Blah-blog

I have a jig-saw puzzle in the middle of the living room floor. Every time I look at it I feel drawn to fill in more pieces, but I'm resisting that siren song right now. I know that if I start easily an hour or two will go by and I risk feeling I haven't accomplished much.

Haven't I though? There is the practical experience of persisting and finding order in chaos. There is the experience of looking for little distinguishing nuances within blandly similar regions, and finding that each gradation has an important contribution to the whole. There's the lesson of feeling overwhelmed, but noticing that little efforts over time reduce the mystery.

Is it worth a few hours with only a few pieces successfully placed? (For someone like me, who does tend to get overwhelmed quickly by details, this puzzle is really hard. Thank goodness it's only 500 pieces.)

It is one of four that I snagged from my neighbor's "Free Or Best Offer" pile out front of their place. Since Scott's learning and understanding remind me of a puzzle--more forest-y than trees--I thought it might be beneficial to him. Beneficial to him, beneficial to Us, since he's the kind of child where meaningful conversation usually slips out in tangent to some other activity. It wasn't long before I realized this puzzle was way beyond him, and by then I had enough investment in it that some stubborn pride has kept me going.

I'll be very cautious before opening any of the others.

I have a veritable box of puzzle pieces spilled around me, and I'm wondering if I'll be able to piece them together.

One of them is Scott. A few days ago I got a phone call from a mother whose child used to be in Scott's classroom at the first elementary school, before I pulled Scott out and took him to Trillium. This is another very active boy. His mother said that Skyline is not working for her child and she's exploring alternatives and so thought of me. Her son's teacher had raised the "M" word, medication, and she firmly said, "I am NOT putting my little boy on Ritalin."

This reminds me of how heated the debate can be over the use of medication to treat attention deficit and hyperactivity in children.

Still, the whole issue reminds me of a puzzle, and I feel overwhelmed. It makes sense to me that if our consciousness is mediated by biochemical processes in our bodies, that the deficiency of a certain molecule may create a gap in a crucial function, such as memory, or the ability to persist in attending over time. I'm not at all ideologically opposed to the use of medication in children, though I sure wish we were further along in refining our understanding so it's not such a blunt instrument. I took Scott's pediatrician's word for it, that ritalin has been subject to years of long-term studies, and that it's safe and effective. I started him on it just about a year ago when it was clear that he wasn't functioning well in the alternative school setting either.

Still, I feel nagged at having 'read the cliff notes' about the medication issue, and not piecing together my own puzzle from the ground up as to its risks and benefits. I'm overwhelmed at the prospects--just now I googled "ritalin use children" and found 1.3 million hits (and top of the list are "ritalin death" results).

I did see an improvement in his ability to attend. He seemed to have more of a solid core, a centralized Presence. He is definitely not a zombie, but he can tolerate periods of stillness longer. His reading has improved.

But with the beginning of school, I'm uncertain. I feel like I need to find another parameter to explore adhd and formulate effective responsiveness to it. I really liked Gabor Mate's book Scattered (Scattered Minds, in Canada), and need some kind of follow-up. I'm at the beginning of seeking another pediatrician, since I've felt this one is not responsive in a timely enough manner to my questions, and does not provide an atmosphere that invites the development of questions and discussion.

I just realize I'm temperamentally unsuited to raising a child with adhd. I tend to be agenda-driven, and have an expectation that when I apply pressure a child moves in that direction. Connor responds fairly compliantly to this--Scott just seems to spread out. If the boys are toothpaste, Connor oozes right out of the tube opening; Scott merely expands in all directions. This impacts everything from getting out of bed in the morning to getting to school to doing homework in the evening. I begin to feel like a drill sergeant, because I need to remind him at every step what the next one is. It's hard to not feel irritated, and outright angry with him. Last night it took a half an hour to read 5 pages from a book, because every word, every picture, reminded him of something else he wanted to talk about. But he was reading beautifully, and far more fluently than he would have a year ago.

