“School’s not very good,” said 9 year-old Shawn. He looked down at the magnets on my desk that he was fidgeting with, then slumped down in his chair. “I try to listen and remember what [my teacher] says, but when I think about other stuff I forget what she says and get in trouble.” We had been talking about executive function – how to get tasks done – because that was where he was struggling. His work was high quality, but often incomplete. Everything distracted him from work–kids talking, clocks ticking. Even the thoughts in his own head.
“Would you like to listen better and finish your work?” I asked him. He exhaled and grew quiet for a moment. “Yep,” he said seriously. “I would love that.”
We assume, correctly, that kids love to play, but underestimate sometimes how driven most are to accomplishment and productivity. Setting goals and achieving them is a primary source of self-esteem. That’s not to say they are happy to interrupt video games and begin chores. However, kids have a fondness for the experience of finishing meaningful work. Further, kids even view productivity as a moral issue. They don’t simply prefer it. They value it.
My last post introduced the ADHD Voices project which involved interviews with children about their experiences of ADHD and medication for it. Ian was 11 years old when he gave the following interview:
“I forget things a lot and I have trouble focusing and being mature. That means, it’s like, I’m not doing my work like I’m supposed to… It’s hard to just sit and listen and work like other kids do. Sometimes I talk to other kids when the teacher is talking, and she tells me to sit down. It makes me feel lame and stupid.”
The study involved hundreds of interviewees, and Ian was one of the majority of kids who not only valued productivity, but considered poor performance to be a moral failure. Ian was then asked about his experience with the effects of his treatment:
“The last time I felt good about my behavior was when I got all Bs and Cs on like my grade card except one D. That was few weeks ago. My mom freaked out she was so happy. I want to keep doing better.”
His best ever report card occurred after being treated with a stimulant. He didn’t particularly like being on a stimulant, but he did like being challenged and succeeding.
So did Shawn. He had been taking a non-stimulant for a month when he came in for a follow-up visit. I asked him if he had noticed any changes since his last visit. “I like this medicine,” he began. “I can pay more attention to what my teacher says, and I’m getting work done when I should.”
“Does the medicine help you feel better?”
He looked at me quizzically, as if if I had asked him whether the medicine made time travel possible. “No!” he said emphatically, then went back to playing with the magnets on my desk.
“Then how does it help?”
“I can just listen and do stuff, that’s all.”
“Should you keep taking it in your opinion?”
Shawn nodded thoughtfully. “I think I should.”
His mother, sitting next to him nodded her head, too. “He likes going to school again. It’s been a long time since he looked forward to it.”