Tuesday, August 28, 2018

You Don’t Know Jack


guest blog by M. Jeffry Spahr, MBA, JD

For years we approached each new school year with renewed hopes and rejuvenated expectations. Certainly, we thought, this would be the year when everything clicked and our son Jack would take off like a rocket through the academic stratosphere. The trials and tribulations of the last year would be lost like so many discarded booster stages. Soon we would be in orbit and on autopilot, soaring ever onward.

Suddenly, our radio would crackle to life and we would faintly hear, “Houston, we have a problem.”

What brought us crashing back to earth was the harsh realization that getting the school team to know our son’s strengths and weaknesses had taken the entire previous year. Through emails and meetings, we’d had to educate them about our son and let them experience for themselves what did, and did not, work with him.

Each autumn we faced a new crew that we would have to educate all over again. I felt like Sisyphus of Greek mythology—the man who was fated to continuously roll an immense boulder uphill only to have it roll back down as he neared the top. When I went to orientation to meet my son’s new teachers, all I could think was, “You don’t know Jack.”

Here’s the problem, particularly if you deal with public schools: As your son or daughter progresses through the grades he or she will be taught by an ever-changing team of teachers. Just when one teacher seemed to understand your child and got the hang of teaching him or her, you moved on to a new teacher or team.

I also realized that just because a person was a teacher did not mean that they would understand the net effect of an executive function deficit or some other hindrance any more than I did. They might be the greatest math, science, or whatever teacher in the world, but they might still have the same blank look as I did when staring at a neuropsychological evaluation assessment report. I realized that where the rubber met the road it did not matter what a challenge was called—what mattered was how it impacted my son’s ability to learn.

So, I decided that I would draft a “you don’t know Jack” letter to be given to each of my son’s new teachers.

Contents of my teacher letter

My “you don’t know Jack” letter would contain a brief description of my son’s diagnoses (in layman’s terms as much as possible), so that the staff could understand what challenges my son was facing. I found this a very important step, because most teachers would never see any of the neuropsych reports or testing results with which we had become all too familiar. While the teachers might see his IEP and in which disability category he was classified, that would do nothing to let them know what to expect (or not expect) from him. Therefore, I concentrated on describing his challenges rather than providing a laundry list of labels.

Jack was diagnosed with ADHD combined type as well as autism spectrum disorder (ASD). He also had severe memory difficulties and significant executive function impairment. I did not feel it was satisfactory to just throw these words down on the paper. I wanted to bring to life what they meant to my son—and consequently what they should mean to his teachers.

For example, I explained the impact of his ADHD, and its interplay with his ASD and other diagnoses, as follows:
“The bottom line is that Jack is hampered by a number of competing disorders and disabilities, any one of which would be a severe impediment to learning. However, taken together, the whole package is much greater than the sum of its parts.”

As far as his ADHD goes, I broke it down like this:
“For example, his ADHD (combined type) alone makes it difficult for him to filter out stray incoming information and makes it difficult for him to attain focus and then retain it (the ‘inattentive’ portion of his ADHD). In addition, he is significantly hyperactive at times and this further interferes with his ability to stay focused (often feeling the need to ‘self-stim’) [the ‘hyperactive’ portion of his ADHD]. Finally, he is exceedingly impulsive—another major impediment to his ability to concentrate.”

After mentioning in the letter that my son’s working memory, short-term memory, and long-term memory were impaired—as was his ability to process, store, and retrieve information. I felt that it would be helpful to the teachers to understand what this might mean in a practical sense. Accordingly, I explained what they might expect as follows:
“Thus, even if he were attuned to a task, he would soon reach a point where he might forget the instructions or a passage in the text or lose his way along a math problem. This then runs full steam into this tenuous grip on his focus and jars it loose.”

Another challenging area for Jack was his writing skills. While many of his typical peers would draft flowing manuscripts of descriptive prose, my son would only be able to produce brief spurts of handwriting containing few words. Was he lazy? No, it was just difficult for him to write. It was very challenging for Jack to create the sentences and plan out the paragraphs in his head. So, I relayed this information on to the teachers as follows:
“In addition, his writing is so laborious that it takes down whatever chance he has of responding as others might. Because it is such a chore to write, he responds in only clipped and shortened responses. Full sentences are an exception. Punctuation is a foreign concept. In addition, due to the length of time it takes, his planned response that was present when he began answering the question is often missing by the end. His deficits in executive functioning make it difficult for him to plan out an answer and stick to it.”

Balancing with strengths

I also was sure to mix in all of Jack’s positive attributes, so that the teachers could play to his strengths. I told them that he had “boundless enthusiasm for things that interest him” and was “fascinated with all things involving technology, mechanical things, and novel things.” I suggested that he have wide access to assistive technologies. He was much more proficient at writing on an iPad or a laptop, for example, than when struggling to manipulate a pencil.

I also told them that Jack loved to contribute and to help out. He liked to be selected to be the one to perform some special task. I told them that when it came time to pass out paper or supplies, my son would benefit from being selected to do this. Not only would it increase his self-esteem, but it would get him out of his chair and moving—a boon to any student with ADHD. I also told them that if he was a bit too fidgety or losing his concentration, they could have him carry a note to the principal’s office and back. (He would not have to know that the note only said “hi” or that it was only intended to get him moving.)

And how did the teacher letter work out? Well, it still was (and continues to be) a challenge to teach Jack. After one team meeting, however, the lead teacher told me he found the Jack 101 handbook really helpful. He thanked me for putting it together and said that he often reread it. So, did the team “know Jack”? Well, maybe not every bit, but certainly a bit better.

