Friday, December 31, 2010

Happy New Year!

Happy New Year to those who follow me as well as to those who read my blog! Let's communicate more in 2011. Let's also carry something good that happended in 2010 over to 2011.

If you guys need to ask me any questions, I will be writing my blog and checking the comments.

Tuesday, December 28, 2010

Do you Get Out Enough for your Own Relaxation or are you too Nervous to Leave your Child with ADHD with a Babysitter?

Let me know if you are interested in this topic by sending me some questions related to it. This a very important conversation because parents who have children with ADHD need an outlet for their own frustrations. Do you exercise? Do you go out to movies? Do you go out with friends and/or with your spouse?

OR

Do you find yourself staying home because you feel more relaxed when you are home to be in charge of any possible problems that might come up?

Let me know...

What Causes Social Skills Problems in Children with ADHD?

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 that are modeled by their parents at home in the same way as children without ADHD do. Even though I spent the past several years studying the social skills problems of children with ADHD, Frank Gresham and Steven Elliott have researched social skills since the 1980s and are certainly two of the most prolific researchers in the field.

Their interventions are arguably considered the standard, and despite the fact that the parents in my research did not use the social skills interventions that Elliott and Gresham (1991) developed, these authors mention five reasons why children do not learn positive social skills.

They are:

✱ Lack of knowledge

✱ Lack of practice of feedback

✱ Lack of cues or opportunities

✱ Lack of reinforcement

✱ Presence of interfering problem behaviors. (pp. 28–29)

Monday, December 27, 2010

Admit it: This Child is so Annoying!

Children with social skills deficits may behave in a very annoying manner to both their peers and adults. They 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 one of the mothers describing her child in such negative terms. I guess she was being realistic, but even so.

How do some teachers respond to children with ADHD, especially those children who are hyperactive?

Michael had ADHD-combined type. Belinda spoke about the difficulty that
Michael had experienced in school, specifically in terms of one of his teachers’ attitudes: And it was a battle. He was in her classroom I think, for four months, because after four months of he’s not getting it, there was no action from her to do anything. Um, I had him moved to a different classroom; I went and met with the principal. There were several incidences that made me very unhappy throughout the school year. And I told the principal that at this point, he does not need to be in her classroom. He needs to be put into a different class, which they did, and he seemed to be doing better. But we still had the old he doesn’t like to write, and if something gets tough, you know, the head itches, I need a drink, I need to go to the bathroom. It was a vicious kind of cycle. Nobody wanted to take the time to help. Nobody wanted to help figure it out. Nobody wanted to make a difference. They all just wanted to be the one to say “He’s not getting it. There is a problem.”

Mary Ann told me a similar story about her son Billy’s experience with his gym teacher:

But also in the classrooms that were somewhat chaotic, [sic] a loud gymnasium where all sounds are coming in loudly, and it seems that there is chaos. He’s had trouble finding, finding his focus when it seems like everyone’s running around crazy. So, even though the teachers in gym felt like they were in control, in his perspective, in what he was seeing, which is crazy, so he’s going to add to it, and run around crazy. So he was having to go to detention, actually for his behavior in PE. . . . It would be that he’d mess up on Thursday, and he would have to wait for the next Wednesday to go to detention. And she even talked about in-school suspension for his behavior in PE. And that type stuff was really starting to weigh heavily on me. I’d worry about him every PE day.

Bess offered an example of one among many negative experiences Aaron had had in gymnastics:

Gymnastics has been a problem, like other activities that we have gotten him involved at one time or another (Mom laughs, nervously), because he has trouble going with the flow. And he gets distracted from what he’s supposed to do very easily, and that can turn into behavior problems with, you know, goofing off with other kids, also sometimes misinterpreting social cues because he gets so focused on one way of doing things. Children such as Michael, Billy, and Aaron have problems interacting with others. To those who are familiar with children with ADHD, this is obvious, right? Bess also remembered a time when Aaron spoke in a disrespectful way to his grandfather. I can remember when he was four and he talked back to his
grandfather. I said nothing, because it was like, you know what the situation was with the grandfather.

I don’t want to say he asked for it, but the tone and attitude and the behavior was such that Aaron was “back at ya,” you know. I did correct him. I told him, Aaron that was not right, even though my thinking was, I’d have done the same thing as an adult. You’re a child, you don’t behave that way. So, it’s always been a very tricky situation. I talked to him at that point. I did say to him, Aaron, you know, you need to apologize; that was wrong. To let him know that it was unacceptable, but at that same point in time I knew that what he said was something that anyone, any adult would have said in the same situation. But the problem was that he wasn’t an adult. He was a child. He didn’t know he wasn’t supposed to say that. That was how he felt, so that’s how he handled it.

Parents and teachers know very well of these children’s behavior and how others respond to it. They are also quite familiar with the social skills problems that characterize these children, as one parent described: 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. I am sure that all teachers have come across students who are inflexible and even noncompliant, like Michael. His mom explained:

When I’ve got his attention, I tell him, “Michael, you need to watch it, he is your instructor. Don’t fight. Don’t put yourself in a dangerous situation.” And many a time the teachers say, it’s okay; I’m glad he’s asking. I’m glad he’s questioning. And I say yeah, but, you know, there comes a point in time when he needs to say okay, instead of fighting it all the time.