It makes me wonder what factors there are to consider in adhd, in the ability to attend. Is there a kind of learning style that is linear, where one idea is foundation for the next, and so on, so that attention is the string of the chain that links the ideas together into learning. This certainly seems to be the style that most schools teach to, and the tests measure--what is going in...what comes out. The picture in the puzzle emerges because the pieces are given in a certain sequence and are adjacent to one another. Perhaps this is where medication has it's most value--to hold one's attention long enough to see the continuity between the pieces. Scott seems to take in and assemble understanding differently. He seems to link a couple of connections at random in one part of the puzzle, then another few in another part, and over time I see that something, some kind of pattern, is emerging. But in the day-to-day, it looks like he's not 'getting it'. Maybe this speaks to a whole different kind of learning style, and medication has much less return for this style. It holds his agitation level down some, and helps him be patience with stillness, but is it really giving bang for its buck in terms of helping him make connections?

I realize I feel really alone in my struggle to comprehend him and find ways to be more effective with him. I need more support, but I'm not sure what kind of support I'm looking for--so that complicates my efforts to find it.

I sympathize with his attention issues. I wonder if making sense of the world is like a big unwieldy puzzle for him too.

There are a lot of tricky issues that have taken a back seat, but they nag at me, and I feel paralyzed. Instead of one big puzzle box spilled all over my floor, there are four or five. The effort to inform myself seems so much. I'm troubled by the tea parties, and their message that Obama is taking our country in a totalitarian direction. My father sent an article from the Investor's Business Daily publication that he gets. Its basic premise is that Obama wants to set up a 'Democratic Dictatorship' (now how's that for an oxy-moron?). Death-panels, Smeath-panels--the Democrats want to hold power to make life-or-death decisions over all of us!

It's peculiar when the right wing wears the cloak of liberty, because it seems at heart they are loyal to a kind of authoritarian mindset. It seems this group was silent in the face of surveillance over Americans, mining our data, authorizing torture, using the material witness act in unprecedented ways to lock people up without recourse, sometimes for years. The only outcry this group gave was against those who revealed and questioned these practices.

Their assertions have a peculiar internal logic that I feel I can't quite just turn my back on. I'd like to follow them up, and see how much is based on fact, how much on distortion of fact. But I just don't have time.

A couple other issues I yearn to make sense of are: Iran's nuclear program: in just the past year I've learned that Iran had a weapons program, but suspended it years ago...Iran is years away from having a bomb; Iran could have a bomb within a year. Iran has a facility that was undeclared until last Monday. Proof of further deceptiveness, or well within the rules? Has Obama painted himself into a corner in his efforts to engage Iran? How about Afghanistan? Has he painted himself into a corner there? Which really does make sense--get serious about protecting the population from the insurgency--or give it back to the Taliban? Isn't that what got us into trouble years ago and culminated in 9/11?

The part of me that loves order wants to put the puzzles together. But I'm daunted by the prospect of where to start, what sources to use, and the spectre of hours going by while trying to find the pieces that match.

Update

Shortly after publishing I was waiting for another program in my laptop to open and was staring at the photo of the puzzle on my blog page. I noticed a gap that had been bothering me, and I also noticed a piece lying right next to it that looked like it was a match. I'd stared at them for a long time yesterday. I got up, and sure enough, Bingo. That piece happened to be a watershed; at least 10 others easily found their homes. Of course, this was in the course of a half hour. I guess the lesson is I need to take a picture of a problem and post a blog about it, and it will "all fall into place".

Reflections from the raft trip

The John Day River is America's longest free-flowing river--no dams whatsoever. Its origin is in Eastern Oregon in the Strawberry Mountain Range. It drains 8,100 square miles of land, and it's source is mainly snow melt. So it's cold.

It was flowing high and swiftly. The section we ran is really more of a float than a run, with two class II rapids.

More on the particulars of the trip later, perhaps. I'm thinking about Scott right now, and the implications of his behavior on this trip for more aggressive rivers.

Late last year after his IEP meeting I made the decision to try medication with him. He's on the lowest dosage of a ritalin-type drug. And it has helped his self-control and focus; I would put him in the camp of children for whom ritalin is a benefit. I generally don't give him medication on weekends, and didn't think it would be necessary for this trip. In the last frantic minutes before departure I'd decided to bring it along as a just -in -case, but got distracted by something else and forgot to get it.

