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Ask Dr. Nadeau
Growing Up is Hard to Do!
(In the following email and response, details and identifying data have been changed to protect the privacy of the family involved. We are sharing this email and response with our readership because it touches on a very common and often difficult problem for mothers raising a daughter with ADD – helping her make a successful transition from school to independent living as a young adult.)
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Dear Dr. Nadeau,
I attended your session about girls
who have ADD and clung to every word you said and ordered your book as
soon as I got home. I learned that so many of my daughter's symptoms can
be attributed to ADD. I've had her evaluated many times and specifically
asked about ADD, but they all said "no -- she doesn't have it."
I am appalled and discouraged that so many professionals were wrong. Now
-- they finally agree with me! And the psychological exam she had recently
agrees too. I still cannot find a psychiatrist who has expertise in ADD,
especially in girls.
My daughter, Heather, is about 15 years old developmentally although 23
chronologically -- quite immature. Her IQ is in the low normal range.
She graduated from high school and did pretty well because I structured
her life and forced her to do homework. She also worked with a tutor.
She's living at home and just got fired from her job for swatting off
someone's baseball cap after he made an insulting remark to her. Vocational
Rehabilitation won't work with her any more since she was fired.
Now, Heather is at home, sleeping late and doing nothing. We've met with
a specialist who helps disabled young adults. She gave Jill some "assignments"
for the week like getting up by 9 a.m. four days and calling her counselor,
keeping a journal, drawing (Heather is pretty creative and has some artistic
talent), reading a book on depression, and exercising 10 minutes a day.
We have such a long, long road to moving out on her own, but I do agree
that these "baby steps" are the way to get started.
I would very much appreciate any suggestions you might have about other
ways to help my daughter.
Sincerely, JB
Dear JB,
The transition from home to independent living is a very difficult one
for many young adults with ADD, and even more so when a young adult like
your daughter also struggles with depression and other cognitive difficulties.
You've clearly done a very good job in working with her - many students
with depression and ADD with above average IQ's don't successfully graduate
from high school with decent grades. The challenge now is to find or create
an environment for your daughter that will offer her the feeling of success
that she needs, while also providing adequate structure and support.
Getting back out into the world is extremely important for her. She
needs to have the company of her peers and a sense that she's working
toward future goals. Having structured activities around the house, as
the counselor suggests, while better than nothing, will promote her sense
of not belonging and her dependence upon the family. Finding the company
of her peers can be in a low-level sales job – at the local mall,
or better yet, in a vocational training program.
Do-able Goals are Critical - Are there any certificate programs
associated with your local community college? Many CC's have a number
of vocationally-oriented programs that can work well for someone at your
daughter's academic ability level and could train her for something in
her area of interest. She’ll feel more confident in her job search
if she’s received training in an area of interest that qualifies
her for a specific type of job.
Don’t Set Her Up for Failure – Like
all adolescents, she may not have a good sense of how much independence
she can manage with success. When she gets to the point of wanting to
move out of the house, it’s critical that she not be expected to
handle too much too soon. She may need financial help now and for many
years to come in order to living independently in her own apartment. Choice
of a roommate is critical. You’ve already seen how her impulsive
and emotional reactions to others can blow up and create big interpersonal
problems. As she lives at home, she needs to gradually take on the responsibilities
that she will have once she moves out – meal preparation, laundry,
maintaining her own personal space.
Finding the Right Job - I've worked with a young woman who resembles
your description of your daughter. She was creative, like your daughter,
happened upon a job in a small family-run printing company. They almost
"adopted" her and taught her many hands-on things about design
and layout of brochures and ads, etc. Eventually she went on to work at
another printing company and has lots of good self-esteem because of the
encouragement she got with the family-run company.
My experience with Voc Rehab is that they're not so careful about the
psychological fit of a job - they just have too many clients to serve
and not much experience with ADD issues - so you and a therapist would
probably have a better sense of what might work. Often, young adults like
your daughter work best in a small place in which most of the other employees
are older - they are therefore less likely to tease her or to trigger
"immature" responses that an age-mate might.
Get the Right Level of Support - You might consider engaging the
services of an ADD coach - to help her to develop more functional daily
habits - along the lines that you described. Using a coach helps your
daughter to make the transition from over-dependence upon you to developing
strengths and strategies herself. Frequent phone sessions with a coach,
can get the parent out of the "nag" role and give the young
adult needed structure that isn't provided by a weekly counseling session.
Helping Young Adults Develop Independent Living Skills - So often,
during high school years, the major focus must be on academics. You and
your daughter had to make many extra efforts for her to succeed at the
level she did during high school. Now, however, it's critical that she
begin to develop practical independent living skills:
- Managing money - controlling spending, bill paying, balancing checkbooks, filing income tax returns
- Daily self-care - adequate nutrition, sleep, exercise, hygiene, medical check-ups, dental check-ups
- Automobile maintenance, insurance
- Household maintenance - cleaning, laundry, cooking, food shopping
You need to gradually shift responsibility for these tasks
to her, doing them together for a period of time until she feels comfortable
with them.
Independent Living Environments - You may want to explore the possibility
of having your daughter move to an independent living program. Increasing
numbers of these programs are springing up around the country, serving
the needs of young adults with learning disabilities and emotional challenges.
These programs are a good transition point between home and complete independence.
In these programs, young adults are helped to learn to live with one another
in a mature, cooperative manner - sharing household responsibilities and
learning independent coping skills such as money management, meal planning,
time management, and holding down a job.