What is causing these problems? Check out my next entry…

Sunday, December 26, 2010

How Playing and Building in the Snow can be Beneficial for Children with ADHD


When children with ADHD are at home for a few days, it can be difficult to manage their behavior. It is so interesting that many times, however, when we have a snowstorm, these children become so excited but NOT in a way that is frustrating in terms of dealing with their behavior. Why? Ah ha…Playing n the snow is a form of exercise. Oftentimes, when children with ADHD go out to play in the snow, especially after a new storm, they seem to use up so much energy playing that by the time they come into the house, they are thoroughly exhausted and unaccompanied by their hyperactive symptoms. 


One caveat: Due to the fact that children with ADHD may arguably become so extraordinarily excited in ways that appear as if any minute they might display impulsive, inappropriate behavior, they need to be supervised outside while they are playing in the snow. You do not have be outside for the entire time, but just make sure that you are observing their activity from time to time in order to avoid some possible altercations.
Encourage them to build in the snow as well as to sled. Sledding is a fun thing to do, certainly, but when they build in the snow, they are using their creativity, which increases their ability to focus that should last for a few hours after they finish playing in the snow.

Thursday, December 23, 2010

An Example of a Task List for your Child to Complete when he is Home During his Christmas Vacation

Here is an example of a checklist that you can design for your child who is home during Xmas break. Make sure that each task is written in a different color ink or marker because children with ADHD will need stimulation in order to discriminate each task on the list.You will notice that I have listed going to the bathroom on the child’s list. Frequently, children with ADHD get so hyperfocused that they forget to go to the bathroom, which could have negative consequences, if you know what I mean. This list organizes your child’s day, but certainly can be revised as per your child’s interest, i.e., drawing, writing, playing with dolls, playing with Legos, etc. This list also is not meant to discourage the child’s creativity but instead, to encourage him to be involved in many different activities in a structured way.


If the child cannot read, then you can access pictures from Google Images which are free and will demonstrate what task he has to complete and place those pictures next to the sentence that describes the task. If you are a good artist, you can draw the pictures yourself. You can also take pictures of the child himself when you see that he is engaged in the activities on the list, so that he will understand what the next step is to complete.

He must check off each step of the list either on the honor system when his parents are not home or in front of his caretaker. If he forgets to check the items off on his task list, then remembering to check off the activities on his list should be one of the tasks on the list that he has to check off. If the child cannot tell time, you can buy a timer with a flag that closes down when a certain amount of time has elapsed. The company from which to buy that timer is http://timetimer.com/



1. After getting up, go to the bathroom.

2. Brush your teeth.

3. Make your bed.

4. Eat your breakfast.

5. Clean up any debris from your breakfast.

6. Check your email.

7. After 30 minutes, which he should set on a kitchen timer or a cell phone, get up from the computer.

8. Go to the bathroom.

9. Wash your hands.

10. Work on a chore that your parents set out for you to complete.

11. Play a video game or a computer game for no more than 30 minutes as timed on a kitchen timer or a cell phone.

12. Take a walk outside or get some sort of exercise, for instance, on an indoor bike for 10 minutes.

13. Read for 30 minutes.

14. Eat your lunch.

15. Clean up any debris from your lunch.

16. Check your email and write emails to those who have written you.

17. Go to the bathroom.

18. Wash your hands.

19. Take a walk outside or get some form of exercise for ten minutes.

20. If you have any homework that is required to be completed during the vacation, complete one subject.

21. Watch television for no more than 30 minutes, as timed on a kitchen timer or on a cell phone.

22. Take a walk or do some form of exercise for 10 minutes.

23. Read for 30 minutes.

Wednesday, December 22, 2010

What can you do to Keep your Child with ADHD busy on Christmas vacation when you have to Work?

This is a tough one…Typically, parents have to work and certainly cannot be home the entire time when their child is off from school. That being said, what can you do to make sure that he is not on the computer for eight hours a day? Clearly, this situation applies either to children who have someone there supervising them or to a child who is old enough to stay at home alone.



If children with ADHD are left to their own devices, they will most typically spend eight hours per day on the computer or some other visual device. Why is this so? Children with ADHD look for stimulation of any kind to help them to lock in or to hyperfocus. As I have said before, if your child plays video games and does not respond when you ask him a question, he is hyperfocused into that visual experience. Some of hyperfocusing is good and some is not so good.


There is much research that definitively links too much television watching and/or too much time spent on a computer with clinical depression in children. I know that you are saying that you will not be at home, so therefore, you will have no control over how much time he spends on the computer, playing video games or watching television, for that matter.


Here is what you can do: Talk to your child and explain to him that if he uses the computer, computer games, video games and/or watches television for prolonged periods of time, that it is unhealthy for him. You can tell him that people whom you respect have told you that that is true.


Tell him that each day that you are not home, you are going to give him a checklist of activities to do so that he will not be spending solitary time on the computer. Tell him that playing on the computer will be integrated into that list, but not for more than thirty minutes at a time, however. Children with ADHD respond best to structure, so believe me, this will work. He is not going to be happy with this change of events, but if you explain to him that this is a decision that you and your spouse or partner has made, he will have no choice.


