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Diagnosis creates a dumb kid self fulfilling prophacy |
adhd - Family dynamics are part of ADHD
Children hear stories from their families about who they are. These stories may be positive or negative. Children diagnosed with ADHD, LD or HFA(high functioning Asperger's) hear many stories that reinforce these labels. These stories may be about his problems, diagnosis, disabilities, conflicts, and failures. They also might be telling jokes about his clumsiness, criticizing him for not getting his homework done, or on the positive side, applauding his getting a good grade on a test, or praising his athletic ability.
These stories describe whether a child is likable or not, skillful or incompetent, happy or sad, socially outgoing, inept, funny, lonely or reserved, athletic or clumsy, smart or dumb at math, reading, social studies or spelling, good looking or plain, healthy or sick, anxious or relaxed, mean or kind, nerdy and so on.
Some families create funny stories about their child’s problems. Under the guise of humor, they create a negative description that is repeatedly retold. Though on the surface it is humor, it repeats the child’s problem to him, often retold from many family members. The child’s self-concept embraces whatever problem is being joked about. Worse, he cannot dispute it to himself or the world because they were “just kidding.”
Reinforcing dumb kid stories
However, these very same parents, moments later, will launch into repetitive, detailed, simplistic explanations to the child of mundane and obvious things I have just said or we are about to do. Though they have just told me how intelligent their child is, they will proceed to talk to him as if he were very dumb.
Repeatedly explaining simple things to children gives them the feeling that those around them think they are dumb, no matter what is explicitly stated. Children, like any of us, see the explicit statement that he is smart as “lip service” and believe the dumb inference of the behavior toward him. Behaviors speak louder than words.
The, previously discussed, “he can’t…” stories conjured by professionals are also absorbed by the child and influence his self-concept.
Children rise to smart kid stories
The contrast to this can be seen in the occasional Reader’s Digest type story about the magnificent teacher, coach or adoptive parent who takes under his/her wing, children from a disadvantaged situation who have been written off as failures by the world at large.
This inspirational adult gives these children a new story by first giving the heartfelt message that they can do something and then reinforcing them with accolades when they do come through. Many of these children then go on to accomplish amazing feats, all because someone cared enough to inspire them with a different and more positive story.
Developing the deficit story: creating a self-fulfilling prophecy
Adults repeatedly explain things to children as they would to a dumb person with phrases such as, “I have told you a thousand times that…” Eventually the child hears the message, “You are so dumb that I have to tell you a thousand times that…” and internalizes it as part of their “dumb kid” self-concept story.
Not only do these demeaning stories fail to get the results parents want, they often exacerbate the problem. A child often repeatedly hears, “if you do not get your homework done, you are not going to pass…,” “don’t you understand that if you don’t pay attention in class you’re not going to get it,” “that was a bad choice you made to hit that kid…,” ” if you do not act better you are going to get expelled” and so on.
As these and similar negative phrases are repeated to children, they are translated into self descriptions such as “I can’t understand,” “I can’t attend in class,” “I am not going to get it,” “I make bad choices,” “I am not going to do better,” “I am going to get expelled.” As the child lives out these stories, the adult’s well meant, but misconceived, efforts backfire.
To demonstrate a contrast for parents, when I talk to children, I talk to them as if they are intelligent. Sometimes I challenge them by talking slightly over what I would expect them to understand at their age. It is amazing how many children stretch to this level to show they are smart. Because of this strategy, many children tell me very insightful things about themselves and their families.
Unfortunately, parents and other adults cannot control all the input their child receives. Other children can be brutal in their, castigating and sanctioning each other.
To quote one mother, "…Later Matthew came home from playing (with a group of friends). He said, 'I stopped playing because Tyler called me stupid.' I fear the other kids are starting to notice this (being in a special reading program) and I don’t want him singled out. " This hurts children deeply. In fact, the first and most important issue most children want to work on with caer are peer relationships. They want to work on the feelings they get when they are rejected, called names, bullied, or excluded.
Because that is first on their list, it is the first on mine. Beginning treatment with helping them feel better about what is important to them gives them a personal, meaningful experience of how caer can help them. After those issues are resolved, they have more free attention and motivation to address the academic and behavioral issues that are important to their parents.
Synthesis of stories into a self-concept
When I use the term “Dumb kid,” I am using it as an umbrella term that includes bad, dumb, lazy, angry, ADHD, LD, or HFA kid. I lump all these stories together as the “dumb kid story,” because that is how these children often think about themselves.
