Slides from our April 30 parents' workshop

1. USING THE WEB SOFTWARE
YOUR MICROPHONE WILL
REMAIN MUTED
ASK QUESTIONS USING
WINDOW ON SIDE
(IPAD APP HAS A ? BUTTON
UPPER RIGHT CORNER)
ALL QUESTIONS WILL BE
ANSWERED BY STAFF IN NEXT 48
HOURS.
1

2. Welcome
THOMAS BAKER, CO-FOUNDER, BRAINTOURAGE
2

3. Today’s Goal
 To change your daughter’s life.
3

4. Agenda
 Case Studies
 Obstacles
 Solutions
 Resources
4

5. About Me
 Research Director
 Co-Founder
 Father of 3
5

6. AboutYou
 Parent(s)
 Daughters aged 6-26
 Immediate focus on girls’ symptoms of inattention
 Teacher or home symptoms
 More than one subject
 More than one semester
6

7. We All ShareThe Same Long-Term Goals
Daughters growing to become
 Happy
 Healthy
 Self-confident
 Self-sufficient
7

8. Problem Defined
 2007
 Rate of teen symptoms:
Anxiety
Depression
ADHD
Substance abuse
Italy 26.0%
Spain 29.0%
Israel 29.7%
Lebanon 32.9%
Germany 33.0%
Mexico 36.4%
Belgium 37.1%
Netherlands 42.9%
France 47.2%
South Africa 47.5%
New Zealand 48.6%
Ukraine 48.9%
Colombia 55.2%
United States 55.3%Kessler et al (2007). Lifetime prevalence and age-of-onset distributions of
mental disorders in the World Health Organization's World Mental Health
Survey Initiative. World Psychiatry, 6(3), 168.
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9. 9

10. Therefore,
If frustrated today,
… likely worse in 5 years
10

11. 3 Common Family Mistakes
 #1: Exhaustion
 #2: - Repeating same frustration pattern
From winter and spring
Over summer and fall
3rd Semester Rule
Ask ‘substantially better?’
11

12. #3- Lure Of False Success
 Short-term supports
Meds, accommodations and/or school change
 Often reduce short-term symptoms
 Symptoms change,
Yet underlying problems remain
12

13. Better Options
 Growth Plan
Details to follow
Applies to majority of viewers
 Consider Unschool / Homeschool
If it’s truly in your heart
13

14. Case Studies for Today
 Staying positive in school when things get tough,
thinking positive about herself. We have tried natural
vitamins, diet changes, counseling.
 My son has a hard time focusing and grasping some
concepts (i.e. math). We think he may have ADD. We
have not tried drugs yet, just tutoring on the side and he
has an IEP. It's helping but he's still behind.
 Low self-esteem due to repeated failures at school and
with friends. We've tried encouragement, breaking tasks
up into smaller time frames
14

15.  Medication works pretty well but I want for my daughter
to develop other skills and coping mechanisms.
 Consistent energy drain, slow progress in school,
frustration level. I tried tutoring, medication, private
school etc.
 We (my daughter and me) are suffering from homework,
project delivery, reading and writing errors.
15

16.  That our daughter may have inattentive ADHD and she
has challenges socially. Getting ready to enter High
School in the fall. We have an appointment on June 4th
with a neuropsychologist specializing in ADHD.
 Finding ways to help her enjoy learning, get the things
done we need to get done, and encourage her natural
curiosity and creativity without having every day just be
play and projects (we homeschool).
16

17. Solution: Growth Plans
17

18. Features of a Growth Plan
 Whole child
 Long-term
 Step by step
 Emphasis on strength-building
18

19. Growth Planning is Affordable
 Our online tools
 Expert support via email
 $19.95 per month
 No contracts
19

20. Other Expert Services
 Upgrade to 1-1 Growth Planning
 Brain training
 parent as coach
 computer as coach
 student/parent as co-coaches
 Study Skills Coaching
 ages 13-26
 1-1 Online (Skype)
 Email Mary Jane or Tom for details
20

