Kids Awareness Series

Archive for the ‘ADHD’ Category

The number one thing I hear from children and adults with ADHD in counseling is-”I can’t get along with others at home or work” or “I can’t seem to keep friends.”  As a result of the impulsivity, distractibility, and hyperactivity that accompanies ADHD (not necessarily all at the same time folks), individuals with ADHD often have difficulty maintaining relationships.  Many children with ADHD are teased because they appear to be different especially when they are hyperactive and seem to be “all over the place” as one parent recently told me.  Children and adults with ADHD often are in arguments with those around them as a result of the impulsivity.  Our words often get us in trouble and when you do not think before you say something, problems usually ensue.  Children with ADHD often have difficulty waiting their turn and this is not popular with other children and causes problems in keeping friends.  In addition, ADHD children and adults are sensitive to noises and to being touched and this will often cause social isolation in an ADHD’r trying to isolate themselves from others in order to cope.  Also, in children and in adults they often have low self-esteem as a result of the problems that ADHD can cause in their relationships.  When you do not feel good about yourself you certainly do not want to be around other people alot of the time and you isolate yourself.  These are only some of the issues that are encountered in psychotherapy with ADHD children and adults and through effective medical and psychological treatment, these issues that affect relationships can be overcome.

For ADHD children in school, this seems to be an enormous problem and for parents it is often the biggest problem when they bring their children in for treatment.  Often, I will hear a parent say, “Lord, you should see their agenda!”  “Their backpack is just a mess of papers and they don’t even write their homework assignments down.”  As a parent, you have likely said something similar about your ADHD child or teenager.   If your child is completely disorganized, they are likely not doing well in school as the level of disorganization does not help keep them focused or improve attention.  It is just one more thing to distract them.  Here are some helpful hints on how to get some organization back into your child’s life.  These will also work for ADHD adults by the way!!

Have a clear set of goals of what you want to accomplish for the day, week, month and write it down in one central location.  An agenda for children is where everything needs to be written. Do not use post-it notes, they seem to get lost when you have hundreds of them in your room or around the house.

Figure out what you feel is your priority on your “to do list” and start with that one thing.  Do NOT start something else until you have finished the first task.  This goes for children trying to complete their homework and for adults trying to finish tasks at work or around the house. 

When you have time to yourself, use your time wisely.  The old saying, “work smarter, not harder” applies here.  Be productive.  If you are doing something currently and it seems to you that it is a waste of time with very little results, then change your priorities. 

Write down how long in a folder or agenda, how long you think a particular task should take.  If a task takes too long, with very little positive results, then rethink what you are doing.

Get organized.  For homework or any type of work to be organized, you first have to think about how to get it organized.  What I mean here is, look at your room or wherever you decide to work and if it is not organized, it will be really hard for you to focus on what you are supposed to be doing. 

Write down ideas in a notebook or agenda and always keep your “to do” list with you.  ADHD kids and adults often have a hard time concentrating during tasks and it will be difficult to remember what you have done and not done if you have not written it down and then checked it off when it is completed.  (You know who you are!!)

Lastly, make deadlines for yourself.  Do not say, “I will get it done”, and not put a time line on it.  Procrastination always has to be fought here.

Part 2

After I sat down at my desk, the teacher asked us to get our math books, which unfortunately I had left at home with the rest of my stuff.  So I just sat there for a few minutes until I got bored and I started talking to two girls in front of me while they were doing their math work.  Would you believe that my teacher yelled at me again for talking and she told me I was disrupting the class!!  I just can’t say anything without getting into trouble!!

I got into trouble again after lunch, because I raised my hand to go to the bathroom.  I really just wanted to get up and walk around.  I was sick of sitting in that desk.  Would you know it, my teacher yelled at me again when I started talking to the kid next to me when she was up in front of the class by the chalkboard talking to everyone about our homework assignments for tomorrow. 

When school was over for the day, I pushed the girl in front of me and my teacher started yelling at me again.  I think that the teacher just loves to yell at only me!!  She told me I can’t seem to keep my hands to myself.  I know when I get hom from school Mom will ask me what happened at school and I will tell her “nothing”.  No one seems to understand me.  I don’t get why everyone is always screaming at me. 

Understanding what your child goes through on a daily basis goes a long way with being patient with them.  They are also struggling each day to pay attention and remember that they are not doing this on purpose!!  Try to put yourself in their shoes and see what they go through in a day.  This story was adapted from a child I see in therapy as he related his day at school to me in session!!

