"Attention Deficit Disorder"
ATTENTION DEFICIT DISORDER Date: Tue, 16 Feb 1999 From: Tom Hart Subject: USYSA's Adidas Workshop and Coaches Convention Matt- I don't know who is the speaker for the ADD session but I suspect it is Linda Meigs of the South Texas Youth Staff. (And Yes she does have ADD herself!) The STYSA publication "The Shootout" carried an article by Linda on ADD. Here is the article that appeared on the USYS website. How to Coach a Kid With Attention Deficit Disorder By: Linda Meigs Linda Meigs is a former coach of the Southwestern University Women’s Soccer Club, holds a USSF “C” coaching license and is a member of the South Texas Youth Soccer Association Coaching Education Staff. She did her undergraduate studies in therapeutic recreation and is co-founder of an ADD support group. Meigs is dedicated to educating both parents and teachers about ADD. She believes that her own attention deficit is her greatest asset as both a player and coach. A question that comes up at all my entry-level coaching clinics is “What should I do with an ADD kid who cannot maintain focus during a practice session?” Coming from a coach, it is a question borne of frustration and caring. For parents, it is a question fraught with pain and despair. As a coach once said, “Every team has at least one ADD player to deal with.” Research tells us that, in most cases, he is correct. What We Need To Know About ADD It has been estimated that six to ten percent of all children (17% to 35% of adopted children) display an attention deficit difference. These ADD children are prone to learning difficulties, have problems developing good social skills, suffer from an inability to pay attention and are extremely likely to harbor unrecognized frustration and anxiety. They may endure quietly, in silence, or if also beset by hyperactivity, may assertively, or even aggressively, seek attention. ADDers, who often “wear their feelings on their sleeve,” may deal with their extreme sensitivity by acting out combatively (Oppositional Defiant Disorder, or ODD), or by turning <doc name> page 1 of 14 printed 10/03/12 in upon themselves and displaying depression. Many suffer from impulsivity, frequently speaking out of turn or acting intrusively without thinking. ADD is a brain-based imbalance of neu rotransmitters which can show up on PET (Positron Emissions Tomography) scans and other recently developed methods for studying the brain. It is genetically linked and usually runs in families. It is often accompanied by allergies. Some ADDers require medication to deal with the overwhelming stimuli of their environment. ADD without hyperactivity—referred to medically as ADHD: Predominately Inattentive Type—rarely presents overt behavior problems at school or in soccer. In fact, these children often quietly remain undiagnosed. They are, however, prone to depression, anxiety, alcohol/drug abuse and solitary behavior. Often they prefer individual activities (swimming, tennis, horseback riding, computer games, reading, music, etc.) over team sports (soccer, football, basketball, etc.) which may provide too much stimuli for them to assimilate comfortably. When bombarded with sensory input—for example, a coach or parent shouting encouragement or instructions— these children will withdraw. ADD without hyperactivity often remains undiscovered until puberty and sometimes until adulthood. ADHD or ADD with Hyperactivity—medically referred to as ADHD: Predominately Hyperactive/Impulsive Type (or, if inattention is also a major problem, ADHD: Combined Type)—is most commonly treated with Ritalin. If given too high a dose of this drug, a normally hyperactive child may exhibit “spacey”, almost catatonic behavior. On too low a dose, he or she may show no reduction in hyperactivity and inattention at all. Parents may, or may not, appreciate feedback on their child’s reaction to medication. Physicians advise some parents to medicate their children while at school, not to increase the amount they learn—studies show that the use of Ritalin does not increase academic achievement over the long run—but rather to help their child relate positively to the school environment. A child who is disliked by his peers or by school personnel will develop a poor self-concept and make few, if any, friends. The difficult task of learning good social skills now becomes impossible because no one wants to be around the child. Parents need to be advised if this circumstance carries over to soccer practice. An ADHD child should expect to benefit from the social interaction at games and soccer practice. If the child finds the experience frustrating or humiliating, the parent needs to be informed. An ADHD child is already at risk for developing anti-social behaviors and poor self-esteem without being forced to participate in a competitive after-school activity which is counter to his or her best interests. If the parents’ well-meaning attempt to give their child a weekend “drug holiday” makes the child an