messy. crazy. amazing. joyful.

We're not all officially ADHD. Dad's unofficial. Our ten-year-old twins have ADHD. Our seven-year old wants to have it because everyone is always talking about it. Our three year old has ADHD--just because she's three. And me, Mom, I think it's contagious. Who can remain untouched in a house where shoes seem to be lost every morning, instructions are routinely thrown aside, and fights erupt over which continent capybaras come from?

Wednesday, December 8, 2010

Always Entertaining




An Izzy story:

When I tucked Izzy in the other night, I noticed a list taped to her wall that reached almost ceiling to floor.

“What’s that?” I asked.

“My Christmas list,” she answered.

I cracked up.

A Luke story:

Luke says to me, “Mom, I’m not one of those people who thinks it’s all the president’s fault that we have a bad economy. I mean he has a lot of responsibility.”

First thought: Did he just use the word economy? Second thought: “Luke, have you been reading Newsweek?”

A Wyatt story: 

Wyatt was hopping up and down as we looked at toys in the store.

“Wyatt,” I said, “Do you have to go to the bathroom?”

“No.”

“Are you doing a pee-pee dance?”

“No.” Starts jumping feet out and in. “This is the pee-pee dance.”

An Annie story:

Seeing outdoor Christmas lights: “Mom, it’s more Christmas!”
Seeing Santa on TV: “Mom, it’s more Christmas!”
Seeing Christmas trees at the elementary school: “Mom, it’s more Christmas!”
Seeing Santa at the Santa lunch: “Mom, it’s more Christmas!”
You get the idea.

Monday, November 15, 2010

Healing



I am healing. I realized as I savasana’ed in yoga last week. As I lay on the floor relaxing after my yoga session, I felt happy and calm—then startled. Wow, I felt happy and calm. For the last four years, as I have savasana’ed and my yogis have told me to unwind, empty my mind, and let go of stress, I have lain on the floor struggling to pacify myself. Instead of emptying my mind, I was agonizing over the ordeals of the day, anguishing over my kids’ unruly and strange behavior, berating myself for my poor reactions and losing my temper, wondering if their constant fighting was in any way normal for siblings, pondering how I could make things better, worrying about what was going on at school, questioning whether they could ever make and keep friends. So much for meditation. I have not been able to empty my mind and relax for years.

But last week, I relaxed. I thought about how great my life is. How I love my husband and my kids. How I have an amazing extended family and wonderful friends. How the world is beautiful, and how I’ve had the chance to enjoy it in so many ways. Then I just emptied my mind and rested. Quite a miracle for me.

As I mentioned, it took me years to get to this place. I have learned patience and how to let go of those things that don’t matter. I have let go of who I thought my kids would be and who I wanted them to be and allowed them to be themselves. I have focused on the positive aspects of ADHD in my spouse and kids and been amazed by their abilities. I have set boundaries with my spouse and kids and realized that I need to take care of myself, too.  We have found medications that work, for the most part, and accepted that they cannot obliterate the symptoms of ADHD but can alleviate them. We have found fantastic teachers who understand and appreciate our kids. The kids are in a great school. They attend “Friends” class once a week for help with social skills. They meet with the school psychologists individually and together to talk through issues and work on behaviors and getting along with each other. It has been a long journey, but I have learned a lot. That seems to be how I always feel when I have reached the summit of a long, arduous trail. It is nice to have a rest at the top for a moment or two.

But I feel like what I have learned is a great blessing. My kids are helping me understand all kids. I have a soft spot in my heart for the goofballs, eccentrics, bullies, ants-in-their-pants kids. I go into my kids’ school every week and read with students. I love hearing about Sam’s vacuum fetish. Five-year-old Mackenzie cracks me up with her fashion critiques and her constant asking if I want to see her do her name in sign language. Dallas brings out my sympathy when he tells me he hits because his dad says he needs to be tougher. I also teach kids at church. When I learned I had a child in my class who could not sit still and who had difficulty communicating, I thought “Why me? I’m dealing with my own kid issues all week long.” But when I got to know this kid, I just loved him. And when he realized I loved him, he responded to me. They just need to know you love them.

Our life is still messy and crazy. That’s just the way life is. But it is also amazing and joyful. That’s the way life is, too.


Monday, November 8, 2010

A Safe Place for Your Child


Jumping down a giant sand dune. A good kind of adrenaline rush.


I went to a great lecture last weekend by psychologist, Jeffrey Ford. The lecture, “How to Create a Safe Place to Talk about Dangerous Things,” focused on how to create a home and build relationships in which kids feel safe telling their parents about their problems, even the most difficult kinds. Ford talked a lot about addiction problems, including alcohol, drugs, pornography, and even gaming. Unbelievable statistics about some of those things, but I'm not going to get into that now. Since kids with ADHD tend to be more prone to addictions and risky behavior, I was very interested in what he had to say. He talked about the 5 Cs: compliment, commit, calm, composed, and connection.

Compliment: When your child has the courage to share his problems with you, start by complimenting him. Tell him you know how difficult it must be to admit the problem and talk about it. Tell him he showed great courage in bringing it up. Tell him you love him no matter what. If you react this way to smaller problems, your child will trust you with bigger issues.

Commit: Tell your child that you are committed to helping her. Tell her that she has probably tried to stop the behavior on her own, but now you are there to be a help and support. Tell your child that you will regularly ask her about the problem. You can even set up a weekly meeting.

Calm: When your child admits to a problem, it is not the time to show anger or overreact. Your expression is especially important because it shows how you feel within a split second. Practice remaining calm in all situations with your child. Remind yourself that you will love your child no matter what problems he has.  Ask yourself, Would I like to communicate with someone who would likely react in anger?

Composed: This is also not a time to cry or act as though the child’s problem is going to send you over the edge. You are the adult, your child needs to be able to depend on you, trust you, and lean on you. Do not keep the problem from one or the other parent. That sends the message that the parent will not be able to cope and will not be able to love the child who has made mistakes. For instance, if you say to your child, “I’m not going to tell Dad about this,” the child may feel that her behavior is so disgusting that her father will not want to know about it. If you catch your child in the act, tell her that you will talk to her in 15 or 20 minutes when you’ve both had time to think and calm down.

Connection: Many addictive and risky behaviors create false emotions. Kids who have real connections with real people are less likely to turn to dangerous behaviors. Kids who are afraid to fail, who feel that they will be criticized or lectured for problems, or who feel that mistakes are disastrous are more vulnerable to seeking false support. The most important factor in helping a child to avoid dangerous behaviors is the child’s own positive self-concept. A healthy relationship between parent and child is key to the child’s self-concept and internal strength.

A little maxim: “Secrets surface in safety.”

This is a lot to think about, but for me, it was a good reminder that my relationships with my kids are critical to their well-being. Solving little problems and building trust now will be a great help when the bigger problems come along. No matter how crazy things get, they need to know I love them. Don’t like the behavior; love them. We had a little chat about drugs and alcohol over dinner and it went great. We did some role plays, and they really enjoyed it. 

Tuesday, October 26, 2010

So Are We Smarter Than the Average Thunnus Albacares?



Just barely. But I don’t feel too badly because the idiocy springs from being a parent. Moms and dads everywhere are bamboozled, sucked in, and manipulated by their own children. My children could be classed as professional negotiators, drama queens, and tyrants, so we’ve got to really be on our toes.

I found a quote in my readings that seemed to light the bulb in hubby’s head. I’ve been reading a lot of Dr. Daniel Amen lately, and I highlighted this from Magnificent Mind at Any Age:

“In dealing with kids, employees, and even spouses with ADD, no yelling! Many people with ADD seek conflict or excitement as a means of stimulation. They can be masters at making other people mad or angry. Do not lose your temper with them. If they get you to explode, their unconscious, low energy prefrontal cortex lights up and likes it. Never let your anger be their medication. They can get addicted to it.”

I think this is what happens in our house. Izzy and Luke draw us into conflict so often; they explode and expect a fireworks response from us. I know this may sound crazy to some. I mean, who likes conflict? No one would say they do, but if it gets your adrenaline pumping and your prefrontal cortex flashing, then whether it’s subconscious or not, you like conflict.

(Also addicted to fire.)

So we are trying not to be drawn in to the drama. We are trying to remain calm. We are trying not to yell or lecture. And I think we’re doing better. No magic bullets—for their behavior or ours—but we’re doing better. That’s what counts. 

Wednesday, October 6, 2010

One Giant Leap for Izzy




ballet+slippers.jpg




I can’t afford to not write about this. It’s a positive, a success, a giant leap for Izzy. And it might be short lived, so I better get it down while the glow of success is still warming our lives.

Here it is. Izzy liked dance class! And then she liked it the next week. And now she has liked it three weeks in a row. She even said, “Mom, do you want to see part of my jazz routine?” I tried not to gush too much and freak her out and scare her off, but I think I nearly sang out, “Yes, of course.” She promptly did a little dance in the family room, which didn’t look like the jazz dances I have otherwise watched, but was definitely a dance with moves all over the room. My husband and I looked at each other astounded and shared a secret smile and raised eyebrows. “That was great,” I told her and gave her a little hug. In my head I was saying, “That was amazing, astonishing, brilliant, triumphant.”

What was so great about it? Well, for starters, she asked me if she could do dance this year. I put her in dance two years ago, but she didn’t like it. She spent most of the class looking in the mirror, chewing her hair, or meandering along when she was supposed to be hopping or chassé-ing. So we did not go back for more last year. When she asked me to do dance this year, I was surprised. I said, “Let’s try one class and see how you like it.”

So we went to the first class, and I prepared myself mentally to not be embarrassed or phased by her strange or unruly behaviors or comments such as “That was boring,” which I knew might possibly be voiced in front of dance teachers, students, parents, and the rest of our little dance universe. I hadn’t prepared myself to watch my daughter enjoy herself, follow a good deal of the instructions, try dance positions and leaps, and talk with other girls. Wow! What was happening? It was a Vyvanse, growing up, choosing-what-to-do-for-herself miracle.

There were definitely classic Izzy moments that made me laugh: During free dance, she chose to climb the doorway with her feet on either side of the door jam, while the other little girls were doing pirouettes and plies. And she had a few moments when the teacher had to remind her to join the class or when she was mixing it up with other kids. But overall, she seemed like a pretty regular kid having fun at dance class. I was as surprised and delighted as if someone had just left a warm, caramel bread pudding on my doorstep.

After class, I asked how it was. “Good,” she said. Amazed. No “Boring,” “Dumb,” or “I want to go home”? We drove home and brought my friend’s daughter with us. (Of course my friend could just send her daughter solo to her first class and have her be brought home with someone else.) Izzy even said a few words to the neighbor girl. I couldn’t hear them, but wow, she was starting a conversation with another child. Unprecedented.

By the next week, my glee had been replaced with a good dose of reality. Sure she liked it last week, but when I told her to get ready this week, I would probably meet a wall of resistance. Surprise again. I asked her to get her dance clothes on and she complied (not without a reminder or two, but without a struggle). She carpooled with my friend and came home happy as a clam for the second time. As she changed out of her dance clothes, she asked me when her new ballet slippers would arrive. And then talking more to herself, she said, “Why am I jealous because those other girls have dance bags? I have this one still.” And she put her dance stuff in her old bag with a big smile. Wow again.

