll frequently hear one spouse say that the other spouse is so preoccupied with the child who needs special care that they or the other children aren't getting any attention. Sometimes this is never expressed outright, but the underlying tension leads to more accusations and criticisms of one another. Fathers have confided in me that they feel unnurtured and unloved, but they haven't shared this with their wives. Instead, they criticize their wives for not being good-enough mothers. 

This is unfortunate because often the mother is trying valiantly and needs more support herself. She may confide in me that she feels unappreciated and criticized, which only adds to her burden. A mother can also make the father feel like the "bad daddy," that he's never doing enough. If only he were earning more money ... If only he were home more with the children ... If only he played better with the kids. So both parents feel micromanaged and criticized and unloved, and there is very little intimacy between the two of them. Neither of them deals with the concerns directly, and both take it out on each other.
 
We can have these same conflicts between two generations - grandparents and parents. Often, parents of an out-of-control child feel that their own parents blame the problems on their parenting. Single mothers or fathers may feel even more isolated. They may feel that their friends or their relatives don't understand the complexity of the problem.
 
As we said, these tensions and conflicts or different types of "acting out" on the part of the family members contribute further to the child's difficulties. Whatever form this takes, whether it's aggression, distractibility, or self-absorption, the child's problems will only become worse. In such an environment, it becomes more difficult to implement the type of comprehensive program we have been describing. An effective program requires the family to work together, working off the same page with a concerted approach. They can each have their different tasks and skills: Father can work on outdoor games and motor exercises, and Mother can work on sequencing and planning, or a grandparent can work on still others. Older siblings or other relatives can help.
 
But everybody needs to be working together as part of a team, not as individuals in a disgruntled group who are criticizing one another or causing more tensions. It is all too easy for the child's problems to precipitate conflicts in the caregivers, which then cycles back, and a vicious cycle may start where a child's problems become worse and worse. Therefore, our approach is to work at all levels - at the caregiver-child level, at the family-dynamic level, and bringing professionals or part of the extended family into the pattern when appropriate and relevant. Problems With ADD

Teachers 

Before getting into some steps that parents and other caregivers can take, let me comment that the same dynamics I have described for families also confront educators. A teacher is very likely to feel like a caregiver or a parent. Other teachers can come into the room and say, "What's the matter? Why can't you keep your class under control?" If there are two or three children with ADHD or ADD-type patterns in the class, it can very easily appear to others that this is a teacher who is not organizing her class well, who does not have her class under control.
 

She may get a look or a comment from another teacher or the principal: "You need to be tougher. You need to show the children who is boss. The teacher can feel all the things that a parent feels and needs support in the same way. We have to help teachers do a good job for these children. The steps that we recommend for the family can help teachers as well. To learn more, you can check out Problems With ADD.
 

Reading With ADD - Family Patterns

Reading With ADD

Parents and caregivers of children with ADHD or ADD quite understandably find it difficult to cope with children who are constantly on the move, physically and mentally. Raising a child with attention problems can be very frustrating. Yet there is much that parents can do to create the kind of calm and supportive atmosphere that helps children engage and focus.
 
When a child pulls things off the shelves in a supermarket or runs around uncontrollably and others look on scornfully, the parents will feel anxious, angry, or embarrassed or all three. They may feel humiliation or fury at the child who is embarrassing them. Most of us in this situation would feel a strong visceral reaction.

Throwing More Fuel on the Fire 

A very common reaction is to shout at the child to get him to stop. Yet the child who is out of control, running around, and overexcited may be acting that way because he is already overwhelmed by a noisy, crowded environment. A child who craves sensation may be running around and touching and grabbing everything because there are so many tempting sensory experiences in the supermarket or restaurant or toy store. The same child may be pushing other children to get in line first to go up the slide. If this happens a lot, the parents may despair at having a child who is "out of control." They may scold and get angry, adding to the turmoil. Afterward, they may feel deeply guilty and think, "Why haven't we been able to teach him how to behave?" In their eyes they have tried valiantly to try to teach the child to have control, but because of his biological makeup, it has been very, very hard to do. Reading With ADD
 
When parents' response to the child's behavior is to put their feelings directly into action without a lot of forethought and counter the child's impulsive actions with their own impulsive actions, this can only escalate the situation. This doesn't mean we shouldn't set limits or let the child know that there are consequences when he pushes another child, or when he goes out of control in the supermarket - we certainly should. But the first step is always to calm the child down and help him become regulated again. 