Gary was right--he could fit camping gear for 2 nights for 4 people (sans camping table) + 75# dog in an 8' x 13' raft, but it wasn't pretty. It wasn't roomy either, and there was a lot of slack time in a small space with two children who could care less about scenery, one of them with ADHD.

I could really see a marked difference in Scott without medication. He seemed much younger, even in speech tones--more like a 5 year-old than a nearly 8 yr-old. His self-control deteriorated markedly. This would cause behavior that inflamed Connor, who had just returned from a week-long outdoor school. That trip had been a disappointment, and he was bitterly disappointed by the prospect of another. He really seems to be a homebody type, and he'd looked forward to "band practice" with his friends for the school talent show in two weeks.

So, small confined space, lots of slack time, child with ADHD, and child with negatively predisposed attitude.

My cousin once sent me a link to Scott Noelle's website Enjoyparenting.com; the title explains it. I was impressed enough by the essay she called out that I got on his 'parenting thought-for-a-day' emailing list. His essays are generally short, but speak very much to the heart of things that are dear to mine.

A few days before we left he'd sent a thought about unconditionality which shed a whole different light on the subject. Frankly before reading his essay I'd considered the idea of 'unconditional love' as a kind of 'Should'--a bar to clear, a standard to reach. It was something I felt I failed at whenever I'd feel irritated at my children's behavior. I'd been under the impression that unconditional love means NOT being upset at some kind of immature behavior that causes me grief or extra work. Here is Noelle's definition that turned that belief around:

Unconditionality is a state of mind in which you are willing to allow well-being into your experience... NO MATTER WHAT

I suddenly realized that I had preconditions for my own sense of well-being that had been hiding in plain sight. Well-being was conditioned upon either the presence or absence of certain sensations within my body. Certain elements tell me whether or not my inner state is, say, irritable. Generally I called well-being absence of such elements. Therefore if I felt those sensations I believed I was unhappy. So I was entitled to be unhappy because the preconditions for unhappiness were being satisfied. Now I understand that those feelings, ANY feelings can be part of my soul's general condition--yet not a determinant of my well-being. That's what unconditionality means. I can be unhappy, angry, irritable, whatever, and still have well-being too. This is an amazing insight for me. I don't have to be unhappy because I'm unhappy!

And this muscle received a real work-out on the trip. I hope it gets stronger; right now it aches a bit. It did get me through many uncomfortable moments--knowing I could hate how I felt sometimes and still be ok.

I need to find a way to be a more effective mother of a child with ADHD. It is so easy to react to the behaviors on their surface apparency, and from within my own frame of reference. My own inner condition does not give rise to hyperactivity, and I assume that his inner condition is the same as mine. Therefore when he behaves the way he does, I think it must be perverse, because I experience in terms of my own inner universe. It occurs to me that perhaps within his frame of reference, his internal thresholds, he feels a much different kind of baseline. In his world, in his internal feeling environment, his behavior makes perfect sense. If I felt the same way in my world as he does in his, I would be behaving similarly. I'd probably have an extra engine fueling my behavior too, which is resentment from always being reprimanded and the focus of much negative feed-back from others. We all start our self-control marathons at zero, but children like him start saddled with a backpack full of bricks. They look just like us, so we can't understand the extra load they're under. Why can't they keep up?

This trip often took him far beyond his endurance. Even to an older child like Connor it seemed endless and boring, the long stretches it took to unload the boat to set up a camp, and then to break down and re-pack next morning.

