> "Every should must come reinforced by a want."
> Unfortunately their therapy only works in prepubescent children. (...) but nobody is ready emotionally to predict how they will change after puberty hits.
Here is my understanding of the issue with the therapy based on my experience with it.
They have created a therapeutic environment with so many rules and demands that the child encounters a constant stream of shoulds. They also implement a carefully thought out set of rewards that gives constant positive feedback for those who are succeeding.
But that positive feedback loop only gets started after the child is succeeding. And therefore it is essential that children enter the program with an overwhelming desire to succeed, and in a state where every one of those shoulds will connect to that overwhelming desire. They have a carefully optimized intake process that creates this initial state. That results in a child who is absolutely emotionally committed to a two year very difficult program.
The problem that I see with people who are older is that once we enter puberty, we become more resistant to receiving constant demands from adults. This undermines that initial commitment. It also undermines the positive feedback loop that is essential to maintaining the commitment into the second year.
Even if I am wrong about why it happens, the program told me that they have an age cutoff because the therapy program doesn't work after kids hit puberty. It isn't just an abstract theory. They tried it, and concluded that it doesn't work.
> The problem that I see with people who are older is that once we enter puberty, we become more resistant to receiving constant demands from adults.
The key to it is this. These kids absolutely HATE the experience of lacking executive control, in a classroom. Teachers have no idea how often they launch verbal attacks, but it is sheer misery for the kids.
Then they encounter this program. The program sits them down. Explains how it works. Lets them poke around. Talk to the kids in the program. Verify that it really works. And lets them know every rule, and every reward.
Then the program tells them, "You can't come unless you have completely internalized it. Every time you fail, you must remember how badly you wanted to succeed. We can't give you a second chance. If you have any doubt, prepare yourself longer."
Separately we parents are told, "This has to be your child's choice. You cannot try to convince them in any way. If you try, we will know and your child will fail. If your child asks questions, answer them honestly. If your child says that they are ready, ask them if they are SURE. If they say yes, then they can come. Not until."
And now the kids are caught. They absolutely know the tiger that they want to escape. It is their daily life. They absolutely know that there is an escape. They know how it works. They know that it works. And they know that it won't work if they have any doubt. Every last rule. Every time they hear it. They must WANT it. For 2 years.
It took my son about a month and half to declare himself ready. The first few months were misery for him. But I'd never seen anyone so determined to succeed. And succeed he did.
Pretty impressive that they can get these kids to this level of awareness, making it feel like it is their own choice. When I look back at my childhood, I can't remember I had any agency like that, nor awareness that you could have one.
I haven't heard that before...I need time to ponder and process that, but on the surface it sounds like gold!
The parents and town I grew up with were extremely religious and authoritarian. I grew up hearing how our personal desires should be ignored and suppressed, and only the will of God and authority figures matters. I think neurotypical people may be more able to function with such a mindset, but it's a losing battle for ADHD brains to try to force themselves too far from their natural wants/interests. Especially since lack of emotional regulation is a significant(but less discussed) difference for ADHD, focusing first on emotions and reorienting wants before focusing on getting the task at hand done might make a lot of sense for us.
It is also worth noting that I have encountered an effective therapy for ADHD, which also works miracles for many with autism. It is available at https://thecraigschool.org/. Unfortunately their therapy only works in prepubescent children. That's because it requires the child to make a strong 2 year emotional commitment, but nobody is ready emotionally to predict how they will change after puberty hits.
Still the fundamental principle of the therapy is generally applicable and interesting. It is to condition to child to the idea that, "Every should must come reinforced by a want." This emotional reinforcement results in getting the most possible out of their executive control. With the result that the child becomes able to task switch away from, then back to, hyperfocus.
It is worth anecdotally noting that I've known a couple of people without ADHD who conditioned themselves to the same idea. They reported that they have both the ability to engage with hyperfocus, and to task switch in and out of that state. If we as a society focused on instilling "shoulds" with mostly positive reinforcement, this would be more common. So what brings people with ADHD and autism up to normal executive control, could bring normal people up to superior executive control.
If I was starting over as a parent (not that I want to, I'm done with that part of life!), I would definitely use this idea to inform my parenting.