To do this, we may need to help the child remove himself from the place that is leading to the frantic activity or aggression or disorganization. It may mean taking the child out of the supermarket and getting into the car, where the environment is calmer. At home, it may mean engaging in activities that are soothing for the child, like a rhythmic activity with music or some deep pressure applied to the back or the arms or the tummy - little firm touching. Or it may mean engaging in a quiet game in which you can begin modulating the child's behavior by going from fast to medium activity and then to a slow and superslow pace. This can help the child get back into a pattern of regulation.

Once everything is calm, then you can talk to the child, if he is verbal, about what happened. If the child is nonverbal because of other special-needs conditions, you may have to be intuitive about what happened, or you may have to suggest choices or use pictures so that the child can help you identify how he felt. Try to figure out together with the child what happened, and then if the child has crossed the line - hit or pushed, for example, not just yelled out loud or screamed - you want to let the child know there are consequences. There may be a time-out, missing or interrupting a favorite activity.
 
Then the child can learn that when he is feeling over-stimulated or losing control, he can tug at your arm to indicate he needs to leave the scene of the action. He can gradually become responsible for his actions. This may take many months or even years to accomplish, but it is an important and worthwhile goal. The principle here is to counterbalance the child's loss of control with calm words and gestures and help the child reorganize and regain focus and attention. Reading With ADD
 

All-or-Nothing, Polarized Thinking 

A second common reaction that we all have as parents (and I have three children of my own, so I can testify from experience) is to get locked into polarize thinking. We blame the child and label the child in our minds, even if not consciously, or verbally. If we don't think it is appropriate to say this out loud, we think, "Johnnie is bad, and he is being bad deliberately" or "He's got ADHD and can't help it." We get locked into that mind-set. This constricts the compassion or the understanding we can show a child or the search for underlying cause such as sensory over- or underreactivity or processing difficulties.
 
With such a mind-set, a parent does not see the child's better moments or strengths. Not infrequently, we see that children with attention problems have a much harder time in one type of environment than another. At home they are little angels, but when they come to the busy pre-school they turn into hellions on wheels and cause a lot of trouble. In self-defense, a parent will think the child is all bad or excuse the behavior entirely and give the child no responsibility for his actions: "This is just the way he is, and he is not going to change. He was born this way, and I have to love him as he is." To learn more, you can check out Reading With ADD.

Boys With ADD - Programs and Games To Play

Boys With ADD

"Thinking About Tomorrow" Game. During hang-out times, both Mark's mentor and his parents simply talked with him about whatever was on his mind. They also did the "Thinking About Tomorrow" game in which he anticipated situations that would be hard, others that would be easy, and situations that he enjoyed and didn't enjoy, such as subjects he felt were hard. We asked what he routinely did when he had those feelings and how that made other people feel and what alternatives he had. He had to brainstorm and come up with the solutions himself. 

We explored feelings that were harder for him - angry feelings, humiliating feelings. We would ask, "Well, are there other feelings, times when you don't feel just sad or happy?" to get him to describe his feelings with a little more subtlety. We made suggestions like, "Do you ever get a little mad - just a teeny, teeny bit?" and he slowly began acknowledging angry feelings and even feeling embarrassed at times or scared, which was hard for him to admit. He didn't like to talk about feeling scared. In these discussions with Morn, Dad, and the mentor, Mark expanded his range of feelings and his ability to reflect on them. Boys With ADD
 
As his program continued, Mark began to feel differently about himself and his "bad brain." Perhaps most important, we found something that Mark was really good at, in which he felt his brain did well. His skill with magic tricks was evident and deepened as he made progress in other areas. As he learned to sequence better, to carry out a series of steps, he could do more complicated tricks. We worked on his fine motor skills by showing him card tricks that required being dexterous with his fingers, which he really enjoyed. His parents enrolled him in a magic class, where he met other kids who loved magic, too. Magic became his "claim to fame," and he even performed for his school class.
 