This is also a great opportunity for an older child to be independent and accountable. How? You can explain to the older child that since you will not be at home, you will not really know if he is completing all of these activities. Therefore, you will treat him as a mature individual and have him check off the activities that he has completed on the honor system and show you that list when you come home from work. He may not be able to complete all of the activities the first day, and may still “lose time,” but if he spends less time on the computer, then giving him this list is worth it.

In terms of the computer time, give him a kitchen timer or have him set his cell phone for thirty minutes so that if he is experiencing what I call “lost time” that the sound of the alarm will alert him. In that way, he will feel a sense of responsibility, which is a vital skill for children with ADHD to develop. You will also tell him that if he was less mature, then you could not have put him on an honor system. Also tell him that you know that you can trust him to be honest now and check off the activities that he has completed.


All of these activities are not huge, time-consuming activities. The list should incorporate playing video games as well, but not for more than thirty minutes at a time. Look for my next entry for an example of a list that you can design so that your child feels organized, structured and busy on vacation!





Saturday, December 18, 2010

Two Tips on how to Diminish Bullying

All of the new research about bullying talks about two main ways to diminish bullying:

1. Always have the child who has been bullied walk around the school between periods with another child. In that way, the bully will be discouraged from bullying because he does not want a witness to see his actions.

2. Start a safe bystander policy. This is imperative because when a child reports a bullying incident, the information that the child conveys must be held as confidential and his/her name must be witheld to avoid any repercussions to that child.

What Leah Davies says about Ideas for Teaching Children with ADHD

I cited Leah Davies' ideas in my book for how to teach manners. I love what Leah Davies outlines for ideas for teaching children with ADHD. Here is the link:

http://www.kellybear.com/TeacherArticles/TeacherTip49.html

30 Ideas for Teaching Children with


Attention-Deficit/Hyperactivity Disorder

By Leah Davies, M.Ed.

The following list may assist teachers who work with ADHD students. For an overview of this disorder see, "Attention-Deficit/Hyperactivity Disorder in Children."



1. Understand the struggle a student with ADHD has and provide an ordered, safe, predictable classroom environment.



2. Establish a courteous, working relationship with the student’s parents. Learn about their child’s strengths, weaknesses, interests and achievements outside of school. Ask what teaching methods have been most effective with their child. Communicate often and send encouraging notes home.



3. Make time to speak to the student individually. Be respectful and express interest in his or her success in school by asking how he or she learns best.



4. Decide together on a sign or a code that you can use to remind the child to be on task. For example, make eye contact and touch your ear or pick up a particular object. Or, you could hold up one or two fingers.



5. Make classroom rules clear and concise. Discuss them orally and post them for easy reference. Explain the consequences for misbehavior in understandable terms and enforce them consistently. Avoid power struggles.



6. Use a point system, tokens, stars, or other methods to reinforce appropriate behaviors (see Rewards in the Classroom).



7. Notice and provide feedback on any improvement in the areas of behavior and academics (see Effective Praise). Avoid criticizing the child in front of others.



8. Give directions in simple, concrete terms. Simplify instructions, tasks and assignments. Have the child complete one step before introducing the second step.



9. Divide lessons into relatively short segments and use a variety of teaching aids such as films, tapes, computer programs and small group work to reinforce the child's learning.



10. Provide the ADHD student opportunities to display his or her skills, talents and/or leadership ability.



11. Prepare for transitions by providing a warning when a change is to occur. A musical clue may be helpful. Try playing classical music or a recording of nature sounds during work time.



12. Have all of the students stand and stretch, run in place, or do an exercise or movement activity when deemed necessary.



13. Color code paper for each subject. If available use off white, tan or light blue colored paper for written assignments.



14. Create schedules, outlines, lists, and/or a homework assignment book to help the student keep organized as well as to increase home/school communication. Tape a copy of the class schedule to the child's desk.



15. Modify required homework to accommodate students who are severely impacted with ADHD. Avoid busy, redundant assignment.



16. Direct young ADHD children to trace their handprints on the front and back of a folder to carry with them wherever they go. Have them place their hands on top of the traced ones to help them remember to keep their hands to themselves.



17. Pause before asking questions or ask the inattentive child a question to gain his or her focus. Use the student’s name or interests in neutral ways during discussions.



18. Walk around the room and pat the child gently on the shoulder or tap the place in the child’s book that is being read to help him or her stay on task.



19. Seat the ADHD child in close proximity to you and in the area that has the least amount of distractions and stimulation, i.e.doors, windows and active students. Or, sit the child by the pencil sharpener and let him or her get up and sharpen a pencil as often as needed.



20. Watch for signs of increasing stress in a hyperactive child. You may want to reduce the workload or provide an opportunity for the child to release some energy. For example, have the student deliver an “important letter” in a sealed envelope to another teacher or school secretary who understands the child’s need to move.



21. Provide opportunities for physical activity. Choose the hyperactive child to hand out papers or do other classroom jobs that can help release pent up energy and contribute to his or her feeling of self-worth.



22. Encourage the child to use self-monitoring techniques to help focus. For example, allow the him or her to rub velcro or another object attached to the underside of his desk or provide a soft ball for a student to squeeze. (Seek approval of any unusual technique from the principal and parent before use.)



23. Allow a student who seems to be sensitive to fluorescent light to wear a visor or baseball cap in class. Turn off the group of lights nearest the windows or dim the classroom lights.