Okay, week three, surely she would be bored with dance by now. No she loved it, and as mentioned above, came home and performed in the family room. What thing or combination of things brought about this miracle? I will never know exactly, but it’s a direction I like.

Tuesday, September 28, 2010

A Little Escape

Cello girl

If you ever need a fanciful flight from my or your ADHD-riddled life, you might like to visit my cousin Kirsten’s blog. Here you will see three darling girls with braids, bows, or buns in their hair; green cardigans, polka-dot skirts, bejeweled necklaces; glasses that are not bent nor crooked nor splotched with dry liquid ovals. The girls play the cello, the piano, the violin. And they love it. They draw and color their own paper dolls. They stroll along country roads. They cozy up next to their mother and cross stitch—probably for hours, all the while humming a happy tune. Nary a laceless, holey shoe will you find in this dwelling. Not a guacamole-encrusted light saber. Not a three-day old peanut butter sandwich stuck to the wall. In short, it is not my house-- just the one I imagined before I had children.

Her blog is a little escape from my galaxy of chaos into an enchanted fairy world. To be fair, her kids are older, they are all girls, and I have one more than her. You will not hate her and covet her neuro-typical life. You will enjoy her perspective. She is honest and funny—a great writer. She, like any mother, has her moments: her ups, downs, in-betweens, and scorpion catching exploits. And I LOVE her photos. She shares all the beautiful things she finds and creates. She has a little Etsy shop with some darling prints if you are so inclined.

Sweet tooth a

I say all this about escape from my world because I do need to escape from it sometimes, but never would I escape for—well, probably more than three days. In fact, I was away last weekend, and I missed my crazy family with a longing that normal people probably feel. (I was away two weekends ago also, and I felt guilty for not really missing them. I needed a chance to breath. So I felt happy that I missed them last weekend. I am not a cruel, self-absorbed, unloving person. Yeah!)

Monday, September 13, 2010

Taking the Bait

High energy kiddos.


We had a little chit chat with the psychiatrist the other day about how things are going. My husband talked about how the kids have been rather sassy lately, and by the time he is done with them, they have lost their Wii privileges for the rest of their lives, are grounded forever, and can’t watch tv for three years. (Then he’s off to work, and I get to deal with the repercussions.) He knows this is too much, but also knows he doesn’t want disrespectful children.

So our dr. told us that we need to have a clean punishment slate every day or else the kids will feel hopeless about ever having a moment of fun again. My hubby said okay, and we were kind of done with the discussion. But then I told on him! I had to. He’s not really changing his ways in the discipline department, despite the new techniques the psychologist is teaching us. Even though he is a very intelligent, kind, reasonable man, sometimes he doesn’t listen to me. Many things could prompt this. Let’s just say he has ADHD, too, and sometimes I am the great reminder of everything he ought to be doing—thus, he has developed a turn-off-the-wife response. Sometimes when he is disciplining the kids, I come and raise my eyebrows and make faces in an attempt to remind him that he is not using the right technique. This is my way of trying to get his attention without coming out and saying, “Honey, have you not remembered one thing the psychiatrist told us about discipline?” which would very likely undercut his authority in front of the kids.

So, I told the dr. that my husband sometimes cannot resist the temptation to lecture and respond to everything my kids say. I have reminded him (see above) that they don’t listen to lectures and that they need short explanations and quick consequences. And often, when they are trying to push his buttons, he allows his buttons to be pushed and just gets more and more angry. (Right here, I will just say that of course, I am not a perfect disciplinarian either.)

The doctor told him that kids can get stuck in a rut of negative feedback. They want action, they want excitement, and an easy way to get that is to rile up your parents. Even though it’s negative feedback, at least it’s exciting. It is as though they are addicted to pushing your buttons even though they will suffer negative consequences. It's a little dopamine rush. So he challenged my husband not to take the bait. He warned us that the kids would be very angry when we stopped taking the bait, but that after a couple of weeks, they would be used to it and would settle down. Quick consequences and then ignore the sassiness. Stick them in their room if needed. Here goes our fishing experiment. I'll let you know if we can be smarter than the average tuna.

Monday, August 23, 2010

Tipping the Ever-So-Sensitive Dopamine Scales




Well, even 5 mg of Vyvanse was too much for Luke. His teacher said he was “climbing up the walls.” Stimulants are just not the thing for him. I suppose we could try a 2.5 mg dose, but I’m not sure how that would work. To give him 5 mg, we have to open a capsule and rather unscientifically knife the powder into two little piles. Could we divide up the one capsule into 4 piles—give him a few grains of powder a day? Not sure.

The amazing news is that Isabelle’s teacher said Isabelle was able to focus, participate, and complete all her work. She said the difference between Izzy with and without the Vyvanse was night and day.  I was really excited to hear that, and I must admit, a little bewildered. It had not seemed like Izzy had done well on the Vyvanse before. But as I thought about it, I wondered if Luke’s horrible days on Vyvanse had affected Izzy negatively so that we thought she wasn’t doing well either. Maybe since Luke was so aggressive, hitting, yelling, and teasing on those days, Izzy was just reacting to him. I was glad I had asked the teacher’s for their input because I’m not sure I would have ever realized that Izzy was benefiting from Vyvanse. Things get complicated when you are trying to figure out the best meds for two kids at the same time.

So we gave Izzy 5 mg of Vyvanse for a couple of days, and I started to notice that at about 3:30 in the afternoon, she was getting wild—I would say wilder than without any meds at all. It seemed that her medication was running out in the early pm. So the next day I gave her a 10 mg dose to see if it would last longer. It wore off at about 3:30 just as the 5 mg dose had. My pediatrician told me that although Vyvanse is supposed to last 12 hours, some kids need another small dose of stimulant after school. So at 3:30 I gave her another half dose (5 mg) of Vyvanse. That was bad. She was a tyrant. She was completely irrational and emotional. I felt awful for her. The things I am putting this little girl through. I immediately realized that was too much medication for her but what can you do? I wanted to magically remove it from her little body, but that was probably impossible short of having her stomach pumped. So Izzy had a rough day and on into the night. She did not fall asleep until about 3 am.

The next day, I went back to the half dose, 5 mg. I thought she better have some meds. I didn’t want her to go from having lots of meds in her body to having none and having withdrawal symptoms. But she must have still had a lot in her body, and she was exhausted. This was her worst day yet, and we were spending it on the lake with all our cousins. She screamed at everyone and everything. When she was being towed on a tube behind the boat, she screamed at her dad for going too fast. She climbed back into the boat calling him a “stegosaurus with a walnut brain, a six-headed monster, a freak, and the worst boat driver ever.” I hope we can laugh at that one day, but everyone was just trying to be patient with her. By late afternoon, the meds seemed to have balanced out, and she was having “an awesome day” and said my sister was “amazing.” Lucky dad was good and unflappable. At the end of the day, she did proceed to climb to the top of a 30-foot tree by the side of the lake where she waved in the flimsy topmost branches. I was cleaning out the boat and my niece said, “Do you see where Izzy is?” My husband went to get her, and of course, like a cat, she could get up but not down and cried as she climbed down, half-terrified, to my husband’s coaxing. I took a deep breath and reminded myself, “The meds can help her, not magically change all her difficult behaviors.”

Important lessons: 1) When you are working out meds with two kids, remember that one child can influence the other. Try to separate them for a while or ask for help from teachers or others.

2) After talking about all this with my pediatrician, I now understand that giving your child a half dose of Vyvanse in the afternoon is not the same as giving your child a 4-hour tablet of Adderall in the afternoon. Vyvanse is a long-acting med, so it will last a long time no matter what amount you take. A small dose just means a smaller amount will be in your system for a long time. On the other hand, a 4-hour tablet is just what it says, a med designed to last only four hours, no matter what the dose.

Oh my poor children are guinea pigs, and I am a medical reject. I hope we get through this in one piece. I love them though--I hope that makes up for a lot.

Tuesday, August 17, 2010

I Can Live with Hyper, It's Better Than Explosive

Hiking in Bryce Canyon.


Both Luke and Izzy are less emotional, less explosive, less trantrum-y. We are completely off Intuniv now and have been on Zoloft (sertraline) for a couple of weeks. I’m glad the atmosphere is more positive, but it is also more hyper, for lack of a better word (without the negative connotation). But Luke and Izzy have said it themselves. They are either more hyper or their hyperness is easier to see now that the explosive episodes have waned. But I have to say, I can take hyper. It is a gift that things are more buoyant around here. Please, do 10 somersaults. Just don’t yell and hit your brother.

Luke has not slept well for the last few nights, and I’m wondering if that is because he is off the Intuniv. Maybe a drawback from stopping that, but maybe the high emotions were related to taking it. I’m hoping bad behavior doesn’t result from this lack of sleep. If it’s not one thing, it’s the other isn’t it?

We started school yesterday, and I was dreading the “dreaded first day of school phone call”--that Luke had hit someone or Izzy was screaming. No call. So that was good. I talked to all the kids’ teachers and asked them how things went the first day. They had all been made aware of Luke and Izzy’s needs in general, so that was good. Both of their teachers said Luke and Izzy had a hard time sitting still and becoming engaged and Luke had some line-up scuffles. That is actually a good day for us. BUT I was still worried about their difficulty in sitting still and doing their work and “scuffles.” I want so badly for this year to be better than last and for them to be able to keep some friends. So I lay awake last night thinking about them and if we should try a stimulant. We were planning on adding a stimulant to the anti-anxiety med in a couple of weeks. And I decided, Why wait? If it’s going to help, let’s get it going. If it’s not going to help, let’s get this over with and on to our next drug trial or therapy or whatever is going to work!!! I started with a verrrrrry low dose (10 mg) of Vyvanse. It was like crack cocaine for Luke last time so I’m really hoping it works differently in a lower dose, without Intuniv, and with the anti-anxiety med. So far, no phone call today.

Sunday, August 1, 2010

On to SSRI's

I'm trying to be on vacation, but also trying to record what's going on. Since Tuesday we have been titrating the Intuniv and starting on a low dose of Sertraline (Zoloft). Since our attempts with Focalin and Vyvanse did not work, we thought we'd hit the anxiety instead of the ADHD. Something is working now. I don't know whether it's the Sertraline or going off the Intuniv (or hanging out at the beach and running around all day) but the emotional outbursts are definitely decreasing. Luke is not sleeping as well, so that's a problem. But the days are going far better.

Thursday, July 15, 2010

Ode to Baby



Once upon a time, I was the mother of three children under two and a half—twins and a newborn. I was so busy for the next few years, with the little guy and two extra-“spirited” kids, the thought of having another didn’t even flash through my brain. But as my first three grew, I kept thinking about having another baby. I told myself I was crazy. I told myself it was a bad idea. I told myself I was lucky to have any kids, let alone three, so I should not push it. I told myself I could hardly handle the kids I had, so why even consider having another.