Getting Help as a Young Woman with ADD - Unfortunately, your experience
in having people repeatedly tell you that your daughter does NOT have
ADD is all too common. The fact that several professionals now recognize
that she has ADD is a positive sign - professional recognition and understanding
of how ADD presents in females is slowly developing. If you cannot find
an adult ADD specialist who works with many young women, it may be necessary
to serve as your daughter's advocate - helping to educate the professional
who treats your daughter - presenting copies of our book for professionals
- Gender Issues and AD/HD - to them and giving them information from our
websites - www.addvance.com
and www.ncgiadd.org.
Growing Up is Hard To Do - and even harder when you're a young adult
with ADD and depression - So - don't lose hope - just keep your perspective
and take a long-term view of her maturation. You described your daughter
as 23 going on 15. It's good that you recognize her immaturity. Her maturation
lag is likely to continue throughout her twenties. At age 30 she may have
grown, with your help and with the supports we recommend, so that she
is truly ready for managing her own life in a productive, responsible
way. Often, the young adults we see who are still floundering at 30 have
not received the structure and support they needed to continue to develop
and mature throughout their twenties. As a result, they've had a string
of failures during their twenties that has greatly damaged their self-confidence
and may have self-medicated with drugs or alcohol, further stunting their
growth and maturation. You've done a great job in getting your daughter
this far. Your task now is to help her find the resources that she needs
and to continue to provide her support, without allowing her to sink into
over-dependence upon you and the family nest.
Other Resources In our new book, Understanding Women
with AD/HD, there is a chapter on young women with AD/HD that contains
much more detailed information on the challenges and solutions of making
a transition to independent living.
Good luck and please let us know how your daughter is doing.
Kathleen Nadeau, Ph.D.
Dear Dr. Nadeau,
Hi, I am a 45-year-old woman with ADD who is having a ton of trouble completing my college degree. In particular, I’m having difficulty getting the understanding and help that I need with depression and ADD. This semester, my biggest problem is in a class on learning disabilities! The professor doesn’t seem to have any sympathy for my difficulties and isn’t helpful at all. I’m only two courses away from graduation, but feel that I’m at the end of my rope. Please help!
Theresa W.
Dear Theresa,
Congratulations on being so near to completion of your college degree! It’s taken a lot of hard work and determination to get as far as you have.
It sounds as if the most important thing you need right now is support – encouragement as well as support in getting the accommodations that you need and that you have a right to.
The student disability services office on your campus is the place where you must register as a student with a disability. Documentation of your disability is required – for ADHD, documentation consists of a full psycho-educational battery of tests – done within the past three years – that documents ways that you are impacted by ADHD and that recommends accommodations needed.
It is very important to develop a close working relationship with your disability services counselor. The better they know you and the more often you communicate with them, the more effective they will be in assisting you. Most disability offices provide a letter that you can give to each of your professors at the beginning of the term – stating that you have a disability and outlining the types of accommodations that the professor is required to offer you or allow you. These accommodations often include such things as: 1) in class note-taker (provided through disability services); 2) extended time on examinations; 3) permission to take exams in a quiet, non-distracting environment (provided by disability services).
It is best to develop a relationship with each professor at the beginning of each class – before you encounter any difficulties. Professors are typically very skeptical about providing accommodations if a student asks for them at the last minute, or after she has failed an examination. The more you demonstrate to your professor that you are interested and motivated, the more likely he or she will be willing to accommodate you.
Often, students report that some professors are very willing to provide other accommodations informally. These might include allowing you to take your examination in an empty classroom across the hall instead of going the more formal route through disability services. Some professors are even willing to examine you orally if you have difficulty expressing your knowledge succinctly in writing.
It is important to carefully select ADD-friendly professors. Networking with other students in the disability services office is often a good way to get to know the most open and supportive faculty members. Another good approach is to actively “shop” for professors. “Shopping” takes advanced planning with your disability counselor – so that you already have a good idea of the classes you want to take next semester. Then, go shopping – that is, sit in on a class or two given by several professors who teach a course you’re planning to take next term. Carefully choose professors whose teaching style you like – who seem enthusiastic, organized, and encouraging.
Another way to avoid a class with a professor who is hostile to ADHD accommodations is to carefully register for 18 or even 21 hours of classes each term – planning to pare down your course load during the first week or two of class to those classes whose professors and course requirements seem the best-suited for you. Choose one, two, or even three classes to drop. Then your schedule is all set. This is much easier than dropping a class and having to furiously search for a substitute class – which may be hard to find after the semester has begun.
Finally, sometimes there is no way to avoid the kind of ADD-toxic professor that you are describing. He or she may be the only person who teaches a course you need to complete your major requirements, for example. In these cases, it may be necessary for your disability support counselor to intervene. Many professors may not be aware that they are required by law to provide certain “reasonable accommodations.” A professor who knows that disability support services is involved will be less likely to be unreasonable or abusive to a student with a documented disability.
Be sure to get all the support you need to pass this difficult class. If your professor is not helpful, you may need to arrange for a tutor, a coach, or other services. Often, ADHD-focused therapy or counseling is very helpful too. In therapy, you will have a place to talk about your feelings and frustrations, to develop strategies to meet the challenges you face, and to build your self-esteem so that ADD-toxic professors won’t have the power to block the path to your goal. You also mentioned depression. I assume that you are in treatment for depression. A combination of psychotherapy and medication is often the most helpful for both depression and ADHD. If you still experience significant symptoms of depression and ADHD, you should consult the physician who is prescribing medication for you. Don’t assume that nothing more can be done – often it’s necessary to change medications and dosages a number of times before you’ve found the right combination.
Another excellent source of support is an ADD/LD support group – a place on campus where you have the opportunity to interact with other students who share many of the same experiences. Ask your disability support counselor if there is a support group on campus.
Good luck! You’re almost there. Let us know how things turn out for you.
Kathleen Nadeau, Ph.D.
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