24. Be flexible and allow a child with the ADHD disorder to stand up or squat in his chair if it helps the student complete assignments. Or, let him or her sit on the floor by you or on a large ball if that helps the child do the work. An air filled pillow or a quiet stationary exercise bike with a desk attached could also be used.



25. Furnish two desks facing each other or side-by-side for one ADHD student. The child can move freely back and forth or lounge between the desks as long as he or she stays on task and in the designated area.



26. Provide a cubicle or quiet area for the ADHD student to use when overwhelmed by classroom activity.



27. If necessary, furnish a specific area marked off by tape that is only his or her space that no one else can enter. In it the student can stand up, sit on the floor, or move around to complete assignments. However, the child must be quiet and remain in the area unless given permission to leave.



28. Encourage sensitivity as the child interacts with peers. If he or she lacks social awareness, it might be helpful to say something like, “Mary looked unhappy when you spoke to her. What is a kinder way to ask for something?” If the student interrupts peers often, remind the child to listen first before talking.



29. Have older students or volunteer parents serve as tutors for these students.



30. Establish a collaborative relationship with the special education teacher, school psychologist, school counselor, administrator and/or other specialist in the school to ascertain the best placement for the child with ADHD.





Used by permission of the author, Leah Davies, and selected from the Kelly Bear website [www.kellybear.com], 11/04

Thursday, December 16, 2010

A GREAT Recommendation for a Holiday Present for your Child with ADHD

I received this email from Children and Adults wth Attention-Deficit/Hyperactivity Disorder (CHADD) with a review of an amazing book for your child or yourself about ADHD. It can be bought on Amazon at http://www.amazon.com/Whats-Astra-Medikidz-Explain-ADHD/dp/1906935130/ref=sr_1_1?ie=UTF8&s=books&qid=1292517139&sr=8-1
or straight from CHADD.org or from many other online booksellers. Please notice the picture at the end of this entry.


"This holiday season, CHADD has introduced a medical education comic book titled “MediKidz Explain ADHD” that explains the basics of the disorder in language aimed at adolescents and teens.



“MediKidz” is a group of five larger-than-life superheroes on the planet “Mediland,” who each specialize in a different part of the human body. The fun-loving and believable characters entertain readers and educate them about ADHD using everyday language that young people easily understand.


Published by MediKidz, Ltd. in Great Britain and written by a medical doctor working with a graphic novelist, this peer reviewed book is perfect for teenagers and adolescents with the disorder, their friends and parents, and for professionals to share with patients, clients and families."



 


Tuesday, December 14, 2010

ADHD is a Developmental Disorder. Does that mean that ADHD is a Temporary Disorder?

I received a very interesting comment yesterday asking whether or not due to the fact that it is definitively known that ADHD is a developmental disorder, does that mean that it is temporary? I wanted to repeat my answer here for all of your information.



Researchers have questioned whether or not there is a delay in the brain maturation of children with ADHD or whether children with ADHD are characterized by a total difference in typical brain development. In a study funded by the National Institute of Health (NIH), Shaw et al. (2007) found, in groundbreaking research, “that in youth with attention-deficit/hyperactivity disorder (ADHD), the brain matures in a normal pattern but is delayed three years in some regions, on average, compared to youths without the disorder.” The areas of the brain that reflect difficulties for children with ADHD are those that control self-regulation in their thinking, attention, and planning, which I believe, affects not only academics but social skills as well. 

Therefore, the maturation of the brain is quite normal, but merely delayed, which should assure teachers and parents alike that these children’s symptoms should diminish as they mature because at some point, the child will have normal brain maturation. This new information should offer teachers and parents great optimism concerning the academic prognosis of children with ADHD. If your child is 13 years old and has ADHD, he therefore, due to the developmental nature of ADHD, may be behaving more like a 10 year old. 

What does this mean for parents and teachers? We all have to change our expectations for these children's behavior, for one thing, as well as changing our expectations concerning how these children plan their academic work, how and if they inhibit anything that interferes with their work as well as how they execute their work. The research does not as yet explain why some adults have ADHD, but we cannot expect all of the answers at the same time! If you would like to read the research article, I will send it to you if you give me your email addresses. You can send them to me at my gmail account which is on my profile.

Monday, December 13, 2010

For the Teacher: How to Teach the Child with ADHD to Join Ongoing Activities

It is very important for you, the teacher, to judge if the child with ADHD in your classroom has acquired the social skill of joining ongoing activities. Children with ADHD typically do not know how to behave or what to do when they want to join in with children who are already playing. Children with ADHD do not know what to do when they want to ask another child if they can join in their play. They do not know that they should wait until there is a quiet time before they ask to join in other children’s activities. These children have been known to barge in on the two children who are already playing. Being able to discriminate between people’s various facial expressions and their associated body language is a major strength when a child approaches another and has to decide whether to ask if he can play in their group.

A child has more of a probability of social failure and rejection when he does not understand other children’s facial expressions and body language. When children with ADHD fail to pick up cues from other children as to whether they will ask them to join in their active play, they do not understand that the particular time that they enter the social interaction may not be an acceptable time to play with these children. It is very important to teach children with ADHD to recognize and to understand body language so they can judge when is an appropriate time to try to join in activities.