insufferable, ineffective teammate at the game on Saturday, the <doc name> page 2 of 14 printed 10/03/12 “drug holiday” may best wait for summer vacation when stress levels on the child are usually greatly reduced. Ritalin may ease an ADHD soccer player’s struggles in dealing with the competitive environment of youth sports. An ADHD player can become a team captain or star goalkeeper if parents and the physician persevere in their search for the proper dosage of medication for the child. Medications other than Ritalin are available if it cannot be properly dosed. A competent child psychiatrist who works regularly with ADD can mix and match various drugs that can impact the level of neurotransmitters in the brain. These medications can help an ADHD child learn to begin controlling impulsivity and inattention and should help the child make better decisions in social situations. If that is not happening, the dosage or the medication needs to be changed. Helping the ADD Player Maintain Focus A learning environment that is helpful for an ADD child will benefit all children. And everything espoused in USYSA coaching clinics to help young players develop their skills will help an ADD player stay actively involved in soccer practice. The better we perform as coaches, the fewer problems ADD players will have. An ADD child will misbehave while waiting in line, but a good coach will avoid asking his players to stand in line. We learn by touching the ball, not standing in line. Soccer, after all, is not a static game. Movement should be praised, and ADD kids are experts at moving. Since we learn by touching the ball, each player should have a ball. Keep instructions and corrections short. Use “coaching points” and catch phrases. Repeat them often and with enthusiasm. Avoid negative feedback. We know that corrective feedback and positive feedback produce better results, simultaneously improving skills and building confidence. Remember to use that “feedback sandwich.” Positive feedback can be given in front of the group, but corrective feedback directed at an individual player should be given privately. Always make direct eye contact when speaking to your players. Ask players to repeat back your instructions to be sure they understand what you are asking for. Boredom inhibits learning. Frustration and anxiety inhibit learning. Break tasks down into small steps so that all players can master each step, but be sure the challenge is great enough to keep your players interested. Success breeds success. <doc name> page 3 of 14 printed 10/03/12 Mistakes happen. They are a natural part of the learning process. View them as growth opportunities. Be respectful and forgiving— of yourself, your players and the referees. Disorganized practices invite misbehavior. Plan a fun practice with instructive games. Have fun yourself! Fitness and fun are not mutually exclusive. Start your practice with a warm-up game of tag. Always give your hyperactive players a chance to be “It,” though not to the exclusion of everyone else. The work rate for “It” is significantly greater than for the other players, and a fatigued player absolutely will not misbehave! He or she will not have the energy for acting up. It beats running humiliating laps. Become a student of the game. Take more coaching clinics. Attend upper level matches. Watch videos. Try playing. The passion you display for the game is contagious and an ADD player who is passionate about the game will give you 110%. Always! There is no quick fix for ADD, just like there is no quick fix for poor teaching or poor coaching. By sharing a copy of this article with team parents at the start of each season, maybe we can begin to help ADD children reach their full potential with and without the ball, instead of simply remaining confounded by their behavior. Date: Tue, 16 Feb 1999 From: Connie T. Matthies As a mother of a child with ADD, and having coached a ton of kids over the years who had ADD or ADHD, I would be skeptical of anyone who claimed that having ADD was an "asset" - let alone their greatest asset. In truth, it is a major hurdle for many of these players - and they succeed in spite of the hurdle - not because of it, at least in my view. I almost fell on the floor laughing when I read this statement: "The better we perform as coaches, the fewer problems ADD players will have." This dear woman needs to meet some of my more severely afflicted ADHD kiddos before making statements like this. While some who are mildly afflicted and are on stable meds will fit her model, it is foolish to think that this is true in all cases. I have had some who had to be removed from the regular sessions at almost every practice and taken off elsewhere by an assistant for separate instruction, because they would not stay in their practice grids; would not listen to instructions; would hurt teammates in their eagerness to get at the ball; and, in scrimmages, would actually steal the ball from a teammate who was getting <doc name> page 