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Easy to miss: Problems of ADHD teatment compliance

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Image source: http://www.wendykeller.com

*MM, a 13 year highly gifted girl at her middle school, was happy with her summer school doing her favorite subject about computer engineering. This is one of the most popular summer school programs for the gifted and talented offered by Johns Hopkins University. This summer, she had a good time learning advanced knowledge and meeting mental peers with comparable abilities.

After the summer program, MM decided that she would not sleep in the class anymore when she returned to Hong Kong. She would rather take the advantage of boring classes, which was too easy for her and lacking any intellectual challenge, to do programming on her laptop.

Last week, she came to see me and looked completely exhausted after school. It is just beginning of the school year. I haven’t ever seen her as tiring as such.

MM comes to see me regularly since treatment of ADHD two years ago. She has some self mentalizing difficulties that it is so hard for her to process feelings and regulate her mood. She was used to getting angry and fighting back whenever she got into social conflicts with her peers.

Over the past year, her parents complaint that MM refused to turn off the computer late at night. She appeared to be increasingly addictive to internet. In the beginning of this summer, she told me that she slept around 6am and woke up around 3pm. Her mother was so fed up with all the fierce but endless quarrels in the middle of the night urging her so badly to go to bed. She thought that her daughter didn’t listen. She just wants to give up. She thought that her husband would be able to coerce MM to turn off the computer and put her to bed, he came home very late though. The mother didn’t want to get involved anymore.

MM told me that the internet game made it possible to escape from thinking about all the unresolved problems. When she turned off the desktop, she would turn on the iPad to watch videos while lying on the bed with her headphone on. It would help her shut off from heated conflicts, if any. Nonetheless, sleep problem is always an issue so disturbing to her. It often takes almost an hour for her to fall asleep. Obviously, she relied so much on watching videos on the iPad to soothe herself.

This afternoon, seeing MM so exhausted and sleepy, I asked her if he took her ADHD medication. She said that she quit medication since end of the summer school. I asked her whether she found anything different after withdrawal from the ADHD medication. She didn’t notice it.

I contacted her mother to cross check the situation. Like MM, she said that she did not notice any difference. She added that MM would make a bit scene when she was asked to stop doing any computer and to go to bed. She didn’t think medical fee for ADHD treatment worth it as far as she didn’t make any improvement regarding her computer behavior.

It is crystal clear that MM would not be able to express her feelings about her school and family. She will likely be inattentive and lack of motivation to do anything mentally effortful.

I ask her if she wants to do programming on her laptop when she gets bored in the class. She yawned and stretched her arms without answering my question. I then repeat that question. I am not sure whether he doesn’t pay attention to my question or it’s too overwhelming to think of school classes without much mentally stimulation to her.

The paradox is concerned with withdrawal from ADHD medication in a way to desensitize her frustration and picking up the treatment for realizing her vocational aspiration of computer programming.

Anyway, very few people will notice the silent suffering that MM is going through. I pray that God will bless her more.

Note*: MM is a pseudo name and modifications are made to formulate this story.

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Whose Vulnerabilties? By Jo Ho

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Image Source: http://drdivaphd.wordpress.com/2012/08/04/there-is-power-in-being-vulnerable/

CK doing Year 10 in the Eastern Coast spends time with his family for this summer holiday in Hong Kong. He studied overseas a year ago and learnt a lot from peer interaction, teacher-student relationship, interactive learning, academic and school adjustment and so forth.

CK couldn’t imagine his growth in confidence and social leadership over the past year. He admits that frequent quarrels and fights between family members since childhood have shaped his withdrawn behavior. He finds unresolved conflicts very overwhelming. He tends to present himself as outgoing, competent and high achiever. Specifically, he can’t handle all the communication problems in the family.

This summer, he starts talking to his elder sister and mom as an adult and stating clearly that he wants them to communicate their true feelings. He doesn’t want them to hide their feelings behind the smart phone, iPad or other forms of technology. He feels unhappy about all the temper tantrum or unnecessary fights improperly channelling personal feelings through personal criticism, complaint about domestic chores and the like. In several incidences, CK urges his family members to admit their feelings and openly share with family members.

