Kids Awareness Series

Archive for the ‘ADHD’ Category

Although there is no such thing as the perfect teacher or the perfect classroom or the perfect anything, there are a few suggestions for the classroom setting for the ADHD child.  As most of us are aware, the ADHD child struggles with becoming easily distracted, inattentiveness, difficulty sitting still, getting up out of his/her seat, and numerous other symptoms.  ADHD symptoms affect each child differently and your child may have some of these symptoms but not all of these symptoms.  However, one thing that is almost consistent across the board with children with ADHD is the fact that they are highly distractible and the more confusion in the classroom and lunchroom, the more acting out behaviors you are going to see at school.  Here are a few suggestions to optimize their learning environment:

Seat the child in the front of the room, there are less distractions from other students this way.

Do not be afraid during test times or on assignments that require sustained effort to have the ADHD child work with a resource assistance or a para-professional at school.  Additional services from the school may be warranted here and will need to be discussed with your child’s school.

The classroom should be minimally distracting.  What I mean is the classroom should not have every available surface covered with art, posters, classroom materials.  The more “stuff” that is on the walls, the more the ADHD child will be distracted by them.

Look at where your child is seated.  If your child is sitting next to the door, the air conditioner, a computer making noises while it runs, or the window, they will most likely be distracted by the noises or movements that they see outside.  Placement of their desk is really that important!!

The rules of the classroom should absolutely be posted (ie.. no hitting, always be respectful, take your turn, raise your hand when you have a question). Clear expectations of behavior should be conveyed.

The children sitting next to the ADHD children are also very important.  If you sit another child with ADHD or a child that gets up constantly from their chair, this will not help your child.  The children sitting next to a child with ADHD should be good role models for behavior.  Children learn through modeling behaviors!!

When the ADHD child participates in activities that are overstimulating such as P.E., the lunchroom, activities that involve the entire class, give him/her time to calm down and engage him/her in relaxing activities.  I often make the children I see in therapy stand up and take deep breaths in and out ten times and then close their eyes and pretend they at the beach listening to the sounds of the ocean. 

Above all, praise ADHD children for behaviors that are appropriate and encourage them to ask questions when they need classroom help.  I hear too often from parents of ADHD children that everyone seems to point out the “bad stuff” about their child but they never hear anything positive!!  All positive and appropriate behaviors should be praised and a reward system at home should also be implemented.  No classroom environment will be perfect, however by implementing some of these suggestions, your child will have much more success in his/her classroom.

A by-product often seen in ADHD children is difficult behavioral problems.  This particular disorder causes difficulty with hyperactivity, impulsivity, and self-control.  It is issues with their self-control that often get them into trouble at home and at school as a result of their inability to restrain their behaviors.  Often times, their behaviors make others upset and I have heard repeatedly from parents, “I swear my child is trying to tick me off on purpose.”  This may actually be the case, it often seems that their primary objective is to get a rise out of their parents as a means to stimulate their brain.  Children of course will deny this over and over, however turmoil often surrounds the ADHD child due to their lack of self-control and inability to censor what they often say and do.  To reshape these behaviors or in Psychology world we call this Behavior Modification, there are several steps that must be taken in order to retrain the behavioral problems of an ADHD child.  First, you must define the particular behavior you want to change.  Only pick one behavior at a time, otherwise it becomes too overwhelming both for the parent and the child.  For example-hitting classmates or a younger sibling.  Secondly, establish a baseline period of time.  In other words, log how long you plan on monitoring this behavior and how  many times the behavior occurs.  Thirdly, communicate the rules and your expectations of your child CLEARLY to them.  Children have to know how they are expected to act in order for a behavioral plan to work.  Fourthly, reward their behavior consistently when the desired behavior is observed.  Lastly, if they engage in the undesired or unwanted behavior, then you dispassionately provide negative consequences for the behavior.  No yelling, no screaming, just pass out punishment for negative behaviors.  Screaming never works, they learn to tune you out!!

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.