Sophie's Last Chance
Her problem: ADHD (attention deficit hyperactivity disorder), a neurobiological condition shared, in various forms, by roughly 2 of every 25 children and characterized by an inability to control attention and emotions. Sophie was diagnosed at 4, and none of the ADHD medications have helped. "Where most kids will cry when frustrated or disappointed, children like Sophie have a complete meltdown," explains NYU psychologist Dr. Karen Fleiss.
Desperate for change, Sophie's mother, Phyllis, 56, a special-education teacher, enrolled her in an eight-week summer day camp run by Dr. Fleiss for kids with ADHD. One of the first of its kind, the camp offers the staples of sports and crafts but features a system of points awarded for good behavior and taken away for bad. Campers who meet their weekly point goals earn a Friday field trip. "It motivates them to choose the right behavior," says Dr. Fleiss. "It gives them structure." Sophie's mom, who adopted her a year before she was diagnosed, just hopes she is up to the challenge. "She can be so generous, kind, trusting, cute," says Phyllis, who paid the $8,900 camp fees with scholarships. "I don't want all of her good to get lost in the negative."
"Mommy, I'm going swimming today!" says Sophie before breaking into song—one all her own—with a chorus of "Here we come, Sum-mer Pro-gram! Here we come!" Phyllis steers their car onto a college campus in the Bronx, where campers have gathered on the lawn. "I want to go on the field trip!" shouts Sophie. "Then you will have to do what people say," Phyllis reminds her. But Sophie has already run off to find the Green Ultra Dragons, her team among the 53 other children at the NYU Summer Program for Kids. Camp has officially begun.
Sophie listens as the counselors repeat that violations like "whining" and "teasing" lead to points lost and, if the misconduct is serious, time-out sessions away from the group. By afternoon she commits her first major violation: She grabs a camper's shoulders during a softball game and hurls him to the ground. The slip-up costs her 50 points and a 10-minute time-out. "It is safe to assume something like this could happen again," says lead counselor Lindsay Sherrin, 23.
At the Hoffmans' apartment, Sophie wakes, climbs into bed with her mom and cuddles. Minutes later, when Phyllis says it's time to get up, Sophie obeys. What seems like a quiet moment is a milestone: Sophie followed orders without punching, kicking or screaming. "I could cry when she does something great," says Phyllis, "no matter how small that great thing is."
Every day counselors pass out handmade stickers rewarding the group's "great team player" or "softball slugger." Sophie has earned two stickers, but she covets the gold paper crown worn by "honor roll" campers. "That's an extra special thing," she says. At home Sophie pretends she's still at camp. She rewrites her report card, cuts crowns out of construction paper and names herself star student. But it's only make-believe, says her mom: "She never wins the big awards. I have no idea what it's doing to her, to have lofty goals but always falling short."
A major meltdown. For this week's field trip, the Ultra Dragons go bowling, and while Sophie didn't earn enough points to attend, the counselors invite her along anyway in hopes of motivating her. But before the fun begins, Sophie starts fighting. "I'm older!" she screams, nose to nose with a girl named Katherine. Sophie, who is younger than Katherine, can't seem to stand it. "Why are you saying you're older than me?" she angrily demands, feet stomping, cheeks aflame. Her tantrum lasts six minutes. Katherine earns points for not responding, and the counselors look away, ignoring Sophie's screams and tears. "We don't want to give extra attention to inappropriate behavior," says Eloise Gale, 20. When the outing ends, Sophie's behavior accounts for about half of the Ultra Dragons' 82 violations. At home Phyllis is becoming discouraged.
Lately Sophie has been throwing tantrums on the bus, prompting a counselor to hold down her arms and legs. But today's ride ends without incident. "I'm so proud of you. That is very great," Phyllis cheers when the counselor shares the good news. Minutes later Sophie is standing in a convenience store, clutching a stuffed black lab—her reward for good bus behavior. "Her name is Blackie," she says. "Next time I'll get the kitty." Phyllis takes her child's hand and smiles.
"Sophie is in such a good mood. She is a completely different person," says counselor Sherrin, noting that Sophie has been sent to time-out just once in the past two days. The good behavior pays off: Sophie finally earns honor roll. "It was such a big deal," says Sherrin. "When she accepted the award, she had this huge smile on her face." Sophie happily wears her gold crown the entire day.
At home Sophie bounces between good and bad days. After practicing violin nicely this evening, she calls Phyllis dumb and pushes her. "That's name-calling/teasing," Phyllis reminds her, using camp language. Sophie explodes. She knocks over a TV and hurls a handful of pencils across the apartment. "Her life is like a big punishment," Phyllis says later, struggling to understand her child.
The last day of camp. Sophie beams at the closing ceremony and collects two certificates and a trophy for "great effort." A boy hugs her and she hugs back. "We'll be friends forever," she says, and they exchange a high-five. Dr. Fleiss discusses Sophie's progress. "It won't necessarily be smooth sailing, but it's like this little window has been cracked, and inside is a child who wants people to like her. Sophie sees a part of herself that was hidden before." Says her mom: "I do have hope for Sophie. She is calmer, and I see her trying to correct herself, at least some of the time." Phyllis hopes her daughter can return to camp next summer. For now, she notes, a camp family has asked to arrange a play date with Sophie. "That," Phyllis says, "is an improvement."