I went to my husband with the idea. He replied the way he might reply if I asked him if he wanted another lemonade, “Sure.” That would not do for the woman who considers everything one million gajillion times before making a decision. I walked away. The next day I pressed him. I asked all my questions. I waited for debate. But all I really got was more “yes,” a confident “yes,” a “yes” with that same faith he seems to have in everything in life: that everything will work out. He felt there was one more child for our family. That “yes” made me so mad because I didn’t think he was taking me seriously; I didn’t think he weighed how much work it would be and how much it would cost. But I also knew that he would say “yes” now and mean it, and I would probably say “yes” after thinking and pondering and evaluating for infinity hours, and it really would all work out in the end anyway.

So we tried for another baby but were not getting results. After a couple of years I gave up and sold every crib, stroller, backpack, and swing we owned. And that’s a lot when you have twins. The next month I was pregnant.  In September 2008, baby Annie was born.



My husband and I were overjoyed, and to my surprise, so were the kids. I was ready for them to scratch, bite, and beat her, but they mostly just loved her. They held her, sang to her, and laughed at her funny faces. They were protective and sweet. I was exhausted, of course, but I somehow managed to get enough (note: not “everything” but “enough”) done every day. She was definitely worth the extra effort.

Now she is almost two. I am so glad we have her. She has a funny, engaging little personality, and we all love her. She adds so much to our family. Yes, the kids do tease her, but I am generally impressed with how good they are with her. Even though we are busier than ever, she somehow brings our family together even more, too.

Toilet-dip hair.


And she is a great reminder of how I should treat the other kids. When she dips her hair in the toilet, I laugh and give her a stern “no, no.” Why should I be less patient when my older kids spread mud on the trampoline? When she is stubborn and doesn’t want to go to bed, I snuggle for a little while longer and then try again. Why should I get exasperated when the older kids whine about having to go to bed? We are all learning at our own pace and deserve patience and kindness. Caring for a toddler reminds me that an eight year old is really just a beginner in life too and will grow out of a lot of things, will catch on to a lot of things, and will make a lot of mistakes and messes. I’m not saying we don’t have to have high expectations for our kids, even those who struggle with ADHD issues, but they deserve love, hugs, and patience instead of yelling (which I am prone to do at those low moments). As the grandparents say, one day we will miss the mud on the trampoline. And even though my husband may not appreciate all my work and struggles as much as I want him to, as in a daily, “You work so hard and are so amazing and the best wife and mother in the whole world,” he really was right. It all works out in the end.


Thursday, July 1, 2010

Farewell to Focalin

Hiking at Zion's National Park

We gave up on Focalin. In my opinion, it is either making things worse or it is not making a significant difference in them. To me, it is not worth it to treat my children with drugs if the benefits are negligible. And I feel like I gave it the old college try. We had them on 5 mg for one week and that was not fun. Then I moved them up to 10 mg and that was no better. They started waking up in the middle of the night. And for them, it seems like lack of sleep compounds horrible behavior exponentially.

But we kept on keeping on, and I gave them 10 mg of Focalin in the morning and 3 mg of melatonin at night hoping that it would help them sleep. They didn’t wake at night, but they didn’t seem to sleep deeply. I would check on them before I went to bed, and when I would brush hair off Izzy’s face or straighten Luke’s blanket, they would wake up and grumble, maybe sit up or open their eyes or roll over. Usually, they sleep soundly, even when I re-tuck them in or check on them. Usually there’s nothing but sweet, sleepy breathing.

So we went back down to 5 mg for another week, and I gave them melatonin at night. Still no noticeable improvements. So, we’re done. I have kept them on Intuniv the whole time, and that has made me wonder if perhaps the Intuniv is no longer working. Or maybe the Intuniv doesn’t work well with the stimulants? I don’t know. One thing that doesn’t really add up is that the Intuniv is supposed to control their emotional difficulties/outbursts, but that is the biggest problem they seem to have. I think the emotional outbursts are toned down by the Intuniv, but definitely not completely controlled. They are still a big problem—our biggest problem (and our even-keeled Wyatt seems be adopting their behaviors and crying and yelling more often). Added to that, the uncontrolled emotions seem to get worse when they are taking stimulants.  At this point, I hardly care that they forget their flip flops at the swimming pool. I can deal with that. It’s the screaming, complaining, lack of compliance, fighting, crying, and tantrums that are overrunning our lives. I just hope for some peace and serenity for them and our family. Serenity now!!
            One good thing. They like the job chart. (myjobchart.com) They are getting chores done and getting ready without too much hand holding, and they are very excited to choose their rewards. So it is working for specific tasks. But they can also earn points for behavior—not yelling, not teasing, etc. They have yet to earn points for good behavior, so once again, we will have to modify that and emphasize the importance of good behavior. 

Tuesday, June 15, 2010

We Need Tranquilizers, Not Stimulants

So sweet, funny, fun, and creative most of the time but inflexible and insatiable some of the time.

I haven’t written for a while because all I want to say is “aaaaaaaaah” again. We’re trying Focalin, and I don’t think it’s working for either of my kids. There seems to be a lot of screaming and whining these days. Loud screaming, sent-to-the-room-to-scream screaming. And teasing and fighting and poking and pushing and wrestling and horseplay ending in tears. I don’t think this can be caused solely by the transition from school to summer.

We started on a very low dose, half a 5 mg capsule, and for about a week we’ve had worse than average behavior. Two days ago we moved up to one pill a day to see if that worked better. That seems to have made Luke wake up at 4:30 am. So the lack of sleep did not help today. Falling on the floor whining at any request—to get a chore done, to get clothes on, even to come for lunch. Oh, it is so exhausting for me, and it seems exhausting for him too. Izzy is going from anxious family policewoman to constant Gestapo girl. She is stressed about every situation.

How is it that stimulants are not working for either of my kids? I’ve read that stimulants do not work for 20% of people with ADHD, but it seems strange that they have not worked for either of them, especially since they have four cousins who do well on stimulants. Our psychiatrist feels that their anxiety comes from their problems dealing with ADHD symptoms, but I’m starting to wonder if anxiety is their primary problem. Maybe we should try meds for anxiety? I don’t know, so we’ll just keep trying.

We are also working on a new reward program. It is all on the computer (and it is free). So far they like it. Izzy said it was fun just because they are allowed to log on to my laptop. It is a little complicated to set it up, but once it is set up it’s great. You set up chores, give each chore a point value, and then set up rewards that they can earn with their points. Chores and rewards are already programmed in or you can create your own. Check out myjobchart.com if you are interested. I’ll tell you how it goes.

Monday, June 7, 2010

New Assignments and Hanging Out with Cousins


This sweet looking boy is the perp.


Aaaaaaaaaaaahh. That’s how I feel. I knew the magic would end when we were supposed to implement our new “plans” and the kids did not magically become un-impulsive, un-explosive, un-screamy, un-cry-ey, un-losing stuff, and all sorts of other things for which words don’t really exist except in my brain.

I have three main assignments to work on to begin with. One, add stimulants to Luke and Isabelle’s meds. Two, find a counselor outside the school who will work with all of us, family counseling, parent counseling, child counseling. Three, set up a rewards and “mild discipline” program at home and work on behaviors one at a time.

So for one, we are adding Focalin to their meds. (Both are already on Intuniv.) We are trying them on a super low dose since they have not done well on any other stimulants. Each is taking half a 5 mg capsule. We open the capsule and give them each a few of the tiny little “balls” inside, which apparently taste really “yucky.”  Day 1 of Focalin and Luke was tears, tears, tears and Izzy was talk, talk, talk. Day 2, Izzy seemed a little lethargic and Luke seemed emotional. They both seemed to eat and sleep okay.

We were away at Grandma and Grandpa’s and then my sister’s last week. They had a great time but stayed up late and ate junky food. They just don’t function well when their lives shift like that. They played well with their cousins, which made me so happy. At least they have friends in their cousins. One incident though, and it was a doozy.  Luke and his cousin Max were fighting over a big beach ball. Max gave Luke a hip check, and though he’s younger, he’s much bigger. Luke went flying. His little rage thermometer raced into the red. You could almost see the steam coming out of his ears. He got up and swung hard at Max, hit him in the face, and gave him a bloody nose. So bloody my sister was ready to faint. I felt horrible. Luke always manages to do something highly noticeable that hurts someone else or draws negative attention. It’s impossible for this kid to fly under the radar. In a way it's good because he's sort of innocent. He's not trying to hide his bad behaviors, he just lets fly. At least the boys both apologized and forgave each other. I think Luke understood the gravity of his actions. He suggested that he shouldn’t have screen time for five weeks! We’ll see if I can survive that.

So we began the Focalin just after getting home from this week away. It’s always hard to know if their symptoms are exacerbated by circumstances like lack of sleep, poor eating, stress, or transitions, or if the drugs are having the opposite of the intended effect. But I think we will be able to keep them on this for at least a couple of weeks to see if there is any real change--improvement I hope. I’ll report later on my other “assignments.”

Monday, May 24, 2010

New Territory: Results from Neuropsychological Evaluation

"I am so bored with this."


Last week we received a written report on Luke and Isabelle’s neuropsychological evaluations. Today we talked to our doctor about the results and discussed ways we can help the kids. I have learned a lot in the last week about ADHD and related issues that we haven’t delved into until now.

Luke’s clinical diagnosis in a nutshell: He has ADHD-combined type (both hyperactive and inattentive), generalized anxiety, and disruptive behavior disorder-not otherwise specified (DBD-NOS). The DBD-NOS is a term for behavioral symptoms that do not warrant a diagnosis of oppositional defiant disorder but reflect difficulties in controlling aggressive and non-compliant behaviors. On a positive note, his intellectual capacity falls into the superior range and his social behavior among peers shows understanding of social cues.

Izzy’s clinical diagnosis in a nutshell: She has ADHD-combined type (both hyperactive and inattentive), mood disorder-not otherwise specified, and pervasive developmental disorder-not otherwise specified. The mood disorder-not otherwise specified essentially means that she has some level of anxiety and depression but not enough to be diagnosed as generalized anxiety or depression. The pervasive developmental disorder-not otherwise specified means that she has symptoms approaching Asperger’s (which is on the Autism Spectrum) but does not cross the threshold. On a positive note, Izzy shows superior intellect in several areas and a “splinter” intelligence in creative cognition. This means that she is exceptional—off the charts, I guess—in creative intellect. Apparently, these splinter intelligences are great gifts but cause difficulties because the person gets frustrated with areas of weakness.
So now, along with learning about ADHD, I need to learn more about anxiety, DBD, and PDD. One thing I learned this week that I didn’t know before is that ADHD is not on the Autism Spectrum. Symptoms overlap, but ADHD is not part of the spectrum. Here is a good explanation I found online:

Understanding ADHD and Autism Spectrum Disorders


It is probably best to consider ADHD as sometimes sharing the following symptoms with—but not part of—the Autistic Disorders Spectrum: 
·         Poor reading of social clues (“Johnny, you’re such a social klutz. Can’t you see that the other children think that’s weird.”)
·         Poor ability to utilize “self-talk” to work through a problem (“Johnny, what were you thinking?! Did you ever think this through?”)
·         Poor sense of self awareness (Johnny’s true answer to the above question is probably “I don’t have a clue.  I guess I wasn’t actually thinking.”)
·        Do better with predictable routine.
·         Poor generalization of rules (“Johnny, I told you to shake hands with your teachers. Why didn’t you shake hands with the principal?)