On Sunday we pulled off the river to a BLM camp, just for a break. I wandered off to find some juniper thick enough to give me some, uh, privacy, and when I headed back toward the river Scott was howling as he was walking up the little trail. He'd wanted to stay down by the river and play; Gary had wanted to walk up to the camp. Scott can absolutely not be left alone on a river bank, especially with the level of impulsivity he was showing. I happened to be feeling generous and so said I'd go back down by the river with him. Where we'd beached the riverbed dropped steeply, so I suggested we walk over to a shallow little area with some willows and a shallow sub-channel. He could pick up mud and drop it to his heart's content and was quite happy there. Unbidden, he said that inside, he feels like he doesn't have "any control, and it scares me". I told him it is very powerful that he could tell the difference between knowing he is in control, and knowing when he isn't. I told him that my job is to find a way to be more patient. (And shortly thereafter became impatient with him when he found a little frog and could not stop picking it up--I was afraid it would get hurt, and to him it was irresistible.)

The delusion is that I require compliant behavior from him; when I don't get it I'm entitled to irritation. All the preconditions for irritation are met and none for well-being. I see that if his failure of self-control is the spoke in the wheel, my own failure of self-control and empathy is the empty space between. His failure is more obvious and so it's easy to lash out at him. It's easy to miss my co-failure.

We need to find ways to keep a family conversation going that doesn't single him out as peculiar (already Connor, in one of his own lapses of self-control, has used the fact of the ADHD against Scott), but promotes empathy and understanding.

He is not defiant. But the latency period between asking/requiring something of him and compliance is often much longer than I'm accustomed to. This could be life threatening on a raft trip. Immediate response is sometimes required in an unexpected situation. The urgent tone of voice that says: "Act-now!" that is usually sufficient to change someone's trajectory is not sufficient for Scott. At least when he's unmedicated. He was not in imminent physical danger on this trip--that's the nature of a leisurely float. Still, even seemingly benign circumstances can be deceiving. I realized this on a stretch where we'd allowed the boys to hang onto the perimeter rope on the raft and drift along beside it in the river. It was cold enough that they didn't do that for very long, and instead laid on the tubes with legs dangling. I saw willows ahead and realized this was shallow water and ordered them to pull their legs in. Connor complied immediately. I had to pull Scott into the boat. I realized how easily a leg trapped between rocks and boat could lever him over the side, to be ground under as the boat passed. It's a full loaded raft--and we would not be able to lift it off of him.

If a slow river was to be a trial before a more adventurous float, then we need another trial of a slow run with him medicated. If he is as slow to respond to verbal direction while medicated as he is without, then he just can't go on trickier runs.

The Meeting

Monday at 2:30 was the IEP meeting for Scott. Individualized Education Program. Present were the school psychologist, the learning specialist, speech therapist, briefly an occupational therapist, Billy, Gary, and myself.

There will be another meeting, to actually come up with goals and a plan for implementation. For the life of me I can't think of how we filled an hour and a half, but we were talking, listening, discussing the entire duration.

I'd received calls ahead of time from the school psychologist requesting that I bring a letter of diagnosis of adhd from the pediatrician. We actually connected on the phone voice-to-voice on Thursday last week. I'd been feeling a bit exasperated because I had some errands to do and Scott had been waiting pretty patiently (teacher planning day, out of school) to go and buy a reward for having behaved well in class that week. (Yeah, I've stooped to bribery. Short term goals and fairly immediate rewards seem to be most effective with him.) I was exasperated because I'd just finished listening to a message from her that went on and on and on. Clearly a long-winded sort that takes a long time to articulate a thought. The gist of the call was the request to bring the letter of diagnosis.

I had one question that I thought could be answered succinctly. Do I have to have the letter physically in my hand on Monday, or can it be in process, in the mail? If I had to have it in hand, this was going to be one of the stops on the errand run, the doctor's office. Friday I was going to the coast for my annual book retreat to choose our next year's reading list, so if the letter was mandatory then Thursday was the only day I could get it.

So that made it worth tracking her down. While on the phone at the Trillium school office with a student worker I concluded that I didn't want the letter faxed to that office. It's a good idea to give students the work experience, but I just didn't have faith that the letter would end up where it was supposed to be. It took a bit of prying to find out which school the psychologist was at that particular day but I finally got a phone number.

She seemed surprised that I'd found her. She couldn't talk long, she said, because she was supposed to be in a classroom doing an observation of an autistic student. She then proceeded to launch into an incredibly roundabout way of saying the letter had to be in hand. My question was answered long before she was finished and I was trying to be as crisp as possible. As we were about to hang up I said that I hoped there would be a lot of tissues at the meeting.