At the end of this summer, CK comes to see me for a review of his personal growth. He says that he is able to turn the family interaction to be more meaningful and effective than before. While he feels capable to reshape the pattern of conflicts in his family, he is concerned about his sense of loneliness and fear. He is worried about the family dynamics without his presence as the facilitator in the following 4 months as he will be staying in the U.S. until Christmas.

He admits that he knows what and when to help people close to them. Few people will know that he is so exhausted and depressed inside.

He is so vulnerable. He tells me that he is eager to help vulnerable people. I know. The truth is, it’s easy to divert our pain from oneself to others who are vulnerable. That’s why true friends are meant to be companion with shared joy and pain therefore no one is left behind along the journey of personal growth.

Vulnerabilities can be a great teacher who helps us recognize that we grow from shared vulnerabilities. Over-identification as a helper, over the course of lifetime, may well be an alert.

Alerting us from a time bomb.

After all, I wish KC a content and fruitful school year in 2014-5.

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13歳升讀海外大學 作者賀若瑩

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Image source: http://www.riosalado.edu

上星期,十三歲的MM告訴我將在今年九月到海外升讀大學。我相信她的生活將變得新奇有趣和充滿挑戰性。那種感覺可能似走進了一個迷宮。

我祝願她事事順利。但我知道MM除了學術上面臨挑戰之外,她更要面對社交和情緖方面的挑戰。

例如,MM要學會適應大學生的社交生活模式。在閞展大學的社交圈子過程中,MM首先要瞭解一些潛在社交規則,亦即如何先與人溝通然後續步融入別人的圈子。這與中學的處境有别,大學生的年齡和社會經驗的差異比較大,沒有特定的模式來爭取同學認同,亦因此而加深了人際間的距離感,尤其在海外升學的「相對幼齡」資優學生,對校園及人際關係的歸屬感不易建立。另一方面又得在適當時候依靠别人提供資料或交流經驗。有時候更要學識多種獨立技能(例如飲食、洗衣服、衞生自理、依循課堂及自修時間表、出入安全、理財等等);有時要懂得向人求助,有時卻要慷慨向有需要的伙伴伸出援手,另外記住往大學的學習支援中心使用有關的服務,擴濶個人的支援網絡。尤其需要懂得與人互動,彼此拉近距離之餘又要學識保障自己身心安全。協商技巧亦很派用塲。所以大學生活成功袐訣絶對有别於中學校園的要求。大學新生要定期参與多一些學會活動擴展社交技能。

在個人方面,要懂得分配時間,以保持工作與娛樂的平衡,尤其照顧自己飲食健康、衣食住行等。另外在學業的壓力下,管理自己的情緒更不能忽視的。

對於僅十三歲的MM,這看似要面對艱辛的考驗,靠一己之力争取佳績絶對並非適應大學生活之道。但我相信MM最終會成功學到一籃子的大學生活適應技能。

更重要的是,我希望該大學能重視這個提前接受大學教育的特別個案,提供一種較完善配套以支援MM的個別需要,關鍵在於個別化支援方案,助她續步增社交情绪上和自理的技能,令她建立解難能力和自信。

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Individual Talent for 21st Century Workforce

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Image Source: startupicon.tv

More and more creative young people find mobile technology part of their life. These people that I am referring to are not simply users of APPs for game or other entertainment. They are young entrepreneur.

Last week, I met some young adults in a local government-initiated entrepreneur center for incubation of mobile technology, including the design of APP. Their creative and diligent work is admirable! They work in teams pooling their effort to create APPs.

Some friends of mine from Mobile Technology industries told me that growing number of enterprising and creative people all over the world work in teams for Tech Startups. By pooling their individual strengths and talent for a target product, these teams are able to create new APPs which potentially appeal to millions of APP users. It is hard to imagine the social impact of such team effort.

What interests me is the growth of these teams? It is a rule rather than exception that majority of startup teams start from scratch. Team members contribute their special knowledge, effort and time Pro Bono. They have to trust others.