4 of 14 printed 10/03/12 ready to score, so that they could be the hero instead. Some of these kiddos could only play as goalkeeper, because they were a hazard to teammates and opponents when on the field. I have had other severely-afflicted ADHD kiddos who were verbally abusive to me, and physically abusive to teammates, due to extremely poor impulse control when things did not go their way. In some cases, the kids were not on Ritalin for practices (because their parents did not view it as necessary - even after being asked to come to practices and to see for themselves what problems were resulting). In other cases, the kids were not yet diagnosed (but plainly needed evaluation - but at least one parent would not hear of doing this, despite confessions by the other parent that the school also had mentioned ADHD as a possibility). In others, the meds simply needed adjusting as the child grew. And, for some, no meds had been found which provided decent control. When these severely-afflicted kiddos got out of control, the best coaching in the world wasn't going to do a thing - because you could not reach them. ADHD kiddos are easily over-stimulated and over-excited. Research seems to indicate that they do not produce some brain chemicals which regulate emotions, so minor stimulus can release an overwhelming flood of hormones which can send the child into a frantic state where any additional tiny bit of stimulus sets them off even more - and there is so much emotional biochemical brain static that they really don't hear you or even see you. When other kids are merely excited about something, many of the ADHD kiddos will go into the stratosphere. You can see in their eyes that they are completely out of control. When this happens, allowing more movement or more stimulus is counter- productive. What the child needs is to be taken out of the stimulating environment immediately, and allowed to calm down. This means taking the child away from the group, turning his back to the group to get rid of all distractions, and talking him down (or walking him down). When the child is in this stage, the only way that he is likely to hear you is if you get down at eye level and force him to look at you - and don't say anything substantive until he can remain focused on you. Once you get used to the truly frenetic ones, you can start to anticipate when they are losing control, and take them to the side quickly so that they can put on their brakes before things get totally out of hand. Over time, as they get older, many learn how to apply the brakes themselves to some degree - although many remain quite impulsive into adulthood. For many, medication is the only answer - as it can truly make the difference between having Dr. Jekyll or Mr. Hyde on your team. I have really enjoyed my ADHD kiddos overall (some of my all-time favorites were ones who were severely afflicted). As you learn what works with them to keep them on an even keel, and to avoid over-stimulation, they usually start to <doc name> page 5 of 14 printed 10/03/12 blossom - and are delightful in their reaction to praise (probably because, for most of their lives, they have been yelled at - and it feels so good for somebody to say something nice about them for a change that they are like happy puppies). But, I am realistic enough to know that, just like I won't usually put my asthmatics in midfield for long stints, I don't need to put my ADHD kiddos in defense (at least without plenty of backup). And, the ones who are severely afflicted get to come stand by me during demos (so I can keep an eye on them). Often, I recruit them as my helpers, just so that we can go off together to set up a grid, where we can have a private chat about what we are planning to do. But, for the severely afflicted, no coach has a prayer of handling the situation unless they have a good patient assistant who can take the child aside - or parents who are willing to work with you on balancing the meds. I should add that the ADD kiddos are not much at all like the ADHD ones. In general, the ADD kiddos come across as genial air-heads. They are not hyper, and don't tend to whack others. Instead, they are the ones watching the butterflies, or examining the caterpillar while the opposing team scores. While the ADHD kiddos may be jiggling and squirming and grabbing handfuls of dirt, they usually can tell you exactly what you just said. On the other hand, the ADD kiddos often can be looking right at you - and not hear a single word. To deal with the distractability of the ADD kiddos, you have to play 20 questions (what are we going to do; when; where; how), and periodically pull them back out of the mist with gentle reminders - "where are you supposed to be", "what position are you playing", etc.. Just thought that it would be worthwhile to give some real-world experience in dealing with ADHD kiddos. It is probably natural that Ms. Meigs would downplay the problems, given her background - but my own experience (and that