In talking with Mark over time, we helped him identify the feelings he felt in his body just before he was about to get fidgety and walk around the room or bug another child next to him or poke someone. So what he identified as "my brain made me do it" and "my brain is bad" became a description of feelings. By reflecting on these feelings, he gained more control. During our discussions, Mark's self-awareness kept strengthening. Eventually, the reasons for his little smirk in the first session became evident, as well as the pleasure he felt when his magic tricks left other people feeling baffled and "dumb." After about eight months in the program, now more skilled in describing his feelings, Mark could see that it was fun getting other people to feel like their brains didn't work right.

As Mark did these things, he came to identify the feelings in his body as being normal and natural. Instead of feeling overwhelmed by the tasks that were hard for him, he became able to identify what he did well, like math when he could concentrate and practice it. He had a little harder time with reading comprehension, but he learned to persevere. With a little more diligence and practice, as he identified things that he was good at and not so good at, what his dad was good at and not so good at, what his mom was good at and not so good at, he began to see that like everyone, there were things that "my brain is good at and not so good at." Boys With ADD
 

Gradually, Mark began feeling better about himself, and these feelings spilled over into the areas in which he had to work harder. As his high school mentor worked with him on balance, throwing, catching, and kicking, Mark became a better soccer player on the neighborhood soccer team. He also enrolled in Little League baseball. He became a better student. These real accomplishments in turn made him feel even better about himself. Dad's more supportive approach and the work on his blackboard maps were also a big help. 

One day he told me, about a year after he started the program, "You know, my brain works better now. I can do more things." The whole family was functioning better, Mom was less anxious because she was feeling more positive about Mark, and Dad and Mark enjoyed doing special projects on the weekends. Mark was no longer identified as an ADHD kid by his teachers or by himself or by his family. He could calm down, focus, and attend, and, most important, he now saw himself in a competent and optimistic light. To find out more, you can check out Boys With ADD.

School For ADD - Mark's Program

School For ADD

With Mark, we instituted an ambitious program that we phased in gradually. We wanted to see if we could help him overcome his attentional difficulties and do it without medication. We would keep medication on the shelf to try at some later point if necessary. We focused on the areas where he needed work, and also on giving him confidence in his strengths.
 

Sequencing. As we saw earlier, Mark had trouble with carrying out complex directions. Working with his parents and with an occupational therapist, we designed treasure-hunt games with two-step directions and then three-step and then four-step verbal instructions. We gave him pictorial instructions with diagrams and maps to help him with his visual-spatial thinking as well. In these exercises, we let him succeed about 75 to 80 percent of the time so we didn't overload him. We built the challenges up gradually with two- or three-step directions in which he could be successful and then added on a fourth and a fifth step until he achieved a 75 to 80 percent success rate. School For ADD

Eventually, like an Indiana Jones character, he had to go through a complex course requiring planning, like getting three chairs or a board to put over the chairs to cross a pretend moat that he wasn't allowed to step into to reach the treasure. We got a lot of new fairly inexpensive magic tricks from the variety shop to use as prizes, so he was very motivated to pay attention.

Planning. Mark also liked to draw. To help him with things like getting his homework done and turning it in, each day we had him actually draw, not write out in words, a little map of what he was going to do that evening and what was due the next day. We arranged for his teenage helper or Mom to do that with him after school. He would make a diagram, showing some playtime and then some before-dinner work and some after-dinner work and what was due the next day, and he would check each activity off himself. 

He would add little drawings, or sometimes he would choose to use words - we let him decide. He did all this on a big blackboard so that at the end of the day when he got all his checks done, he could erase it and put up a new list for the next day. Whenever Mom or Dad was worried that he wasn't getting his work done or wasn't going to hand it in on time, rather than nagging him, they would just say, "Let's go look at the board together" and "Oh, boy! You have a lot of check marks today! Is there anything else you need to do?" Mark enjoyed tracing his progress on the big board.
 