M. Jeffry Spahr, MBA, JD, is an attorney in Norwalk, Connecticut, and the proud father of two children, one of whom has ADHD. He has been the driving force behind the Connecticut governor's annually declaring an ADHD Awareness Week in the state. Spahr is president of the Connecticut Association of Children and Adults with Learning Disabilities and founded the Association of Parents of Exceptional Children and Siblings to assist Connecticut parents in coping with the legal and academic challenges they face for their children. A former member of CHADD’s board of directors, he is a member of Attention’s editorial advisory board. The original version of this blog appeared as an article in the August 2018 issue of the magazine.

Monday, August 27, 2018

Pack It Light, Wear It Right: Backpack Awareness 2018

guest blog by Zara Harris, MS, OT

National School Backpack Awareness Day falls on Wednesday, September 26, 2018. Across the USA, backpack events will educate parents, students, educators, and school administrators about the serious health effects heavy backpacks worn improperly have on children.

More than 2,000 backpack-related injuries were treated in hospitals and clinics in 2007, according to the US Consumer Product Safety Commission. Countless students display stooped posture and complain of aching backs and shoulders and/or tingling arms. Too much weight improperly supported over time can cause long-term problems for developing spines. According to a Boston University study, approximately 85% of university students self-report discomfort and pain associated with backpack usage. Good habits need to be set during the earlier school years.

For those of us whose children have ADHD, more often than not we are more concerned that our kids remember their backpacks and have the right books in them than that they are carrying them correctly.

For students with organizational challenges, taking everything with them all the time seems like the best strategy. But the weight soon adds up. Using their lockers between classes to switch out books is often a step too far in time — and that locker has its own organizing challenges. So, what do we do?

Start out right

At the beginning of the school year, pick the best backpack for your student (see the guidelines below). If your student carries a laptop or tablet to school, consider getting a backpack with a special padded compartment that can be accessed from the outside without disturbing all those bits of paper. Buy a second (labeled) power cord that can either live at school or in a compartment in the backpack. Keep the other one permanently plugged in at home.

When possible, have a set of duplicate textbooks that lives 
at home. This both reduces the weight of the backpack and the frustration of not bringing home the right books. Label these books well so they do not creep back into school later in the year. When buying school supplies buy the jumbo packs. Keep a supply in the backpack, a set at home for homework, and keep the rest in a closet ready for when the first lot go missing.

Most students with ADHD struggle to use ring binders effectively and do better with an accordion file so that papers can just be dropped into the well-labeled pockets. Beware, though, that these fill fast. Beware also that if the accordion file is dropped, it is a paper disaster. Get a tabletop box of hanging files (with the same labels) and plan to transfer papers once a week from the accordion file to the box file.

After-school activities or subjects like music or sports that require special clothes or equipment on special days present extra challenges. Consider having a separate bag with those items that can either be carried separately or inserted into the backpack on those days. At one time I had a Monday bag, a Tuesday, bag, and so forth. It might be useful way of recycling last year’s backpack. 

Privacy issues

As students gets older, the contents of their backpacks become increasingly “personal.” Before school starts, make a plan to manage the organization at a regular time and give the student time to remove any “personal” items before you sort it together.

If you can, arrange for a regular locker check, too. This may be done with the help of the teacher or a better-organized student. Make sure that your student can use the padlock provided for the locker and can reach the hooks within. Invest in some locker shelves and organizers to help your student see belongings more easily.

The older the student, the more he responsible should be for his own belongings. Backpacks fall into the must-be-done category, however — think about those week-old sandwiches under the social studies book, to say nothing of that completed science project she forgot to hand in. A regular weekly backpack and locker check can be an essential tool for school success.


  • To fit the student, the bottom should rest in the curve of the lower back and NEVER more than four inches below the waistline (two inches for smaller kids).
  • Broad, well-padded shoulder straps and back of pack.
  • Adjustable straps to fit the pack to the child and to allow for growth during the year.
  • If possible, find one with waist and chest straps to secure the pack to the child’s body.
  • If a younger child has to carry many books, then consider a wheeled bag with a handle long enough that he or she can pull it without stooping.
  • If the student will carry a tablet or laptop, consider choosing a backpack with a special pocket that opens to the outside (handy for airports, too).
  • Label it well!


  • A full backpack should not weigh more than 10% (15% absolute maximum) of the child’s body weight.
  • Load the heaviest items closest to the child’s back.  
  • Arrange books and materials so that they don’t slide around in the backpack.
  • If the backpack is too heavy, consider having the child hand carry a book or lunch box. It can be useful to have one that clips to the backpack for storage in school.


  • Distribute weight evenly by using BOTH straps. Wearing a pack slung over one shoulder can cause a child to lean to one side, curving the spine and causing pain or discomfort.
  • Wear the waist belt and chest strap if the pack has them. This helps distribute the weight more evenly.
  • Adjust the shoulder straps so that the pack fits snugly on the child’s back. The bottom of the pack should rest in the curve of the lower back and not below the waist. A pack that hangs loosely can pull the child backward and strain muscles.


To ease those dreadful morning scrambles, load the backpack the night before and place it by the door.

More information is available in the Backpack Awareness section of the American Occupational Therapy Association website.

With over thirty years of experience as a pediatric occupational therapist, Zara Harris, MS, OT, is licensed in both the United States and the United Kingdom. Specializing in helping students who are struggling with handwriting, homework, attention, time management, and organization, Harris has worked with international schools on three different continents. She is deputy co-chair of the editorial advisory board for Attention magazine.