Here are some ways to teach children with ADHD to appropriately join in with another’s activities. The following activity is for children with ADHD who like taking on roles and who do not have social anxiety related to being in front of people.

Charades: We all remember the game charades. It is a great game for helping a child with ADHD to recognize facial expressions as well as body language. If the child does not really understand what the facial expressions mean, read himToday I Feel Silly & Other Moods That Make My Day by Jamie Lee Curtis (1998). They can manipulate the facial expressions at the end of the book themselves. One child can model one facial expression, such as angry, while the other guesses that facial expression. The teacher can make up two teams and the team that guesses the most facial expressions wins. The teams should be mixed randomly with children who have ADHD and those who do not have ADHD. All children, those who do and do not have social anxiety, can try the next exercise.

Mirror, Mirror on the Wall: Mirrors are great tools for showing children who might not otherwise realize what a certain facial expression means to learn to understand their meaning. Either a teacher or another child can make a facial expression in the mirror. Ask the child with ADHD to name the facial expression (i.e., happy, angry, nervous, afraid, etc.). Then, ask the child with ADHD to make the same expression in the mirror that the other child did. If the child with ADHD did not pay attention to the other child’s facial expression, have the child make the facial expression again.

Candid Camera: The teacher can gain permission from the child’s parents to take pictures of the children themselves making the various facial expressions. The teacher should write in an informed consent letter that the pictures will only be used for the teacher’s educational purposes. It may be easier to teach facial expressions to children with ADHD if they see pictures of themselves making the various expressions. They typically laugh and seem to remember the facial expressions because they become personally relevant. Children with ADHD learn and remember when they are engaged in the learning process.

When teachers make learning experiences meaningful and relevant to children, they are more likely to remember what they have learned. Digital photography offers another lesson as well. After you take the pictures, look at them with the child with ADHD and agree that he has made a particular expression. If not, you can delete it until the child makes the facial expression that was discussed.

Candid Camera Video: Children with ADHD and other disabilities, for that matter, often do not see other people’s viewpoints as to how they are behaving. A great way for these children to see themselves from what I call a worldview is to videotape their behavior in situations where they are trying to interact with other children. Make sure that you gain the parents’ permission before you videotape. Do not be concerned that your presence will affect the quality of the social interaction, because it will not. During my field research, I had that same concern. However, I quickly learned that not only do I become invisible, but more interestingly, the children cannot and do not alter their behavior in any way. Children with ADHD do not perform for anyone. They exhibit the same behavior no matter who is in the room.

Children with ADHD behave as they behave; that is it. I would recommend viewing the videotape first yourself, just to make sure that in your opinion, nothing about the tape embarrasses the child. As I said before, most children with ADHD do not see themselves from other people’s viewpoint, so in most cases the videotape will be fine for the child to view. I would, however, view the videotape privately with the child, as you should be certain to state precisely on the informed consent. Once the teacher has decided that the video footage is a good representation of what she wants to teach, then do not delete either the tapes or the pictures. You might want to go back and refer to them later on. The following are cues that teachers can help children with ADHD to look for when they want to join in with children who are already playing.

Explain what body language means:

Are the children’s bodies facing in the same direction?
Are the children’s heads and faces close together?
Are the children engaged in an animated conversation
with each other?
Are the children playing in a corner of the room away
from others?
Do the children look at the approaching child when he
moves toward them?

One book that might help young children to understand the basics of joining in with another’s play is Join In and Play by Cheri J. Meiners (2004). Now that the teacher/parent has taught the child with ADHD to join in on activities, it is also crucial that the child learn about volunteering to help peers.

The social skill of volunteering to help peers is one for teachers to think about before they begin to teach it. This is really a thinking social skill. You will remember that I discussed making each social skill you teach meaningful to the child with ADHD as a way to help him learn it. Well, let us explore how to do that. First, try to encourage the child to think about the last time he observed that one of the children in their class needed
help of any kind. Did someone have to pick up blocks quickly to get to the next activity? Was a child holding many things in his hands while trying to open a door? Did someone have too much to carry when he held his lunch tray? Did someone lose something important to him? Additionally, just to make sure that the child really understands what you mean by helping another child, you could read a book to the child, such as The Berenstain Bears Lend a Helping Hand by Stan and Jan Berenstain (1998) and Helping Mom by Mercer Mayer (2002).

Another great idea that would make this social skill lesson meaningful is for both the teacher
and the student to write a social skills story based on a time when a child needed help and another child came to his assistance. A peer support or a peer buddy system is a very useful tool for teaching social skills to children with ADHD. In this example, the teacher speaks to a typical child and asks him to help a specific child when he needs assistance. Bob has been building a large block structure for an hour. The teacher says, “Okay, everybody, we have to clean up because lunch is in five minutes.” Bob looks around and looks worried and says aloud, “How will I ever put all of these blocks away in five minutes?” Before he becomes very upset, Bill, another child in the class, goes over to him and says, “Bob, would you like me to help? Two of us can put the blocks away faster than one!” Bob says, “Great. Thanks, Bill!” They put the blocks away so fast that Bob and Bill are the first in line for lunch!

Be sure to include pictures along with the social stories to make the meaning very clear for the child reading it. The child can draw the pictures, the teacher and the child can draw the pictures together, or the teacher can take digital pictures (with informed consent, of course) of one child helping another as a real example.

