Mindful Living for Kids

UWindsor Blog Post by: Carlin J. Miller, Ph.D

Goldie HawnMindfulness is a hot topic in the media. Football players do it. Hollywood types do it. Kids in Vancouver Public Schools are even doing it. Yet, many people really don’t know what mindfulness training entails. Mindfulness training is about learning to meditate, which means paying attention to thoughts and feelings and behaviours as they happen without getting caught up in them. The goal is to not ruminate over the past or plan for the distant future, because both block our ability to experience what is happening right now. Most of the time, mindfulness is an “anchored practice,” which means you learn to focus on a specific aspect of your experience, such as your breath or the sounds you hear around you. There is no intention to block other thoughts or to change thinking. It really is about noticing.

Mindfulness training might sound very mystical but it isn’t really. It came from a Buddhist practice and was transformed into a secular activity in 1970s by a researcher in Massachusetts who wanted to help people with chronic pain to live more full lives. Since then, Mindfulness-based Stress Reduction and the many related interventions designed for special populations have been taught to hundreds of thousands of people. There are even forms of it for women during childbirth, people undergoing cancer treatment, and survivors of trauma and other potentially overwhelming experiences. Programs also been developed for children in classrooms, parents, and teachers.

Mindfulness in SchoolsOver the last year, my research team and I have been teaching parents and teachers of children with ADHD to meditate in a program called Mindful Living. We hoped that as these adults, who spend time with somewhat more challenging than typical children, learned to be present in their daily lives they would be less stressed and more effective in their interactions. We also hoped they would experience greater life satisfaction and more joy. Although we have only worked with 20 people thus far (too few to present any real statistics), our participants enjoyed the 8-week intervention and many continued to meditate following their completion of the program. It also appears that they are less stressed, more mindful, and have a better understanding of ADHD. We are now working with one of the local school boards to expand this training to more teachers this spring and next fall.

Because so many of our participants suggested these strategies would be helpful for the children and adolescents with ADHD in their lives, we developed a program called Mindful Living for Kids. Our first round of 6-sessions starts on May 13th and the sessions are 1 hour in length. We will have a group for children in grades 3-5 and another for preteens in grades 6-8. Unlike meditation training with adults, this program will be very hands-on with crafts, activities, and movement-based meditation, rather than emphasizing sitting quietly. If you would be interested in hearing more information or having your child participate, please call Dr. Carlin Miller at the University of Windsor (519-253-3000, x.2226).

About the Author:

Carlin Miller is a faculty member at the University of Windsor in the Department of Psychology. As a clinical psychologist with extended training in developmental neuropsychology and school psychology, she has spent the last 20 years trying to improve the quality of life for people with ADHD and learning disabilities. Prior to her doctoral work, she was a public school teacher. She found her passion for advocacy and research through her experience of growing up in a family with multiple people diagnosed with both disorders. In addition to her long resume with many publications and presentations, Dr. Miller has also been meditating for the last decade and brings to her research on meditation the positive experience of trying to live in the present. In addition to her work with the local chapter of the Learning Disabilities Association, she is also a provincial appointee to the Board of Directors of the Windsor-Essex Health Unit. When not at work, she is a mom, a wife, an avid gardener, and someone trying to be the person her puppy believes her to be. 

ADHD and Handwriting

UWindsor Blog Post by: Thomas A. Duda, M.A.

The diagnosis of Attention Deficit-Hyperactivity Disorder (ADHD) often conjures to mind an image of a child who doesn’t pay attention during school, is very talkative, acts without thinking, and appears to be constantly on the move as if powered by a motor. In addition to these cardinal features of ADHD, those with ADHD also tend to present with other differences compared to those without ADHD, including problems with motor control. In particular, the handwriting of those with ADHD is often described as illegible and less organized than those without ADHD. However, looking at what’s written down on paper isn’t the only way to think about handwriting. For example, other kinds of research has identified differences in the handwriting of those with ADHD at the actual movement level. Said another way, there are differences not only in what handwriting looks like, but also in the movements during handwriting. As one example, scientists in Australia found that how forcefully children with ADHD wrote was related to symptoms of hyperactivity and impulsivity. There are several different ways to conduct these kinds of studies, but scientists have most frequently used digitizing tablets (think “iPad”) to study handwriting motor movements.