21. Features of a Growth Plan
 Whole child
 Long-term
 Step by step
 Emphasis on strength-building
21

22. Whole Child Defined
 Mind
 Brain
 Health
 Education
See www.imbes.org
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23. Whole Child Examples
 Mind
Self-esteem, self-efficacy, autonomy, motivation
Expand M view beyond treatment of illnesses
 Brain
Working memory, processing speed, fluid reasoning,
executive function
23

24. MBHE
 Health
Physical health, physical safety, emotional safety,
environmental safety
 Education
Reading, math, writing, science, college major,
professional skills
24

25. Why Historic Trend to Focus on
‘E’ Factors?
 Because E elements are easier to see
Teachers paid to monitor E factors 7 hours a day
 Because E elements are easy to test
A-B-C-D-F origins to Pioneer Days
25

26. Why is a MBHE (Whole Child) View
More Important to You?
 She is more
… than the sum of her parts
 Growth and happiness
… are different than ‘not sick’
26

27. Mind
Health
Brain
Education
Mind
‘Well-Being’ Is More ImportantThan
 Test-scores
 Local or national
politics
27

28. Growth Planning
As Compared To Historic Options
 Medical symptom management
 Manage grades and test scores with
accommodations
 Manage day to day homework with brute force
 Escape frustrations by changing schools
28

29. Paradox of Short-term Relief
 Many (most?) short-term bridges
eg, meds, accommodations, brute force
 Provide short-term relief
Sometimes even life-saving
 Yet can be crippling if allowed to persist long-term
 Metaphors: pain meds, kids on crutches
29

30. Short-term Bridges Not Always Bad
 Understand each child’s individual needs
 It’s okay to combine short and long term planning
 But remember,
Unlikely the ‘system’ will change
… while your child is still a child
Ignore politics, biases and myths
Focus your energy on factors you can change
30

31. Background for New Viewers
 Full webinar replays available on request
Including research references
 How Kids’ Brains Grow and Thrive
 ADHD Meds and Myths
 504: Lure of False Success
 Devastating Costs of Academic Stress
31

32. Alternatives to Growth Planning
 React as symptoms appear
 Struggle day to day, week by week
 Each year: patterns repeat, evolve, get worse
 Although 25% may self-resolve
 Reality: 99% of our clients woke up one day and
realized a pattern of reactions
 60% of families have ‘intuition’ response from one
spouse much earlier than other
32

33. Or, Redefine Symptoms as
Chronic Illness
 eg, diabetes, asthma, cystic fibrosis
 Therefore palliative care
33

34. Option: Medical Symptom
Management
 Stimulants proven to change behavior in
short term
 Assumes learning challenges are primarily
medical
 Assumes changing behavior likely to ‘cure’
learning challenges
Or assumes incurable (palliative)
34

35. Medication Webinar
35

36. ’Gold Standard’ NIMH Long-term Trial (99-07)
 “We had thought that children medicated longer would
have better outcomes.
 “That didn’t happen to be the case.
 “There were no beneficial effects, none.
 “In the short term, [medication] will help the child
behave better, in the long run it won’t.
 “And that information should be made very clear to
parents.”
MTA Investigator William Pelham, University at Buffalo
Daily Telegraph, “ADHD drugs could stunt growth, “ Nov. 12, 2007.
36

37. 1,379 Canadian Youth
 14 studies that lasted a minimum of three months,
Canadian investigators concluded that there is “little
evidence for improved academic performance” with
stimulants.
 Source: R. Sachar, “Attention-deficit hyperactivity disorder,” Canadian
Journal of Psychiatry 47(2002):337-348.
37

38. 2005 Oregon Public Health
In a 2005 review of 2,287 studies at Oregon Health and Science
University:
 “no good quality evidence on the use of drugs to affect
outcomes relating to
 global academic performance,
 consequences of risky behaviors,
 social achievements, etc.”
 Source: McDonagh, “Drug class review on pharmacologic treatment
for ADHD,” 2006. http://www.ohsu.edu/drugeffectiveness
38

