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Miss Deena Kotlewski, Ma, Lcpc. On Adhd - Page 2

Deena Kotlewski: So you know any--any specialist whether it be a psychiatrist or a psychologist or a doctor or a counselor or a social worker, you know any of those things would be a good place to begin and then you know build a team from there.

Interviewer: Right; now do you have to disclose? I mean if I"m in school and I"m--I"m a child with ADHD do I have to let them know? Or if I"m working and I"m an adult do I have to disclose hey I have this diagnosis; I"m taking this or I"m not taking? Is--is there an obligation?

Deena Kotlewski: Well within the school system if you want your child to receive accommodations then yeah you would need to disclose that; you would need to actually have a written diagnosis from a physician stating you know my child has attention deficit hyperactivity disorder and you know therefore they may need certain accommodations such as you know extended time during exams because you know they"re not able to maintain focus or frequent breaks if they have difficulty sitting still. So in order to get those specific accommodations--also if a child is taking medication they have to disclose that they have a diagnosis in order for the nurse at school to provide medication. So there's a couple reasons to--you know disclose it for a child.

But as far as an adult I mean I think that would be within your own judgment you know. If you wanted to disclose it you could disclose it.

Interviewer: All right; so what--what are these special services that a child might be eligible for in that setting?

Deena Kotlewski: Okay; well there is something called an IEP which is Federally mandated; it's across the nation--it's called Individualized Education Program, so if in fact your child has this at school, if you were in Maryland or if you were in Arizona or you were in California you would still be entitled to all of the same benefits, but they"re for kids with any special learning need--any kind of learning disability including ADHD that impact learning and accessing the general education program.

So if you have ADHD and that's impacting your learning you are able to get special services. And actually it's called Special Education where you know parents are often worried, like oh you know my child now is you know in Special Education. Well maybe back in the day Special Education was considered you know that--that behavior you know class you know where you"re separated from all of your other peers. But Special Education now days is you get pulled out of your classroom maybe for half an hour to an hour to get specialized services whether it be speech and language, whether it be--basically in-school tutoring with a Resource Teacher--all of those accommodations are available to someone who has ADHD and where that ADHD impacts their learning. So sometimes it doesn't impact their learning; so if it's not impacting their learning and they"re just diagnosed with a medical diagnosis they would be qualified for a 504 Plan and that too is a Federal--Federally mandated program. So you know whether you"d be in any State, you"d still get the same accommodations but a 504 Plan would allow your child to have like for example during testing sometimes you have to you know read a question and then bubble the answer in a separate sheet. Well sometimes children with ADHD have difficulty you know reading in one area and then trying to match up and bubble in another area.

Interviewer: Yeah.

Adhd Lcpc Ma Kotlewski Deena Miss

Deena Kotlewski: And yeah; because you know they"re a little bit disorganized and they would be able to have you know--write in the test booklet, like that would be one of the accommodations. Or sometimes children who have ADHD have very, very poor penmanship, you know--not only--you know the disorganization not only is in their paperwork but it's disorganized on the paper. So they might have you know larger ruled paper, you know as an accommodation. And--and that's available--that would be available through the 504 Plan as well as IEP but the main difference is during a 504 Plan--would be that they"re--that the ADHD is not impacting learning but that they need certain accommodations to be the most successful.

Interviewer: So what are some of the suggested strategies that you have for children and parents in order to manage this disorder? Is there something you can do like before, during, or after school or what--what are your tips for the parents?

Deena Kotlewski: Well oh gosh--there's so many different strategies but primarily--first of all I would make sure that the parent is--has dealt with whatever issue they may have themselves. So if they have ADHD or they need some parenting skills or parenting education that they have themselves in order first, so that you"re providing a calm environment for your child; so when you"re starting a child out like--for example, for the beginning of the day you want them to come from a nice, organized, calm home and you know where their book-bag is in order, where their clothes are on right, where their hair is on straight and they have a good meal. And you know when they start out like that they"re going to be much better prepared for any issues that they"re having internally. And you know during school hopefully the parent will have communicated with the teacher saying you know my child is disorganized or we need to write down their homework in an assignment book so that we make sure that you know the child is doing all the things that they"re supposed to do or you know I would like you know daily email communication from the teacher, you know the parent, or you know there's so many things that the parent and the teacher could do working together to make the child successful.

