Come to Hear Me Speak!!!

Tonight, I will be arriving at the CHADD International Conference in San Francisco. I will be speaking in a breakout session this Friday at 9:00 A.M., so come to hear me speak. I will be speaking on ADHD and social skills, of course. 

The conference is being held at the San Francisco Airport Hyatt Hotel, so come on down.

Suggestions for Helping your Teenager with ADHD

Hopefully, the first time that both parents and teachers reach out to help teenagers with ADHD is not when they are teenagers. That being said, there are certain strategies that you can employ that will help to diminish the symptoms of ADHD.

First, it is imperative that you make sure that these teenagers get enough sleep. Teenagers always seem tired, as I am sure that you have witnessed when they get up at noon on the weekend. When they have not accumulated enough sleep, they do not have any reserve in order to retain patience and resolve.

Second, teenagers with ADHD, even more so than children with ADHD, need a structured routine with the same wake-up time, mealtime, and bedtime each and every day of the week. Additionally, they require clear, consistent rules and direction to guide their behavior at home as well as at school. They must be made responsible for keeping a precise, rigid schedule that will allow for the optimal success at homework, activities and chores. It would also be effective to set up a reminder schedule that is engaging and reflective of their interests.  

Third, they should be encouraged to learn a skill in which they have a particular strength. In that way, they will be more likely to make friends who also have a strength and interest in that skill, which will inadvertently build their self-esteem.

By making sure that teenagers get enough sleep, adhere to a consistent schedule and learn a particular skill, the symptoms of their ADHD will be diminished and they will develop positive self-esteem.

The Importanceof Teachers having Prior Knowledge of their Students with ADHD's Life Experiences

We read and/or have read many descriptions or models of ADHD, some of which have defined ADHD in a similar fashion and others that have offered varied descriptions. In my experience over many years of teaching children with ADHD as well as in my field research, I have found that most children with ADHD do not fit into a specific diagnostic category. Therefore, teachers must be cognizant of the specific and unique behavioral characteristics of each child with ADHD.

 Even though most children with ADHD are distractible, for example, not all are impulsive. Additionally, they do not all have social skills problems, although arguably, a large percentage of children with ADHD do.  However, some of these children may exhibit organizational difficulties, among other symptoms. Being familiar with the types of symptoms that a child exhibits reflects whether or not a teacher has background or prior knowledge of the child’s real-life experiences.

 If a teacher does have this knowledge, she will likely be able to help the child

with ADHD learn how to manage his behavior, so he can attend more effectively to his teacher’s instructions. Additionally, as part of that prior knowledge, a teacher will know if the child interrupts others’ conversations.

 If the teacher has prior knowledge of her student’s behavior, she will also be able to look into the possibility that other children may reject and ostracize the child with ADHD. If the child is indeed rejected by his peers, he will have a very difficult time trying to make friends.

  If he has difficulty making friends, his self-esteem will be negatively affected. Presumably, he will also have difficulty interacting with adults in a reciprocal way, which will generalize to his experiencing great difficulty obtaining a job.

 Therefore, when the teacher has prior knowledge of her student’s background, behavior and life experiences, she will be more successful in terms of helping a student with ADHD to succeed socially, and therefore, increase his positive self- esteem.

Methods to Teach Children with ADHD how to Introduce themselves to their Peers

Introducing oneself might be a skill that you think is something only adults should have within their repertoire. It is just as important for a child with ADHD to know how to introduce himself to others as it is for an adult to do so. The reason that

it is so important for a child with ADHD to do so is that if he does not introduce himself, he will feel that he does not know anyone in that situation, and he will not! It is no wonder why children with ADHD often feel that they are on the periphery of social interaction.

When children with ADHD feel isolated, they may exhibit socially inappropriate behavior. When a child with ADHD exhibits one socially inappropriate behavior, that behavior often sets off other socially inappropriate behaviors. Feeling isolated

and apart from a group of people might be a reason that a child with ADHD may exhibit socially inappropriate behavior. However, if he introduces himself, he may avoid that empty feeling of isolation. The social skill of introducing oneself may
incur some anxiety. However, the social isolation that results from not doing so is more painful.

The child with ADHD whom I observed in New England had a great deal of anxiety. He especially became anxious when he did not feel that he was familiar with the people who were interacting in close proximity to him. When I first met him, his mom was talking to me and had not introduced him to me as of yet. By the time she got around to introductions, he was already running in circles around us, jumping up and down and pulling on his mom’s dress.