of numerous HS Special Ed teachers with whom I have dealt over the years) suggests that she is not seeing the full picture. Date: Tue, 16 Feb 1999 From: Connie T. Matthies Hi, Tom: Sorry if I ruffled your feathers. However, to be honest, NO soccer coach should have kiddos standing in long lines. ANY child will tend to get disruptive when bored. To that extent, I can understand Michael Rolfe's confusion about how ADHD and ADD differ from normal childhood behavior - if all that is needed is to use child-appropriate coaching methods. This is where I took issue with Linda's article. I felt that it tended to trivialize the extent to which this disability can truly cripple a child - and an unprepared coach. My first experience with a very severe ADHD kiddo was in my 2nd season of coaching - and I thought that the child would drive me crazy. When he got into the frenzied stage, you simply could not reach him - his eyes would go wild and it <doc name> page 6 of 14 printed 10/03/12 was plain that he did not hear you. He literally would attack anybody with the ball (teammate or opponent) in his zeal to be the hero - and he was a big kid who could break your shin with a hard kick and who would knock a teammate over in a heartbeat. Did I get parent complaints? You betcha. Did I get complaints from teammates? What do you think? Truth to tell, the child was almost a menace - even though he did not mean to be. However, I really wanted to see if I could help him - and still keep the team together (the other kids wanted to murder him) - so I sat down with several good friends who are Special Ed teachers. I spent untold hours learning about the disorder, and trying different things suggested by these experienced teachers. Good thing that I did so, as it turned out that this child is about #3 on my all-time severely ADHD list (I've had 2 worse). Thank God that these kind teachers put their heads together - and suggested that I try him as a keeper because of the additional structure. And, Thank God that I had a kindly assistant coach who would take this dear lad away (ostensibly to practice on being a keeper) whenever it was clear that he needed some quiet time. Honest to Pete, Michael. Wait until you see a really severely-affected ADHD kiddo. They are near-tragic figures (sometimes even with the meds). When they get over-stimulated and out of control, they can act like the movie demos of someone on PCP (almost crazed). Sometimes, these poor kids even end up in mental facilities (as another one of mine did at one point when he got so upset by constant problems at school that things cracked). Happily, many ADHD kids respond well to the meds - and some who are borderline may be able to cope with some behavioral modification training. But, at least in my experience (and I have had quite a few of these children), the problem is more acute when there are multiple stimulii - and you get lots better success with these kiddos when you can reduce the stimulii (especially when the meds are wearing off or need adjusting). Not just my observation, by the way - as the standard approach in Special Ed is to pull these kids out when you need them to focus (such as for tests). Why? Because they have an attention deficit - which means that they are easily distracted and easily lose focus. And, when they are hyper, they get more and more hyper as they get more and more distracted. Don't have any idea why - but the idea of brain static seems to sum it up better than anything else, from what I have seen. Date: Tue, 16 Feb 1999 From: Paul Cialone I've read the ADD posts with interest, and the thought that runs through my mind is whether the "best" thing for the severely affected child and his/her teammates is to keep that child on the team? True, this may not seem fair to the affected child at first glance, especially in an era of mainstreaming. But the intent behind that philosophy is that the challenged child can thrive, in some instances, when <doc name> page 7 of 14 printed 10/03/12 being placed with "normal" children and having "normal" expectations for performance placed upon him. But, to force a markedly affected child to participate in an activity that he/she cannot do well in without an inordinate amount of time being devoted to that one child, to the detriment of others perhaps, seems unfair. It is the parents' responsibility to see to it that the child be placed in an environment that is to his/her advantage, but to have that child literally attack teammates and earn only their anger and contempt in return does the child no good. Certainly, choosing to ignore the problem or withold medications that help are not in the best interest of the child either. This all reminds me of an experience I had while in my 20's. I was a counselor at a very exclusive(read "rich, I mean REALLY rich kids)day camp - my group was 10 year old boys. One of them, Michael, seemed to be the sweetest, most polite and pleasant of the group. Yet, every day for a week, he would be