Here are the assessments included in their evaluation:

Conner’s Comprehensive Behavior Rating Scale Parent and Teacher Form
Autism Spectrum Rating Scales Parent and Teacher Form
Home Situations Questionnaire
Elementary School Situations Questionnaire
Review of records
Social Attributes Checklist
Teacher Observation Checklist
Cognitive Assessment System
Purdue Pegboard
Autism Diagnostic Observation
PDD Screening Questionnaire
Letter/Number Writing Sample
Wechsler Intelligence Scale for Children IV
Conners’ Continuous Performance Test II
Woodcock Johnson III Tests of Academic Achievement
Peabody Picture Vocabulary Test IV
Expressive Vocabulary Test II
Developmental Test of Visual Motor Integration
Revised Children’s Manifest Anxiety Scale
Reynold’s Children’s Depression Scale
Clinical Interview

And how do I feel about all this? I’ll get into that next time. Baby’s awake.

Wednesday, May 12, 2010

Riding Is My Ritalin


Riding Is My Ritalin is a great article from Bicycling Magazine that was posted on another ADHD web site. (I can't remember whose.) I feel like I could have written the same thing and called it "Exercise Is My Prozac."It makes me want to get the kids riding bikes more and wishing they had more regular PE classes and recess. They only have PE during one of their five terms. The other terms are music, Spanish, art, and drama. Also, their recess is essentially nonexistent. They have lunch at 12 pm and can go out and play after that—until 12:30 pm. I know the teachers let them out for recess, but not consistently. They have days with no recess, no exercise at all during the school day.


This article makes a lot of sense to me because I’ve found that exercise is critical for me. It helps me sleep, digest, feel more happy and energetic. Last year just before Christmas, I was not exercising at all. I didn’t like my gym, and I couldn’t find anyone to run with me in the dark, cold mornings. (What? That doesn’t sound like fun?) I was a piece of work, crying over everything and feeling stressed and CRANKY. That works really well for my family…

In January I started exercising again at a gym that I really like and that, along with some other stuff, helped me do a 180 turn around. I just felt like the troubles of life could roll off me like water on a duck’s back. My very, very favorite thing is exercising outside in a beautiful place. Nature kind of rejuvenates me somehow. My next favorite is at least getting outside anywhere and exercising. And then if all I can do is exercise inside, that’s still pretty good. I know not everyone is so rejuvenated by exercising, but I wonder if it does have at least some of these positive side effects for everyone. And I wonder how I can get my kids to like aerobic exercise as much as computer games. Wouldn’t that be nice? If they were constantly asking me if they could go outside and ride their bikes and fighting over who got to go first? They do at least like riding. And they love the trampoline. So that’s a start. Maybe I’ll tell them the doctor insists that they exercise for at least a half hour a day before they play computer games or watch tv. Would that be naughty?




Friday, May 7, 2010

First Impressions after Neuropsychological Testing

The Love/Hate Twins



Back from our multiple-day neuropsychological testing with Dr. Adam Schwebach. Though we will not receive all the written results, diagnoses, and advice for another week, I can say at this point that I am glad we did it. The kids felt comfortable with “Adam” and thought the testing activities were “fun.” After each day’s testing, Dr. Schwebach talked to me about his thoughts and preliminary findings and answered any questions (as always, quite a few) that I had.
He thinks that both Luke and Isabelle do have ADHD. He didn’t feel that either of them have Asperger’s. While Izzy does have some symptoms of depression and anxiety, he feels this is due to the stress caused by her ADHD. If we can cope better with the ADHD, these symptoms may improve. He was also concerned about her reversals in writing. She often writes letters (not entire words) in reverse, especially “s” and “g.” We may have her assessed for motor skill development. He thinks that she is more intelligent than her schoolwork shows because ADHD hinders her problem solving and emotional responses. She does fine academically, but it would be nice if she enjoyed school more and experienced less frustration.
 On the other hand, Luke may have some anxiety that should be addressed separately. This was a surprise to me since I worried more that Izzy had anxiety issues. Luke understands social interactions but cannot control his emotional reactions. He knows that what he is doing is unusual or that he is overreacting, but he cannot stop doing it. Though both kids are using Intuniv, Dr. Schwebach said he would like to try them on stimulants in addition. (Both grandmothers are groaning here.) The Intuniv is a norepinephrine drug, and he feels they may benefit from a drug that stimulates their dopamine production. We did tell him about our Vyvanse nightmares, so we will try other drugs, maybe Concerta, Adderall, etc.
I’m looking forward to getting the results. Dr. Schwebach will include suggestions on behavioral therapies to implement at home and at school and how to work with the school to best help the kids. That sounded great to me. I can think of some teachers that could use a little ADHD education…
Dr. Schwebach also gave me the book, “Raising Resilient Children” by Robert Brooks and Sam Goldstein. I will give it a read and see what I think. (Aren’t I skeptical even though we had a good experience?) Dr. Schwebach is an associate of Sam Goldstein, who is quite a well known psychiatrist, speaker, and writer. ADHD is one of his special interests. He has a web site with some good resource links. If you are interested check out http://www.samgoldstein.com/ Why didn’t we go to Dr. Goldstein? I didn’t want to wait six months! And I think Dr. Schwebach was good. Sometimes the “famous” people are too busy writing books, giving speeches, and teaching at universities anyway right? So there are my first impressions. I will write more when I get our results.

Wednesday, April 28, 2010

Neuropsychological Testing


I love the trampoline.
            Next week is our appointment with psychiatrist, Dr. Adam Schwebach.  As we probably all do, I am hoping he will make solid discoveries and diagnoses and will know exactly what to prescribe to solve all our problems. But if I have learned anything about medicine and healing (from infertility treatment, my father having cancer, and trying to figure out family ADHD stuff), I’ve learned that medicine is not an exact science. I already have two conflicting diagnoses for Luke. His pediatrician thinks he has ADHD, but the school psychologist thinks he just has social difficulties arising from being gifted and feeling different.
            We have three different appointments on three consecutive days. The first day we will bring all our files to the office and go over them with the staff. We have been asked to complete several parent forms:
-       a seven-page childhood history form
-       a seven-page Conners CBRS parent form
-       a two-page social attributes checklist
-       a home situations questionnaire
-       a two-page ASRS parent ratings response form

In addition, each child’s teacher has filled out several pages of forms that we will bring. (They were really interesting to read as their opinions about the kids were different from ours in some cases.) And we have been asked to bring school records, report cards, medical records, and previous testing records as well.

We will spend an hour discussing each child’s case. I have funny thoughts about how I am going to respond. Sometimes I think, “I don’t want to give them too much information or influence them with my perceptions, I just want them to come to their own conclusions.” But then I think, “Half of a psychological evaluation comes from observation, and I’m the one who observes them most.” Also, I know their intent is to help us, but I have had some appointments where I feel like I’m advised to just be a more caring or consistent parent. Then I think, “Maybe I shouldn’t have been so open. I shouldn’t have admitted that I’ve spanked them.” How do you let them know that you are a truly committed, loving parent but ready to tear your hair out and send the kids to their rooms for the rest of their lives sometimes?

Okay, so I know we’re not going to arrive at any definitive answers, but there are a few things I hope we can address. I would like to know if ADHD is the right diagnosis for Luke and Isabelle and if they have co-morbid conditions such as anxiety, ODD, or sensory processing disorder. I want to help Izzy have better peer friendships, better problem solving skills, and greater emotional control. I want to help Luke keep a jacket for one entire season, have better peer friendships, less aggression, and be better able to enjoy activities other than television and computer/video games.  Plus, I would like some advice on behavioral and occupational therapy. No instant miracles. Just the next step in climbing Everest.

Wednesday, April 21, 2010

Just Say No to Red Dye



I'm following the Friday Food Challenge from a mom's view of ADHD blog, making some diet changes for the family that I hope will help with ADHD symptoms. I have made a lot of food changes lately through a nutrition challenge at my gym, so one more seemed a bit overwhelming. But Penny is taking baby steps with the challenge, so I thought I'd jump in. This week we are cutting out FD&C Red 40, an artificial food coloring that has been shown to increase hyperactivity. 


I am trying to stay away from processed foods altogether so there isn't much we eat that has red 20. But when I went to buy ketchup I saw that the organic Natural Directions ketchup was on sale, even cheaper than Heinz. So I bought it. I thought that the kids might whine and say it wasn't good ketchup or "the right" ketchup, but they never even noticed. Cheaper, healthier, no brainer. A baby step in the right direction. 

Monday, April 19, 2010

Breakthrough


We had a great day skiing as a family this weekend. We took all the kids—even Annie in the backpack—and we all had a wonderful time. Instead of moments like this,





we had moments like this.

Despite Luke’s face, he had a great time. He was “whoo-hoo”-ing as he raced down the hill. Last season, our family ski trips were generally more boo hoo than woo hoo.

My husband and I both love skiing and skied with our families growing up. So we always figured skiing would be a great activity for our family. We started the kids out when they were tiny, three years old. At that age they loved it. They skied between our legs or with us holding them on a leash. They had no worries and just whooshed down the hill. When they fell down, we picked them up. But as Luke and Isabelle got older, we tried to teach them to ski on their own, get up on their own after a wipe out, and to turn rather than go straight down the hill. This was met with not your garden-variety kid resistance but with screaming, whining, crying, and all sorts of that kind of fun. Our little family activity became a nightmare.

We didn’t want to stop because the kids had enjoyed it before, and we were hoping we could get through the learning curve. Last year we vowed to take it easy, focus on the hot-cocoa-in-the-lodge fun, and go home when the kids got tired. We did, but it was still a painful season with lots of whining, crying, and begging for hot cocoa after just one run.

This year I took a look at the situation and decided I was going to eliminate my teaching agenda. After all, I remembered my dad commenting on every run about how to improve my skiing and it got pretty old. Plus, since moving, we ski at a small resort, and on the bunny hill, you can see all the runs and the lift at a glance. So I decided to let the twins just do what they wanted and enjoy.

They loved it. They sped straight down the hill and rode back again a million times. They taught themselves to turn since they had to avoid other skiers and make it to the lift line. They rode the lift without me, and we waved as we passed each other. We did have a few meltdowns. Once Izzy fell and her ski came off. I heard the wailing for miles away and got to her as fast as I could. And there was a lot of whining when one wanted to stop and the other go on. But all in all, we are back to enjoying skiing.

A few lessons learned in the ADHD family:

ADHD can make kids less emotionally mature than their actual age. Grin and wave at onlookers when your child is screaming bloody murder on a bunny hill.

