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Do you have any tips for what to do with kids who are constantly fidgeting with things? I have this one student in particular who always has to find something to play with or fiddle around with in his hands. When I take one thing away, he finds another. This student has ADD and I want to do whatever I can to help him be less distracted in class.

Marilyn, 5th grade teacher

Dear Marilyn,

What you are describing – the need to have something in their hands – is very common among students with AD/HD. In fact, your response of attempting to remove the object is a very typical one for teachers. What I recommend, however, is trying just the opposite strategy…GIVING them something to touch, hold or fiddle with during times when they are expected to sit and listen. What the student with AD/HD is frequently doing by touching/manipulating things with their hands is their attempt at self-regulation. It often helps them activate their attention, and stay better focused and alert - especially while having to sit and listen. It’s similar to those of us who need to doodle while listening to a speaker. My favorite thing to use with students is a piece of Wikki Stix (see link to our ERS catalog), I cut the wikkis (which are twine covered in colored wax) in half. Besides being more portionable, I find this to be a good size for enabling a child to inconspicuously twist, manipulate, or wrap it around their finger. Sometimes I give kids a keychain with something attached to it (like a rabbit’s fur).. . The keychains are good in that they can stay attached to a loop of the child’s pants (and are less likely to be flying around the room or bothering others). A koosh or stress ball, piece of clay, pen cap, work, as well.

You will find it a futile attempt to try removing things from touching/fiddling access, because a child with this need will ALWAYS find something…even a piece of lint to play with. The rule, however, is: If you ABUSE the privilege… you LOSE the privilege. If the student starts abusing the privilege (e.g., poking a neighbor with the wikki, throwing the object around, or basically being disruptive to others), it is removed until the student can show that he/she can use it appropriately, without bothering others in the process.

In anticipation of the next question that typically arises when I suggest giving a child an adaptive tool or item to use that the rest of the class typically won’t be using, I will pose the next question to myself:

WHAT ABOUT THE REST OF THE CLASS WHEN YOU ALLOW ONE OR TWO STUDENTS TO USE A TOOL THAT THE OTHERS WON’T BE USING? IS THAT FAIR?

As far as fairness, I tell students that as their teacher I promise them that I will NOT be treating them all the same way. My job as their teacher is to do everything I can to meet their needs and to help them learn and be successful. As we all are unique and different, so are our individual needs. For example, some of us can pay better attention and focus more easily if they have something in their hands when they’re listening. Most of us don’t have this need.

I recommend, whenever possible and appropriate, to let everyone first see and try the wikki (or whatever the adaptive device or tool may be). Most students are curious, will want to try it, but will have no desire to use it. ..just those with the real need. Letting students know that fairness is providing students with what they need, not with what they necessarily want, has always worked for me (and most all teachers I know). Students seem to understand this rationale and accept it as being fair and legitimate. Follow up with…"if you have a special need you think I should be aware of, that I can try helping you with, please see me later and we can talk about it together."

Good luck to you and please let me know if you have success with this strategy. 

Best regards,
Sandra

My son is in 7th Grade and school has been a battle since 1st Grade. He is not on medication as it never consistently helped his ADHD. His biggest problem is attitude and staying focused enough to do the work. What do you think about homeschooling for ADHD children?

Alicia

Dear Alicia,

Unfortunately, for many students the middle school years (6th, 7th, 8th grades) are often the most difficult and stressful years in school. Kids who may have struggled but were able to cope well enough with the demands/expectations in elementary school, find themselves overwhelmed in middle school - and fall apart at this stage.

As far as homeschooling, I know that some families find this to be an option that is a lifesaver for their child – especially if the child is feeling so defeated, angry,or depressed that he/she is simply unable to cope (socially, emotionally, academically) within the school environment. There are families with students who have AD/HD who are very successful with homeschooling, and it is an option you may wish to consider.

However, homeschooling is obviously a huge commitment and investment of time, energy, etc., etc. that would not be possible for most families. It is a commitment that many would be not be able to follow through with successfully. If interested in pursuing, I recommend you carefully do your homework - exploring the various homeschooling options which vary from state to state, and locally (district to district). In some school districts, for example, homeschooled children have access to district resources and materials. They can participate in extracurricular activities , programs, and so forth. Contact your school district and ask if there is an office that coordinates homeschooling, and can provide you with information. Also, look into the homeschooling organizations which can provide a lot of information, guidance, and supports. Some homeschoolers are part of a cooperative - working together with, and participating in educational activities with other homeschooling families.

Before removing your child from school for homeschooling, I would advise that you make sure your son has received the benefit of all the supports, accommodations, and services that he may be entitled to under the law. Have you had a recent meeting with the school team? Has your son been evaluated and been found eligible for either a 504 accommodation plan or any special education services? Is there any support plan orinterventions in place provided by the school? Is there any adult in the school who helps interface with the classroom teachers, and with whom your son can go to for assistance? Regarding the lack of effectivenes s of medical interventions: Does the school understand that you have used medical treatment in the past but that it was not effective in his case? Have you recently consulted with medical and/or mental health professionals who specialize in ADHD?