Child with ADHDResearchers at the University of Windsor have been studying handwriting movements in children and adults with ADHD since about 2011. During this time, several interesting discoveries have been made. For example, parents and educators talk about children with ADHD as having a problem “doing what they know” rather than “knowing what to do.” They also show a lot of variability in performance such that the only thing that is consistent is their inconsistency! They may do really well on one assignment, but on the next one, although similar, do very poorly. They may complete chores satisfactorily sometimes, whereas on other occasions, these chores are completed haphazardly. This variability isn’t limited to these kinds of activities. Compared with adults without ADHD, Windsor researchers found that the handwriting movements of adults with ADHD were significantly more variable on average. Interestingly, this was only the case when learning a new symbol and it didn’t matter if they were on or off their medication for the treatment of ADHD. It was also shown that these adults with ADHD didn’t become as fluent in reproducing the new symbol as quickly as the adults without ADHD. This could mean that it takes more practice for adults with ADHD to become fluent when learning how to write.

Handwriting TabletThe next question might be, why is this important? Good question! First, these findings show that certain characteristics of ADHD (i.e., differences in handwriting motor movements) are not limited to childhood and continue into adulthood. In addition, the observation that adults with ADHD may take more time to become fluent at a motor task could have implications for accommodations. What’s more is that within the greater scope of psychology, researchers are trying to come up with new ways to identify and diagnose different kinds of psychological and neurodevelopmental disorders. Needed are more objective measures of functioning and this type of research can help with developing new methods to do this! Researchers at the University of Windsor are currently investigating if differences in variability and learning how to write that were observed in adults can also be found in children with ADHD, how different “thinking” abilities might be related to developing fluent handwriting in those with and without ADHD, and whether or not an objective measure of handwriting fluency development can successfully identify those who have ADHD.

Thomas A. Duda, M.A.
PhD Candidate
University of Windsor

Motivating Children with ADHD

UWindsor Blog Post by: Brie Brooker, M.A.

ADHD ChildIt is often said that being a parent is one of the most rewarding experiences of adult life. But for the parents of children with ADHD, the joys of parenting often come with daily struggles to manage a child’s behaviour and to keep him or her on-task. These challenges can leave parents feeling drained, frustrated, and isolated, often wondering if there is hope that their child’s behaviour is within their control. At the same time, children with ADHD may also feel frustrated, often desiring to comply with their parents’ requests but struggling to resist competing impulses and focus on the task at hand.

So what are parents of children with ADHD to do? Overreliance on punishing undesirable behaviour can be frustrating for a child, but when it comes to reinforcing good behaviour (whether through praise or a more tangible reward), research suggests that children with ADHD process this reinforcement differently than other kids do. By basing parenting strategies on these differences, parents may increase their (and their kids’) success.

Here’s what research tells us about how kids with ADHD are motivated.

  • Reward JarKids with ADHD may need more rewards in order to achieve the same level of performance as their peers. This suggests that parents of kids with ADHD may achieve better success by celebrating even the small victories, such as completing part of a chore or homework assignment.
  • Immediate rewards have a greater impact. Research also suggests that kids with ADHD are more motivated by immediate rewards rather than the promise of a reward later. However, parents may wish to teach their children with ADHD the value of working toward a more distant goal. One strategy which has been successful for kids with ADHD is the use of “tokens”: children earn small rewards (stickers, marbles in a jar) which may be collected and exchanged for a reward after a point (for example, after the child earns 10 stickers).

These are, of course, general findings based on large groups of children with ADHD, and every kid with ADHD has their own unique strengths and weaknesses. Moreover, it’s been suggested that individual factors such as ADHD medication can also impact reward processing, making kids with ADHD respond to rewards more similarly to non-ADHD kids. However, these findings may serve as a starting point for increasing success opportunities and making the parent-child relationship more rewarding for both of you.

Brie Brooker, M.A. (Doctoral student in Clinical Neuropsychology at the University of Windsor)

The Role of Psychological Assessment in Intervention

UWindsor Blog Post by: S. Scott, M.A.

When your child is having difficulties in school, whether in the area of academics, social relationships with others in the class, or one or more other areas, the first instinct as a parent or teacher is to intervene to help make the situation better and meet the child’s needs.