If your child doesn’t take kindly to a lot of coaching, back off. Just let them do their thing, and you’ll all enjoy yourselves more.

Growing up will ease a multitude of pains. The meltdowns decrease and the rational thinking increases just because they are growing up. Many behaviors that threaten to send me over the edge and have me wondering how I (and they) can survive motherhood have simply diminished enough to make life more bearable. Glory be, this season felt like such a breakthrough on the slopes!

Wednesday, April 14, 2010

Talking to Our Kids about ADHD




Until recently, we had not told our children that they have ADHD.  Our pediatrician told us that we could simply give them their medicine and tell them it was to help them focus on their work at school and stay calm. I was never comfortable with this, probably because if it were me, I would want to know. However, they are young (eight now), and so I waited until they were a little older to tell them.

My husband and I talked together before talking to the kids. We used some work sheets from the Let’s Get Fit to Focus web site, which is a site that helps families work through ADHD issues on a week-by-week basis. The week one worksheets had my husband and I make a list of positive traits in our kids. That was a good way to get us in a positive frame of mind. Then we sat down with the kids and talked about ADHD and how it can be difficult but can also be positive. We told them some things that we loved about them. We showed them a page we’d printed from the week one worksheets with pictures of famous people such as Walt Disney and John Lennon who likely had or have ADHD. (It would have been nice to have pictures of more contemporary people with whom my kids were more familiar, but I didn’t do the research on that one.) We also had the kids draw a picture of what ADHD looked like.



Luke drew a picture of himself at school thinking about being with his friends and not listening to the teacher. He thought it was funny. Izzy drew a picture of herself on a rollercoaster because that showed that she “liked to do exciting things.”



The whole thing went surprisingly well. I think focusing on the positives or gifts of ADHD made the whole thing palatable. We also told them that Dad has ADHD and that also made it cool.

Since then we are getting some pretty interesting comments. Izzy told me that one of her favorite book characters, Babymouse, probably has ADHD. When I asked why, Izzy said, “Because she likes to do all kinds of crazy things and she gets in trouble and she is very creative.” Luke says he is pretty sure Fregley from Diary of a Wimpy Kid has ADHD “cause he gets hyper when he eats sugar. And maybe you don’t know this Mom, but I get really hyper when I eat sugar.” Luke seems to be enjoying being extra hyper. He has been bouncing off the walls and telling me that he can’t help it because he has ADHD. I tell him that ADHD is not an excuse to act like a wild man, but that it means he might have to work harder to stay calm sometimes, which I’m sure sounded like “Blah blah blah, blah blah blah blah,” to him. But at least for now, they have a positive outlook on ADHD.

Monday, April 12, 2010

Friday, April 9, 2010

Isolation, Guilt, and Judgment


Here are a few highlights from a communications paper that I wrote on social media and mothering children with ADHD. The paper is 20ish pages long, and no one in their right mind would probably want to read it. (Even I can't read it anymore.) But my research helped me understand why I often feel isolated, guilty, and judged as a mother, especially as a mother of children with ADHD. So here are some  excepts that might be helpful

The Pew Internet and American Life Project found that 80 percent of Internet users search the Web for health information, and a majority of these participants access user-generated health information (Fox and Jones, 2009). People looking for health information do not want just facts and figures from experts but also want to hear about the experiences of others in similar situations. They want to know what others say about medication and treatment, they want to get emotional support, and they want to build awareness around a disease or cause (Sarasohn-Kahn, 2008). This is likely the kind of ADHD information users are seeking when they go to A Mom’s View blog or ADHD Moms.

ADHD is an ideal vehicle for a contemporary rhetorical analysis because of its cultural implications, including its ambiguity and recent detection by the medical community. According to Malacrida, “It is a diagnosis that, since its discovery in the early-to-mid 20th century has engendered considerable controversy regarding its nature and treatment” (2004). Conrad and Schneider tie its legitimacy not to medical research but to “aggressive pharmaceutical marketing strategies” (cited in Malacrida, 2004). Because ADHD in children often manifests itself in behavioral rather than physical problems, the question arises, Is the child misbehaved or suffering from ADHD? The behavioral problems then reflect not only on the child but also on the parents and their inability to control or discipline the child. Malacrida notes that ADHD, “because of its cultural and historical ambiguity, brings mothers into conflict with discourses of good motherhood” (2001).

Motherhood is the final element in this triad of contemporary culture. Though we may think of good motherhood as a static ideal, Medina and Magnuson stated, “The standards for mothering are socially determined and have changed over the past century” (2009). Sharon Hays found that since the 1980s, the standards for good mothering have been escalating into what she calls “intensive mothering.” Intensive mothering is “expert guided, emotionally absorbing, and labor intensive” (1996). Susan Douglas extended this term for the 21st century, defining “new momism,” and said that unlike today’s moms, a mom in previous decades was not expected “to pipe Mozart near her womb so this perfectly tuned child came out, or drill him with flash cards…or expect him to read The Iliad by the time he was four” (cited in Peterson, 2004). If the average mom in today’s culture feels pressure to be a perfect mother, then the mother of an ADHD child feels even more pressure. On top of the demands of new momism, she must find ways to help improve her child’s erratic behavior, do extra work with school and health professionals, make treatment decisions, and create an accommodating environment at home, among other tasks. Moreover, she must shoulder these additional burdens on behalf a child who may not appear to have special needs, and thus, the child’s behavior is unlikely to prompt empathy for the mother, but rather harsh judgment.

But there is a backlash against this ideal of perfect mothering, some of which has been generated through the “mommy blogging” community. Lopez noted that mommy bloggers create a “different picture of motherhood to what we see in the mainstream media.” Through their realistic descriptions of life, “we see women who are frazzled by the demands of their newborn baby, who have no clue what to do when their child gets sick, who suffer from postpartum depression, and whose hormones rage uncontrollably” (2009). These are not the June Cleaver moms of the 1950s, nor are they of the Thelma and Louise extreme ilk. These women fall somewhere in between, trying to be good mothers but acknowledging the realities and difficulties of their role. I compare this to the heroes portrayed in current films. Superman and his superhuman, shiny, happy, persona is not currently quite as popular as the more human, flawed, Batman, whose weaknesses make him more rounded and believable. While the appeal to being a supermom still works as a rhetorical strategy the most up-to-date appeal comes from the realistic, mulitfaceted supermom.
             
Lopez described the format of blogs as having “the potential to capture this multifaceted portrait” of mothering “in a way that no other medium has been able to accomplish thus far” (2009). Lopez described how mommy blogs show that “motherhood can be overwhelming and exhausting, hilarious and exuberant, dirty and disruptive, all at once.” Mommy blogs differ from other discourse on the web in that they are self-expressive, cathartic, creative, and influenced by the community. Williams’s A Mom’s View blog likely appealled to online moms because it incorporated these elements, in essence, she spoke their language. She likely appealed specifically to ADHD moms because her discourse reflected a concept of mothering that they can relate to: the authentic mom who makes extraordinary efforts but also extraordinary mistakes.

The mommy blogging ideal of the perfect mother does not mean perfect in the sense of flawless but authentic and unapologetic of her role. Lopez noted, “Showing the ugly side of motherhood has the potential to be liberating and beneficial for all women” (2009). This new definition of motherhood is intended to inspire mothers to be their best but free them from the impossible demands of ideal mothering myths. The appeal of this new concept of mothering is especially attractive to mothers of children with ADHD because of the added demands on them and because others may see their child’s problems as an indicator of unacceptable weakness in them (Malacrida, 2004).

Subjects such as ADHD are relevant to current rhetorical theory because they reflect cultural currents. What effect does the $250-billion drug industry have on the legitimacy of this recently discovered condition? Can drug companies and other businesses create an acceptable place on a social networking site? The implications of new concepts of motherhood also relate to ADHD mothers.  Will the ideal of authentic mothering created by mommy bloggers relieve ADHD moms of their guilt, empowering them to make independent healthcare decisions for their children?

ADHD Paper





This is a paper I wrote about social media, mothering, and ADHD children. It's a Comms paper but it really helped me understand some of the issues I was dealing with as a mother of ADHD children. This is the whole enchilada, 25 pages.

An Appeal to Authentic Mothering: Comparing Social Media Rhetoric
 on Mothering Children with ADHD

Introduction
            In this paper I will compare the rhetorical appeals of two social media sites for mothers of children with Attention Deficit Hyperactivity Disorder (ADHD). One site, A Mom’s View of ADHD: My Everyday Life with My ADHD Son (A Mom’s View), is a popular personal blog written by Penny Williams, the mother of a seven-year-old son, Luke. The other is a Facebook page (part of a social networking site) entitled ADHD Moms and sponsored by McNeil Pediatrics. Comparing the two, which appear similar at first and fall into the same genre of social media, exposed a wide gap in the messages and methods of the two texts. I chose to analyze social media discourse on ADHD and mothering because each of these elements alone is a popular contemporary subject in communication and culture. Analyzing the interplay of the three elements--social media, ADHD, and mothering--revealed even more fully the complexity of our Information Age (now moving into the Attention Age) and the corresponding changes in rhetorical strategies.
            Social media is a relatively new form of discourse and is constantly evolving. Generally referring to online applications such as wikis, blogs, podcasts, video sharing, and social networking, social media includes any media that allows the creation and exchange of user-generated content. These kinds of interactive sites are becoming more popular than traditional websites, with those that encourage quick exchanges becoming the most popular. Steve Rubel noted, “We’re favoring what we can scan and skim over what we can read or watch. This is why Twitter, YouTube, and Facebook are so irresistible and dominating” (2009). Though social media began exactly as its name suggests, as a social exchange, it is rapidly becoming commercialized. Rubel directed advertisers, “Take your message to where the people are…. This will ensure that you’re taking full advantage of the two key ways consumers will find content—pull (e.g. search) and push (e.g. content that finds you increasingly through social networks).” This may be what McNeil Pediatrics had in mind when they created ADHD Moms, a hybrid of social and commercial media, on Facebook. Many blogs, a genre that began as a vehicle for self-expression, now contain ads that generate income for the blogger. While A Mom’s View blog is not a business-sponsored site, it does contain advertising.
            Social media is tied to health issues such as ADHD because of the trend to search for health information online. The Pew Internet and American Life Project found that 80 percent of Internet users search the Web for health information, and a majority of these participants access user-generated health information (Fox and Jones, 2009). People looking for health information do not want just facts and figures from experts but also want to hear about the experiences of others in similar situations. They want to know what others say about medication and treatment, they want to get emotional support, and they want to build awareness around a disease or cause (Sarasohn-Kahn, 2008). This is likely the kind of ADHD information users are seeking when they go to A Mom’s View blog or ADHD Moms.
            ADHD is an ideal vehicle for a contemporary rhetorical analysis because of its cultural implications, including its ambiguity and recent detection by the medical community. According to Malacrida, “It is a diagnosis that, since its discovery in the early-to-mid 20th century has engendered considerable controversy regarding its nature and treatment” (2004). Conrad and Schneider tie its legitimacy not to medical research but to “aggressive pharmaceutical marketing strategies” (cited in Malacrida, 2004). Because ADHD in children often manifests itself in behavioral rather than physical problems, the question arrises, Is the child misbehaved or suffering from ADHD? The behavioral problems then reflect not only on the child but also on the parents and their inability to control or discipline the child. Malacrida notes that ADHD, “because of its cultural and historical ambiguity, brings mothers into conflict with discourses of good motherhood” (2001).
Motherhood is the final element in this triad of contemporary culture. Though we may think of good motherhood as a static ideal, Medina and Magnuson stated, “The standards for mothering are socially determined and have changed over the past century” (2009). Sharon Hays found that since the 1980s, the standards for good mothering have been escalating into what she calls “intensive mothering.” Intensive mothering is “expert guided, emotionally absorbing, and labor intensive” (1996). Susan Douglas extended this term for the 21st century, defining “new momism,” and said that unlike today’s moms, a mom in previous decades was not expected “to pipe Mozart near her womb so this perfectly tuned child came out, or drill him with flash cards…or expect him to read The Iliad by the time he was four” (cited in Peterson, 2004). If the average mom in today’s culture feels pressure to be a perfect mother, then the mother of an ADHD child feels even more pressure. On top of the demands of new momism, she must find ways to help improve her child’s erratic behavior, do extra work with school and health professionals, make treatment decisions, and create an accommodating environment at home, among other tasks. Moreover, she must shoulder these additional burdens on behalf a child who may not appear to have special needs, and thus, the child’s behavior is unlikely to prompt empathy for the mother, but rather harsh judgment.
But there is a backlash against this ideal of perfect mothering, some of which has been generated through the “mommy blogging” community. Lopez noted that mommy bloggers create a “different picture of motherhood to what we see in the mainstream media.” Through their realistic descriptions of life, “we see women who are frazzled by the demands of their newborn baby, who have no clue what to do when their child gets sick, who suffer from postpartum depression, and whose hormones rage uncontrollably” (2009). These are not the June Cleaver moms of the 1950s, nor are they of the Thelma and Louise extreme ilk. These women fall somewhere in between, trying to be good mothers but acknowledging the realities and difficulties of their role. I compare this to the heroes portrayed in current films. Superman and his superhuman, shiny, happy, persona is not currently quite as popular as the more human, flawed, Batman, whose weaknesses make him more rounded and believable. While the appeal to being a supermom still works as a rhetorical strategy the most up-to-date appeal comes from the realistic, mulitfaceted supermom.
             
