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/)