I wish you and your son the best of luck, and a successful new school year.

Best regards,
Sandra


Our oldest son (11 years old) seems to be affected by ADHD. He is  characterized by the following:


-Daydreamer
-Slow in completing tasks (taking hours to finish eating, do homework, etc.)
-He is careless (losing his things)
-Difficulty relating to and communicating with others children and adults
-We are unable to motivate him and he doesn’t respond to our disciplinary measures.

He has been given play therapy treatment but there is no remarkable improvement. In the beginning, incentives did work, but now it is the same.

We would appreciate your advice.
Concerned Father

Dear Concerned Father,

Your son has symptoms that may or may not be due to AD/HD. There are a number of possible reasons that a child may exhibit the behaviors you describe that have nothing to do with AD/HD. Also, be aware that approximately 50% of children who do have AD/HD, have other co-existing conditions in addition to the ADHD (such as learning disabilities, anxiety disorder, depression).

Has your son been evaluated by specialists very familiar with AD/HD and other childhood disorders? If he hasn't had a thorough evaluation including medical and psycho-educational (tests to determine academic skill levels, learning and cognitive abilities, processing skills and styles, language/communication abilities), that would be my first recommendation. It is important to get an accurate diagnosis - a clear picture of his strengths and weaknesses - in order to effectively meet his needs.

If your son does have AD/HD, play therapy is not an effective treatment. The research shows that a combination of medication therapy that is well-managed, together with other behavioral, social/emotional, and academic supports and interventions are what works best. A unified plan and close communication between parents, the school, doctors or other professionals involved in your son’s care is necessary. As a parent and your son's number one advocate, you will need to become aware of behavioral approaches that are most effective, as children with AD/HD often don't respond to the typical disciplinary measures. Punishment, for example, will do little to change the undesirable behaviors. More positive, proactive techniques work better - teaching, encouraging, and motivating your child to exhibit the behaviors you want to increase (e.g., on-task behavior, work completion, organizational skills).

Incentive systems need to be constantly readjusted and revised. It is common for the effectiveness to wear off after a while. Rather than give up on an incentive approach, try revisiting the incentive plan and make adjustments to reactivate the system. Also, look at any structural supports and accommodations the school can provide and that you can assist with. For example, if it takes hours to complete a task, the task must be broken down into more manageable steps. Perhaps the assignments need to be shortened, or your son be allowed to dictate verbally his responses while someone else writes or records what he says. You may be interested in my book How to Reach & Teach ADD/ADHD Children and / or my video How to Help Your Child Succeed in School for concrete strategies that may be helpful.

Good luck to you and your family.

Best regards,
Sandra

My son, Alex, has been diagnosed with ADHD when he was five. I’ve worked hard witht he doctors and Alex has gone to counseling on and off since he was five. He is in counseling now. I also have ADHD. I know that you can’t just treat with a pill. That is just a small part of the pie and treatment involves much more. I’ve had to learn over the years that not everyone will ever believe in ADHD. I used to try to convince people and the school system.

As I got older I have chosen to choose my battles. The most important one is my son. My biggest problem has always been the public school system. My son spent the first two years of school in the office. So I took him out of the public school and put him in private school for second and third grade. Because of the high cost of private,I put him back in the public school and they held him back for third grade because he was so far behind.

Now he is in fifth grade in special ed and working on a third grade level in all subjects but math. I am very concerned about this current school year. In fact, I am meeting with the school later this week because he Alex has not been allowed to go to recess since school started three weeks ago. I asked if he was getting any warnings before he received the ‘no recess’ consequence. The teachers say he has to follow all the rules as the other fifth graders. So I’ve asked there be a behavior plan in place to help him. I’ve offered the school to bring Alex early to school or have him stay after school for punishment.

I feel kids with ADHD really need recess to let off some steam. He really enjoyed school for the last couple of years. I feel he is very frustrated this year already and we have come so far to have it all go down the tubes now. Do you think I am over-reacting? Thank you for any advice.

Janet

Dear Janet,

I understand how frustrating and painful an experience this has been for you and your family over the years. Unfortunately, it is a common story for those with AD/HD to have to deal with so many who don't understand the disorder, and because they believe kids SHOULD have better self management, self control, etc. tend to be inflexible and unwilling to make reasonable accommodations.