attacked, whether verbally or physically, by other boys in the camp. I could prevent this while he was with me under my direct supervision, but that wasn't always the case. The other boys said only that Michael constantly said mean things to them, which seemed unlikely given his demeanor. Michael vehemently denied the accusations, but said something I'll never forget - "why does everyone always say those things about me and why do they always beat me up? They're always trying to hurt me and I just want to make friends" His parents confirmed that he was frequently targeted in school. Finally, I saw what the boys were talking about. Out of nowhere, and in the space of 2 seconds, Michael turned to two of them one day and spewed out the most foul utterances you ever heard, accompanied by a frighteningly terrible looking facial tic. As he was being "jumped" by the 2 boys to whom this was addressed, and as I sprinted over to stop it, his normal facial expression returned and he literally cried out "what did I do, what did I say, why do you all hate me?" I finally figured out what was wrong after watching him closely and doing some research - Michael has Tourette's syndrome, which is characterized by physical tics and verbal (usually expletive- laden) outbursts that are uncontrolled. With the verbal outbursts and the almost demonic looks on his face, the other boys feared and hated him, but since they were so quick and relatively spaced out during the day, no counselor had witnessed them. The poor kid had no idea what was wrong with him. His parents admitted to seeing this in him but didn't want to sully their aristocratic name by admitting the poor kid had a "mental problem" and getting him help. My point with this whole story is to say that, now, in his mid-20's, Michael is well- controlled with proper medication and therapy with regard to his Tourette's. But he will never recover from the years of self-loathing that came about as a result of being put into situations his family could have improved/controlled for him if his interests were truly a priority. Placing a child with uncontrolled, untreated problems in a situation where his peers resent him for the problem's effects on their lives is not in the child's best interests long term, in my opinion. I wonder what a league or coach could do in this litigious world of ours - is it looking out for the poorly controlled ADD child's best interests by letting him play, endangering himself and his peers? Some of your stories are scary in that regard. What if the ill-informed coach has no assistant who can focus the child or divert him when <doc name> page 8 of 14 printed 10/03/12 needed? What if Mom and Dad forget to mention the affliction to the coach, and the ADD child, or someone else's child, is hurt as a result of behaviors that are due to ADD but aren't modified or controlled well? I mean no disrespect for anyone by this, or for anyone's child. My first son had severe physical problems, and although he died shortly after birth, these issues have always been in my mind - I can't imagine putting my poorly controlled ADD or otherwise affected child into the kind of situations described in various posts. Sorry if the post is a little of a downer, but it seems to be a topic which interests a number of list members. Date: Wed, 17 Feb 1999 From: Ivan Mann > If a player has a vision problem, does the coach post to the > coaches list about possible remedies? If a coach has a player on the team > that is suffering from ADD, wouldn't the coach somehow have a medical > professional take the lead. Adding some thoughts: if the kid breaks a leg, does the coach do anything about it? I won't. I'll call the paramedics and make the kid lie still until they get there, simply because I do not have training or knowledge about how to handle broken legs. Suppose Johnny has some psychological problem like ADD. Do you really want me to (1) diagnose it, (2) plan a treatment protocol, and (3) treat the kid? Much better (IMHO) is to treat the kid pretty much like everybody else, expect the same stuff, and send him to parents' control whenever necessary (just exactly the same as you would send any other kid). You may send him off more frequently than others, and the parents may have to deal with it when they really want to ignore it, but the price you pay for having children is having to raise them. Date: Wed, 17 Feb 1999 From: Connie T. Matthies Hi, Paul: You raise the question of whether it is fair to the other kids or to the coach to saddle them with a child with a significant disability. This is a question which I suspect that any coach who has been faced with such problems will ask himself (just as teachers and parents have done). I think that the answer is "It all depends". Certainly, if the child cannot be controlled after some reasonable trial, and presents a serious hazard to others, it makes sense to place the child into a different environment. There are tons of solo sports where the child could excel (ranging from tennis to golf to rock <doc name> page 9 of 14 printed 10/03/12 climbing), and this may be a viable option in many cases - and perhaps the ONLY option in some cases. However, under assorted federal and state laws, you have to have some objective evidence that the child's problems cannot be accommodated before he can be excluded - and you can be subjected to some expensive litigation if you don't comply with these requirements. Completely apart from the legal issues (which are significant), the fact of the matter is that you are dealing with a little kid who wants to participate and who has a problem. Are you going to be one more adult in his young life who rejects him and makes him feel like he is worthless - or are you going to give it a fair shot to see if you can make it work? Most people who coach like kids - and wouldn't be doing this job if they didn't enjoy the chance to make a difference in their lives. So, it only makes sense to try - and to only give up when you have exhausted all of the resources at your disposal. I talked about the down-sides, because I think that it is important to be aware that this can be a hugely crippling disability in some kids. It is not uncommon for kiddos with this problem who are not properly handled to engage in all sorts of risk-taking impulsive behavior; fall in with others who take advantage of them; have huge emotional problems from a lifetime of rejection; use drugs/alcohol to self-medicate; and end up in prison or early graves. But, there is also a huge upside, which makes the effort worthwhile, IMHO. Some of the most terrific kids I know are ADHD kiddos who have been properly controlled and medicated and counselled so that they can cope with the difficulties of the disorder. Because they know what rejection feels like, they can be hugely sympathetic and empathetic, and very generous with time and $$. Many of these kiddos are extremely bright, and show lots of artistic talents. I often wonder if part of the over-stimulus problem is that they see and feel too much, and get overloaded until they can learn to build some walls and shields to protect themselves from some of the sensory load. So, probably time for some success stories, to encourage those who want to pull their hair out and/or strangle the little dear. Remember the kid who was so out- of-control and big that he was a menace. Well, he ended up being the most awesome keeper that you could imagine. He apparently was very good at math, and could anticipate trajectories and angles beautifully. And, for a keeper, it doesn't matter as much that you are a little bit crazy or a bit too rough, does it? He would fling himself into traffic - and any ball in his area was something that he OWNED. Didn't take long for his teammates to appreciate him in this role, and to start praising his efforts. Besides, by virtue of pulling him out when he started to get manic, and by fairly constant monitoring of his behavior, we had slowed down the disruptions to the point where the kiddos were able to forgive earlier <doc name> page 10 of 14 printed 10/03/12 problems (one of the more wonderful things about kiddos is that they have short memories, and forgive/forget easily). As he gained acceptance by the group (probably for the first time in his whole life), and started to succeed in our setting, he started to blossom. The rewards for being nice seemed to make him want to struggle harder to control the static (and the static itself seemed to decrease - maybe the balm of acceptance creates a balancing hormone, who knows?). He was quite smart, as I noted - so, once he started to get what he wanted (praise, acceptance, winning), he was more able to give us what we needed, which then made it easier to reverse the negative spiral and start to train him in some methods which helped him to cope (one is pretty simple - and just involves shutting your eyes and consciously shutting out the stimulus so that you can calm down - kinda like meditating). Over time, things got better at school as well - and you could see the difference in the child in the way that he walked, talked and acted. Whenever I am at the fields, this kiddo always makes a point of coming to see me - and telling me about how things are. In a way, I think that he sees me as one of the first adults who saw any good in him - and this helped him to believe that success might actually be possible (no question in my mind that the kiddo was on a spiral - and was about ready to quit on all of us - no point in trying if you are always wrong and bad and awful, is there?). So, in my mind, it was worth the effort - but it took a heck of a lot of effort (and, with this child, truly wouldn't have been possible without a terrific assistant, so that one or the other of us could take him away when he got too difficult to handle). At the time, I was feeling my way - and not as confident of what to do or how to approach parents, etc. Now that I have had a lot of these kiddos, I don't think