Parent and child stories interact
The bad feelings elicited by the onset of homework often triggers children’s internal stories such as, “Homework is really dumb,” “I am too dumb to do it,” “I will never need this stuff,” “My parents just like to be mean to me.” Such stories could generate either angry or depressed feelings and sometimes outbursts from the child.
Parents may hear the angry side in phrases like, “I hate homework,” “It is not fair,” or “You can’t make me.” If the depressive side appears they may hear, “I can’t do it,” “Everyone does it better than I do,” or “I will never get it.”
Both types of emotional outpourings trigger feelings and then responses in parents. The child’s angry phrases usually precipitate anger in the parents and are typically responded to with anger. The depressive phrases elicit supportive and caring responses. Either way, these parent responses reinforce the child’s story in two ways.
First, any attention that the adult gives the child in response to these phrases will reinforce them. The more emotional the response, the more reinforcing it will be. That is, both the angry response and the caring response will reinforce the child’s dumb kid story.
Second, these intense dialogs distract both parent and child from the most noxious element, the homework itself. So, a child is being reinforced by adult attention as well as temporarily escaping from the homework.
Why do parents get sucked into this? For the same reason children do: intense feelings. When parents hear the angry outpouring, it usually makes them angry via mirror neurons. This triggers an angry internal story such as, “that little brat is not going to get away with not doing his homework!”
The depressive story likely triggers sympathetic feelings in the parent and a story that may go something like, “I feel so sorry for him. He is trying so hard. He needs my love and help to make him feel better.” Parent stories reinforce child stories and child stories reinforce parent stories. As it spins faster and faster, it becomes less anchored in the situation that started it. The exchange develops a life of its own.
Parents also have their side of the story loop. As the interchange with their child becomes less and less successful, many parents begin to build a story about themselves as ineffective parents. It may go something like, “I just do not know what I am going to do with Dylan. Everything I try fails because I am clueless as a parent.” As previously discussed, this type of story provides a depressive lens (confirmation bias) that filters out any information that is contradictory to this conception. It only lets in “clueless parent” data. It becomes a self-fulfilling prophecy because emotionally distressed, depressed or anxious parents often do not have the attentional resources to make good parenting decisions or to stick with them.
Parents in such an interaction also begin to develop negative stories about their child, often augmented by the authority of medical or educational professionals who wrap these stories in diagnoses. The diagnostic stories become self-fulfilling prophecies that ignore reality. For example, the class clowning of an eight-year-old boy may be perceived and described as self-stimulation behavior (part of autism) by his teachers because at age five he had been misdiagnosed as autistic.
Even though the teachers were able to describe the classroom interaction articulately and in detail, including the socially reinforcing laughing and imitation by other children, they were not able to see that the other children’s responses were reinforcing this classic brat behavior.
They were stuck in the individual pathology "story" of autism and its component self-stimulation. Of course, this also meant that they were relieved of the work of having to change their part of the interaction pattern. The child was perceived as “nuts” and there was nothing they could to do about it. So, they did not have to try.
This child was in no way even close to being autistic. The autistic diagnosis was completely bogus. He was a bright, able boy who had learned to play the game to his short-term advantage. He was a virtuoso at “brat” because it worked for him to get admiring attention, in the way of laughing and imitation, from his peers. Over time, with consultation from me, his teachers began to see and treat him as a normal child and his behavior improved dramatically. The point here is that the "story" of autism had, for the teachers, become a way of organizing their expectations of this child to act in "autistic" ways. This story blinded them to what was really going on.
Stories justify one’s actions
Typical justification stories are, “I won’t need this stuff,” “my parents are mean and dumb,” “my teachers are idiots,” and “other kids are immature.” The point of such stories is to feel righteous about dropping out, acting out, withdrawal, being oppositional or lazy.
For the parent, their story of the child having a deficit, and therefore being incapable, may justify being too helpful, controlling, blaming the other parent or disengaging from the pain by outsourcing a portion of parenting to professionals or drugs. There is a significant marketing effort designed to create justification stories for the last two options.
I want to be very clear; I am not talking about any conscious, intentional or overt manipulation. All these feelings and stories are experienced as genuine. They just chain together in a dysfunctional way because they work in the short-run.
To break these negative interaction loops in which each person “feeds” off the other, extinguishing the feelings that trigger both the adult and child sides of the interaction is most helpful.
