ADD Dilemma

ADD Dilemma
Dr. Phil has advice for learning to bond with a child you don't like.

"My husband and I are at our wits' end with our 4-year-old son, Kevin," says Leslie. He is constantly throwing tantrums, screaming and yelling. "Kevin tells me to go away. He tells me that I'm a bad mommy. He told my husband that he wanted to get a piece of glass and cut Mommy and his baby sister."


Her husband of eight years, Jerry, explains, "He will go ballistic. He will turn purple in the face. He will get sick to his stomach. He will tell us, 'No, I don't want to do that.' He'll knock his little sister down. He likes to put a choke hold on



Kevin's school diagnosed him with Asperger's syndrome and ADHD. "They say his behavioral and social skills need a lot of work." But their pediatrician says Kevin will outgrow the behavior.


Leslie realizes that Kevin's behavior is putting a strain on her marriage. "I do feel myself pulling away from Jerry because he's not here all day," she says. "There are times I get so angry with Kevin that I do scare myself. It's almost like the room is spinning," Leslie explains. "Sometimes it just feels like we're living in a hell."


Turning to Dr. Phil she says, "I love Kevin with all of my heart and soul and I would do anything to help him. I just don't know what to do."

"The first thing we have to do, obviously, is what we refer to as a differential diagnosis. He's been diagnosed with ADHD and
Asperger's syndrome and there has to be a decision made so you treat the right thing," Dr. Phil tells Leslie and Jerry. "There are qualities of this behavior that suggest to me that it is not neurologically based."

Dr. Lawlis offers his opinion. "When you give in to him, he starts to behave correctly," he points out. "ADHD kids don't do that. They're either all of the time or none of the time."

Dr. Phil asks Leslie and Jerry what they think is going on with Kevin.

"I know a lot of it is my fault. I've been under, probably, a tremendous amount of stress," says Leslie, explaining that she had a miscarriage, lost her mother and had two C-sections. "Poor Kevin has not seen a lot of great out of his mom the past two and a half years."

Jerry gives his opinion. "I think Kevin can be very charming and he can really turn it on when he wants to. But I can't tell if there's something wrong with him or he's just learning how to play us," he says.

Dr. Phil explains that to make the differential diagnosis, they must look at a few things, including whether Kevin can turn his behavior on or off when he wants to. "There are things you can do to minimize the ADD or ADHD if it's there, but a

child just doesn't turn this on and off." If it is not neurologically based, there are alternative explanations. "Both of you acknowledge that you are very inconsistent and at times irrational in your reactions to him," Dr. Phil points out. He looks at Jerry and says, "You said you will give in to his tantrums just to shut him up."

"Sometimes I will," Jerry agrees.

"We have a child and he doesn't want to do something and he resists and you don't give in. He resists some more, and you don't give in. So he really resists now. He's yelling. He's screaming. He's peeing in his pants. He's throwing up. He's choking. He's threatening you with a broken bottle, and you go, 'OK, that's fine. Stay up.' What have you just taught him?" Dr. Phil asks. "The last behavior that occurs before the payoff is the one that is reinforced most powerfully. You've conditioned him to be not only be rebellious, but durably rebellious," Dr. Phil adds.

Jerry questions which battles are worth fighting.


"You do pick your battles, but once you choose one, don't ever lose," Dr. Phil makes clear. "If he's writing on the wall and you don't want to deal with it, then don't see it. But if you go in

there and see it and deal with it, you must prevail. If you don't, you're teaching him that he's controlling you." Dr. Phil offers some solutions, starting with Jerry. "There's nothing you can do except just take some time off of work — you cannot leave her to do this alone. And you have to master a few things. You have to identify and use currency so you can shape his behavior. You have to learn how to use positive reinforcement. You have to catch him doing things right ... You just have to lurk around the corner, scoop in and grab him up and say, 'You are such a good boy.'"


Dr. Phil suggests they read Family First to learn how to stop reinforcing and extinguish negative behavior, and how to stop tantrums. Dr. Phil concludes that Kevin doesn't appear to have ADD because he doesn't act out like this in daycare.