The Story of Rapido: A Case of ADHD? by Dr. Renée Fuller

The authoritative voice on the other end of the telephone line expressed pleased surprise, and then asked: “He did some work for you?”

“Yes!” was my answer. “He built an addition to my house. No one else thought what I wanted could be done. But Mr. Nelson, contrary to all the other contractors, immediately understood; and in a remarkably short time he did it!” Then I repeated my previous pronouncement, which had produced pleased surprise from the authoritative voice; “You are indeed lucky to have such a job applicant.”

Rapido (that was my nickname for Mr. Nelson) was successful in getting the desired job. Some years later I met the person behind the authoritative voice who had called me about Rapido’s job application. He too remembered my assessment, now years later. “You were so right. We are indeed lucky to have Mr. Nelson. He’s the best. Mr. Nelson is the best.”

Nowadays most of our school systems would not have considered a young budding Mr. Nelson as “the best.” Nor would they have regarded themselves “lucky” to have him as their student. Why? Because Rapido, even now in his mid-forties, can’t or won’t sit still. He is continually on the move. Even his reading is at top speed, as is his comprehension of whatever he is reading, and the rapidity of his scrawled printing. As a youngster Rapido solved his school boredom and tension by choosing a “work-study” program: something that had been possible more than 30 years ago by what was then, as it is now, considered one of the best public schools in the country.

Rapido’s choice of a work-study program had a serious drawback. It meant that the presumed excellent school never noticed that here was a youngster with superior intelligence and aptitudes, which if properly nurtured would have allowed him to enter and bloom at one of the top engineering universities. However, more than 30 years ago the school system of this particular upscale, class-conscious and snobbish community automatically assumed that a top engineering university would be an inappropriate choice for the offspring of a blue-collar family. And so the school system considered a work-study program the appropriate and sensible choice for such a youngster.

And nowadays? How would the same school system treat a Rapido in our present 21st century? Today’s Master’s level homeroom teachers in Rapido’s superior public school would have been taught the latest in diagnostic categorizations. In all likelihood a child like Rapido, who doesn’t sit still, has a continual need to move, never concentrates on one aspect of a lesson for more than a few minutes, would, within the first few school days have been “diagnosed’” by his homeroom teacher as ADHD. The youngster would then have been sent to the school psychologist, who as expected, would verify the diagnosis of attention deficit-hyperactivity disorder. This would lead to the suggestion, if not the demand, that the youngster be put on Ritalin or a similar drug. The local doctor would usually comply and write out the prescription.

And what would happen then?
Ritalin and its various sibling and cousin drugs are by now well known in the scientific community for their paradoxical and highly individual effects. Contrary to the expected energy lift that amphetamine drugs usually give to most adults, they frequently have the opposite, a presumed “calming” effect, on many children. Hence the reason they are prescribed for the ADHD diagnosed children – aside of course that these prescriptions have produced billions in dollar revenues for the bottom line of some drug companies. However, there can be additional as well as unanticipated features to the simple childhood-paradoxical effects to the amphetamines: unexpected aspects for which I can personally vouch.

During my college career amphetamines were extensively used while cramming for exams and finishing term papers. At that time they were readily and easily available without prescription. Hearing the hype about these new wonder drugs I naturally anticipated to also experience the hyped results. But that’s not what happened. Instead I found out that I am one of the presumed few adults on whom the amphetamines have a paradoxical-childhood effect. The fatigue that followed my taking of any of the amphetamines was overwhelming. Now I had no choice but to sit still. If I had been forced to continue any of these drugs I would, like a number of ADHD children so prescribed have lost my slim figure and become fat from lack of movement and activity. Here is another example of a paradoxical aspect to the amphetamines, which have at times been prescribed for weight reduction for obese adults.