From what you describe, you are clearly a parent who has tried to address the needs of your son from a young age through the recommended multi-modal treatments (medical, counseling, and special education). I don't think you are over-reacting to the disciplinary measures (loss of recess) the school is taking. I agree with you about loss of recess being an inappropriate consequence for children with AD/HD who to even a greater degree than other kids have the need to physically release energy and get a break from the long instructional day. If a student on occasion loses recess privilege, that would be acceptable and reasonable. However, losing recess for 3 consecutive weeks - especially from day 1 of the school year is not reasonable. You have demonstrated your willingness to work with the school and cooperate in the provision of alternative consequences (detention after school or paying back 'time owed' before school). It is hard for me to imagine that the school isn't willing to work together with you in this regard - especially since 3 weeks of loss of release obviously hasn't resulted in a change of behavior. You haven't shared any of the specific behaviors that resulted in the school's disciplinary action, or what the school team has recommended. Are they taking any positive/proactive steps to help your son?

Any student in special education whose behavior impacts upon successful school performance needs to have those behavioral needs addressed in the IEP (individualized education program). The IEP team should openly discuss and decide upon any additional supports and accommodations needed (e.g., use of extra prompting, cueing, signaling, or other forms of reminders/warnings; behavioral contracts; positive incentives and reinforcement for specific behaviors the team would like to encourage and motivate your son to exhibit more frequently). I would include Jason in gathering input and planning strategies and supports to help him be more successful in following the classroom rules.

I wish the best of luck to you and Alex.

Best regards,
Sandra

Dear Sandra,

I have a 4-year old son (he's a twin, by the way) with ADHD.  We recently took him to a specialist who diagnosed him right off and put him on medication. He will start PRE-K soon. When his medicine starts wearing off (late in the afternoon) he sometimes has a horrible tantrum over trivial things and gets completely out of control with screaming and kicking.  It really frightens me.  We put him in the time out chair and try to ignore him.  What do you recommend?

Karen

Dear Karen,

It is good that you are having your son treated by someone who is a specialist in the area of AD/HD, and will hopefully, work closely with you in adjustment of the medication and the medical management.  Some children do have what they call a 'rebound effect' as the medication wears off - which may be what you are describing.  Discuss this with your doctor.  This isn't my area of expertise, but I know that it often takes time and several trials until the right dose and regimen of medication is determined.   Lots of children with AD/HD are over-reactive which is part of their disability in self-regulation, self-control, and their capacity to inhibit their responses.

If you are like most parents who have recently had your child diagnosed with AD/HD, this is most likely a difficult and overwhelming time for you.  It is hard to adjust to the reality that your child has a disorder which will require far more from you (as far as providing structure in the home, effective behavior management strategies, and other supports) than is required of other parents.  Please know that there is a lot of help that you can access that wasn't as readily available a few years ago.

I hope you will draw upon the support of those who are very familiar with what you are going through because they have 'been there'... other parents of children with AD/HD. I strongly recommend you look into organizations such as CHADD (Children & Adults with Attention Deficit Disorders). See the CHADD website at www.chadd.org. You will need to arm yourself with as much information you can get on AD/HD, so you will be most prepared to help your son, manage and minimize the difficulties, and do what is necessary for your child to be successful.   One of my favorite books for parents that I recommend is the one by Dr. Russell Barkley entitled, "Taking Charge of ADHD."

There is a high probability with twins, that when one has an attention deficit disorder, the other does, as well.  Be aware that there are different subtypes of AD/HD.   One of the subtypes is the 'predominantly inattentive' subtype.  These children do not have the hyperactivity.  Some children with milder forms of AD/HD, and those who have AD/HD without the hyperactivity are typically identified much later because the symptoms aren't interfering with their functioning.  Just be aware that signs of AD/HD in your other twin may possibly become apparent at some point.

Now for your specific question:  Pay close attention to the demands and expectations placed upon your son (especially later in the day when the medication wears off).  This is probably not a good time to have your child come with you while running errands, or be placed in situations where it is expected that he cooperate and interact with others.  Sometimes, because there is less structure at that time of day, or due to over-stimulation from the environment, your child's fragile coping mechanisms are overtaxed. Also, your little guy may just be very fatigued at that time of day. So, try very calming activities such as listening to music or playing with quiet toys.  Physical activities (e.g., swinging) that have a "soothing effect" are also recommended.  I guess my first response would be to look at the environmental changes that you might need to make in order to reduce the likelihood that your child act out inappropriately.  Time out is an appropriate strategy.  I would read Dr. Barkley's advice on administering time-out with your AD/HD child.

In sum, you will need to be proactive in making sure that the school experience is one that will be beneficial to your child.  Speak to the principal and pre-k teacher about your son and his special needs.  Enlist their support in making the appropriate accommodations.  Make sure the classroom is conducive to your child's success and at the very least ...the teacher has an awareness of AD/HD, and willingness to work together with you as a team. 

By the way, my new book (that was recently released) is entitled,
Ready...Start...School - Nurturing and Guiding Your Child Through Preschool and Kindergarten (Prentice Hall Press, 2001).  That, along with my book, How to Reach and Teach ADD/ADHD Children, may provide you with the resources you need.

Wishing you the best,
Sandra

 

 

 

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