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NEW ENGLAND CENTER FOR PSYCHIATRIC TREATMENT AND EDUCATION

SIMON EPSTEIN, M.D.
91 STRAWBERRY HILL AVE. #140
STAMFORD, CT 06902
203-348-8579

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From Dr. Simon Epstein and the New England Center for Psychiatric Treatment and Education


Monthly NewsNotes

Monthly NewsNote

September 2007

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A Possible Clue to ADD

There are a few patterns that are so typical of ADD that I think of them as diagnostic clues. These include such things as homework trouble and procrastination. I'd like to discuss another diagnostic clue in this issue of my Monthly NewsNote. Let me call it "I thought I did well."

Here's an example with Mary. She was a 7th grader at a local middle school. She was seen in consultation to find if she had an attention deficit disorder. Her marks were only fair and I asked how she did on tests. Mary answered, "I always think I did great but then I get a C." Her mom, who was in the room, confirmed this. She said that Mary studied and then thought she aced the test. She was always surprised and disappointed when she did poorly.

The pattern of thinking you did well only to find out that you were wrong can be very bad for self confidence. It is also a mystery to the student who has no idea why this keeps happening.

There are two points that I need to make. The first is that if you think a student might have ADD you have to ask about this pattern. The student won't think to mention it, because he doesn't correlate it with a problem. But if you do ask, you will often get a positive response. More than that, you will get an appreciative look, as the student feels that someone understands something about their problem. Remember, if you don't ask, the person doesn't think to tell you.

The second point is directed at the cause of the problem. I don't believe that "I thought I did well" is due to bad luck or inadequate studying, but more probably the sign of distractibility in ADD (or some type of learning disability). This means that the student needs to be questioned more closely to see what the specific test-taking problem might be. Does he/she get distracted and need to rush? Could it be that the question is misinterpreted because of going too fast? Could it be that slow processing interferes with a good answer?

Bill has ADD and goes too fast. He thought he did well in a test but got a poor mark. As we analyzed one answer we found the question asked for a character who showed empathy. Reading too rapidly, he got the question wrong and wrote about the character who did not show empathy. He wrote an excellent answer to a non-existent question and did poorly.

Another cause of this kind of problem came from Rick. When I was talking about extended time he very proudly told me that he didn't need it because he always finished first. It didn't seem like he would give up this title easily.

In summary, the problem of "I thought I did well" can be a symptom of uncontrolled or perhaps undiagnosed ADD. Use it as a tool to help diagnose the problem. If found, the situation can be discussed in detail, and a solution worked out.


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