And in addition you know letting the child in on all of these plans you know--if the child is on a behavior contract you know holding them to it--making them responsible for that. And then also some activities for a child after school would be you know karate--that really focuses their energy especially when they have a lot of energy. So you know that would be a great activity for a child to get out you know some of their excess energy and if karate wasn't something that the child wanted to do then I would suggest gymnastics or any kind of activity that would focus their energy into something you know because sitting at a school desk for six hours a day is extraordinarily difficult for a child who is diagnosed with ADHD. So you want to you know make sure you give them the opportunity to get out that excess energy.

Interviewer: Right; and what about when a parent is struggling with--with the discipline factor? What--what are some tips for working through that?

Deena Kotlewski: Well there's actually a great book that I often suggest to parents called One, Two, Three Magic, and it's a very you know easy to follow discipline program--basically gives the child you know one, two, three strikes, and then he's out and then has to sit like in a time-out area. And really you know [Sighs] it's--it's just a matter of being extraordinarily consistent and the more consistent that you are with a child or the more consistent that you are actually with anything the more successful it's going to be. So I would really suggest you know consistency and if the parent is having difficulty with consistency you know go to their school counselor and you know get some tips, you know whatever school they"re at, or you know even go to their you know local community you know--church--churches often have parenting programs. I know within our community there's a lot of parenting programs through Montgomery County, so that would be my suggestion if you"re--if you"re looking for help and assistance, you know being a better parent.

Interviewer: Right; what about dealing with your environment within the family like sometimes it might be harder during the holidays or you might have some unsympathetic relatives or friends? Have you come across that and what are your suggestions for dealing with that?

Deena Kotlewski: Well I think if you"re having--if you have a consistent discipline program set up in your home take it with you wherever you go. If you"re going--if you have a behavior contract for example at home and you"re know there are certain expectations that your child needs to follow at home have your child follow those same or quite similar expectations you know if they"re going to grandma and grandpa's and talk to grandma and grandpa beforehand and say you know we"re doing this you know behavior program and this is what's working and you know we want you to support us with that. And you know I think if people are open and communicate their needs and communicate you know with each other as to you know best support the child, best support each other then it's going to be a successful situation. But I think sometimes when you hide things or you know you"re not upfront with the people around you it's really difficult to support you know somebody who you don't know what's going on. You don't know why the child is acting like this. You don't know why the parent is you know disciplining in that way. You know it's hard to support a person when you don't know what's going on; so communication is key.

Interviewer: Right; let's talk about the--the adults. What would you suggest for you know parents or you know a--a couple when you"re married to someone who might have ADHD or an expectant mother? How can the adults deal with their--with their diagnosis?

Deena Kotlewski: Well I think if you"re an adult with ADHD--well first of all you probably developed a number of coping skills that do work by the time you"re an adult or if--if they"re not working you"re--you"re probably [Laughs] you know really struggling. But if they"re not working--if whatever coping skill you"ve developed has not worked, I would definitely go see a counselor like right away and try and work with somebody to support you and help you and--and maybe change some of the patterns that aren't working well for you.

It--you know if you"re married to somebody that you know you"ve having difficulty communicating with or who is disorganized or you know isn't contributing to the relationship, I mean that too I would suggest you know going to a therapist and trying to work through those issues. I mean I really think communication is the key and you know working together as a unit, you know to create something that's successful.

Interviewer: Right; does ADHD affect pregnancy at all? Or, should an expectant mother pay close attention--well of course they shouldn't smoke, but is there anything else that they should pay careful attention to during their--?

Deena Kotlewski: I mean if you have ADHD and--and you"re on certain types of medications I would absolutely you know consult with your doctor and--and talk about you know this is what's going on and these are the medications that I"m on and will this affect my pregnancy and you know all of those thing? I mean ADHD--it's you know--it may create an environment where you"re disorganized; I mean also you have the--the hormones you know going crazy when you are pregnant, so you know all of those factors may you know just make your pregnancy a little bit more uncomfortable but I don't--I don't really know of any other you know correlation between ADHD and pregnancy.

Interviewer: Right; have you come across any exercise or nutrition suggestions with regard to them alleviating symptoms?