Balance and Coordination. We also noticed that Mark was, as I mentioned, having some trouble with balance, though he was pretty good at throwing, catching, skipping, hopping, and jumping. We made balance exercises part of his play with his mentor/big brother who would come over and sometimes do this with him and a friend. Mark was actually rather popular. Even though other kids made fun of him at times, he had many friends. The high school student, who was a good athlete, would have a balance beam and Koosh pads to use with Mark and a friend. 

Each took turns being the leader. Mark could do some of the things really easily, like just standing on a Koosh pad or standing on a balance beam. It was when they got into the more complex balance exercises - like throwing and catching a ball while standing on a balance beam or Koosh pad, and then talking while throwing and catching the ball, and then throwing and catching the ball with one hand while standing on a Koosh pad and talking and telling jokes, and so on - that Mark had some challenges. Eventually, we had him doing magic tricks while standing on a Koosh pad or balance beam. He enjoyed that thoroughly and got better with his balance and coordination. School For ADD
 
Mark's program also included plenty of running, jumping, hopping, skipping, throwing, and catching kinds of games, too, just to reinforce things he already did reasonably well, as well as his sense of competence, Because Mark didn't have a lot of fundamental problems in motor coordination and he had good muscle tone, we didn't have to work on some of the more basic exercises that we outlined earlier.
 

Regulation Games. We also played many regulation games with Mark - going fast, slow, superslow; playing the drums loud, soft, supersoft. Also, we exposed him to different environments - just a little bit of noise and a little bit of commotion and a little bit of touching, then in groups with friends banging into him, then more and more stimulation until he learned to regulate himself and not overreact in those situations, not become overloaded. 

The Modulation Games - fast, slow, superslow; playing the drums; running fast, slow, then in superslow motion - were geared to deal with his sensory craving, the moments when he became impulsive and sped from 0-60 in two seconds. He learned to enjoy slow motion. All this occurred over a period of many months. As we were doing this, we often asked him how he felt, and he became more and more able to reflect on his feelings. To learn more, you can check out School For ADD.

How Do You Find Out If You Have ADD - Mark's Profile

How Do You Find Out If You Have ADD

In looking at Mark's processing profile, in addition to his social interactions and thinking skills, he was reactive to certain sensations - noises and different kinds of touch would get him hyperstimulated - but also very sensory craving. He liked to move, he liked to touch things, he liked to get into environments that stimulated him, and he craved the very sensations that overstimulated him.
 
Mark was pretty good verbally and was a good talker, but he had a hard time remembering five instructions in a row. I did a little exercise with him during the interview in which I asked him if he could go get a toy and put it in a drawer and then get another toy that was in the same drawer and bring it to me and then to his dad, but he couldn't remember the sequence. On obstacle courses he had a hard time with the sequencing, although he was active and considered an average athlete by his peers. His fine motor skills were a little sluggish, although he liked to draw. He liked to do magic tricks, but he had a hard time making his letters and shapes.

Mark's ability to balance - for example, walking on a balance beam - was also a little bit below age expectations, although it was not really bad. He had some relative strength there but not quite where we wanted it to be. How Do You Find Out if You Have ADD
 
When it came to big-picture thinking, Mark tended to overfocus on one or two details. For example, when I asked him to search a whole room for something, he tended to look in one spot rather than taking into account the whole room and figuring out strategically where the object might be. So there were a number of processing areas where he was not quire as strong as he could be.
 
Family Dynamics 

In talking with Mark's parents, it became clear that there were some family issues that needed attention as well.
Dad tended to be very punitive and thought Mark was just being bad and doing all this stuff deliberately and tended to take a hard approach toward him. He had few interactions with him other than scolding or punishing him with time-outs. He didn't get angry or hit Mark, but his voice was gruff and he had a very negative attitude.
 
Morn tended to get overwhelmed. She was an anxious, caring person, but she worried when Mark got into trouble and was very embarrassed when she was called into school to talk to the teachers. Mark was not doing well in his studies - he was getting Cs and some Ds and often did not hand in his homework. They had three younger children - Mark was the oldest - and she felt, just as she put it, overloaded. She was also mad at her husband because she felt he was unsupportive. She also thought he was too harsh on Mark and worried that Mark might get depressed and become a delinquent adolescent and use drugs and alcohol.
 