39. 2012 New York Times
 “Attention-deficit drugs increase concentration in the short term,
 “But when given to children over long periods of times, they
neither improve school achievement nor reduce behavior
problems
 . . . to date, no study has found any long-term benefit of
attention-deficit medication on
 academic performance,
 peer relationships,
 or behavior problems”
 --Alan Sroufe, professor emeritus, University of Minnesota
 Source: New York Times, “Ritalin Gone Wrong,” January 28, 2012.
39

40. 2013 Wall Street Journal
7/8/2013
40

41. In Support
 2012: Shire Pharmaceuticals funded a study, led by its medical director,
that reviewed studies of long-term outcomes (>2yrs) for ADHD.
 Reported 29 studies of favorable outcomes for treated ADHD in the
literature, on some measure or another, when compared to patients
who weren’t treated
 Vs. 20 reports of no benefit or worse outcomes for treated ADHD.
 Authors concluded: “Treatment for ADHD improved long-term
outcomes compared with untreated ADHD.”
 (Shire manufactures Vyvanse, Adderall XR and Intuniv)
 Source: M. Shaw. “A systematic review and analysis of long-term outcomes in attention deficit hyperactivity
disorder.” BMC Medicine10 (2012):99.
41

42. Do ADHD Girls ADHD Fare Better Than Boys? 42
Poor
Outcomes
12%
Positive
Outcome
88%
Non- ADHD Girls’ 10 Year
Results
Poor
Outcomes
84%
10 year
Positive
Outcome
16%
ADHD Girls’ 10 Year Results

43. Most Troubling: Link Between Other ADHD
Meds and Lifetime Disability
 Children on SSDI for mental health issues
43

44. Features of a Growth Plan
 Whole child
 Long-term
 Step by step
 Emphasis on strength-building
44

45. Medication As Alternative to Growth
Planning
 Symptom-driven
 Only treats behaviors
 Only effective in short term
 Physical side-effects
 Psychological side-effects
 Delayed side-effects
 Emphasis on chronic weakness
45

46. Case Study AJ age 13
 Soccer star grades K-5
 Relative gap declines each year as weaker players drop out
 Underweight, sleep issues
 Yet ‘elite’ club workouts 830-10pm
 Parents’ View of Stimulants
 ‘Side-effects are worth it.’
 ‘Can’t function in school without his meds.’
 ‘We try to make him eat, but he refuses.’
46

47. Dr. Ken Weaver,
Dean, Emporia State University
 Q: Are you concerned that the medication
mindset will become part of our national fabric in
the next ten years?
 A: No, I don’t think it will – I think it already has.
Personal Communication 4/25/2014
47

48. Option: Manage Grades and Test
Scores With 504
 Federal mandate (IDEA 1988, 2002)
 Defined as modified curriculum requirements to improve
test scores
 Eg, extra time on test, copy of teacher notes, shorter spelling list
 Useful in short-term crisis situations
 Example books on tape for student with eye injury
 Unfunded
 Expect current or future teacher resistance
 Metaphor long term audiobooks vs Braille training
48

49. Research on 504 Accommodations
 Law enacted prior to research
 201* studies
 149 accommodations described
 9 measured
 No (negative) evidence of incremental benefit
 *(vs 1.1 million studies on reading scores)
49

50. Research on Accommodations
 “Multiple accommodations are being recommended
without any evidence of effectiveness. This approach
 … costs students in terms of their potential long-term outcomes,
 … costs teachers' effort and time providing services unlikely to work,
 … and costs districts and communities the resources used to provide
these strategies
 Harrison, J. R., Bunford, N., Evans, S. W., & Owens, J. S. (2013). Educational
Accommodations for Students With Behavioral Challenges A Systematic Review of
the Literature. Review of Educational Research, 83(4), 551-597.
50