Perhaps that's what opened the way for what came next, which made my (impatient) patience with her worthwhile. She said, "I want you to know that we have six of those meetings scheduled at the school that day, and we intentionally scheduled his for last so that we'd have a full amount of time, and more if necessary to really talk about him."

She told me that as a child she herself had been 'tied to my chair' with a length of jump-rope, she was so hyperactive. I gasped and she said she was nearly 50 and it was a less enlightened time. I told her I remembered that time too. She had specialized in adhd in her career as a psychologist, and wanted to tell me her story as a means of encouragement about Scott's prospects. I told her I appreciated that she would have empathy for him and she said, "Oh! He's an adorable kid."

So that was very kind.

I spent all day Monday preparing for the meeting. I'd had a sort of plan to cry all day so there wouldn't be anything left for the meeting and I could conduct myself with some dignity, but it turns out there was no need. I've crossed a line somewhere from dread of what is to acceptance of what is. I realized the meeting wasn't so much about them giving me bad news about my child; it was about figuring out a plan to get him what he needs.

So, the short story is:

1) We had a meeting
2) It was non-adversarial, I felt solidly that these people were on Scott's side and in agreement that the school system was not serving his needs.
3) With diagnostic letter in hand, supported by various tests and evaluations more services were going to be requested and probably secured.
4) We would meet again in 2 weeks to discuss a plan for implementation
5) Resources are very limited. Welcome to the struggle millions of parents before me have engaged and engage now.

That's the condensed version. The learning specialist asked if we planned to try medication. I said that I wanted to see how he did with the special services first. She then told us that at best she was going to be able to serve him 60 minutes per week. To people who have been-there-done-that maybe that's a huge amount of service, but to me roughly 15 minutes a day in a 7 hour day seems shockingly inadequate. I think she was telling us this to illustrate the impact we could expect from special ed: kind of like trying to turn an ocean cruiser by pushing against it with a canoe and a paddle. The reality of this didn't hit me until yesterday, after the meeting.

I think she may have taken some personal risk in bringing up medications and with as clear a tilt as she did. She said, "I'm not advocating for medications. I'm advocating for him. He should be enjoying school. He should be at the top of his class, he's so smart. He is so consumed with being tortured by his adhd he just can't take in what he needs to engage him."

Wow.

I'd independently come to a notion that he is not getting the bigger picture, the underlying theme of school. In the same way he didn't get the underlying theme of baseball, was just being hit in the face over and over, neither does he comprehend there's a kind of grand design of school. Most of the other children absorb that by osmosis, that they are participating in something. And it has an underlying structure and meaning for them where they can begin to take satisfaction in mastery within that structure. Scott does not have this. So his behavior is at odds with the other children and with the classroom. In addition he has a serious communication disorder which keeps him from understanding what people are telling him. It really must be torture for him to be at school. It holds none of that secondary pleasure for him. It's an exercise in will power to keep himself reined in.

In a one-on-one setting he does quite well. It seems the chances for getting that are microscopic in the public school system. (Oh, what $10 billion per month going to Iraq could do...) Homeschooling is, and always will be an option. I don't think I am the best teacher for him, and to afford a tutor I would probably have to work full time. And since I'm the primary caregiver, when would I work, and/or who would take care of Scott while I do it? So if I keep him home he's stuck with me as teacher.

I'm beginning to grasp that he may be more profoundly affected than I'd realized. I would not withhold insulin from a child with diabetes. If his well-being is dependent on replacing some chemicals that are missing in his nervous system, then it's somewhat urgent to start soon, before he's entrenched in a negative posture toward school. And set in maladaptive behaviors.

More to think about. Waiting for a call from his pediatrician.

Sigh. My poor little boy.

More thoughts on anxiety and self regulation

I finally opened a library book I've had lying around for weeks: Scattered, by Gabor Mate´ M.D. The subtitle is How ATTENTION DEFICIT DISORDER Originates and What You Can Do About It.