This family pattern had characterized their relationship with Mark since he was little. It turns out that since he was a little baby, Mark had been very active and sensory craving as well as becoming overloaded easily. So our task was to help Mark feel better about himself while instituting a whole program to help him learn to pay attention a little bit better.
 
The first step in our approach was to help the parents support the program we were going to recommend, and encourage them to help Mark feel better about himself. In working with Dad, we talked about why he was feeling so punitive and angry toward Mark. After many discussions, it turned out that Dad had an older brother who was very active and intrusive and had often hit him when he was growing up. He felt his parents had never protected him, Dad was very worried that Mark would get out of control and be a "monster" like his older brother. How Do You Find Out if You Have ADD
 
Once Mark's dad saw the connection in his mind between Mark and his older brother, I encouraged Mark and his dad to have some "hang-out time," or what we call Floortime, when Dad came home from work. On the weekends they could hang out more and do special projects together. Dad could get involved with Mark and his interest in magic. I encouraged him to follow Mark's interests, to set limits when needed to, but to establish a warm relationship with him first. Dad was able to recognize that his worries about Mark and the connection with his older brother were fueling a lot of the anger he had toward Mark, and this helped him relax and enjoy his son.

 
With Dad being more supportive, Mom was able to calm down and be a little less anxious. Also, I encouraged Mom and Dad to start getting off by themselves once a week, which they had stopped doing, They were able to rekindle their own relationship. I was able to help Mom prioritize her work with all four children and also get some help in the afternoons. They hired a big-brother mentor, a high school student, to help carry out some of the recommendations that I made for Mark. Since Morn was so worried about Mark's future. I helped her put this into words and see these worries in perspective. She talked about her dad, who had a period of alcoholism and had gotten into some trouble with the law, and she was obviously very worried that Mark may have inherited a "bad gene," Talking this through helped her calm down and relax a little bit. Giving her a lot of support, a little bit of insight into her own family, helping her structure her day, and getting a high school student to work with Mark's program in the afternoon all helped to ease her anxiety. To learn more, you can check out How Do You Find Out if You Have ADD.

I Have ADD What Do I Do - Symbolic Thinking in Words and Pictures

I Have ADD What Do I Do

As children reach these higher developmental levels, they are also getting into more symbolic expression. In addition to expressing ideas verbally, by giving labels to the different spatial dimensions, they can also do it with pictures, as their motor control improves. They can actually draw pictures of people, relationships among people, or designs and diagrams showing how things work. They can also act out ideas through dance or drama. Many forms of expression can keep a child involved and focused more strongly than words.
 
As children first start to use letters and words, Pat Lindamood, in the Lindamood-Bell Learning Process, likes to have children make the shape of a c, for example, with their whole bodies, and walk a c shape out on the floor. Children can then begin symbolizing words, such as the word dog, by walking or dancing the letters out, by writing the letters, by drawing a picture of a dog, by saying the word, by pretending to be a dog and running around and barking, and by creating a dog from blocks or Legos. So as children begin to symbolize their worlds, we want them to do it using all their skills and senses, not just using the words they see or hear. This makes the symbols (the ideas) more meaningful and helps children integrate more of their sensory and motor worlds.
 

Reflective Thinking 

In understanding what we see and hear, we also reflect on it and make judgments according to our own or others' standards. A child playing the drums can decide whether he's keeping a rhythm. A child trying to design a house can evaluate his design with pictures of Buckminster Fuller's or Frank Lloyd Wright's designs. A child drawing buildings and designing rocket ships can think about how well they might work. In encouraging kids in various activities, we also want to make sure that their rationales make sense, that their ideas are logical, and help them evaluate and improve their own work. Such reflective thinking keeps a child on track and focused, and is particularly important for a child with ADHD. I Have ADD What Do I Do
 
Once a child is hooked on an activity of her own choice, there is no end to the focus and skill she can bring to it. A child's natural bursts of creativity are channeled and enhanced when a child can step back and evaluate her own work. Whether it is coming up with new soccer moves or dance steps, fixing engines, or painting, both imagination and reflective thinking are needed.
 