Brilliantly stupid
It is often more effective, from the child’s point of view, for them to appear more and more incompetent as parents work harder to get compliance. If the child is will practiced, he will offer a convincing blank stare and grunt, “I dunno,” or some such, in a lethargic manner. If the child is skilled at this, the parent will be convinced that he has a brain dysfunction. Parents are shaped to believe he is, at core, incapable of responding appropriately. That is, he leads them to believe he has a cabbage for a brain.
From the child’s point of view, this is a clever strategy. What does he want out of this exchange? He wants to get his parents out of his face. If he acts intelligent, then parents are encouraged to ask more questions, make more demands or give more lectures. However, from his viewpoint, if he can truly persuade his parents that he is incapable or defective, they will be convinced that there is absolutely nothing they can do to get the behavior they want from him.
Parents become disarmed, helpless, and often give up. But, they take the pressure off and that is all the child wants because it stops his pain and negatively reinforces being brilliantly stupid.
Now let us contrast this with his other choice. He could blatantly refuse to comply by saying no or something worse. From his point of view, that would be truly stupid. Since parents control his access to resources, they have innumerable ways to make his life miserable, and he knows that. So why provoke such misery when a perfectly easy way to get your parents off your back is to convince them that you are defective and incapable. Now that is brilliantly stupid!
Defending the ADHD excuse
Following treatment, one of my patients emailed me about her nine year old daughter, Sarah, "You don’t know how many times I’ve heard, 'you’ve changed, now you’re the MEAN one. I don’t like it. I’m still ADHD…' She’s wanting it to go back to the way it was. Since mother’s emotional response to this story had been extinguished, she did not fall for this ploy. Mom hung tough and later reported that Sarah was now getting mostly A’s and had many friends.
ADHD was Sarah’s curse and her cop-out. It is the story that she believed about herself that became her self-concept and self-fulfilling prophecy. It was also her comfort zone so that she did not have to challenge herself. Sarah’s parents used to play into that story, but no longer. When it no longer “worked” for Sarah because of how the parents changed their response, Sarah’s behavior and academic performance improved markedly.
The power of stories
In 1957, Schachter told college student experimental subjects that he was testing the effect of a powerful vitamin on memory. The pill he gave them was actually an amphetamine (similar to ritalin) that stimulated their nervous systems. It made them feel wide-awake and full of energy. (Since his subjects were not fully informed, this study would be stopped as unethical today.)
Half the subjects waited in a room with confederates of the experimenter (a confederate is one who knows what is going on with the experiment and plays a role for the experimenter) who were instructed to talk about how worried they were about the experiment. The other half of the subjects waited with confederates who talked about how exciting it was to be part of the research.
When Schachter tested the emotional response of the group with worried confederates, he found that the drug caused them to be very fearful and tense. They even had sweaty palms! However, the positively excited group were extremely happy.
The point is that the “story” the college students were given caused them to report dramatically different emotional experiences from the same drug induced physiological response. Remember, the subjects of Schachter’s study were young adults. Children are more prone to have their experience shaped by stories because they have less experience in life and therefore fewer competing stories to explain their experience.
The study is relevant here because children often hear adults (confederates in Schacter’s study) discuss their diagnosis as well as describing the symptoms that go with it. As you expect from Schachter’s studies, your child learns to behave as they are described.
That is, if the diagnosis does not fit now, it soon will.
Stories are self-fulfilling prophecies
One’s stories also impact intellectual performance. In an experiment, two groups of college students were primed with a different story by having them imagine and write about how it would be to be either a college professor (a smart person) or a soccer hooligan (a brainless ruffian). Then they were asked to answer 42 dificult Trivial Pursuit questions.
Students who imagined being a professor got 55.6% right, whereas those imagining soccer hooligans only got 42.6% right. Since students were randomly assigned to each group, the “professors” weren’t smarter, more focused or more serious than the “soccer hooligans.” Rather a smart or dumb mind-set has an enormous effect, 55.6 % vs. 42.6% on intellectual performance.
In yet another experiment of the same ilk, 220 women were told that there are definite sex differences in math ability. Half of these women were then told that this was genetic, thus unchangeable. The other half were told that women are less able than men because of the way their teachers interacted with them, such as in elementary school, thus changeable. On subsequent math tests, the difference in scores between the groups was profound. The unchangeable “genetic” group got about half as many correct answers as the changeable “experiential” group. Thus, if you and your child believe that his “deficit” is unchangeable, physiological, or neurological then this can become self-fulfilling prophecy and his performance will be decremented accordingly.