Part 1

Hi!!  My name is Tommy and I am 10 years old!  My mom and dad told me a few weeks ago that I have ADHD.  Whatever that means!!  All I know is that I am in trouble all the time and everybody I know is always yelling at me.  It is not my fault that I am in trouble all the time.  I don’t understand why they are always so mad at me anyway.  My teacher really seems to be mad at me almost every single day.  I don’t think I am all that bad.  Let me tell you about what happened yesterday and you will see what I mean. 

My day started with my mom screaming at me to get out of bed.  So what if I didn’t get up until 7:30 and the bus leaves at 7:40.  She came into my room like four times to get me out of bed and then finally starts screaming at me.  I had to eat breakfast on the bus, because I didn’t have time for my mom to make me breakfast, which really seemed to upset her.  I realized half way to the school that I had forgotten my backpack!!  That means I also wasn’t going to be able to turn in my homework again.  I just don’t get why mom got so mad about that.  Really, I should be the one who is mad because I am failing in a few of my classes.  Gee!!  

When I got to class, my teacher asked for us to turn in our homework and my teacher got really sore with me when I told her that I left my backpack at home.  Her face even turned red when I told her, “it is no big deal, I will just give it to you tomorrow.”  What difference does it make when I turn in my homework.  She asked me to sit down and I walked by Lucas, my friend, in class and thumped him on the head like I always do and she got even madder at me and yelled, “keep your hands to yourself already.” 

MORE ON TOMMY TOMORROW!!

Be consistent in disciplining your child.  If you reward or punish your child use the same reward or punishment every time!!  Parents become so frustrated with their child’s behavior that they punish a behavior and because their child becomes angry or throws a temper tantrum they “cave in” and let them have their way.  What I often hear is that a parent gets tired of saying the same thing over and over and “gives up” and lets the child have their way.  (For example, your child refuses to do their homework and you tell them if they finish their homework they can watch their favorite television program when they are done.  Halfway through completing their homework, your child throws a temper tantrum and tells you they are not going to do it.  You as the parent let them watch television because you are tired of fighting with them and you try to get them to finish their homework later.  However, what you have done here is reward noncompliance with your rules and you have just undermined yourself.  You as the parent are going to have to go through this all over again when you try to get them to finish their homework later).

When you are trying to teach a new behavior, it is the most effective if you reward the behavior every single time it occurs.  The reward should occur IMMEDIATELY after it happens and if you are implementing a behavior change program it should be utilized for at least two weeks before you call it quits and decide what you are doing is not working.  Lastly, repeating yourself and repeating yourself and repeating yourself will not work with the ADHD child for sure.  Talking and telling them about their negative behavior certainly is NOT going to change it.  We need action here!!  Consequences have to be used to change a negative behavior in your child.  If you tell them that you are going to do something for a bad behavior make sure you do it and do it every single time.  Don’t try to reason with your child, you are the parent and rules need to be followed.  At the end of the day, your child is your greatest gift and you as a parent want to produce the best possible child so they have all the tools to become a successful adult.

Above all else, never blame yourself and think that you are a BAD parent.  I here this all the time as a therapist!!  You are doing your best and there is no such thing as a perfect parent or a perfect person.  Never give up!!

Children with ADHD have difficulty staying on task and they usually live for the moment and often do not see future consequences for behavior.  On tasks which they perceive as boring (often homework) you have to provide immediate feedback that they are doing a good job.  Positive feedback can be given a number of ways, but it is most often given as praise or as a compliment.  Often it can be given as a reward such as increased privileges or special treats or snacks.  Be sure to be specific when you tell your child the behavior that they did that was positive.  When you are trying to CHANGE a negative behavior, make sure you provide a quick reward and feedback for behavior that is done correctly and have quick negative consequences for acting inappropriately.

A mistake that is often made in parenting a child with ADHD that is displaying noncompliant behaviors is that we as parents forget to praise positive behaviors and we focus on the behaviors that are negative that we want to change.  ADHD children require feedback and consequences that are VERY frequent.  We as parents often get caught up in our own work and household chores that we forget to praise our children when they are behaving themselves at home.  What I often tell parents is to put post-it notes in conspicuous places in their house reminding them to praise their child often.  There is no better way to change a negative behavior then by providing frequent and consistent praise.  Positive behaviors should be rewarded more often than punishing negative behaviors.  DO NOT punish your child for everything they are doing wrong, this will not motivate your child to do well.  The positive’s have to outweigh the negative’s in order to change behavior.

