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.