This is not my first encounter with this book. I read parts of it back when Scott was a baby, not because he was showing any symptoms of ADHD, but because I found the subject added to my understanding of how the brain and mind work. There is something about that I find deeply satisfying, and this book fed that craving. This was the book that gave me the concept of "Fish in the Sea."

Now I'm revisiting the book, and from a position of personal need. Scott has a diagnosis, and I need education. I need to take the approach of a path with heart. I think this doctor's perspective holds that promise.

"Like Fish in the Sea" is the title of a chapter in Part Five: The ADD Child and Healing. It opens with the quote: "Parents who are faced with the development of children must constantly live up to a challenge. They must develop with them." Eric Erikson, Childhood and Society

Yes.

Mate´ says: "self-regulation is the goal of development; the lack of it is the fundamental impairment in ADD. One way of describing self-regulation is to say that it is the ability to maintain the internal environment within a functional and safe range, regardless of external circumstance."

He uses cold-blooded and warm-blooded organisms as an analogy. The warm blooded animal can exist in a wide range of habitats because of its ability to self-regulate the temperature of its internal environment. The cold blooded animal is vulnerable to the fluctuations and extremes of the external environment...

{I once had a realization that parenting is characterized by being interrupted. If anyone ever asked me what advice I might have for new parents I was going to tell them to be prepared to be interrupted repeatedly for the next 18 years. Case in point: the phone rang as I wrote and I ignored it as usual. But it rang again, and since Connor was over at a friend's, I wondered if the call might be a rquest to spend the night or if it was time for me to pick him up. So I answered, and it was his friend. He said that Connor was 'injured.' I figured he'd gotten a bruise or two, the usual 'scars' he loves to display and brag over. But the friend's mother got on the phone, said he'd been going fast down a hill on his skateboard, got spooked when a car turned onto the street, tried to turn too quickly and was flung to the asphalt. Fortunately he was obeying me and wearing his helmet. She said he 'is pretty scratched up' in a tone that suggested an escalation over his usual war-wounds. Then I could hear him say, "It hurts" tearfully, which is extremely unusual for him. I said I'd come get him, but she offered to bring him home instead. I asked her to give him some ibuprofen.

20 minutes later he's here, with some pretty impressive road rash. The wounds all look superficial with the worst a gouge just above his hip, his right shoulder, and his right elbow beginning to swell. He's moving his elbow in all directions, and is using the arm to bear weight to relieve pressure on other sore areas so I don't think it's broken. I ran a bath, thinking that submerging him in water might be more humane than the trauma of using a washcloth on the abrasions. He tolerated that fairly well, except he couldn't stand dunking the shoulder. I tried letting him sit a while, to let the ibuprofen take more effect so he'd be better able to manage it. Applying gentle pressure with a washcloth gave him some relief so I tried having him submerge while applying pressure. He couldn't bear that either. I dredged up an old irrigation bottle and tried gently rinsing but that was too intense too. So I did what he could tolerate: kept re-wetting the washcloth with warm water and gently pressing it to the wound. I can still see the asphalt, the black stain, but the wound is very superficial, just the top layers. So I decided to content myself with less-than-pristine-clean, but watch it carefully. I might have him try to soak again a little later, and if he can do that maybe try standing under the shower. He's feeling much better and is nearly giddy from the relief of that. In fact, he's pretty darn grateful for my ministrations, which is nice. I'm hoping that a collateral benefit is a greater awareness of and respect for his limits.

Gary got to miss the excitement. He's up on Mt. Hood. It might be best that he wasn't here for this; he has a tendency to overreact.}

My original train of thought is completely derailed. Perhaps I'll return to the theme of self-regulation and homeostatic mechanisms and how they pertain to ADHD and the emotional climate of the home. I'll try another post in the future. Maybe I should wait until the kids are back in school, or until (oh joy) Gary takes them to visit his dad in Washington next weekend. (I wonder if he realizes I'm not going?)

Swimming Lessons

Today is week 2 of daily swim lessons for Scott.
I think his level of progress at this point in his life as compared with Connor's may highlight the extent to which he is hampered by attention issues. This even in accounting for the normal differences of temperaments and abilities in siblings.