A good thing for her to do before she got into any complex discussion with me might have been to whisper to him, “Michael, this lady is Dr. Rapoport. Tell her your name.” If he was too anxious to tell me his name, she could have just said “Say hello to her.” Greetings are a very important skill for children with ADHD to learn. Instead of greeting an oncoming person, children with ADHD or similar disorders seem to look down at their feet when they pass someone in the hall, for example.

 It is very important to teach a child with ADHD what to do after the initial nonverbal or verbal interaction, and that is to introduce himself to the other person. Make this task as simple as possible by teaching him to turn his body to the person, as I have said before, and then say his first and last name. For example, have the child with ADHD say, “Hi, my name is John Smith.” This social skill among others must be practiced. Using puppets is a good way for children to take on the role of another person and practice the social skill of introducing themselves.

One puppet says: “Hi, my name is Ellen Jones.” Then, hopefully, the other puppet says, “Hi, my name is Bill Evans.” You can have everyone in the classroom practice this skill. They can either use real puppets or paper bag puppets. If the child with ADHD has difficulty role playing using the puppets, then you can try finger puppets. If he still has too much anxiety to talk through role playing with puppets, you can ask him to draw the two people involved in the introduction.

The teacher can draw bubbles and write words within them herself, or have the child with ADHD write the words in the bubbles. Additionally, the teacher can place pictures within the bubbles for young children who cannot write. The best picture to use, of course, which is so easy with today’s digital photography, is the child’s own picture. (Please obtain permission from the child’s parents before you use any pictures of the child to teach him social skills!) If the child does not want to use his own picture, you can use pictures from magazines that you can glue onto craft sticks. Believe me, there are many ways to show a child with ADHD an image that will affect him in a way so he can learn to introduce himself to others, especially to other children. When they know how to introduce themselves to other

people, they can begin to learn to initiate conversations.

Questions about your Child with ADHD?

School just began, so I am sure that you have questions about your child with ADHD and his/her social skills and/or executive function problems.

Please send your questions and I will answer them as soon as I can.

Why do Children with ADHD Exhibit Socially Inappropriate Behavior?

Children with ADHD who have social skills deficits may behave in a very annoying manner to both their peers and adults. Parents and teachers know very well of these children’s behavior and how others respond to it.

These children may talk excessively without realizing that they are doing so or they may talk so infrequently that people do not even know they are in the room.  Their parents seemingly do not like them; their teachers seemingly do not like them; and other children do not like them. I felt so sad hearing a mother describing her child in such negative terms. I guess she was being realistic, but even so.

As far as social skills go, I do think that kids with ADHD have significant issues with this. Sometimes it seems to be a matter of the fact that they do not notice their own behavior as being unusual or inappropriate in any way. Thus, they make no effort to control it. But, even when pointed out, they often seem unable to control odd or inappropriate behavior.

Okay, so let’s get to the bottom of these children’s social skills difficulties. Children with ADHD of all types may have social skills problems, even though their behavior may be varied.

Why? They have social skills deficits. These deficits typically have been described as either “can’t do”1 or “won’t do” (Gresham et al., 2001, p. 33). They either do not know how to behave in a socially appropriate manner or they know how to behave in a socially appropriate manner, but do not do so. Children with ADHD have social skills deficits that prevent them from developing positive social skills. These children typically do not pick up and internalize positive social skills.

  

Children with ADHD do not learn positive social skills that are modeled by their parents at home in the same way as children without ADHD do due to the following

• Lack of knowledge
• Lack of practice of feedback
• Lack of cues or opportunities 
• Lack of reinforcement
• Presence of interfering problem behaviors. (pp. 28–29).

To be continued….

Should Educators and Parents Teach their Children with ADHD in accordance with their Developmental Levels or their Chronological Ages?

In 2007, researchers at the National Institute of Health[1] found that “Cortical development in children with ADHD lagged behind that of typically developing children by several years” (Shaw et al., 2007, p. 19650).

 

“The prefrontal cortex supports a host of cognitive functions, such as the ability to suppress inappropriate responses and thoughts, the executive ‘‘control’’ of attention, evaluation of reward contingencies, higher-order motor control, and working memory” (Shaw et al., 2007, p. 19651).

