While Specialized uses road cycling, Mendlewski sees unique advantages in adding mountainous terrain to the equation. "When kids are mountain biking, they need to use a lot of focus and attention because there's a lot going on," he says. "If they're riding on a trail at a moderate pace and all of a sudden there's a turn ahead, they're going to need to put all of that together in their mind and prepare for that turn. I teach kids that when you're mountain biking you're focusing on the horizon in front of you. You need to see everything because you need to know what's coming up next."
Letting the Best of the Kid Shine Through
ADHD and ADD are often difficult diagnoses to make, and parents may realize that something is up with their child for years before arriving at a clinical definition. "I'm conservative about [making a diagnosis like this], because psychological problems with kids are often expressed in overlapping ways," says Sandra Regis, a psychologist who, with her husband Mark Guido, has a private practice in Goshen and also works with kids at the Storm King School. "Hyperactive behaviors that appear to be ADHD might really be an expression of anxiety or other emotional issues. You can also have ADHD overlapping with a conduct disorder or learning disorder." That's why it's important to get a thorough evaluation, Regis advises—whether it's through a private psychiatrist or a school psychologist who, unbeknownst to the child, can visit the classroom to observe him or her in action and also meet with the child individually, using a rating scale to determine a diagnosis.
Yet it is tricky terrain to medicalize a kid's personality type, putting a clinical label on something as intangible as a child's spirit. "Any provider in mental health services has to have that sitting on his or her shoulder," says Regis. "How much of something is a disorder, and how much is just an expression of who they are?" Of course, a diagnosis is useful—even, some might argue, essential—if certain behaviors prevent a child from realizing their full potential and succeeding in school and in life. Some children will have social problems because a hallmark of ADHD is impulsivity, and social problems can lead to low self-esteem. A diagnosis can open up a world of options for treatment and support; often, a pharmaceutical solution is part of the equation.
Take the case of one 16-year-old boy, Alex Gold from Red Hook. Gold (not his real name) started Adderall about three months ago after his parents suspected for years that ADD might be an issue that was holding him back. "He was always a little rambunctious," says his father, "a little bit mischievous, not paying attention and sometimes disrupting class. He's smart, so he picks things up quickly, but as he grew older we found that he had difficulty retaining interest in any particular thing. He might be athletically gifted, good in one particular sport, but he'd lose interest and move on to the next thing."
Over the years, Gold's doctors brushed aside his parents' concerns and said he was fine. Yet when things worsened, the boy wasn't focusing on academics, his attitude soured, and he was rude and disrespectful a lot of the time. "That was not the kind of a person we believed he really was," says his dad. "So we took him for testing, and now the doctors say they could have missed something; there is probably some ADD here after all." Once Gold started on Adderall, the change was dramatic. "His focus has increased, he does better in school, and the attitude and rudeness have largely gone away. It's allowing the best of the kid to come through."
Road Map for a Challenging Course
Putting a kid on medication isn't easy for parents, who often worry about the child's developing brain or their chances of instigating a substance abuse problem. "I don't know if there is any clear evidence that this is true, but pharmaceuticals permeate our culture and it's a legitimate concern," says Regis. Gold's parents are looking into switching him from Adderall to a newer drug called Vyvanse, which is metabolized in the stomach and not as habit-forming. Side effects are a concern as well; Adderall can in some cases cause stomach pain, loss of appetite, weight loss, a faster heart rate, and sleep problems. And some people complain that ADHD/ADD drugs have the effect of flattening or muting their personality, particularly with long-term use.