that I would have been quite as patient with the parents' refusal to medicate the child for practices - and would have insisted that they do so or that they attend practices to assist when he got out of control. But, at the time, my son hadn't been diagnosed with ADD (and wasn't on Ritalin), and I hadn't worked with a bunch of other parents on adjusting dosages, so I was pretty green. Would have been tougher to look the parents in the eye and insist (from the point of actual experience) that they take responsibility for the child too - and not cop out from using needed meds with some excuse of "well, we just don't want to get him too dependent on them....or, we just don't like using meds, so..." Well, if I had a player who stopped breathing constantly due to asthma problems or went into constant shock from diabetes or had frequent seizures, I would insist on meds or not allow them to leave him with me. Ditto with ADHD!! Which leads to the parent management issue. Every Special Ed teacher in the world will tell you that this is the most difficult part of their jobs, especially if the parents are fairly successful. Quite often, there is a huge obstacle of Denial or Avoidance to contend with, because nobody wants to have a child who isn't "normal". This occurs in spades with ADHD kiddos, particularly from the ADHD <doc name> page 11 of 14 printed 10/03/12 parent who doesn't want to face reality that this child who is just like them has something wrong (which means, of course, that they also have something wrong - as ADHD has a firm genetic link and almost always will appear in a parent as well). So, they can watch their offspring blithely knocking others down, or stealing the ball away, or refusing to pay attention - and it is ALWAYS someone else's fault or there is some excuse for why this really isn't a problem (the other child got in the way, or the practice was boring, or the kid was just being playful or hadn't been feeling well or just ate some sugar or whatever). Have one very ADHD mom of a very ADHD kid (probably #2 on my all-time list) who loathes me to this day because I refused to put up with her flightiness (you never knew if she would bother to bring the child to practice or games - and she might call you 3 times on Saturday morning while she dithered about family plans); insisted that she follow attendance rules (and mailed her copies on 3 separate occasions); and also strongly suggested that she talk to the school and the doc about having the child assessed for ADHD because he clearly had some real problems in group settings. [Yes, I know that this condition requires diagnosis by professionals - but, even an amateur horticulturist gets to know quite a bit about roses if he works with them long enough]. The true problem in the equation was Mom, who was so scattered herself that it would have been impossible to expect her to provide needed structure for the child. I turned cart- wheels when she haughtily informed me that the child would not be coming back to my team. In general, you are facing an uphill fight if the parents will not face reality that the child needs more meds (if diagnosed), or that the child is creating huge discipline problems (if not yet diagnosed). Sometimes, the parents need to hear from 4-5 separate teachers and coaches that the child is a real problem before it sinks in that it is the child - not the other folks. In those situations, I think that you need to get the club involved early - especially if the child appears to be a hazard to others. In the interim, you need to separate the child from the others whenever manic, for the protection of everyone. When the parents are supportive, and realize that you simply want to help (not to beat them up for failing to discipline their awful child), this can make the situation a lot easier to handle - and usually a lot less trouble. If the child is properly medicated, the child often will not appear any different than any of the rest (which means, of course, that he may act up like any kid - but not lots more than normal). And, once you have time to work on stimulus reduction techniques, this may help the child to reduce the need for the meds in some cases or at some times. As they get older, the kids usually are able to tell when their dosages need adjusting (as they grow, they frequently will tend to need higher amounts to adjust for increased size and weight). Certainly has been true of my child, as well as others. However, when younger, they may not realize the need for <doc name> page 12 of 14 printed 10/03/12 adjustments - and may fight the idea of medication (either because it makes them feel different or because the meds make them feel "tired" or "funny"). So, input from the coach back to the parent is useful (along with input by the teachers and any IEP monitors) in letting the doctor decide when it may make sense to alter dosages. Date: Wed, 17 Feb 1999 From: blp >I have NEVER been involved when a soccer coach noticed a child who >was exhibiting