The above research would indicate that if children have a smart kid story about how smart, clever, creative, funny, or social they are, they are more likely to live up to that story and perform well in those areas. Equally true, if they have a dumb kid story which includes, ADHD, LD, HFA labels, then they are more likely to act out, space out, struggle with certain subjects, be social nerds and get stuck with teachers trying to teach them things they may already know.
For anyone who doesn’t believe that children learn bad behavior from watching TV and playing violent video games, the following study should cure them of that illusion. This study demonstrates three facets of the effect of stories on behavior: 1) stories effect social behavior, 2) the effect of stories can be subtle, and 3) that stories only have to be experienced. They do not have to be owned or attributed to oneself.
To create the story experience, undergraduate experimental subjects were given one of two different tasks. One group solved scrambled word sentences for 5 minutes that were sprinkled with rude words such as “aggressively,” “bold,” “rude,” “bother,” “disturb,” “intrude,” and “infringe.”
A second group solved similar sentences, but their sentences contained polite words such as like “respect,” “considerate,” “polite,” “courteous,” and “behaved.” These critical words were mixed with many neutral words so that they were not apparent to the subjects. Upon completing the task, subjects were asked to go find the experimenter, down the hall and around the corner, to get their next experimental task. Next came the interesting part.
When the students arrived at the experimenter’s office, they found his office door blocked by two confederates who were locked in conversation. Subjects primed with rude stories interrupted after about five minutes. However, 82 percent of those primed with polite stories never interrupted until the confederate conversation ended after a predetermined maximum of 10 minutes wait. Who knows how long they might have waited. (The experimenters had promised the human subjects research committee they would stop waiting at 10 minutes.) These effects happened without the subjects’ awareness of the experimental manipulation or the effect of the experiment on their behavior.
Stereotyping studies point to the same pattern. White college students who were about to take the Graduate Record Exam were divided into two groups. One group wrote an essay about a day in the life of a white student and the other group wrote about that of a black student. Stories about the black student were consistent with the stereotype of academic under performance.
Students who wrote stories about black students did worse on the Graduate Record Examination math test compared with students who wrote about white students. Such a simple one-time task made a significant difference in performance in students who were not part of a stereotyped group themselves. Imagine the effect on those who are part of a stereotyped class, whether it is racial, as in the example, above, or a diagnostic label that carries the idea of a defect such as ADHD, LD, or HFA.
In other words, one does not have to tell children they are dumb, ugly, ADHD, LD, aspergers, a social klutz, clumsy, mean, poor at math, or they have no friends. Exposure to these concepts in the stream of dialog that the child is exposed to is all that is necessary for them to accept that “story” and act as if it is true. Does your child ever overhear you discussing his problems, praying about them or reading books about them?
If the subtle short stories exhibited in the above studies can have such a dramatic effect on adult behavior, the stories a child hears are undoubtedly going to shape his behavior. If a child at school or home hears discussions of behavior problems, social problems, learning struggles, anger, etc., these are going to prime him to perform as described. It will work just as such stories affected the performance of students writing about soccer hooligans, experimental subjects primed with rude words, women who believed they were genetically inferior in math, whites who wrote stories about black students or students whose experience of taking an amphetamine was different depending on the story they heard.
The research is unequivocal. I hope you are convinced!
With these self-fulfilling prophecies, we project our expectations, positive or negative, unto future feelings and behaviors. A child’s dumb kid story becomes true for him, whether factually true or not, and he acts it out like the script of a play.
A child’s “can’t…” stories assure that he can’t in the future. His social klutz stories assure future social rejection. Such children may give up and feel hopeless because their self-concept story does not forecast success.
Just as the experiments demonstrate, the more dumb kid messages they get, the more likely they are to live out these messages. Like other negative loops of interaction, the more they live out the dumb kid story, the more likely they are to receive further messages they are dumb and so on. This process can quickly turn small problems into big ones. These feedback loops are a behavior amplifier.
With repetition, these negative dumb kid stories are not just experienced when the child hears them. They are constantly being triggered in the child’s mind by situational cues. If the story is about a failure in math, the presence of math related cues will set it off. If it is about poor social skills, the presence of other children will set it off and so on.
This triggering repeatedly reminds children of their failings, which is apparent in their anxious, frustrated, angry, depressed, or withdrawn demeanor. These negative emotions use up attentional resources and makes it less likely they have will the resources necessary to change the negative patterns.