 

How do the results of this definitive research affect how educators and parents teach their children with ADHD and manage their behavior? Should we teach these children according to their current developmental levels or according to their chronological ages?

 

I presented to a wonderful group of teachers at the Goddard School in Yorktown Heights, New York last Friday, and their questions echoed the concerns of other teaching professionals with whom I have spoken concerning the results of this research. As I told them, especially in preschool, in my opinion, educators should try to teach young children with ADHD according to their developmental levels. Why? If you try to teach these children according to the milestones that are attributed to their chronological ages, they will have gaps in their knowledge which will be very difficult to overcome.

 

The best strategy is to work within each child’s learning strengths and preferred learning style, according to the developmental level that they have reached. Little by little, teach them to a point where they are challenged but not frustrated. In that way, you will help these children feel that they are reaching new strides in their learning at a pace in which they can succeed.

 

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[1] (Shaw, P., Eckstrand, K., Sharp, W., Blumenthal, J., Lerch, J. P., Greenstein, D., Clasen, L., and Evans, A. (2007). Attention-deficit/ hyperactivity disorder is characterized by cortical maturation. Proceedings of the National Academy of Sciences of the United States of America, 104, 19649–19654. Retrieved from http://www.nimh.nih.gov/science-news/2007/)

 

 

Challenging Classroom Situations for Young Children with ADHD

One of the most challenging situations for both young children with ADHD as well as their teachers are transitions. These transitions may include going from one activity to another; going from one station to another; going from the classroom to recess; going from the classroom to lunch; or leaving school to board the bus at the end of the day. Why are transitions so difficult for young children with ADHD?

Young children with ADHD become highly focused on the activity in which they are involved. Therefore, they do not pay attention to the directions that their teacher tells them to follow in order to make a smooth transition to the next activity. They are driven by the moment in which they are involved in one activity, so when it is time to transition to a new activity, they find it very challenging to leave the one in which they were occupied.

Additionally, these children often become overly excitable when they are required to move, which may result in them rushing to the next activity that they find more interesting.

Why do young children with ADHD behave in this way? They have developmental delays in their ability to inhibit inappropriate behavior, in some cases of up to three years. In other words, the behavior of a six year old may be more representative of the behavior of a three year old.

This developmental delay offers a dilemma to teachers of young children with ADHD, which we will discuss in the next blog. They do not stop to evaluate their actions. Additionally, they do not remember the reminders that the teacher gives them to put their things away, such as their toys, before going to the next activity.

What can teachers do to help young children with ADHD to transition more smoothly? It is imperative for the teacher to be very clear about the class rules as related to transitioning. In fact, if the teacher collaborates with her students to agree upon the rules for transitioning, the children will feel ownership and will most likely transition more successfully. However, it is very important that the teacher is very specific concerning exactly what she wants the children to do during transitioning, rather than what she does NOT want them to do. It is easier to walk, for example, than it is NOT to run.

Finally, ask the parents to practice transitioning behaviors at home with their children, so that they will have more practice. In that way, the child learns to exhibit new, positive transitioning skills in two settings, ensuring success in whatever setting in which they find themselves.

My Comments on a Parent's Statement that Children with ADHD should not be permitted to Participate in some Activities: Are you Kidding??

I received a rather upsetting question/comment awhile back about which I would like to comment. Here is the comment by a parent of a child who does not have ADHD:

“What can I do as a parent of a non-ADD or ADHD affected child, from thinking how "annoying" the ADHD kids are? For example, one little boy (ADHD- I overheard his mom telling the instructor) really disrupted a summer sports lesson tonight. The other kids were upset, the other parents were upset. My child has already expressed she does not want to go back. Some activities should not allow these children there. His mom was really trying but it was not enough.”

I became very upset when I read the sentence “Some activities should not allow these children there.” Many thoughts came to mind, with the very first one being “What has gone wrong in our world for parents to want to exclude another child from activities just because his behavior may be a little annoying?” How would that parent have felt if THEIR child was not permitted to participate in an activity?  

 Sadly, people like the person who commented to me just did not get it. What did they not get? They did not understand that children with ADHD do not want to behave in the way that they arguably do. They would much rather behave in an acceptable way which would be conducive to making friends. 

The most often asked question I am asked by a child with ADHD is, “Why don’t I have friends?” These children have social skills deficits that prevent them from learning positive skills, which leads them to exhibit inappropriate behavior.