symptoms and was in any way involved with treatment. I have, Michael. And, until I posted my situation to the List, and heard back from people who have coached, parented, or themselves been an ADD/ADHD child, I hadn't a clue what I was dealing with. Suffice to say that one of the kids involved is now succeeding with one of our Select soccer-school age groups, thanks in large measure to the advice I was given on the List. The other boy had to be released, after a year of effort. His parents were deep in the denial Connie has described. They sent the boy to soccer with a grandfather who couldn't speak English and couldn't help control or focus his grandson. We have since learned that the boy was eventually diagnosed as severe ADHD with mild Tourette's Syndrome. We tried and failed. But Lord knows we tried... and indirectly, perhaps, we had a part in finally getting him the professional help and support he needed. And, frankly, whether or not that comes under coaching is not something I worry about. Date: Wed, 17 Feb 1999 From: Connie T. Matthies Hi, Ivan: You write: "This is a pointless debate.... If the kid doesn't pay attention and disrupts practices, it doesn't matter if it is lousy upbringing or medically caused." Sorry, Ivan, but an awful lot of the coaches on this list end up taking whatever the soccer gods happen to send along to them for the season - and are stuck with the child (sometimes until the child decides to leave or until the child graduates from the age bracket) - unless the coach decides to end it all early by quitting. And, it does make a difference if the problem is caused by a disability. I promise you that the public accommodations provisions of the Americans with Disabilities Act will apply to most soccer clubs. Under this statute, the club is required to make reasonable accommodations to the disabilities of patrons in order to allow the patron (in this case, the child) to utilize the services in the same manner as the rest of the patrons. Many states have similar disabilities statutes - which also <doc name> page 13 of 14 printed 10/03/12 will apply. Under at least some of these statutes, the individual who discriminates can be sued personally - along with the organization - and may be liable for punitive damages, compensatory damages (emotional distress, etc.), and attorney fees for the child. So, it isn't going to be possible to say to a parent that you are refusing to allow the child to play on your team because he is disruptive - if the reason for this disruptive behavior is ADHD or some other disability - UNLESS you also can show that there is no reasonable accommodation available which would allow the child to participate without undue risk to himself or others. How do you go about proving what is a "reasonable accommodation" or what "undue risk" might be? Well, the club's lawyer or insurance agent probably will tell you that you are going to need to have objective evidence that you tried various options to control the child; consulted with the parents; provided some special services (maybe finding another assistant to help the coach); and the child continued to be disruptive. If the child actually is hitting or striking other children, you may have a lesser standard - depending on the amount of harm which might be expected to be caused. However, as we know, there are occasions when entirely "normal" kids may decide to whack each other - and soccer is a contact sport - so this is not as easy as it might sound. Of course, the other kids on the team might decide to abandon the Club or team to avoid the child. However, if the team disbands and the Club has ever moved kids to other teams when a team has disbanded or failed to make, the disruptive child probably has some claim to being moved as well. So, this brings you back to square one - which is that you have to show that you cannot accommodate the child's problems. It also makes sense to note that many parents of kids with ADHD are successful middle class folks (lots of ADHD individuals end up in careers like sales) - and, if their kids already are on IEPs (individualized educational plans), they will be quite conversant with the laws which govern discrimination against kids who have disabilities. Rest assured that, if your Club makes the decision to toss an ADHD kid because he is disruptive without making some reasonable efforts to accommodate his problems, there is a very good chance that you could get a claim under the Americans with Disabilities Act or some comparable state law. Think about how upset a jury might be to see the tear-stained face of little Johnny, talking about how terrible he felt to be kicked off the team - closely followed by the testimony of the experts that he just needed some minor changes in his meds because he had grown or just needed some time-out time (but, of course, nobody ever asked - they just tossed him). Then, imagine a verdict which includes a lot of zeros and commas. <doc name> page 14 of 14 printed 10/03/12