Was I an ADHD child? In retrospect the answer would probably have to be “yes.” But at the time of my childhood the diagnosis of ADHD was reserved for obviously brain-damaged cases who had to be institutionalized. Instead of the negative label of ADHD that would have followed me most of my life my amused teachers thought of me as an especially active, engaged child. It helped that our classes were small, that the teachers did not have Master’s degree that included diagnosing various presumed pathological conditions, and that I was a very polite little girl rather than a rude little boy. My mother considered good manners an essential life skill. Consequently I was taught that when an adult in authority spoke to me I must stop running around, smile at them and curtsy: and of course listen to what the adult had to say. Such was the training of a child many years ago by some ex-European parents. Would the correspondingly similar but of course up-to-date behavior on the part of a child be as effective in today’s classroom? Or would today’s teachers and administrators consider themselves irresponsible for missing the obvious pathology of ADHD in this particular child? The last would in all probably be the case.
As for getting fat from the lack of activity and movement after a regimen of Ritalin and similar drugs, that may or may not always happen. The present diagnosis of ADHD represents such a mixed group of behaviors and presumable neurological-genetic underpinnings that divergent reactions are, and should be expected.
Esther, our local chief librarian will, with considerable distress tell you about the loss of energy and burgeoning obesity that ensued after her star junior librarian, Mike, was prescribed Ritalin. Prior to the medication the youngster had been working after school at the library from the time he was ten. “He was just wonderful! In no time he’d take all the returned books and place them back in their slots on the shelf where they belonged. He got so good that by the time he was thirteen he was able to figure out ahead of time which new books should go on display. He even found the appropriate book reviews that should go along with them. All that was before the school diagnosed him as ADHD and insisted that our local doctor prescribe Ritalin for him.”
“Within a couple of weeks of being on Ritalin Mike was a totally changed person. He just didn’t have the energy to work at the library any more and so he had to leave us. When I saw him in the street many months later I didn’t recognize him at first. His face was all droopy. And he had gotten fat! He moved s l o w l y. He was a totally different person. He even talked real slow – not the fast exuberant speech that used to be Mike. You know what?!: That school destroyed our bouncy and hard-working Mike whom we all loved!”
Not every child has Mike’s or my response to Ritalin. A recent study claimed that ADHD children who have been prescribed Ritalin had somewhat higher follow-up scores in reading and math than ADHD children who had not been prescribed the drug. However, the two groups had not been matched statistically. So far there don’t seem to be any careful statistical matches and follow-ups as to what really happens to the youngsters who have been prescribed these drugs.
Are there other youngsters like Ernie Belinski whose highly indignant mother told me that her son only pretended to take the drug? To her surprise and indignation she found that the reason her son immediately went to the bathroom after carefully placing the pill in his mouth was in order to spit it out and send it down the toilet. After repeatedly questioning him he growled: “That stuff’s poison. It makes you sick.” So Ernie instead of arguing with his mother or the school authorities sent the Ritalin down the sewage system. Ernie’s mother was in a tizzy until her husband somewhat disgustedly said, “Leave the kid alone. He’s fine just the way he is.” That was the end of it because Mrs. Belinski never bothered to tell the school that the “much improved” Ernie was not on Ritalin.
Nor did the school realize that the reason for Ernie being ”much improved” was because of their new science teacher, Mr. Malcolm. The school had hired Mr. Malcolm despite his having neither a degree nor even a course in education. What with a shortage of science teacher applicants, there had been no other candidate for the position.
Lacking a background that courses in education would have given him, it had never occurred to Mr. Malcolm to look over the school records and thereby discover the potential pathological diagnoses of some of his students. So when Ernie jumped up and down with excitement when Mr. Malcolm described new experimental findings in physics, chemistry or biology, and kept interrupting the new teacher, the new teacher took no offense. Instead he interpreted Ernie’s response as excitement about the implications of the experimental findings. Since he shared Ernie’s enthusiasm about various aspects of science it was not long before Ernie became Mr. Malcolm’s unpaid teaching assistant. Meanwhile the school authorities attributed Ernie’s continued behavioral improvements to Ritalin. How were they to know that the prescribed drug was now sitting lonely and unwanted in a bathroom cabinet of the Belinski household?