51. Features of a Growth Plan
 Whole child
 Long-term
 Step by step
 Emphasis on strength-building
51

52. Versus 504 Option
 Only targets test scores
 Only effective if effective defined as short-term
test scores
 Future performance side-effects
 Future psychological side-effects
 Implied chronic weakness
52

53. Case Study – Wendy G
 Lifetime of meds and accommodations
 Evaluated by University learning specialists
Accommodations …. Meds
 3x failure at elementary
ed practicum
 Vicious critique from dept
chair
 ‘False sense of success’
53

54. Variation: IEPs vs 504 Plans
 IEPs are legally binding, 504s are not
 504s are un-funded, IEPs receive federal funds
 Turf issues: Fed, State, District, School
 Internal politics: RTI
 IEPs are ‘E’ plans,
 not MBHE plans
 IEPs objective
 Improve Reading and Math scores (‘E’)
 Working ‘around’ not ‘on’ M, B* or H* obstacles.
54

55. Option: Brute Force
 Homework H---
Parent
Student
Superstar teachers
Hired tutors
 School as Prison Camp
Saturday school
Summer school
55

56. Features of a Growth Plan
 Whole child
 Long-term
 Step by step
 Emphasis on strength-building
56

57. Versus Manage Homework with
Brute Force
 Only targets homework completion
 Moderately effective in short term
 Drains physical and emotional energy
 Drains parent, student and often family
 Spills over into sports, music, church, social and
free play time
57

58. Case Study – Dr Smith
 I didn’t realize what we were doing until I talked
to you – I’m so embarrassed.
58

59. Variation: Permanent Tutor
 Tutors effective for
Short-term, defined mission
Especially when ‘cause’ is clear
However,
 Expensive for long term
 Psychological side-effects
 Delayed side-effects
59

60. Case Study – ‘D’, female age 14
 Adult max dosage Vyvanse in 85# 14 year old
 Father physician, mother personal trainer
 Initial med plan didn’t ‘work’
 so increased dose
 Turned up heat on teachers and on daughter
 who was desperately trying to comply
 Parents dismissed weak ‘B’ factors
 and missed coaching sessions, eg, couples massage
60

61. ‘D’
 ‘Can’t let her fail 8th grade’
‘Her self-esteem already low as it is’
‘Only option is tutor through high school’
61

62. Variation: Punitive Summer School
 Your punishment for hating school is…
More school
62

63. Option: Repeating Grades
(Holding Back)
 Relative age – better to prevent vs treatment options
 Repeating K acceptable
 Moderate risk repeating 1st or 2nd
 Reduce risk by changing schools
 High risks repeating older grades
 Original problem remains
 Adds new, permanent, self-esteem problem
63

64. Webinar – Kids’ Brain Growth
“NEUROPLASTICITY “
64

65. Brain Training in Children
 Children can improve their performance on cognitive
control tasks as a result of training.
 demonstrated in healthy children
(e.g., Karbach and Kray, 2009; Thorell et al., 2009; St. Clair-Thompson
et al., 2010; Bergman Nutley et al., 2011; Loosli et al., 2011), and
 children with cognitive or attentional impairments
(e.g., Klingberg et al., 2005; Shalev et al., 2007; Bangirana et al., 2009;
Holmes et al., 2009a; Mezzacappa and Buckner, 2010; Rabiner et al.,
2010; Van der Molen et al., 2010).
65

66. … Children
 Cognitive training changes task performance and brain
activation in children diagnosed with ADHD
 Hoekzema et al., 2010
 training-related activation changes were found in syndrome-
associated brain regions in frontal lobe and cerebellum, which are
also target of psychostimulant medication.
in: Jolles, D. D., & Crone, E. A. (2012). Training the developing
brain: a neurocognitive perspective. Frontiers in human
neuroscience, 6.
66

