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 Loneliest Kid on the Bus

Sad boy in foreground being teased and bullied by three kids in the background.

Many kids with LD or ADHD also have social skills deficits which make school and life that much harder.

A Twitter ‘retweet’ via the LDAWE flashed onto my screen a few weeks ago, and it said this: “Stats Canada reports that 3.2% of Canadian children have a learning disability; that equates to 1 child in every full school bus”.  And it occurred to me as I read this that the one child on the bus who has the learning disability would very likely be the child who was sitting alone, being ignored or being bullied. I shared this observation with a friend, who pointed out to me that it would be just as likely that the child with the learning disability might also be the child wreaking havoc and doing the bullying. In either case, the reason might be the same: it is estimated that 75% of children with learning disabilities also have social skill deficits that make it difficult for them to have and keep friends.

It was these kids that Rick Lavoie was referring to when he coined the phrase “last one picked, first one picked on”, capturing the idea that it’s a real struggle for these kids to understand and “fit in” to the social structure around them. It may be that they were unable to learn the social skill or rule in the first place. It may be that they learned the skills but fail to consistently recognize when and how to use them. It may be that a lack of self-control results in negative behaviours which prevent them from either learning or applying good,  appropriate social judgment. Whatever the reason, the result can be a child who feels broken, lost, rejected, and unable to connect with the people around them for reasons they don’t understand.

A significant consequence of this kind of social struggle in kids can be anxiety, which only exacerbates the difficulties they are having. Although this is by no means a comprehensive list, a social skills deficit might manifest in ways that include:

  • Missed social cues
  • Failure to use proper manners
  • Difficulty taking turns in conversations
  • Missing important pieces of information
  • Distractibility, or appearing to ignore others
  • Misreading body language or facial expression
  • Misunderstanding information, not understanding jokes
  • Inability to maintain topic in a conversation, or ending a conversation abruptly
  • Disorganized or scattered thought and speech
  • Sharing information that is inappropriate (disinhibition, impulsivity)
  • Avoidance of social situations

For most of us, how we interact with one another is second nature, and is something we learned mostly unconsciously and without much effort (albeit with a few bumps and bruises, a bit of trial and error, and perhaps a touch of drama along the way). For most kids with LD or ADHD though, it’s not at all natural or easy. The good news is that, although they may need to learn these skills differently, they can in fact be learned with the right kinds of interventions.

For local resources, parents need look no further than the LDAWE’s Child Programs, and in particular the BEST Social Skills Program (BEST: Better Emotional and Social Times), for children 8-12. Their Summer Enrichment Camps also have a focus on social skills enrichment, with lots of opportunity for kids to practice what they are learning. For older kids (13-18), the LDAWE’s Youth Programs include a Youth Recreation Program where kids can “practice their social skills in an understanding environment and… become more active within their own community”.

Without the right kind of guidance and support, kids with social skill deficits are likely to become adults with social skills deficits, making it difficult for them to get and keep stable employment   The LDAWE ‘s Adult Programs offer support through their ERASE Program (Effective Resources and Skills for Employment), their Employment Supports Program, (Job Placement, Job Advancement, and Job Retention), and their Adult Recreation Program.

I don’t imagine that it’s easy to be the loneliest kid on the bus, nor to be the last one picked or the first one picked on, but this is not typically a problem that will get better on its own.  The reality is that if left unacknowledged and unaddressed, social skill deficits are more likely to become bigger problems than to go away as one grows older.  The loneliest kids on the bus often grow up to become the loneliest people in the workplace, if they are able to land and hold jobs at all.  But it doesn’t have to be that way, and with the right guidance and support and information and resources, these kids can learn to develop and sustain the kinds of supportive, productive friendships and relationships that we are all entitled to have.


If you’re looking for a good book on the topic of social skills deficits and LD/ADHD, I offer a couple of recommendations:

“It’s So Much Work to Be Your Friend: Helping the Child With Learning Disabilities Find Social Success” (Richard Lavoie)

“What Does Everybody Else Know That I Don’t?”   (Michele Novotni)

And finally, Rick Lavoie’s video, “Last One Picked, First One Picked On”  is a terrific resource for parents and educators. Check out the Viewer’s Guide below for some very helpful information.

last one picked

Organize your Life!

One of the most frustrating parts of having executive functioning difficulties, is the lack of a clear organizational system. Simple, everyday tasks become difficult when you don’t know where to begin or worse…when you are ready to begin you can’t because you cannot find the necessary tools for the job. This can really get in the way of not just learning, but life in general. Those with poor organizational skills often end up late for school, appointments, social functions, etc.

Whether it is the child that is lacking in organizational abilities, or the parent (I’m guilty of this!) here are a few suggestions and strategies to help make things go a little smoother.