Miss Deena Kotlewski, Ma, Lcpc. On Adhd Health & Special Psychology

Deena Kotlewski: Well I have heard--I don't have any specific experience with this but I have heard that if you cut out white flour and sugars from your child's diet that may help; you know if there's kind of a more protein and complex carbohydrate diet that may help alleviate some of the symptoms of ADHD. I know some people have tried that in addition to behavioral therapy. So you know dietary changes might work; I mean I would--I would say try it. You have nothing to lose.

Interviewer: Yeah; it seems like exercise alleviates everything; so--.

Deena Kotlewski: Yeah, yeah; exercise will make you feel good.

Interviewer: What about sleeping? Are--are sleeping patterns affected and are there any tips for restoring that into a regular normal pattern?

Deena Kotlewski: Well sometimes people with ADHD need less sleep; they just you know--they"re--they"re active and they need less sleep. Also children that are on some of these medications may need less sleep, you know based on a--you know an effect from the medication, so--but if you know--if you"re a person that can sustain themselves on five hours of sleep and--and you"re doing a good job at work or you"re doing a good job at school you know then I would say that it's non-effective, you know not affecting you. But you know if you"re exhausted everyday then you know I would talk with a doctor about that or maybe you know do some kind of meditation or--or you know yoga to relax yourself before going to bed.

Interviewer: Yeah; are there any tools out there like electronics for children and adults that can help them stay more organized?

Deena Kotlewski: Well you know we have tried so many different types of things within our school. You know a lot of kids have a lot of difficulty with penmanship; they have difficulty controlling the pencil and then also making the words you know--the handwriting clear. You know we"ve offered children the option of using a computer versus you know writing their homework assignments; I mean really I think any classroom you know or school setting would probably do a lot to accommodate to a child in order to help the child be successful. I mean that's how it is within my school setting; you know I can't speak for everyone but you know you really want the child to be as successful as possible in their learning environment, so anything that you can do to accommodate to that would help. I mean I know that there's a little--little computerized thing called an Alpha-Smart that our Special Education teacher frequently uses with some of the ADHD kids and also some of the kids with learning disabilities. So you know there's probably a lot of tools out there that could help a little bit. [Laughs]

Interviewer: Yeah; now finally what is--what is one or--or some of your greatest success stories in the--either the school or the therapy setting?

Deena Kotlewski: [Sighs] Oh greatest success stories--okay; I have one really great success story. He just graduated yesterday.

Interviewer: All right.

Deena Kotlewski: Well he graduated from fifth grade yesterday. [Laughs]

Interviewer: Great.

Page 2 Adhd Lcpc Ma Kotlewski Deena Miss

Deena Kotlewski: But when I met him he was in kindergarten and he had an extraordinary difficulty controlling his behavior and communicating and I worked with him for six years--not only myself but I also worked with the Speech Pathologist, I also worked with the Special Education teacher as well as the parent, as all--as well as also his physician. We did try medication with him for a short period of time but mom didn't want him to be on medication, so he didn't stay on medication but nonetheless he's a success, because in fifth grade he is able to communicate when he is frustrated, when he's upset, when he needs a break; I mean there were many, many times where he would have just a total complete meltdown rather than just saying I just really need a break. And now he can say I just need a break. He walks out and he gets a drink of water and he returns back to the classroom and continues learning. So he's a great success.

Interviewer: Great.

Deena Kotlewski: [Laughs]

Interviewer: Well thank you Deena; this has been very helpful. We really appreciate your joining us. Just in conclusion, we"ve been speaking with Deena Kotlewski. She works for Montgomery County Public Schools and has a private practice in Chevy Chase, Maryland and working with children, adolescents, and their families. She is a Licensed Clinical Professional Counselor. And we"ve been speaking about attention deficit hyperactivity disorder. Deena, how can we get in touch with you?

Deena Kotlewski: Well you can call me directly at (202) 423-6778; that's my office line and I also have a web page, www.therapistdeena.com; and there's a lot of information about my private practice as well links to other additional information that parents may find helpful; so--.

Interviewer: Great; well we want to thank everyone for listening. We hope that this information has been very helpful and that you"ve learned quite a great deal about attention deficit hyperactivity disorder. And Deena thank you again so much for joining us; we"re glad to have you.