The teacher might want to include the reasons why is it important to help another child in a social story. The teacher and the child with ADHD, therefore, can collaborate and write a social story that describes a situation when a child wants help from another child. Perhaps the child with ADHD can offer assistance to a typical child. The child with ADHD will feel good about himself, because he is helping someone else. Most important, helping another child might be the first step in making a friend.

Speaking of steps, here are some steps to teach a child for when he decides to help another child. Notice what the child has to do in the first step. We have discussed this social skill previously. The steps can be written on a task card, which we will see examples of later.

Maintain eye contact with the child.
Smile and use a kind voice.
Say, “It looks like you might need some help putting away
the blocks.”
Ask, “Would you like me to help you?”
Help the child. (adapted from Hensley, Dillon, Pratt, Ford, & Burke, 2005, p. 162)

Sunday, December 12, 2010

What do you do when a Child has a Temper Tantrum? Teach him Social Skills!

When a child has a temper tantrum, a good opportunity may present itself to the classroom teacher in terms of teaching social skills to the child with ADHD. If this intervention is difficult for the classroom teacher to implement, in consideration of the fact that she has many other children in her classroom, she can find a “safe place” for the child to have the temper tantrum.



For example, sometimes the gymnasium has an area with padded walls. Hopefully, as in some of the schools I have visited, there is a collaborative effort among the faculty, so that each teacher helps another in an emergency situation. If the teacher has an assistant or a paraprofessional in the classroom, the teacher must instruct that person how to respond when the child with ADHD has a temper tantrum. Everyone who is involved with this child must have a clear understanding in how to respond, yet not react to his misbehavior. When a teacher responds to a child’s misbehavior, that response is intentional and planned. When a teacher reacts to a child with ADHD’s misbehavior, he behaves in an emotional manner, which oftentimes reinforces his behavior in a negative way, therefore encouraging him to behave in that way frequently. As the child is involved in the temper tantrum, you know very well that he does not see or hear you at all. So you have to wait; in fact, you have no choice but to wait. So, you wait, and you wait, and you wait for the child to stop the temper tantrum. He finally slumps down in the chair and quiets down.




Now what? The first thing to do is to talk to the child and try to find out what triggered the temper tantrum. Most times the teacher might think that the child would not have any idea of what possibly triggered the tantrum. However, you can usually find out a little bit at least about what might have been one of the causes of the tantrum if you have a conversation with the child. That conversation, however, must begin with open-ended questions. Let me give you an example of what caused a temper tantrum in a five-year-old boy with whom I am working. I entered the door of Eddie’s home at the same time as he entered. Eddie was five years old with a diagnosis of ADHD, hyperactive type. We often arrived at his home at the same time. He noticed immediately that his toys were not in the same place as they had been before. He started to cry at first, demanding to know the location of his toys. In fact, he was crying and then screaming so loudly that his babysitter (who took care of his younger sister and him when he was not in school) became very upset.




Apparently, it was the babysitter who put his toys away in order to try to make the house neat. She certainly did not mean any harm, but somehow was acting as if she had indeed done a terrible thing. Therefore, she began to give him his toys back. I was at his house to teach him social skills. I honestly thought that it was unreasonable to reward him with his returned toys when he had been crying, screaming, and shouting. Well, when I mentioned to Eddie that he could have his toys back if he said please, you would have thought that the world was exploding. He even threw some toys at me. His temper tantrum then escalated into a full-blown tornado. His mother interjected, unfortunately, and infantilizing him, held him on her lap and asked him, “Was someone mean to you in camp today?” Well, come on! I somehow convinced her to permit me to handle it with her in the room, and then finally convinced him to agree to have her exit the room while leaving the door open.




After she left, I slowly began asking him open-ended questions such as, “Did something happen to upset you?” “No.” “Did someone say something to you that upset you?” “No.” Then my questions became more pointed in order to try to figure out what got him so upset that he had the temper tantrum. “Did someone in camp upset you?” “No.” “Did someone in camp say something to upset you?” “No.” “Did something happen on the way home?” “Yes.” Ah . . . now we were getting somewhere!!!! He then proceeded to tell me (in answer to more specific questions) that his mom had picked him up from school after his entire class went to a Build a Bear store as a class trip. They each received a “Build a Bear.” What a school and what a trip; I could not believe it!

Anyway, his mom was on her cell phone as she was driving, talking away, as usual, and he kept trying to talk to her over and over again. She simply did not hear or did not respond to him. He wanted her to stop and buy clothes for his bear RIGHT THEN AND THERE. Atypical for her, and perhaps for the first time ever, she said that she could not do that now because she did not have time. She needed to drop him home and get ready to attend a fund raiser at his school. She said she would take him the next day to buy the clothes.


Apparently, initially he became frustrated when she would not talk to him in the car and then became frustrated and ANGRY when she refused to buy him clothes for his bear at that moment. THEN, he walked into the house with that frustration all churned up, saw that his toys were not where he left them, and EXPLODED. After he calmed down, I talked to him about how to control his anger next time. He told me that he could not control his anger because “My body had the temper tantrum and I could not do what my body did not want me to do. My body did that, not me!”