ADHD children like children who do not have ADHD do not always do what they are told. No child behaves perfectly all the time every single day, however a child with ADHD seems to be at a greater risk of noncompliant behaviors that will anger, infuriate or disappoint their parents.  By very definition, children with ADHD have difficulty with self-control and do not organize well, have problems controlling their behaviors and predicting that there are consequences for their behaviors.  Russell Barkley, a psychologist and leading expert on ADHD says it well when he advises parents of some simple instructions in dealing and correcting behavioral problems.  (1) It is much more effective to give clear instructions (2) rearrange work so that it is more interesting and motivating for them (3) redirect the child’s behavior towards future goals versus immediate gratification and (4) provide immediate rewards for a completed task or adherence to rules.

As a therapist, what I frequently find when a parent brings their child in for counseling, is that the parent is angry; frustrated and seems to have lost perspective of what the problem actually is.  Parents when they are angry or frustrated end up yelling at their child and this usually will provide a reverse effect in your child (they become even more noncompliant and end up tuning you out).  Try to keep things in perspective and remember that your child has a disability and never argue with your child when they are not listening to you.  Here are some simple rules to follow when parenting your ADHD child.  By no means is this list conclusive in nature and a health care professional may be of instance in developing a behavioral management plan with you and provide feedback on it’s effectiveness.

Part 1 of the list will follow.

What to say-Don’ts
•    Don’t tell them they need to learn more about what ADHD is.  That is the job of the parents and teachers that work with your child
•    Don’t tell your child that ADHD is who they are.  ADHD is only PART of who you are, it does NOT define who they are as a person or who they will become as an adult
•    Do NOT say that they have a disorder.
•    If your child is being placed on medications, don’t make this a big deal for them.  Some kids are embarrassed that they will have to take medications and often even more embarrassed if their friends find out about it.

•    ADHD is not a PROBLEM, it is a challenge in life that can be tackled like any other problem
•    Don’t get technical with them.  If a health care professional has explained to you what ADHD is, reword it into language they can understand, but emphasize that this has positive aspects as well

You are your child’s best ally!  Even when you lose patience, remember that your child is struggling right along with you.  ADHD affects them more than it affects anyone else.  The moment of diagnosis provides you as the parent with the opportunity to help your child develop their talents and individual strengths.  Overall, ADHD is a challenge and not a problem.

What to say-Do’s
•    Emphasize that now that we know that you have ADHD-we can work together as a team to help make things at home and school better.  Be encouraging and positive!
•    Tell them that lots and lots of people have ADHD.  They are not alone.
•    Explain that this can be used to their benefit.  ADHD children constantly have new ideas and are full of energy.
•    ADHD just does not go away, but parts of ADHD that they don’t really like can be worked on with help from you and others in your child’s life
•    Identify that ADHD can be a strength to them, but make sure you don’t convey that ADHD is merely an excuse for bad behaviors.
•    Reinforce to them that they have a part in their success at home and at school and also in their life for the long-term

Part 4 – what not to say.

Talking to your child about ADHD should be done in a very reassuring and constructive manner.  Tell them the truth, but do not “sugar coat” things for them.  The reality is that your child will have to work at this just as much as you as their parents will and his/her teachers.  As parents, you have most likely taken you child to his/her pediatrician or a health care professional and your child was evaluated by them.  Your child is probably by now wondering what is going on and if there is a problem.

Start the conversation in a very positive way and emphasize that their brain works “very fast” and even faster than most people around them.  When you tell your child that they have ADHD let them know that they are not alone.  Every single, solitary person is different in a lot of different ways and we should celebrate these differences.  If you keep it a secret from your child that they have ADHD, this actually implies that to have ADHD is shameful and they should really be embarrassed.  As with everything else in life, there are positive aspects and negative aspects to absolutely everything.  Reinforce that ADHD is something that they also can get control of with help from you as the parent, but they have to do their part as well.  Above all, be realistic in what you tell your child and make sure they understand what you are saying.  If your child is looking at you with that blank stare, it probably means you lost them in your explanation of what ADHD is and how it affects them.

Part 3: What to say and what not to say.