The good news is that positive social skills can be taught, if they are taught by someone who is responsive to the child with ADHD’s learning strengths and learning styles.

Parents are their children’s first teachers. How can a parent educate their child to accept those children who are different if they themselves do not want them around?

TO ALL PARENTS WHO ARE READING THIS BLOG ENTRY:

Please let us remember that our children model our thoughts, ideas, actions and behavior. If a parent is critical of another child’s behavior and expresses the fact that a certain child should not be permitted to remain in an activity, the child himself will take on his parents’ beliefs and ideas as his own, which will lead to that child rebuffing and rejecting children with ADHD. Is that the kind of exclusive rather than inclusive behavior that our children should be taught today?

"I Forget to do Things because I have ADHD." When does that Argument Lose its Appeal?

Children with ADHD must become accountable for themselves. However, accountability and self-regulation may not appear to be easily accomplished, because these children’s ADHD may arguably cause them to exhibit certain symptoms.

One of the most persistent symptoms that characterizes children and adolescents with ADHD is forgetting.  Even though it is true that children with ADHD do forget to do certain things, which is actually a well-referenced symptom of ADHD, at some point, they must become accountable for their actions.

It is definitely more difficult for children and adolescents with ADHD to remember to do their homework, to put their homework in their school bags, to hang their clothes up in the closet, to pick up their toys, among other examples. However, the fact that they have ADHD may not be used as an excuse for their forgetting.

What happens if children with ADHD are permitted to use their ADHD as an excuse for their forgetting to do specific responsibilities? They then will arguably blame their difficulty remembering as well as their other symptoms on their ADHD, as well. 

Why is it so critical that children and adolescents with ADHD not blame their actions, such as forgetting on their ADHD? If they blame their symptoms on their ADHD, they will not work to try to learn certain methods of diminishing those symptoms. Therefore, they will not become responsible for their actions.

I have taught many children and adolescents with ADHD to become more adept at remembering. However, in order to ensure that they will succeed at learning those methods, they must be on board in terms of understanding that instead of blaming their forgetting as merely an unavoidable symptom of ADHD, they need to learn techniques that will help them to self-regulate and diminish their symptoms. In that way, they will be able to reduce their symptoms, such as forgetting.

Therefore, one of the most important lessons for children and adolescents with ADHD to learn is to become accountable for their actions. If they can learn to be responsible for their actions, these children will be on their way way to enjoying happy and successful lives, where they are responsible and accountable.

How to Help Children with ADHD to Organize their Thoughts and Ideas

Children with ADHD often have difficulty organizing their thoughts and ideas, which arguably may lead to them “getting stuck” in terms of articulating their ideas. In fact, this difficulty in terms of organizing their thoughts may lead to their speaking in sentences that are unrelated in topic to each other. How do people with whom these children are speaking respond to this type of disorganized conversation?

They invariably become annoyed because as much as they try, it is very difficult to maintain a conversation with someone who jumps from topic to topic. So, what can you do to help your child to speak in a more organized way?

In consideration that it is likely that he cannot discriminate whether or not his thoughts and statements are organized, it might be a good idea to write down his statements on small pieces of paper for him.  Read each sentence to him aloud. 

Then, tell him to read the sentences aloud to you. Ask him to organize the sentences in chronological order, i.e., which one should be said first, second, third, etc. As he is reading each sentence, ask him if each sentence should follow the one before it in terms of their meaning.

If you determine that his organization of the sentences is not in a chronologically correct order, have him read one sentence aloud at a time and ask him if the sentence that follows is in the correct chronological order.

If he senses that a sentence is out of order, tell him to move that sentence on the piece of paper that is written on around until he is satisfied that it correctly follows the one before it. Then, have him read those sentences aloud again to determine if they are finally organized in the correct chronological order. Try this method and let me know if it works.

How can you Help your Child with ADHD to Decrease his Excessive Verbiage?

Children with ADHD have all of their thoughts spinning around in their minds. They just cannot wait to say what is in their thoughts. Seemingly, they must say those thoughts immediately, which they express as excessive talking and continuous verbiage.

What can a parent do to help their child with ADHD to decrease the amount of verbiage that they are expressing?  This social skill is one that requires children with ADHD to learn how to self-regulate their verbiage.