He also said that he likes to be angry because then he is “tough.” I told him that a person could be tough and not be angry, but he did not understand that concept or accept it. I decided at that point that he would not be able to listen to my words, so I read him the book When Sophie Gets Angry by Molly Bang (1999), to him. Unfortunately, being five years old and having ADHD, he laughed when the little girl in the book became very angry. We talked about the book. Little by little over a few sessions he began to understand that it was counterproductive to react to something that he was angry about by having a temper tantrum. (I did not use the word counterproductive to him; I said that having a temper tantrum did not help him to figure out why he was angry.) So, I gave him some steps to try the next time he became so angry. Before his body becomes so angry, I told him to ask himself:




“Why am I so angry?” “


Am I angry at a person?”


“Am I angry about something that happened to me?”




If he cannot ask himself those questions (as one step on the journey to self-regulation), then I told him to take three deep breaths and count to five before his “body” becomes so angry. We practiced the deep breaths together. When we spoke about how he could control his temper tantrum during our next session, he did say that he tried the deep breathing, but he also said that “When my body takes over, it takes over.” I realized then and there that it would be a long process before he would be able to self-regulate his temper tantrums as a vehicle to learn social skills.




Teaching social skills to children with ADHD, as you can see, is not always as easy as it appears to be. It is not just a matter of actually teaching the social skill. As you saw from my example here, the teacher cannot achieve real success in terms of the child learning the social skill and diminishing his socially inappropriate behavior unless the child with ADHD is totally, 100 percent “on board” and in complete agreement that this skill is important for him to learn.

Saturday, December 11, 2010

Why would a Five-Year-Old Child with ADHD be so Angry?

I was speaking with a young woman yesterday who told me about her five-year-old nephew whom she suspected had ADHD and was very angry and defiant. She told me that her nephew was not only angry at home but was also angry at school, saying things to his teacher such as, “I don’t have to do the Math if I don’t want to.” “Don’t tell me to go out for recess. I am NOT going!” He also had temper tantrums at home as well as at school. Why would a five-year-old child be so angry?



First of all, as I told this woman, it is not typical for a five-year-old to be so angry. Second of all, I told her that oftentimes children who are angry behave in a defiant manner at home, but not at school. It concerned me that this child had temper tantrums and was defiant in school, where one would think that he would not want to embarrass himself.


Why would a five-year-old be so angry and defiant? Well, there may be many reasons.


Here is a possible list:


 The child is speech-delayed and becomes frustrated when he tries to express his thoughts.






 The child, due to the fact that he is very distractible finishes his schoolwork at a much slower pace than do his classmates. Additionally, he oftentimes cannot complete his work by the end of the time that the subject is being taught.






 There is a new baby at home and he feels that no one is paying attention to him. As far as he is concerned, negative attention is better than no attention.






 What is expected from him academically is not achievable for him at the moment.






 He wants to have friends but is very frustrated at his failure to make friends.






 He has a great deal of difficulty writing and is embarrassed when others see that his writing is not legible.






 He tries to listen to the teacher’s instructions but never remembers what she tells the class to do.






 Other children have been teasing him and making fun of him.






If any of those things have been happening to your child, write me, and I will give you some interventions to try. Trust me that this child does not want to be the “bad child,” who is constantly reprimanded by adults every day as well as being ignored by the other children due to his behavior. Please do two things:


 One: Try to be patient. Five-year-old boys with ADHD typically behave in a much younger fashion than children who are his age but do not have ADHD. At some point, he will behave in the same way as children who are his age do, but do not have ADHD. In other words, ADHD is a neurobiological and a DEVEOPMENTAL disorder, so that the child with ADHD will catch up with his peers at some point down the line.






 Write me, so that I can suggest some interventions that you can try with your child.






The Vanderbuilt Assessment: A New Method to Diagnose the Frequency of Symptoms and Diagnose ADHD

Check out what they are doing at Children's Hospital, Boston regarding diagnosing ADHD

http://www.childrenshospital.org/views/october08/managing_adhd.html

Thursday, December 9, 2010

The Importance of Modeling how to Compromise and how to Cooperate for your Child with ADHD

I often talk about teaching children with ADHD to compromise and to cooperate with each other.


However, in consideration of the fact that children hear their parents talking about how not only the two political partied in the United States cannot agree, they are also hearing that people within both the Democratic and the Republican parties do not agree. Now, certainly all people do not have to agree on everything, but they certainly should be able to agree on some issues.

We all know that parents sometimes do agree on some issues. However, the problem occurs for our children when their parents do not agree on certain paramount issues, such as discipline. It is confusing for all children. It is especially detrimental for children with ADHD who are dependent on structure and consistency when their parents disagree on issues pertaining to morals, values and/or discipline.

When we are teaching our children to compromise and to cooperate it is essential that we model similar behavior so that our children behave in the same way. They look to us to set a standard for their behavior toward others. Children with ADHD will typically exhibit enough symptoms that they cannot control, so it is imperative that they have people to model positive social skills for them, such as how to compromise as well as how to cooperate.

Wednesday, December 8, 2010

Parents of Children with ADHD: The Challenges that you Face

I talk so much about helping children with ADHD to develop positive social skills, which is of course, very important to discuss. However, it is equally important, arguably, to discuss how parents of children with ADHD meet the challenges of managing their children’s symptoms each and every day. When I talk with parents, I quickly realize that managing their children with ADHD along their children who do not have ADHD is an arduous task.