StudentsThis motivation to act is critical, as is gathering information about what exactly the child is having trouble with and why.  Such information is key in providing direction in deciding what supports would best help the child. The process of identifying the necessary supports can be achieved in several ways, one of which is by completing a psychoeducational or a neuropsychological assessment.  These types of assessments evaluate skills and abilities in areas relevant to school performance in a standardized way.  That is, the child’s performance is compared to other children who are the same age, and this provides information about areas of strength and weakness compared to their age-mates. This method can help to speed up the process through which a child is formally identified and accommodated at school.

Clinical psychologists who specialize in assessing children have a variety of tools in their toolbox to help pinpoint the difficulty and potentially determine the reasons why it exists.  The assessment process overall can take several weeks or more and requires a fair amount of information to be collected, including the child’s performance on standardized tests; a clinical interview with parents to gather background information; observations of the child’s behavior during testing; and other informal assessment procedures, such as reviewing samples of the child’s classroom work or direct observation of the child in the classroom (Sattler, 2008).  Teachers and parents may also fill out questionnaires to help the psychologist better understand some aspects of the child’s everyday behavior.

Although it is a time consuming process, at its conclusion, recommendations are given that are tailored to the child’s unique combination of strengths and needs to ensure the most appropriate interventions and learning strategies are put in place.  Additional resources often become available after a child has been diagnosed and formally identified, such as access to assistive technology (if warranted), and other accommodations in the classroom that will support the child’s learning, such as preferential seating in the front of the classroom or additional time to complete tests.

Another benefit of completing an assessment is ruling out diagnoses that do not fit with the difficulties that the child is experiencing.  That is, accurate diagnosis enables steps to be taken to initiate appropriate intervention, significantly reducing the chances of starting down a path that will not prove to be helpful and potentially losing valuable time treating the real problem.  It is well established that different developmental disorders often require different interventions.  For example, Nonverbal Learning Disorder is best managed with classroom accommodations that draw on a child’s strengths in language based academic and learning tasks (e.g., developing step-by-step written instructions that can be memorized to solve mathematical problems or to find a classroom when entering a new school), while minimizing reliance on weaker visual spatial skills.  In contrast, Autism Spectrum Disorders are treated most effectively with Intensive Behavioral Intervention (Perry et al., 2008) and techniques that incorporate Applied Behaviour Analysis (Dawson et al., 2010).  The methods used to reach an accurate diagnosis are continually refined by the findings of new research. Currently, additional research focusing on the way decisions are made by clinical psychologists and other health professionals to arrive at the correct diagnosis of an Autism Spectrum Disorder or Nonverbal Learning Disorder is needed to further reduce the chances of misdiagnosis.

If you have noticed that your child is struggling in school, an assessment from a clinical psychologist would almost certainly be helpful, and there are a number of options available.  If educators have identified your child as having difficulties in school based on their academic performance, then children may be assessed by clinical psychologists who are employed by the school board.  As a parent, it is within the scope of your rights to have discussions with your child’s teacher about concerns you have and to ask if your child would be eligible for an assessment through the school board.  Another option is to obtain an assessment privately.  There are a variety of clinical psychologists in Windsor and the surrounding area who specialize in assessing children.  Often, the child’s teacher or other parents who have been consumers of psychological services can make recommendations regarding who to contact.  A complete list of registered psychologists and their specializations can be obtained from the website of the College of Psychologists of Ontario.

House on Sunset - Psych ServicesIt is not uncommon for children and their families to face financial or other barriers to accessing diagnostic psychological assessments.  For those facing such barriers, several alternatives are available.  Psychological assessments are completed on the University of Windsor campus by licensed psychologists and clinical psychology graduate students based on a sliding fee scale for qualified individuals and families (for further information, please contact the Psychological Services and Research Centre directly at 519-973-7012 or access through their website.

Another option available from time to time is to involve your child in a research study that includes a comprehensive psychoeducational or neuropsychological assessment, usually free of charge.  Such research studies are often available through the Department of Psychology at the University of Windsor.  Each study has its own particular criteria that a child must meet in order to participate. Browsing the websites of Psychology Department faculty will give some idea of what is available.  For example, there is currently a study that is investigating the similarities and differences between Autism Spectrum Disorder and Nonverbal Learning Disorder in order to better understand the characteristics of each and to ensure that a correct diagnosis is reached. In this case, participants receive a neuropsychological assessment free of charge. To participate, however, children must be between the ages of 9 and 16 (inclusive), be able to speak in sentences, and have a diagnosis of Autism Spectrum Disorder or meet study criteria for Nonverbal Learning Disorder.To find out if your child is eligible to participate in this study, please call 519-551-8997 or email asd.nld.study@gmail.com.