67. Features of a Growth Plan
 Whole child
 Long-term
 Step by step
 Emphasis on strength-building
67

68. Option: Changing Schools
 Effective only if original obstacle was curriculum (‘E’)
 and only in that school
 Caution: many private/rural schools pay lower wages; have
fewer specialists on staff
 Wealthier districts have more reading and autism
specialists
 School district takes a percentage of federal resources
 If forced to change schools, get it right
 Unwise to change again
68

69. Variation: Demanding Extra Services
from Schools
 Temptation of ‘legally required’
 Avoid adversarial at all costs
No matter how wrong you think they are
 Reality: they can afford to delay, you can’t
 The ‘system’ won’t change
 Although sometimes individuals do
 Don’t waste precious adult resources
 Ask twice, politely .. (unlikely 3rd request will spark a change)
69

70. Rare For Demands To Carry Over
 Even year to year in same school
Dangers of ‘cume’ comments
 Less to middle school or high school
 Certainly not to college or job
 Wear them down with baked goods, not outrage
70

71. Case Study – Ernie C
 Experimental magnet K-5
 ‘Expert’ dx in 3rd
Dyslexia, ADHD
 Extensive accommodations
Extra time, books on tape
71

72. Ernie
 Transfer to elite middle school
Huge bump in homework demands
Accommodations continue
Mother willing to invest brute force
 Complains can’t remember facts from
audiobooks
 Although decodes math word problems
‘because I’m good in math’
72

73. Dyslexia as example of ‘B’ challenge
 Commonly treated with an ‘E’ solution
 Improving ‘E’ scores,
but leaving residual ‘B’ obstacles
creating ‘M’ barriers to future well-being
73

74. Details for Educators and Academics
 Research-based webinars
How Kids’ Brains Grow
ADHD Meds and Myths
504: Lure of False Success
Devastating Costs of Academic Stress
Psychology of Success vs Psychology of Repair
74

75. Webinars for Parents
Brain Training for Sports Performance
‘Secrets’ of College-aged Entrepreneurs
75

76. Growth Plan Benefits
76

77. Features of a Growth Plan
 Whole child
 Long-term
 Step by step
 Emphasis on strength-building
77

78. Growth Plan Benefits - Whole Child
 Because learning obstacles rarely just ‘1 thing’
MBHE factors all interact
Can work together to spark growth
Can work against to sabotage growth
Eg, ‘allostasis’
 Future ‘Mind’ obstacles as teens
Especially motivation and self-esteem
Have roots in B and H factors as children
78

79. Why Trend to ‘Over-treat’ E Factors?
 Because E symptoms are easier to see
Teachers monitor E factors 7 hours a day
Teachers’ nature to ‘help’
 Because E factors easier to test
New: schools’ financial incentives to boost scores
79

80. Downside of Growth Plan
 Unlikely local specialists
 Poor career move to decline insurance reimbursements
 Limited research funding for non-medical alternatives
 Parents can expect mild to moderate resistance
 Parents have most to gain / lose
 Yet affected families already stretched so thin
 Rare for Invitation to Growth Community
 Most families required to take initiative
 And create their own growth allies
80

81. Case Study – Lawrence C
 Mom, reading specialist at elite
school
 3rd grade
 ‘Enigma’
 Declined brain training
 4th grade … Medication
 5th – 7th grade
 Struggled … Quit sports
 Brute force (kid)
 (Mom promoting meds)
 8th grade
 Mom lost job …
Lawrence dis-enrolled
 Never a ‘behavior’ or ‘report
card’ problem
 Yet ‘M’ Result
 ‘Let the family down’
81

82. Versus Benefits of a Growth Mindset
82

83. Benefits – Long Term
 Maintains ‘balanced’ point of view from adults
 Long term is most important
 Short term is most urgent
 (Brains wired that urgency trumps importance)
 May reduce teacher pressures to ‘do something’
 Less parental guilt when obstacles arise
 Thus more parent energy
83