As I speak to parents at my presentations at various schools, I see their levels of frustration, exhaustion as well as difficulty in understanding why their children behave as they do, which is very understandable. It is vital to remember that it is just fine to feel frustrated and exhausted.


However, it is NOT fine to blame yourself for your children’s behavior and/or the fact that you may be experiencing great difficulty managing it. It is not your fault that your child behaves in a certain way, and it is definitely NOT his fault. No child wants to be reprimanded multiple times a day and no parent or teacher wants to reprimand these children. But…getting back to your feelings…


When you start to feel that sense of frustration, think back upon the small strides that you have helped your child to achieve. It does not matter if those achievements include remembering to hand their homework in on time or remembering to brush their teeth. Each and every improvement that your child has made is due to your encouragement, teaching and patience. We cannot expect ourselves to manage our child’s behavior perfectly and/or for everything to go perfectly, as my older son always tells me, or we would not be able to function under that pressure.


What we can expect from ourselves is to try to be patient with our child’s behavior as well as when we do not really understand what to do to diminish it. If you are patient, then your child will look upon you as a model and he will learn to be patient with his own behavior as well. Trust me on this outcome…..

List of appropriate school-based accommodations and interventions

Copy and paste this link into your browser for some great tips on school-based accomodations and interventions by R. Booth

http://atto.buffalo.edu/registered/ATBasics/Foundation/Laws/AccomList.pdf

Tuesday, December 7, 2010

Controlling Temper when in Conflict with Peers

Do you remember when we discussed the child with ADHD being able to control his temper with adults? The whole idea of showing temper with adults is the same as showing temper with a child’s peers. If a child reacts (and you see that I am purposely using the word reacts here instead of responds) to a peer by having a temper tantrum, can the child with ADHD expect that child to be interested in playing with him? I would answer a resounding no to that question. It is the teacher or the parents’ job to give the child with ADHD an internalized plan for handling reactions to a conflict with a peer.

Try this method:

Do not react.

✱ Think about exactly why the peer is disagreeing with you.

✱ Is the disagreement based on something you said?

✱ Is the disagreement based on something you did?

✱ Is the disagreement based on something your peer thought that you were going to do?

✱ Is it so important who is right and who is wrong?

✱ Before you react, think about the questions above. Is there any other way you can respond without using your temper?

✱ Have the child say: “Do we have to argue about this?”

✱ Also have the child say: “How can we both end up being happy about this? This is not worth an argument.”

The best thing about this process is that by the time the child with ADHD has answered those questions, his temper has been diffused. You know your child with ADHD’s personality and his ability to learn steps in a task analysis such as above.

Monday, December 6, 2010

Cooperating with Peers: Using Emotional Intelligence

Teaching children with ADHD to cooperate with their peers takes more than simply telling them to cooperate. When these children do not cooperate with their peers, how do others typically respond? They put them in timeout; they become annoyed with them; they punish them in some way, such as staying in from recess or not being permitted to attend extra-curricular activities.


What can you do to help your children to cooperate with their peers? You can use emotional intelligence to help them to cooperate. What is emotional intelligence?

“Emotional intelligence refers to the capacity for recognizing our own feelings and those of others, for motivating ourselves, and for managing emotions well in ourselves and in our relationships” (Goleman, 1998, p. 317).

Here are some suggestions so that you can teach your child to cooperate by using emotional intelligence.

Cooperation with Peers: Using Emotional Intelligence

Has your child or student ever been asked:
How are you?
Are you okay?
Did something happen to you that upset you?
Arguably, children with ADHD and similar disorders are not asked these type of questions.

What Should You Do?

Read the students a story about a situation where neither they nor their peers cooperated successfully


Ask them questions that encourages a conversation about their feelings about what happened.

Story


Arthur and Sam were on a team. They were assigned to make cupcakes. Sam always made cupcakes with his mom, so he thought that he and only he knew the best way to prepare the recipe before baking the cupcakes. He also decided on the flavor of the icing beforehand. From the moment that Arthur and Sam began their project, they had problems cooperating.



They did not make a list of jobs before they began. When they started putting ingredients into the bowl, Sam argued with Arthur about which ingredient that each of them would put into the bowl first.



They also argued about who should mix the ingredients, who should pour the batter into the cupcake cups, and who should put the cupcakes in the oven. Arthur tried not to argue and to accept, begrudgingly, what Sam told him to do, until the cupcakes were done.

Sam started putting his choice of flavor for the icing, chocolate, on all of the cupcakes. Also, he didn’t even like chocolate icing! At this point, Arthur was almost in tears, because he was so frustrated with Sam’s behavior. Finally, Sam took two of the cupcakes for himself and walked away, eating one as he walked in the other direction! Arthur was so upset, that he took the rest of the cupcakes and threw them all over the floor, causing most of them to break apart in crumbs!


Questions to Ask the Children

What should Sam and Arthur have done before they began the project?

What was unfair about the way Sam behaved?


How did the way Sam behaved make Arthur feel?


What could Arthur have done to avoid the problems he experienced when baking cupcakes with Sam?

How should the teacher have responded to Arthur and to Sam as related to their behavior?




































































What did Arthur do when he saw Sam taking the cupcakes and eating them?
What happened because the boys did not assign jobs to each other before they began preparing the recipe?