CNRG: Child Neuropsychology Research Group

Regardless of the route you take to have your child assessed, it is a helpful process that offers numerous benefits to your child, and potentially to children who have yet to be diagnosed and are having difficulties in school.  Through research, there is an ongoing refinement of methods used to reach an appropriate diagnosis and to identify the most effective interventions.

References:

Dawson, G., Rogers, S., Munson, J., Milani, S., Winter, J., Greenson, J., . . . Varley, J. (2010). Randomized controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125, e17-e23. doi: 10.1542/peds.2009-0958

Perry, A., Cummings, A., Geier, J. D., Freeman, N. L., Hughes, S., LaRose, L., . . . Williams, J. (2008). Effectiveness of Intensive Behavioral Intervention in a large, community-based program. Research in Autism Spectrum Disorders, 2(4), 621-642. doi:10.1016/j.rasd.2008.01.002

Sattler, J. M. (2008). Assessment of children: Cognitive foundations (5th ed.). San Diego, CA: Jerome M. Sattler.

S. Scott, M.A.
Child Neuropsychology Research Group
University of Windsor

Why Participating in Research is Important

UWindsor Blog Post by: Carlin J. Miller, Ph.D

ResearchAs a researcher, I often have trouble understanding why parents of kids with ADHD would not participate in helping us better understand this disorder. I’m passionate about the process because I know the difference what scientists have uncovered in the past 20 years makes. And, I know how much is still unknown or unclear.

As a parent, I get it. You have limited time and you don’t want to spend the little free time you have filling out forms and traveling to the university. You aren’t sure it will benefit your child. Consider this post an opportunity to find out what is happening in ADHD research at the University of Windsor as well as a chance to better understand the process.

First, let’s deal with the time commitment. We, as scientists, understand being busy. Those of us who are parents experience the same time crunch you have and we don’t want to waste anyone’s time. We try to ensure that every question we ask is pertinent. We try to administer measures that help us better understand ADHD but we are also trying to be helpful to you. Just the same, gathering information takes time.

MindfulnessI can use my own recent project as an example. Our group offered an 8-week program in mindfulness-based meditation to parents and teachers of ADHD last spring. Before they started the program, we had participants fill out forms about their current psychological state and what they knew about ADHD. We also kept track every week of how they were doing at incorporating meditation into their daily lives. At the end, we had another round of questions about their emotions and their ADHD knowledge. Because it was a pilot project with a very small group, the statistical data isn’t very useful, but the information provided by participants helped them track their own progress. I was also making sure that each participant was not in enough distress to need encouragement to see their family doctor. At the end, participants said the program was very helpful and they would recommend it to others. They also reported feeling less stressed, less anxious, and more competent around their parenting. If you are interested in hearing more about this project or participating in the next 8-week program for parents and teachers later this fall, call me at the University (519-253-3000, ext. 2226) or send me an email (cjmiller@uwindsor.ca). We are also in the process of developing similar programming for school-age kids and adolescents to be offered in the late fall and early in the winter.

The mindfulness program is not the only research project on ADHD or related issues at the University of Windsor. One of my undergraduate students is surveying local parents and teachers of preschoolers about the relations among preschooler temperament, parenting style, and risky play. We hope to find that a child’s personality predicts risky play and that parenting style may make a difference in play outcomes. Another student is in the process of developing an online intervention to promote on-task behaviour in university students. A student in another faculty member’s research group will begin a project in the winter to examine handwriting performance in 10-12 year olds who have ADHD and are taking stimulant differences. (You can reach that student, Tom Duda, at dudat@uwindsor.ca.)

Without ongoing research, treatment for ADHD will stay where it is today. By volunteering your time and/or your child’s time as a research participant, you are helping us improve life for many, perhaps even you.

Carlin J. Miller, Ph.D.

Associate Professor, Clinical Neuropsychology
Department of Psychology
University of Windsor
http://uwindsor.ca/cjmiller