Literature Review
This paper combines four elements: rhetoric, social media, ADHD, and motherhood. I did not find any literature that included all these subjects but found studies that researched one or more of theses areas.
Killingsworth’s study, “Rhetorical Appeals: A Revision” provided the framework for my rhetorical approach. As the title suggests, Killingsworth revised neo-Aristotilian rhetoric to create a definition of appeals that better suits modern ideas and genres. While traditional appeals often relate to authority or evidence, contemporary appeals may relate to gender, race, the body, etc. and allow for the designation of a great variety of genres.  This broader definition of appeals worked well in my study of the developing genre of social media and appeals to identity. In further research, the contemporary view of appeals could be used to analyze a wide variety of genres and discourses.
All the research I found on social media came from 2009. It is the popular genre of the day, reflecting the culture of the moment. In “The Radical Act of ‘Mommy Blogging’: Redefining Motherhood through the Blogoshpere,” Lopez examined how mommy bloggers have exposed the myth of perfect mothering and are creating a new, more realistic conception of motherhood. She also discussed how mommy bloggers are creating a community of support and validation for themselves. My research examined the importance of understanding the mommy blogging concept of motherhood when reaching out to online moms.
            Burns, in “The Misuse of Social Media,” discussed the ethical standards that bloggers must maintain as public relations practitioners and advertisers. Influential bloggers can criticize “flogs,” or fake blogs, through their blog comments and various social media. I extended Burns’ ideas to the genre of social networking, which is closely related to blogging.
            According to Rubel, social media is shifting from a focus on blogs to social networking sites such as Facebook and Twitter. The popularity of these sites is gaining the attention of advertisers and social media is becoming commercialized. Rubel’s article was short, and while he advised advertisers to use social networking sites, he didn’t discuss how advertisers should approach this new medium. My research examined how a social media site’s approach can determine the appeal of the site.
            Ellison and Mack commented directly on one of the texts in my study, the ADHD Moms Facebook page. Ellison warned that parents should be skeptical of McNeil Pediatrics’ presence on Facebook. She found the discourse was biased toward drug use for ADHD and that McNeil Pediatrics presented a false “friend” identity. Mack also reported the purging of Debbie Phelps as a group leader on the ADHD Moms site after her son Michael Phelps was caught using drugs. He lamented that readers were not able to hear what Mrs. Phelps had to say about a real-life problem with an ADHD child. These studies point out problems in social media rhetoric. My paper highlighted these problems by comparing individual and commercial rhetors and showing how their rhetorical strategies can improve or diminish appeal within the genre of social media.
Two studies I used intersected health and social media. Sarasohn-Kahn’s report on health and online social media defined social media, noted that people use a variety of social media tools in their searches for health information, and described how users were seeking information on personal experiences and treatment advice (2008). Fox and Jones published a report entitled, The Social Life of Health Information, for the Pew Internet project. The report listed statistics showing the cultural relevance of the Internet as a means for researching health information (2009). With an explosion of online healthcare information, not only “what” but “how” information is shared becomes critical.
Malacrida authored two studies on various aspects of ADHD and mothering. The first, “Motherhood, Resistance, and Attention Deficit Disorder,” outlined how the cultural and historical ambiguity of ADHD has brought ADHD mothers into conflict with ideals of good mothering. She examined how ADHD mothers formed their personal knowledge and power to bolster their credibility (2001). “Medicalization, Ambivalence, and Social Control” built on Malacrida’s previous findings from a new perspective, analyzing ADHD mothers’ interactions with educators (2004). This study also touched on efforts of pharmaceutical companies to legitimize ADHD. I transposed these finding to examine ADHD and mothering within the contemporary context of social media discourse.
Finally, I looked at cultural ideals of motherhood and how they have evolved into the present model. Sharon Hays researched sixteen years of social evolution and applied the term “intensive mothering” to the labor intensive, child-centered parenting ideal (1996). This concept was further developed by Douglas, who defined the term “new momism” in her 2004 book. In an interview with Karen Peterson, Douglas described “new momism” as an impossible ideal that set mothers up for failure and guilt. Modena and Magnuson reviewed the literature on motherhood and addressed the social construction of motherhood and its impact on mothers. Lopez’s study brought the previous research up to date by defining the present ideal of motherhood in the mommy blogosphere as a backlash against unrealistic ideals for mothers (2009).  I compared these definitions of motherhood to depictions of motherhood in my texts and analyzed how appeals addressed to mothers work in a cultural context.

Research Questions
RQ1: How do social media sites for ADHD mothers appeal to their audience?
RQ2: How do rhetorical strategies depend on contemporary culture?

Rhetorical Approach
Explanation of the Texts
When searching Google for “ADHD Mom” or “ADHD Moms,” both A Mom’s View blog and the ADHD Moms Facebook page appeared at the top of the search. I chose them because of their popularity and because they both fit the genre of social media.
By nature, social media sites consist of almost limitless discourse, with archived posts going back, in some cases, for years and theoretically unlimited future posts. I created parameters for the texts I examined by choosing a date, November 16, 2009, and analyzing the four most recent posts to the site on that date, along with permanent content. For Penny Williams’s blog, A Mom’s View, this consisted of a November 2, 2009 post entitled The “Wild Thing” Now Visits Every Morning!; a November 3, 2009 post entitled I’m Published; a November 8, 2009 post entitled Starting from Scratch; and a November 16, 2009 post entitled Mom’s Homework.
            The structure of the ADHD Moms site is somewhat more complex than the average blog, with six tabbed headings: Wall, Info, Advice, Leaders, Mombassadors, and Boxes. I used as texts the messages that were linked to the four most recent Wall posts from November 16, 2009. These were ADHD Awareness Week: ADHD Moms Leader in Action by Ana Romero (which included a personal story), Learning to Fly Solo by Dr. Partricia Quinn, What Is a Mombassador? (anonymous), and ADHD Moms Welcomes New Mombassador Fan to Community Leadership by April White (which also included a personal story). I also analyzed the permanent content, the Wall posts, and the information and comment from the Boxes tab of November 16, 2009.

Rhetorical Appeals
I analyzed the ethos of both texts according to a neoclassical interpretation of ethos as the argument from the character and credibility of the speaker. I then analyzed how ethos created a rhetorical appeal. I read the texts asking myself a simple question formulated by rhetorician Jimmie Killingsworth (2005), “What is the appeal?” (p. 253). Killingsworth’s contemporary definition of rhetorical appeals extended the meaning of Aristotle’s ethos, pathos, and logos and observed the interaction between the three. He argued that ethos focuses on the position of the author, pathos on the position of the audience, and logos on values. A rhetorical appeal moves the author, audience, and values into alignment, the values acting as a “star that guides the audience into the port of common interest with the author” (p. 252).
But while this structure of appeals is simple, the direction is not. Killingsworth noted, “One interesting thing about appeals is that they tend to proceed indirectly toward their goal” (p. 253).  Killingsworth illustrated this with an example from a television toothpaste advertisement claiming to enhance the users’ sex appeal. Here the author and audience are easy to identify; the toothpaste company is the author and the television viewer is the audience, but the values are more complex. While the obvious appeal might be to the value of dental health, the author chooses a more indirect value, sex appeal. According to Killingsworth, “Appeals always involve such acts of transformation and substitution” (p. 254). In the case of ADHD Moms and A Mom’s View blog, the obvious appeal would be to the health of the child, but both sites focus more on the appeal to mothering identity.
Killingsworth also cited the importance of other rhetorical elements affecting contemporary discourse. Relevant to my analysis are medium and genre. The medium of exchange is the textual, historical, and cultural context of language and the genre is the form of language, such as an epic poem, a comedy film, or a blog (p. 262). Killingsworth noted that the old modes of discourse often appealed to authority or evidence but contemporary discourse tends “to form into genres rather than modes” and appeal to a variety of interests such as gender, age, or the body (p. 262). The texts I analyzed exist in a medium of online culture, fall into the genre of social media, and appeal to identity: the contemporary ideal of the ADHD supermom.