While maximizing the opportunity of success, the team has to speed up the content and product development of the new APP. In order to attract more intelligence such as business planners, strategists and fund raising agents, the team has to disclose varying proportion of their invention. Leaking information is always an issue. One of the solutions may be speeding up the production and business growth while appropriate measures for protection of the intellectual property par se should be in place. Just like a forest burn-and-slash man who provides food for his tribe, he has to set fire in a way safe enough to grow crops for feeding his people. He has to balance threats and productivity by managing pros and cons aptly.

Finding a job for secure future is a kind of outdated or 20th Century mindset. Maximizing creative potentials and returns, in the 21st Century, require radical flexibility of minds. Look! Review of the Journey of personal, professional and social growth of people who started up social media like Facebook, Instagram and many others, we find optimism, shared risks, limitless capacity of problem solving, flexible minds and friendship.

Such new culture of APP or Tech startup teams reveals the truth that individual talent is not sufficient in itself to make a difference. I strongly recommend gifted and talented young to develop their business intelligence since elementary school. Instead of being a frequent user of mobile technology, it is so much fun to get involved with teamwork for turning innovative ideas into real. It holds true especially for highly able people with Autism Spectrum Disorders.

In sum, the pearl of startup experience is enlarging the social impact of shared passion. Making meaningful friendship is the corner stone for sustainable growth whereas personal and professional growth is inseparable.

Everything starts with trust!

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Autonomous Learners’ Model (ALM) group 「自主學習者」小組

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Autonomous Learners’ Model (ALM) group 「自主學習者」小組

Each iteration of ALM offered by ICGT closely follow the guidelines set out by Prof George Betts. Since we believe in the satisfaction that self-directed learning gives to gifted individuals, we place special emphasis on students’ individual needs through individual development, orientation, in-depth study, seminars and enrichment. Each student takes the role of learner as well as facilitator.

有疑問? 歡迎聯絡我們查詢: 電郵 或 致電 +852 2636 1860

from www.gifted.hk

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Social Stories & CBT 社交故事及認知治療

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Social Stories & CBT 社交故事及認知治療

有些聰明好學的學生,偏偏社交技能較弱,在別人眼中可能很有才華活像一個 「小專家」,但與人溝通時郤重覆出現一些難題 。

教導他們可能很費力,因為可能講但他們無聽,聽又未必明,明又未必做,做又可能 做錯,錯又未必認,認又未必肯改,改又未必服,服又未必講得出個道理,師長未必察覺這些難題的急切性。更何況這些學生可能成績表現理想,豈料這種較為 「自我」 的特性原來是急需改進的 , 否則將來難以獨立,更遑論應付將就業和社會的各種要求。

事實上,研究已指出自小在社交發展出現問題,明顯增加了日後學業及工作成敗的機會。所以家長要及早採取行動,為孩子學業和社交發展鋪路,雙軌並進,才可穩步發展,做個有用的人。

給資優孩子的信:

越來越多家長留意資優孩子的內心世界,
社交故事對促進個人社交告情緒發展實在有效。
對於天資聰穎而又有亞氏保加症(一種自閉症) 特質的孩子的幫助更大。

踏出社交情緒教育第一步

個別學習對象:

– 智力常在卓越或以上水平 ( IQ 120 以上 )
具有不錯語言能力,但受限於心智理論發展的遲緩、社會能力與經驗的缺乏,對周邊發生事物常無法正確理解與反應,導致人際互動過程中出現許多不合常理或令人困擾之言行舉止,嚴重影響其社會參與及情緒發展。


課堂次數: 12次一期 (視乎個別需要)

時間: 每堂1小時,適宜每星期一次

做法: 個別形式學習

功能:
個別學習社交故事
具有臨床功能,可以促進輔導的效果
由日常事件入手,加深當事人瞭解心路歷程
可助走出心理謎宮,減低創傷。

目標:
– 幫助他們按以下的層次提升社交情緒的技能
1. 遇到不如意事情,引發負面情緒時,只懂得發脾氣,或作反叛性行為
2. 透過漫畫圖象化事件
3. 敢於憶述事件
4. 一起重溫當事人的感受
5. 師長能跟他討論問題的關鍵
6. 留意主觀的看法,學習擴闊自己
7. 感到被別人了解
8. 改進個人管理情緒的能力