One of the tasks I set myself is to learn more about ADHD, and the nature of the diagnosis. He scored high on a behavior checklist. So is a diagnosis confirmed? I need to consider whether it would be useful to have the consultation of a child psychologist, or perhaps a neuropsychiatrist. Then I need to find out if our medical insurance will cover such a consult. I can't remember, I never can remember, our password for our online account to verify coverage. It's amazing what an obstacle this can be. This means I need to steel myself for a lengthy time on hold. I need to make sure the boys are occupied and don't require my attention. I need refreshments, fortifications. I need to get my ducks in a row for questions to ask once someone comes on the line. When my boys are occupied I'm reluctant to let that window pass doing chores. I want to be blogging, or writing in my journal, catching up on the news. So when there is a good opportunity to take care of phone-calls-for-information, that is in conflict with my good opportunity for some Time For Myself.

Another task I've set for myself is to look into medication. His pediatrician says there are three classes: the "straterra's", the "ritalin's" and the "adderalls". Nice that there are only three. I need to examine the mechanisms of how they work, the positives and drawbacks, the potential side effects. I need to seek out blogs of parents of children with the diagnosis and receive the wisdom of their experience. I need to talk with friends I know who are teachers.

With schools on their summer vacation I've lapsed in my resolve to accumulate this knowledge so I have a footing to base some decisions on. I've given myself a break since the need is less apparent, and less urgent, with him out of school.

Interesting how predictable it is that mentioning Scott having attention issues will elicit the admonition: "Don't medicate him!" My feeling is that it doesn't serve Scott well to oppose medicating out of ideology--it is a requirement that I research it first and see where the information takes me. If I'm persuaded that medication is the best route for Scott, then he shall have it.

When Connor was nearly 7 he was jumping off the high dive at our local pool in St. Louis. He was independent, safe to wander the pool grounds at will. He had had the skills for a year to swim in the deep end of the pool.

Scott, at nearly 7 is repeating his second level of swim classes. No matter how many times he is reminded he is not able to bring his arms out of the water in a full circle for more than about 3 cycles. He can't remember to keep his tummy up and his chin back when on his back. He is fascinated with how well he can see underwater when he has the goggles on, and so often when the teacher is talking he has his head underwater, looking around. Given the person that he is, it seems he requires a narrow set of circumstances where he can learn, and these are not present in this class. His teacher is excellent, easy-going and flexible, which is a huge plus. However, there is a child who requires much hand-holding and nurturing or she will dissolve into tears. A good deal of class time was spent on day 2 in such hand-holding. Another circumstance that isn't favorable is the proximity of another active, impulsive boy. Scott gravitates toward these children, and they toward him. Then they form a volatile combination because their attention becomes fixed on each other. Their priority is not to learn from the teacher: it is to best each other. So while the teacher is talking they are jockeying for position. Rather than swim across the pool, they watch the other's progress. If the other is pulling ahead, they will stand and leap forward in order to pass the other, leapfrogging across the pool in this way. It is all about winning. If one is behind he will claim he is 'not playing' as the other gloats over his 'victory.' If the teacher reprimands one, the other will taunt, "HA-ha!" When the teacher is holding the needy child's hand, reassuring, cajoling, the boys are splashing water at each other, jostling, getting reprimanded.

I can see where other children in the group (the rest are girls) have made the connection between what they do with their bodies and how that propels them across the water. I can see they are beginning to build on this and refine it; how they are gaining mastery. I can see how Scott has not yet made that connection of how to make his body engage with the water and pull him through, and how he can enhance this.

That was my reminder today that I need to follow through on my goals to get the information I need to make some decisions in the attention arena. Back to the Harrison Bergeron analogy--assuming that what for most of us would be easily ignorable extraneous input is equivalent to the jarring alarms and interruptions for a person with ADHD, reducing or removing such alarms would be very welcome for a person trying to think. Perhaps medication does just that. Perhaps the greater wrong would be in withholding something that can mute the strength of distraction.

I also recommended to Lizzie, his teacher, that she put as many girls between these boys as possible.