Analysis
Ethos and Author Position
Both the blog and the Facebook page ostensibly provided objective information about the concerns of ADHD mothers, but since every author has personal values and a worldview, every text is imbued with implicit rhetorical messages. In these two texts, the rhetorical strategies were for the most part latent rather than manifest. The persona of the author, revealed through the text, varied in its power to create a rhetorical appeal. Because Williams reflected the contemporary “mommy blogging” ideal of mothering, her ethos was more influential than that of the ADHD Moms site, which presented a disjointed, disingenuous ethos and an outdated ideal of mothering.
Penny Williams, author of A Mom’s View blog, is a real estate broker and mother of two living in North Carolina. She described herself as a “t-ball/softball mom, a soccer mom, a working mom, and a mom of an ADHD child” (user profile).  She is a top health blogger for the ADHD community (main page) and a recently published magazine writer. She explained in her I’m Published entry, “While I have a long way to go, I now have a published piece. I am elated! This piece, an excerpt of one of my blog entries, is printed in the upcoming Winter 2010 issue of ADDitude Magazine.” Her success in writing and the popularity of her blog lent to her credibility as an author.
            Williams is also very knowledgeable about ADHD, providing detailed descriptions about medical treatments, nutrition, creating a supportive home environment, and interacting with health specialists. Discussing her son’s medical treatment, Williams mentioned the names of drugs, doses, side effects, and long hours with doctors. In her Mom’s Homework entry, she described,
“We saw the new doctor in their office…about medication. We spent over an hour with him going back over all the experiences and medication trials with Luke. He agreed the Vyvanse was the wrong medication and the amphetamines in general (Adderall too) were not right for Luke. He gave me the option of going back to Concerta and meeting every 3-4 weeks to try to make it work or to try Focalin which we hadn't yet tried. I decided to go back to the Concerta, without the Tenex, and then work with this doctor to try to make the Concerta work. We know the Concerta was very effective with very little side effects when it worked. The problem was that it lost effectiveness after a month or so. We bumped the dosage up once but the same thing occurred. We are at the last dosage (36 mg) and we are down to 1/2 mg of Tenex once a day right now and will be off of it entirely on Wednesday. After Thanksgiving we'll go back to the doctor and evaluate how things are going and make any adjustments we need to at that time.”
            Williams showed interest in nutrition for children with ADHD and included a great deal of detail about her son’s diet as well:
            “I borrowed an old-fashioned egg cooker from my mom to be able to make eggs for him...He ate the entire egg and half a piece of toast with peanut butter this morning. A full glass of Vitamin D milk too…. I have read over and over lately that lots of protein in the morning is the best thing for ADHD symptoms and for taking meds” (Wild Thing).
            In her Mom’s Homework entry, Williams described how she works at “creating and maintaining the best possible environment for Luke” at home. She also takes care to make her home supportive for Luke’s sister and for her husband and herself. She has decided to limit screen time for the children and implement a rewards system for good behavior. She said of all this effort, “It is going to be a lot of work but I am looking forward to finally implementing all the systems… I knew were the right thing to do in the first place.” Williams is very aware of her son’s behavior, even noting changes from hour to hour. She described how Luke experienced “outrageous morning behavior and…the afternoon lull,” acting especially hyper “from about bout 2-4 or 5 pm every day” and finally settling down by 5 pm” (Starting from Scratch).
            Williams described a life full of interactions with medical specialists, including physicians, counselors, and occupational therapists, sometimes seeing more than one specialist in a day, “We see the therapist again Wednesday morning and have occupational therapy again Wednesday afternoon” (Starting from Scratch). She and her son meet weekly with a counselor for help in “managing and resolving any issues we are having” (Mom’s Homework). Physician visits occurred regularly because of the difficulty in prescribing and managing medication, “[The therapist] was able to talk to the doctor in their office directly Friday morning and get him to squeeze us into his schedule at noon this Monday so we can get the medications straightened out” (Starting from Scratch). Williams’s extraordinary knowledge and efforts bolster her character as a hard-working, loving mother, further increasing the strength of her ethos. She is striving to reach the cultural ideal of the perfect mom, and in dealing with ADHD, she has elevated herself to an ADHD supermom.
            But Williams’s discourse also contained an undercurrent of self-effacement, venting, and confession, revealing her partial rejection of the perfect mom myth. The subtitle of her blog, “My Everyday Life with My ADHD Son,” is an attempt to identify herself as an “everyday” mother with whom her readers can relate and not as an expert or authority from outside the group. This identity reinforces her membership within the ADHD mommy blogging community.  In her entry on getting published, Williams admitted to being disappointed about the photo chosen to go with her piece, “I’m working really hard right now to not obsess about how much I hate the photo and ruin this monumental moment.”
            Talking about limiting screen time for her children, Williams confessed, “I got lazy. It got hard, and I gave up. I have always rationalized that we live where the kids can’t go outside to play.” When talking about creating a reward system for her children, she said, “That is just too much of a change all at once for children who are set in their ways of controlling me!” (Mom’s Homework). Williams shared her dejection at the thought of starting from scratch with her son’s medical treatment, “Thinking about all we have been through for the last year being for nothing is painful. Depressing really….” And Williams admitted that with his bad behavior, she “was reduced to tears at least three times yesterday” (Starting from Scratch). While some may see Williams’ admission of flaws as detracting from her credibility, other mommy bloggers and social media moms likely see it as a strength. As Lopez said, “Mommy bloggers are developing their own voice for discussing motherhood, and it is distinctly different from the radiant image of the good mother that has dominated our media, with its impossible demands and assumptions about women” (2009). Williams identity as an ADHD supermom is buffered by her admission of flaws and failings, making her what the mommy blogging community might call an authentic mom.
            The ethos of ADHD Moms is much more complicated than that of A Mom’s View blog, authored by Williams. To analyze the ethos, I needed first to discover, Who was the author of ADHD Moms? The “who” was not immediately apparent as the first page on which the user arrives did not mention any authors or make the company affiliation clear. By clicking on the Info tab I learned that “ADHD Moms is sponsored by McNeil Pediatrics,” which sounded to me like a pediatric physicians’ practice or group. The Info tab provided a link to www.mcneilpediatrics.net where I learned, after some investigation, that McNeil Pediatrics is the manufacturer of the popular, long-acting stimulant drug Concerta, often used to treat ADHD. I later noticed that on several pages the ADHD Moms site had McNeil Pediatrics logos incorporating the text “Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.,” but the text was so small that it was almost unnoticeable and very difficult for me to read.
So who is ADHD Moms? It is a large pharmaceutical company that manufacturers ADHD drugs and hides behind the more appealing name of McNeil Pediatrics that hides behind the name of ADHD Moms. I would not describe this as a total lack of transparency but enough to put a dent in the site’s ethos armor. In Burns discussion of the misuse of social media, she noted, “Transparency is paramount and blogging programs that lack transparency will be criticized by the blogging community….” (2009). Though McNeil Pediatrics seems to have learned—in part—its lesson from the past mistakes of others such as Wal-Mart and McDonald’s who were criticized for creating “flogs,” or fake blogs, to promote themselves and their products, McNeil has nevertheless created a phony identity. ADHD Moms calls itself an “online community where mothers of children with ADHD can hear directly from other moms” (Info tab). However sincere its desire to help mothers of children with ADHD, McNeil is still a for-profit company with a stake in establishing the legitimacy of ADHD and ADHD medication. McNeils’s attempt to meld their social, commercial, and even therapeutic identity into one created a confusing and counterfeit ethos that decreased ADHD Moms’s credibility.
The authorship of various entries on the ADHD Moms site proved to be just as problematic. Many entries were anonymous, some were marked with an ADHD Moms icon, and three others were attributed to various authors. Dr. Patricia Quinn is a pediatrician who treated children with ADHD and mother of three children with ADHD. Ana Romero and April White are also mothers of ADHD children, and they share personal stories in their entries. Each of these authors, however, “is a paid spokesperson for McNeil Pediatrics” (Mombassadors, Flying Solo, and Leader in Action). I do not know to what degree the authors’ entries are limited and edited by McNeil, but some level of censorship is likely. In fact, John Mack noted on his Pharma Marketing blog that Debbie Phelps, mother of Olympic swimmer Michael Phelps, was a paid spokesperson for the ADHD Moms site until Michael was photographed using illicit drugs (2009). Thereafter, Debbie Phelps’s entries were censored from the site. McNeil responded to Mack’s blog, saying, that Debbie Phelps’ departure had been previously scheduled to occur at that time. Thus, just as the ethos of the site as a whole was diminished by commercial interests and censorship as well as a misleading identity, the ethos of the authors was diminished in the same way.
As noted above, Williams’s credibility was strengthened by her success, knowledge, efforts, and identity as an online ADHD mother. Romero, White, and Quinn each had some degree of legitimacy simply by being mothers of children with ADHD. The authors of the ADHD Moms entries laid some claim to credibility through these elements, but couldn’t match the vitality of Williams’ ethos. Quinn’s credibility was strengthened by her position as an expert—a physician, and as a mother of ADHD children. Romero gained credence because, as described in a short, anonymous introduction, she “stood before Congress to advocate for greater awareness of ADHD” (Leader in Action).  Romero was praised as having “unwavering dedication to raising awareness of the condition and advocating for her son.” April White was described anonymously on the site with this glowing appraisal: “April’s positive attitude and determination to learn as much as she can about ADHD is truly an inspiration to our community” (New Mombassador). Delineating these virtuous characteristics seemed to be an attempt at bolstering the credibility of the authors, but because the language was so overdone and came from a disembodied voice, it had the opposite effect. The language appealed to the concept of the perfect mother rather than the modern authentic mother.
 Romero, White, and Quinn share their knowledge of ADHD treatment but not in the detail that Williams does, and each of the authors only describe using medication for treatment leaving out any discussion of the potential benefits of nutrition, for example. Romero includes a personal view covering her son’s entire life and gives us a general idea as to her ADHD knowledge and experiences but no day-to-day details. She mentions that she began her son on stimulant medication twice a day in first grade and then changed medication when he was a teenager (Leader in Action). White also described treatment for her son, “We recently changed medications to use a non-stimulant, which greatly improved his daily ‘rebound’ when coming off the medicine…working with the dosage and type of medicine has helped control his outbursts” (New Mombassador) Quinn’s entry is not a personal story but an advice column about helping young people with ADHD make the transition to college. She mentioned medicine in general terms, “Will he remember to take his medicine?”, “College students must develop the ability…to independently form daily routines for…taking their medication,” and “[t]he student should focus on developing the skills needed to function on his own. That may mean…scheduling medical/dental appointments and filling prescriptions” (Flying Solo).
None of the authors mentioned specific treatments or drug names or doses, as proscribed by McNeil: “We will not post comments about any specific products or treatments” (Boxes tab). Perhaps McNeil did not want to appear to be pushing Concerta on the “Moms” site.  Nevertheless, the frequent mention of drugs and their benefits, and the absence of discussion regarding other treatments, suggested that drug treatment for ADHD was the only legitimate and beneficial option. This latent bias emphasized McNeil’s commercial motives over social or therapeutic, again undercutting the site’s ethos. Not mentioning specifics also left out important information for mothers of children with ADHD that was present on A Mom’s View blog: what drugs children have taken, doses, side effects, and effectiveness.
Romero, White, and Quinn do include discussion about their efforts in creating supportive environments for children and working with various specialists.  Romero described significant mothering efforts,
“I was a single mom, working 50 hours a week at a fast food restaurant to make ends meet,
“I decided to work even longer hours and received a promotion so that I would be able to place him in a [parochial] school. In my mind, all Richard needed was a stricter environment and more discipline.” (Leader in Action).
She related, “I learned all I could about ADHD, reading books, magazines, anything I could find,” and “I have learned how important it is for me, as the caregiver, to educate myself about the disorder.” She also briefly talked about putting her son in therapy and taking a recommendation from her doctor to have an educational evaluation for her son.
White brought up her mothering efforts and work with specialists in her entry:
“Last year we worked with a therapist on social skills and ways he could express his feelings and frustrations. I ask his doctor questions on new topics and research different behavioral techniques…. Staying as engaged as possible is the key to our success.” (New Mombassador)
Pointing to the home environment White created, she said, “Having a release that he enjoys is important to allow him to blow off steam and have fun.” By sharing personal stories, knowledge, and efforts, Romero and White built an ethos more akin to that of Williams.
Romero and White included some self-effacing comments on the difficult realities of ADHD mothering in an attempt to identify themselves with the authentic ideal of “mommy blogging” moms. Romero described having a broken heart and “crying myself to sleep” (Leader in Action) after a school open house at with her son. She talked about the challenge of having a teen with ADHD, saying, “We were once again a mess.” And she closed by saying, “My struggles…are far from over.” White noted that her life with her son “continues to be a struggle as he gets older” (New Mombassador) and that he had a daily “rebound” with one particular medicine. And while anonymous authors described them along the lines of impossibly perfect mothers, their personal discourses did reflect an understanding of the new mommy ethos in social media, even if they are unable to fully assume that ethos.
            In contrast, Quinn offered detached advice for mothers working with specialists in her Flying Solo entry, “Most colleges provide services for students with disabilities. In some circumstances, it may be beneficial to also consider working with a coach.” And the anonymous author in What Is a Mombassador? referred to ADHD mothering efforts in general by defining a Mombassador as “someone who is passionately committed to ADHD caregiving, and believes in doing everything she can for her child with ADHD.” The Flying Solo and What Is a Mombassador? entries lacked personal descriptions and seemed too formal, authoritative, and  affected for social media. Overall, the disingenuous identity and the lack of understanding of current, online mothering ideals weakened the ethos of the ADHD Moms Facebook page.