84. Benefits – Step By Step
 Long-term, step by step
 Takes the pressure off in short term
 Reduces pressure to find ‘cure’
 More comfortable using other options as short-term
bridges
 Many (not all) teachers will celebrate your thoughtful
planning
84

85. Benefits – Emphasis on Strength-
Building
 Happiness is more than absence of
emotional pain
 Strength focus increases resilience and autonomy
 Autonomy protects against helplessness
and depression
 More likely to create win-win parenting moments
 versus I win, you lose parent battles
85

86. Best Methods for Motivation?
 Punishments?
time-out, spanking, grounded, losing video games
 Rewards?
money, shopping spree, ice cream party, extra recess
Vs
 No need for external motivation
Re ‘intrinsic’ motivation
86

87. Getting Started
 Pick a framework
 Our online option is $19.95 a month
 20-30 minutes of weekly email exchange … online workshops
 Recruit allies
 Unlikely 1 parent will succeed working alone
 Procrastination is number one enemy
 Recognize that change is hard
 Decide cost of change vs long term value of change
87

88. Your Growth Allies
88

89. The Best Allies Are Non-Judgmental
 Helps you keep perspective
 It’s so easy to get caught up in trees
… and miss the forest
89

90. The Best Allies Support
 Always ‘safely’
 Without deciding for you
 While telling you what you need to hear
90

91. Knowledge Of New Research A Plus
 Or at least a willingness to learn
91

92. Option To Hire Us As A Growth Coach
 Same growth planning tools as available online
 Adding 1-1 bimonthly or weekly Skype calls
 $295-$495
 Faster first stage (vs email)
92

93. How To Recruit Allies
 “Invest time to save time”
 “Our kids deserve better”
 “The benefits of making lemonade out of lemons”
 Don’t play the guilt card … Invite without judgment
Let them come to you … when they are ready
All parents want healthy happy kids
93

94. Fine-tuning Your Growth Plan
 Start with a framework
 Add details year over year
 Risks of ‘waiting for clarity’
 Adjust with growth
 ‘Whole child’ expected to
change and evolve
 Don’t blindly label
 Unless the label is clearly
helpful to child
 Remember ‘growth’ goal
 Not achievement
 (See ‘Success’ webinar)
 Move past pain to gain
 Liberating for both
parent and student
94

95. Case Studies Reviewed
 Staying positive in school when things get tough,
thinking positive about herself. We have tried natural
vitamins, diet changes, counseling.
 My son has a hard time focusing and grasping some
concepts (i.e. math). We think he may have ADD. We
have not tried drugs yet, just tutoring on the side and he
has an IEP. It's helping but he's still behind.
 Low self-esteem due to repeated failures at school and
with friends. We've tried encouragement, breaking tasks
up into smaller time frames
95

96.  Medication works pretty well but I want for my daughter
to develop other skills and coping mechanisms.
 Consistent energy drain, slow progress in school,
frustration level. I tried tutoring, medication, private
school etc.
 We (my daughter and me) are suffering from homework,
project delivery, reading and writing errors.
96

97.  That our daughter may have inattentive ADHD and she
has challenges socially. Getting ready to enter High
School in the fall. We have an appointment on June 4th
with a neuropsychologist specializing in ADHD.
 Finding ways to help her enjoy learning, get the things
done we need to get done, and encourage her natural
curiosity and creativity without having every day just be
play and projects (we homeschool).
97

98. Takeaway: Leaning to Optimistic
 But realistic too.
98

99. Other Expert Services
 Upgrade to 1-1 Growth Planning
 Brain training
 parent as coach
 computer as coach
 student/parent as co-coaches
 Study Skills Coaching
 Ages 13-26
 1-1 Online (Skype)
 Email Mary Jane or Tom for details
99

100. Growth Planning is Affordable
 Our online tools
 Expert support via email
 $19.95 per month
 No contracts
100

101. We’d Love To Have You Join Our Team
EMAIL TOM@KCBRAIN.ORG
101