Expert: Norm Bishop - 10/30/2007

Question
I have a stepson whom we gained custody of at age 9.  Up until that point, he lived with his mother who rarely took him to school (he missed, on average, 50+ days a year), as well as doing many other things to him under the influence of cocaine.  In 5th grade, he was "diagnosed" with ADD--he took some tests with his school counselor and they had his teachers and parents (his father and I) fill out some surveys about his behavior.  His doctor looked at all of these and decided that he had ADD.  He was put on ADDerall XR and did GREAT the rest of his 5th grade year, but then, in 6th grade, the lazy attitudes started again.  They increased his medication twice, and it didn't help at all.  Then, his psychologist decided he didn't need to see him anymore because there was "nothing wrong with him" that he could see (although we were still having many problems at home and school), and therefore his psychiatrist would not prescribe him medication.  Now, at 15, he wants to go back and live with his mother/grandparents because he knows they will not make him go to school or do any work--they will pay for whatever he wants and let him just lay around.  His mother has not yet gotten her life straightened or gotten completely off of the cocaine, and we know that if we send him there, we are setting him up for failure, but he still refuses to do ANYTHING here.  We have two little ones (7 and 3) to focus on, too, but they get very little attention because we are always so focused on him.  We are at a loss as to what to do--he simply has no motivation for anything, and as soon as he has to do even a 3 or 4 problem assignment, he says, "Can I just leave?  I'm not going to sit here and argue about this--I don't want to do it.  I don't see why I should have to.  I can go live with my grandparents and you all won't have to deal with me and I won't have to do this."  He's not a snotty kid--we really don't have many discipline problems other than the laziness.  Any ideas on how we can break this?

Thanks so much!

Answer
All 15 year olds, regardless of ADD or not seek out the path of least resistance.  This particular child has suffered some pretty severe emotional wounds.  The abuse and neglect from his parent (who is supposed to nurture and protect him), and the feelings of abandonment, having to leave what he hoped would be a real mother.  Those wounds may take a lifetime to heal.

You are correct about his returning to his mother/grandparent, it would be more than a set up, it would a a prescription for failure, with the potential for him falling into a life of drug abuse as well.

There are no easy ways to reverse this pattern.  First, I would seek a different Clinical Psychologist to start working on the real issues that are underlying this behavior.  I would seek out a Clinical Psych who specializes in adolescents.  The second thing I would do is to sit down with him and create a plan.  You need to be honest about what you see, and be clear about how it will affect his life down the road.  Adolescents who resist doing any school work, don't do well in school, wind up being pretty unsuccessful in life.  The plan should create incentives for completing his school work, including a promise of assistance if it is difficult for him.  At 15, he probably is looking forward to driving soon...there is no reason his compliance with school work completion shouldn't be an requirement to even learn how to drive.  That can be one motivational tool.  The other one that seems to work well is to have him earn his video game playing or TV watching time by completing assignments.  Good grades bring a family celebration by going out to dinner, to a place of his choice.

The negative consequences need to be logical, like if you don't do your homework, then you will need to sit in your room...no tv, no video games, no phone, you can sit and read, that's all.  

The best plan is created jointly with the authority persons and the child.  He will resist, probably become defensive, but structure is what is going to get him to change.  

I don't see medication as helping all that much.  There is no magic pill to cure this type of behavior pattern.  Somehow, he needs to identify with hard work as having a pay off...Check out the difference in income between those who don't complete High school and those who complete College, it is more than double average annual income.  The only way to complete HS and College is to work hard.  

I wish you luck.  

Norm