Visual and auditory processing abilities are a key part of helping children with ADD or ADHD attend to the challenges they will face in getting along with others and at school. To summarize, the key steps in developing these processing skills are, first, to invest all parts of their world with emotion, that is, to care about what they are seeing and hearing. Next, they need to integrate these and other senses. They need to learn about different spatial dimensions and create logical connections between objects in space and a logical sequence in what they hear.
 
Much experience with physical objects and play with others lays the groundwork for symbolic thinking, such as the concept of conservation. This, in turn, develops the foundations for math, science, and reading comprehension. Children who learn to reflect on what they see and hear are able to remain focused, recognize distractions, and follow through on their goals and dreams.

Building Self-Esteem in Children with ADHD and ADD

One of the biggest challenges in caring for children with attention problems or hyperactivity is to help them fed positive and good about themselves. Many such children, regardless of whether they have broader special needs or just limited attention, suffer from low self-esteem. They feel bad about themselves.
 
A good illustration is Mark, an eight-year-old boy who, when he was talking with me, said, "My brain doesn't work." I asked him what he meant by that, and he said, "Well, when the teacher is talking, I'm stating out the window, or my body just wants to move and I get up and I walk around the room or I talk to my friends." l said, "Well, what do you mean your body just sort of does it?" and he said, "It just sort of happens. It's like my brain doesn't work." 

I asked him how he felt about that, and he said, "Bad." "What do you mean by 'bad'?" "Well," he said, "I have a bad brain, and it's just bad," Then he gave a silly little grin, like part of him enjoyed being mischievous, but when I told him he was smiling about something, he wouldn't comment. He just ignored it and said, "I get into trouble a lot. Some of the kids make fun of me because I get into trouble. Even my friends sometimes make fun of me." I asked him how that made him feel, and he said, "That makes me feel bad." 

I empathized, pointing out that a lot of things made him feel bad. He gave another silly little grin and nodded in agreement. I asked him if there was anything that made him feel less bad, and he thought and thought and then said, "Well, one of the things I like is magic, and my room and dad got me a magic box with some tricks in it for my last birthday, and I like doing that. If the trick works, I feel good. I can kind of trick people." I said, "How do they feel when you trick them?" He said, "They feel dumb!" I said, "So it's fun to make people feel dumb with your tricks?" and he grinned from ear to ear.
 
As I chatted with Mark and watched him interact with his parents, I could see that he could focus and attend in a supportive situation. He could engage with me and with his parents with warmth; he could show us things and solve problems in a social way. He also came up with a lot of ideas and at times could be creative and make up stories. In fact, at another point during the interview, Mark told me that when he got into trouble, he sometimes made up a story about why he did what he did. I Have ADD What Do I Do

For instance, one time when he was poking the kid next to him, the teacher asked him why he was doing that, and he said, "'Because he was making tun of me, and he made up a story that I peed in my pants and that wasn't true.' I told the teacher all that," Then he looked down, and I asked him why he looked down, He said, "Well, I made all that up so the teacher wouldn't be mad at me." I said, "Boy, you have a good imagination! You can make things up pretty easily!" and he smiled. Mark clearly could be creative and use it for self-serving purposes.
 

Mark could be logical and answer "why" questions, and he could even do a little bit of what we call "comparative thinking." During the interview I asked if there were any other children who did the same things he did in class. "Well, there is one other boy who also always get into trouble and has a bad brain." I said, "Well, who has the worse brain?" and he said, "Well, I think mine worse." I asked him why, and he said, "Because I do more bad things. I get into more trouble." When I asked him how bad he felt, he could show me with his hands that he felt very, very bad, which showed that he could do some gray-area thinking as well.
 
When I asked Mark about other feelings, like what else did he feel along with the bad feelings, and gave him some examples, like happy, sad, and angry, he could talk a little about feeling sad, but he had a hard time talking about angry feelings or about feeling embarrassed or humiliated. Whenever those feelings came close to being described or I even brought them up, asking whether he ever felt that way, he changed the subject and talked about something he wanted for his next birthday or anything else: "Oh, did I tell you about this new video game?" He had a hard time talking about those kinds of feelings, which was obviously contributing to his low self-esteem. To learn more, you can check out I Have ADD What Do I Do.