Fortunately, the opposite is also true. If you talk about and respond to your child’s competencies and positive attributes, you will get more of those. You can prime the future to unfold either way. Optimistic, positive, success stories about self and our world drive future success.
I am not suggesting that you fabricate fictitious positive stories about your child. They will quickly smell the lie. I am suggesting that you create stories about their attributes versus their problems.
Case study: a story of defect
Janis believed it was important to explain and discuss her nine-year-old son Kyle’s diagnosis and problems with him. She avidly read everything she could find from the bookstore and on the Web. These books and articles were scattered around the house. She would even read key sections of this material to him and discussed it at the dinner table with her husband Tom. In some undefined way, she thought if her son understood, it would help him improve his behavior and school work.
Contrary to her expectations, his performance continued to deteriorate in spite of his increasingly informed state.
At the beginning of the first day of treatment in Spokane, Janis diligently and thoroughly reviewed all of Kyle’s failures, symptoms, diagnoses and treatments. It was clear that both father and son had heard this many times before. It was in an impressive, but very disquieting litany. I politely brought this review to a close as quickly as I could.
It was clear that this was Kyle’s dumb kid story, and he was living it out.
I immediately had a twofold agenda, extinguish the affect off the story for everyone and diligently find opportunities to model reinforcing Kyle’s positive behaviors. The first part was taken care of with CAER later that morning.
At lunch, I made sure that I talked about how well Kyle had done in the CAER machine, how articulate he was in describing his feelings and memories, and how he had made clear progress. Kyle beamed as I talked. I pointed this out to his parents, and then explained Kyle’s bad kid story, how it was a template for his behavior, and how I was trying to systematically articulate and reinforce a positive alternative story.
Over the next three days, I continued to model, prompt and reinforce the parents’ articulation of a good kid story. Kyle’s behavior clearly improved over the three days the treatment, and his good kid story was a template for exactly how his new behavior unfolded. A feedback loop developed between his more positive behavior and the growing story that described it. As his behavior improved, so too the story, and as the story improved, so did his behavior, a win-win situation.
The negative power of labeling
The expectations teachers or other adults have for your child changes how they respond.
The power of teacher expectancies to shape student performance also holds for broader intellectual development. In one famous study done in the 60’s, at the beginning of the year, teachers were lead to believe that one group of students were “academic spurters.” These randomly selected students showed about a 12 points increase in their IQ scores, compared to an increase of 8 points for the rest of the class on year-end testing. For IQ testing, this is a huge difference.
Teachers’ subjective assessments of reading showed similar differences. Spurters were also seen as better behaved, more curious, friendlier and had greater chances for future success than other students.
The deficit model: reducing expectations for success
Because interventions based on the deficit model generally do not work, much of what is recommend for teachers to do to help these children leads to failure and frustration vs. effective solutions. Understandably, after repeated frustrations, teachers no longer expect to be able resolve a child’s problems. They merely expect to maintain the status quo a little in their favor, where problems are just under control, but the struggle goes on.
After many such frustrating, dead-end experiences, teachers approach the next strategy in a suspicious, unenthusiastic and unmotivated way. Rightfully, they expect it to be as unsuccessful as previous efforts. This becomes a self-fulfilling prophecy that assures continued failures even for interventions that have potential for success, if implemented correctly. “The devil is in the details.”
If a child has been refractory to treatment, it is more likely that his problem behaviors will be interpreted as a neurological or developmental problem, which means that it is permanent and can only be managed. Of course, this interpretation places severe limits on the amount of improvement parents or teachers expect from treatment. And, by know you know what that means-you subtly shape the behavior you expect, not the optimal the child is capable of doing. Yuck!
Confirmation bias
For children, once these concepts are implanted, they will tend to notice what is congruent and miss what is incongruent with their negative self-concept story. In our moment-to-moment experience, we tend to focus on data that confirms our story, and filter out what contradicts it (confirmation bias). If, for example, we think of our self as an uncoordinated “klutz,” we will notice every time we do a klutzy thing such as drop a plate, or trip on a sidewalk. We don’t notice the 99% of the time when we do things perfectly well.
Since our experience of ourselves and our world is filtered through the stories we create, we tend to selectively see aspects of our experience of ourselves and our world that is congruent with our stories. This happens whether that story or self-perception is objectively true or not.
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