Medium
Killingsworth noted that “[t]he success of the appeal depends upon the movement of the audience toward that of the author. Such a movement always takes place through a medium” (2005). The medium of discourse is the language and contextual elements such as social, cultural, and historical factors. Medium is crucial to the appeal of these texts because mommy blogging, and by extension mommy social networking, has a culture and language of its own. Lopez described the format of blogs as having “the potential to capture this multifaceted portrait” of mothering “in a way that no other medium has been able to accomplish thus far” (2009). Lopez described how mommy blogs show that “motherhood can be overwhelming and exhausting, hilarious and exuberant, dirty and disruptive, all at once.” Mommy blogs differ from other discourse on the web in that they are self-expressive, cathartic, creative, and influenced by the community. Williams’s A Mom’s View blog likely appealled to online moms because it incorporated these elements, in essence, she spoke their language. She likely appealed specifically to ADHD moms because her discourse reflected a concept of mothering that they can relate to: the authentic mom who makes extraordinary efforts but also extraordinary mistakes. On the other hand, the ADHD Moms page does not seem to grasp this online mommy culture or language.

Genre
            Williams’s A Mom’s View blog followed typical blog format, displaying online entries that were updated frequently and archived in reverse chronological order. It was accessible to social media users because it fit the genre.
What ADHD Moms was—its genre—was unclear. Though it was housed on Facebook, a social networking site, it did not seem to fit the social media genre. Most people are familiar with Facebook, a popular site commonly associated with individual users who post photos and information about themselves through online profiles, but they may not be familiar with the expanding commercial uses of Facebook. A Facebook page, unlike a profile, is an online community sponsored by an official business, organization, or entity and not simply an unofficial fan page. A Facebook page could also be confused with a Facebook group, which is an unofficial group of users with a common interest. ADHD Moms’ presence on Facebook was also confusing for me because I expected much of the content to be similar to that of a Facebook profile or group, in other words, informal, spontaneous posts from friends or fans.
Though the ADHD Moms Wall tab is overflowing with encouragement for users to “share your answers” and “share your experiences,” there were only three second-party posts on the entire site. That seemed to disqualify it from categorization as a social networking site. Furthermore, these comments were strictly controlled and limited by sponsor McNeil Pediatrics. The Boxes tab on the site described these restrictions,
“For a limited time you will be able to provide your thoughts on the topic listed below.
“Our ADHD Moms community wants to share moments of ADHD caregiver pride with, by and for you. Simply answer below to share your story.
“All submissions will be reviewed and must be approved by McNeil Pediatrics before being posted. Comments that do not directly relate to the event topic will not be posted. Comments which are off-topic, offensive, or promotional, will not be posted. Please note that we will not post comments about any specific products or treatments, whether they are sold by McNeil Pediatrics™, affiliated companies, or competitors.”
Sharing “your story” did not seem particularly simple. Ellison described the ADHD Moms Facebook page as “atypically non-interactive” (2009) and said that though the drug Concerta helped her family during a crisis, “that doesn’t mean McNeil Pediatrics is my ‘friend.’” Though ADHD Moms purports to be a unique online community of moms, the community is highly controlled by McNeil Pediatrics. Entries on the page come overwhelmingly from paid spokespersons rather than independent fans. It is an unsocial social networking site.

Rhetorical Appeal
Appeals “are directed from an author to an audience by way of an established position of value” (Killingsworth, 2005), and as mentioned above, the appeal is often indirect, substituting an obvious appeal for a more alluring one. An obvious appeal to a mother of an ADHD child would be to the health of her child, but both sites focused on a more indirect appeal, the appeal to identity as a good mother. In each of the analyzed discourses, the authors sent a latent message to the audience: I am a perfect mother and you can be to.
The mommy blogging ideal of the perfect mother does not mean perfect in the sense of flawless but authentic and unapologetic of her role. Lopez noted, “Showing the ugly side of motherhood has the potential to be liberating and beneficial for all women” (2009). This new definition of motherhood is intended to inspire mothers to be their best but free them from the impossible demands of ideal mothering myths. The appeal of this new concept of mothering is especially attractive to mothers of children with ADHD because of the added demands on them and because others may see their child’s problems as an indicator of unacceptable weakness in them (Malacrida, 2004).
Williams’s discourse generated strong appeal because she exuded this ethos of ideal ADHD motherhood, because she used the language of the mommy blogosphere, and because her blog fit in the popular contemporary genre of social media. The ADHD Moms Facebook page did not create as strong an appeal because it did not reflect the contemporary cultural concept of authentic motherhood; it did not seem to understand its online mom audience. The site also lacked appeal because its identity was confusing and false and it did not fit within its intended genre.

Discussion
            Social media sites for ADHD mothers appeal to their audience by reflecting the ideal of authentic mothering being created by mommy bloggers. Motherhood--as most concepts in the social media environment--is constantly being redefined, and rhetorical strategies must adapt to this cultural shift. Though content on traditional websites may reflect mainstream media, effective social media content is customized to reach the highly digitally literate social media user. Rhetorical strategies are closely connected to contemporary culture because we are experiencing so many changes in how and what we communicate. Medium and genre are becoming more relevant than the old modes of discourse such as narrative, exposition, and argument because of changing cultural values and the development of new kinds of communication. Even the tools of communication are affecting our discourse. Because we text and tweet on phone applications, messages are becoming shorter and more succinct. Ethos can be communicated in just a few letters.
Subjects such as ADHD are relevant to current rhetorical theory because they reflect cultural currents. What effect does the $250-billion drug industry have on the legitimacy of this recently discovered condition? Can drug companies and other businesses create an acceptable place on a social networking site? The implications of new concepts of motherhood also relate to ADHD mothers.  Will the ideal of authentic mothering created by mommy bloggers relieve ADHD moms of their guilt, empowering them to make independent healthcare decisions for their children?
The dynamic nature of social media creates limits for further study in this area. For instance, the ADHD Moms site seemed to have disingenuous ethos in part because it was a commercial site trying to carve out a presence on a social networking site. But the commercialization of social media is inevitable—where the people go, the advertisers and business go. If commercial pages become ubiquitous on sites like Facebook and Twitter, we will likely come to accept their presence in the social media. We will not be so offended that they are trying to be our “friends,” because we will know that the social media genre is not longer exclusively social.
            For now, it seems the average Internet user may not recognize the messages and authors in the new media. In the flux of digital communication, how can we be more aware of who is speaking to us and what rhetorical strategies are influencing us? How can we become more critical users/interpreters of social media communication, which is becoming ever more prevalent? As more ways to communicate evolve, it seems this problem will become even more complex. We will have to be more skilled, discriminating, and sophisticated in our communication and recognition of rhetoric in social media and its future iterations.





References
Burns, Kelli S. (2008). The misuse of social media: Reactions to and important lessons from a blog fiasco. Journal of New Communications Research, 3 (1), 41-54.
Fox, S. & Jones, S. 11 (2009, June) The social life of health information. Pew Internet. Retrieved from www.pewinternet.org/Reports/2009/8-The-Social-Life-of-Health-Information.aspx?r=1
Hays, S. (1996). The cultural contradictions of motherhood. New Haven, CT: Yale University Press.
Killingsworth, M. J. (2005). Rhetorical appeals: a  revision. Rhetoric Review, 24, 249–63.
Lopez, L. K. (2009). The radical act of “mommy blogging”: redefining motherhood through the blogoshpere. New Media and Society, 11 (5), 729–47.
McNeil Pediatrics. (2009, November 16). ADHD Moms. Retrieved from http://www.facebook.com/ADHDMoms
Mack, J. (2009, March 12) Debbie Phelps purged from McNeil’s ADHD moms Facebook group. How cruel! Message posted to http://pharmamkting.blogspot.com/2009/03/debbie-phelps-purged-from-mcneils-adhd.html
Malacrida, C. (2001). Motherhood, resistance, and Attention Deficit Disorder: strategies and limits. Canadian Review of Sociology and Anthropology, 38 (2), 141–65.
Malacrida, C. (2004). Medicalization, ambivalence and social control: mothers’ descriptions of educators and ADD/ADHD. Health, 8 (1), 61–80.
Medina, S. & Magnuson, S. (2009). Motherhood in the 21st century: implications for counselors. Journal of Counseling and Development, 87, 90–96.
Peterson, K. S. (2004, February 25). Motherhood. USA Today, pp. 6d.
Rubel, S. (2009) Setting your brand free to find fans wherever they are. Advertising Age, 80, 32, 20-20.
Sarasohn-Kahn, J. (2008, April). The wisdom of patients: Health care meets online social media. California HealthCare Foundation. Retrieved from www.chcf.org/topics/chronicdisease/index.chc?itemID=133631
Williams, P. (n.d.) A mom’s view of ADHD: My everyday life with my ADHD son. Message posted November 16, 2009 to http://adhdmomma.blogspot.com