The first thing that must be done is for the child to realize both the amount and the speed of his verbiage. In consideration of the fact that children with ADHD are not typically characterized by self-awareness, this is the pivotal part of helping him to diminish his excessive talking.

A feasible way to help the child to become aware of how much and how fast he is speaking is to have someone videotape him speaking to you. I would video three or four segments at various parts of the day, so that he can see that he speaks in this way on numerous occasions throughout the day.  Nowadays, videotaping is an easy task, because every Smartphone has a video component.

It is imperative however, that the child does NOT think that he is weird and/or that he does NOT think that is doing something really terrible. Children with ADHD arguably have low self-esteem and you certainly do not want to make him feel worse about himself.

Watch the video with your child and ask him general questions about his interactions with you in the video. If he does not see how he is speaking, then very carefully, ask some more direct, specific questions, as I have written below.

Ask your child the following questions about his behavior in the video:

v How close is he standing to you? Is he standing too close to you?

v Is he waiting for you to answer his questions, or does he just keep talking?

v Does his talking escalate into more and more and faster and faster talking, without him waiting for answers?

v How are you reacting to his excessive talking?

v Are you trying to stand further away from him as he speaks?

v Are you trying to answer his questions but unable to answer them because of his excessive talking?

v Do you appear frustrated as he is speaking to you, because it is very difficult for you to answer him because he does not stop talking?

v Does he appear frustrated that you are unable to answer his questions?

Observe his reactions as to how he is talking in the videos, so that you can gauge your next step in terms of teaching him how to self-regulate his excessive talking.

Let me know how your child reacts to his excessive talking on the videos, so that I can describe some interventions that you can try.

Survey for Teenagers

Dr. Esta M. Rapoport
Email: estamrapoport@gmail.com
Blog: adhdanswers.blogspot.com
Twitter: adhdanswers

Survey on Teenagers with ADHD

ALL ANSWERS TO THIS SURVEY WILL BE CONFIDENTIAL. NO NAMES WILL BE USED.

Instructions: Please type answers and send them to me on a separate piece of paper than the one that includes the questions. Please answer the questions in as much depth as possible, and email your answers to me at estamrapoport@gmail.com.  Feel free to write as much as you like in addition, especially whatever pertains to your emotions and/or feelings. You will be helping the many teenagers with ADHD who have academic and/or social difficulties who struggle to get through each and every day. I am very grateful for your input.

Dr. Esta M. Rapoport

Part 1

1.      When and in what circumstance did your parents tell you that you had ADHD?

2.      How did your parents describe ADHD to you?

3.      How were you sure that you understood what having ADHD meant?

4.      How did you feel about having ADHD?

5.      How did your parents respond to the fact that you had ADHD?

Part 2

           6. What symptoms did you exhibit as a young child?

7.      What symptoms do you exhibit or have you exhibited as a teenager?

8.      What symptoms did you exhibit as a child that have diminished when you became a teenager?

9.      If those symptoms diminished, why do you think that happened?

10.  What added symptoms do you exhibit or have you exhibited as a teenager that you did not exhibit as a young child?

11.  How have the symptoms or did the symptoms of your ADHD affect your school work and your grades as a teenager?

Part 3

          12. How is having ADHD or how has having ADHD been difficult during adolescence?

13.  How does having ADHD affect your self-confidence and self-esteem as a teenager, or how has having ADHD affected your self-confidence and self-esteem as a teenager?

14.  How do or did your parents respond to you when you experienced difficulties in your teenage years?

15.  How do your siblings respond to you or did your siblings respond to you when you had difficulties as a teenager?

Part 4

           16. As a teenager, what have you told your friends or what did you tell your friends 
                 about having ADHD?  If you told your friends that you had ADHD, how did they 
                 respond?

17.  As a teenager, what have you told or what did you tell your extended family about having ADHD? If you told your extended family that you had ADHD, how did they respond?

18.  How does having ADHD affect your social life, or how has having ADHD affected your social life, specifically being able to make and keep friends?

Part  5

           19. Have you been bullied or were you bullied as a teenager? (If you were not bullied,
                 were you teased?) If you were bullied or teased, what was done to you?

20.  What do you think was the cause of being bullied? (or teased-please clarify)

21.   How was being bullied (or teased-please clarify) related to your having ADHD?

22.  What did you do to stop being bullied? (or teased-please clarify) How did the techniques work that you used to stop being bullied? (or teased-please clarify)