Can ADHD be for real? The only for-real case that I have personally met and dealt with was Melissa. She had been institutionalized with severe brain damage from the time she was three. At that time Melissa’s institution was considered one of the best in the country, which explains why she was not locked away but extensively played with. At age six she was enrolled in the institution’s superior school. No regular public school would have been able to handle Melissa’s constant need to move, or her inability to pay attention for more than a fraction of a minute. Despite her severe cognitive deficits, the encouraging treatment of the school meant that Melissa developed a commendable degree of language skills. However, because of her inability to sit still for more than a fraction of a minute the school’s persistent attempts to teach Melissa academic skills such as simple arithmetic or reading met, as was to be expected, with failure.
But academic failure is not what happened when the staff of my psychology department were the teachers. Did the staff try to enforce a “sit still” requirement on Melissa? Nothing of the sort. Then how come that, surprise, surprise, they were able to teach Melissa to read and relish the stories she was reading? And how could they accomplish this when Melissa, thoroughly disgusted after more than ten years of attempted reading instruction, was still unable to recognize any of the alphabet letters: despite the steadfast efforts of the dedicated teachers in the superior institutional school? What was so different in the teaching approach of the staff of the psychology department that made it possible for them to produce a genuine intellectual breakthrough for Melissa?

It was primarily the stories. In the Ball-Stick-Bird reading system a hilarious science fiction story already begins in the first lesson. This is achieved by introducing four alphabet letters with which simple short sentences are built that begin the adventures of Vad of Mars who has rockets for feet. In subsequent lessons more alphabet letters are introduced and the sentences and vocabulary become more elaborate as the story becomes progressively more involved.

To my complete surprise, for I had not expected that story cohesion and genuine story fascination would be cognitively possible for severely brain-damaged humans, Melissa thoroughly enjoyed the stories. But even more astonishing was that she had little difficulty learning how the words that tell the story are built with alphabet letters – alphabet letters that she had previously failed to recognize and therefore learn after more than ten years of schooling. How could that be? The answer: Even a damaged human brain finds learning to read within its reach when the usual meaningless drills of alphabet letters are avoided and instead, as the alphabet letters are gradually introduced meaningful words are built which tell an exciting story.

Did Melissa sit still to accomplish this truly unexpected intellectual feat for someone with such severe brain damage? Nothing of the sort. While Melissa was moving around the room at a rapid clip her unconcerned teachers would leave the book open on Melissa’s side of the desk. After Melissa finished reading the fast-moving continuing story on each page the teacher would then turn the page for her. As I watched the reading sessions through the one-way mirror it seemed as though Melissa was at times all but jumping up to the ceiling and reading the book upside-down. Back on the ground she would occasionally give the book and its illustrations a fleeting but concentrated look while laughingly reading aloud the continuing story.

Previous to Melissa and our several dozen other severely brain-damaged students I had had no real comprehension as to how stories function as essential creators of meaning for our human brain. These students demonstrated the powerful role that stories have for all of us, even the majority of the severely brain-damaged. The function of stories is that they structure the world for us. In order to make sense out of what is happening we give it story cohesion. Curiously, even the least of us with a little bit of encouragement will indulge in cognitive story play. Which is why story building and organization, being basic to how our brains function, holds such a fundamental fascination for all of us. And here comes an important note: the need and fascination of story organization overrides either the imagined or very real diagnostic categorization that has been labeled ADHD.

Can interesting stories function as an alternative to Ritalin? Does being engrossed in an exciting story explain why some parents keep insisting that at home their youngster shows no signs of attention deficit or even hyperactivity? Is that because at home, rather than a boring sit-still school-drill routine, the conversation and educational narratives involve the child in interesting stories?

As for people like Rapido or myself, will we stop moving around when we hear or are involved in an interesting story? Sort of. However, we’re the people whose legs keep swinging and changing position. We bend our hands and crack our knuckles. Those of you who are sit-still-wonders are familiar with our type. We’re the ones to whom some teachers have repeatedly said, “Will you just sit still!” But of course we never do, or for that matter are able to. However, that doesn’t mean that our brains aren’t just as active as our hands and feet. On the contrary: our thinking tends to be as active as our hands and feet, moving from one subject to the next and to the implications of an exciting story. It is no accident that many of our most creative minds would nowadays be labeled ADHD. And most important, being social animals it is our very differences, our variability, that have allowed us humans to be productive as well as creative in innumerable and wonderfully different ways.

About the author:

Dr. Fuller received her M.A. in experimental psychology from Columbia University, and her Ph.D. in 1963 in physiological psychology from New York University.

In addition to developing the Ball-Stick-Bird reading system, and the story-as-the-engram theory of cognitive organization, Dr. Fuller has published widely in the field of clinical physiological psychology. At present she is continuing her work in developing learning programs and writing books and articles about how children learn. For more articles and information, please visit her web site:
http://www.ballstickbird.com