1.ROUTINE – Create a routine for your family. This is so important. Routines can easily become habits when they are DSC_0014-3Snap 2012-03-07 at 08.02.04consistent. This paves the way for leaning life-long strategies to help organize your life. Time management is always a valuable lesson. Making a schedule for your young children to follow can cut out a lot of family arguments as well. If children have assigned shower times and homework
times, there is no fighting over who goes next in the shower and yelling to turn the tunes down (depending on the age of your children). Always include homework time, a chore and free time in the routine. A balance is necessary. If your child doesn’t have time for these things, you may want to consider a shift in activities for better time management.calendar

2.FAMILY CALENDAR – Have a central family calendar that is posted somewhere with high visibility, like the fridge. I bought an “Mom’s Ultimate Family Fridge Calendar”. It comes with stickers for different activities and
appointments. You could also find many different DIY calendar ideas on Pinterest. It is way easier to plan events and activities when everyone knows what is going on.

2.PERSONAL AGENDA – Another important tool for children as students is the agenda. Many students are expected to carry an agenda for school each day. This
provides an essential daily means of communication between the parent and teacher. Phone calls and interviews are good for periodic checks, but in order for you to get the full picture on your child’s agendaschool day, an agenda routine is necessary. Some teachers and/or schools do not follow this policy. If that is the case it may be difficult for you to convince your child to consistently use an agenda, but give it it a try. It keeps them organized with assignments and homework and they can transfer any important days onto the family calendar at the end of the day.
Some teachers use blogs and websites to relay this type of information. That is great news! Make sure that checking the blog or website is built in to your child’s nightly routine.

3. ORGANIZE! – Organize and reorganize and reorganize! We finally get a room organized and then VOILA! All your hard is gone. Of course it is…it takes work to stay organized. Make sure you expect this to happen. Look for lots of ideas on how to organize parts of your house. I find most of mine on Pinterest or Google. It does take time to adjust to news ways of organizing your items, but it is worth it when you are looking. I use labels and pictures to help organize things at home and things at school. If you aren’t sure where to start, a FANTASTIC website for organizing your life is:

http://www.flylady.net/

 

This website really can help you clean and organize your entire house. She has tons of great ideas and even better – a routine to follow!

Most of my favourite ideas come from Pinterest though…

shoe-organizer-boy-spring-craft-photo-420-FF0408BABYA14

books

4. GENTLE REMINDERS – Remember – everyone needs lots of reminders! That usually includes the parents too. It takes a lot of work to change a lifestyle. You can do it! Life will be so much easier in the end.

More Anxiety Tips…

In my last blog I talked about anxiety in children and offered some tips to help your child deal with anxieties. I want to stress again how difficult it is to follow the steps. The thing you have to remember is these are tips offering long term solutions and life strategies, not immediate response tips. In the moment they are the hard things to do. What you want, and it’s the job of any parent, is an adult who can function in society in any situation they may face, be it social, job related or by chance.

To continue on the list I started last time, I am going to offer some more tips, but first let’s revisit some of the suggestions from last time:

self awareness

  • Reduce excessive stress
  • Create a routine
  • Give consequences
  • Be supportive
  • Encourage their independence
  • Build their self-confidence

Set realistic expectations. It is important to have expectations, but remember that an anxious child may get frustrated if goals or expectations do not seem attainable. Break larger tasks into smaller steps and offer encouragement so your child feels a sense of accomplishment. Let them take steps forward, but let them do it at their own pace.

Control your reactions. Although it is important to be understanding and caring, do not overreact or let anxiety trick you into thinking that something is too hard or impossible for your child. Keep things in perspective. Yes, it might be challenging, but it can be done! On the other side of the pendulum, sometimes it is hard to understand our child’s anxiety or why something is so difficult for him or her. When we don’t acknowledge that our child is having a hard time with anxiety, the child may try to hide it (and suffer alone) or the symptoms may become more pronounced, (the pouting, arguing or misbehaving) in order to get the attention he or she needs.

Be Self-aware. It can be very difficult dealing with an anxious child. As important as it is to control your reactions for your child’s sake you also must manage your own reactions, for your own good. Do some things for yourself (enjoy a night out, read a book when the kids go to bed, go for a walk, or whatever helps you keep a positive perspective). Remember the basics: eat well, get enough sleep, and exercise! You can’t be helpful to your child if you don’t take care of yourself. You also need to be careful not to pass fears on to your children. Try to present a neutral reaction to situations and let you child know it’s safe to explore things.

Try Something New

Take Risks. This is true for everyone, but doubly important for an anxious child, so that they can build self-confidence and develop the necessary skills for dealing with people and their environment. Encourage your child to try new things such as ordering the pizza, or asking the store clerk a question. The other thing to remember is that children learn from example, so you can model brave behaviour by trying new things yourself.

Avoid Avoidance! Anxious children tend to want to avoid things that cause them anxiety. Even though avoiding things may reduce stress in the present, it allows fears to grow and makes things more difficult in the future. Avoid letting your child avoid things. Instead, encourage him or her to try things and take small steps towards facing fears!

Once again I do not offer this information as an exhaustive list, but as someone on a learning curve myself. Stay true to what you believe and know is right for the big picture, and not to simplify or ease the present situation. 

ADHD: Approaching Discipline as a Teacher

Frustration 1
How should the teacher approach discipline?

I have to admit this subject has always been a difficult one for me as an educator. On one hand I understand the implications of ADHD and understand that behaviors that typically require some sort of discipline in a school setting stem from impulse and behavior issues that the child does not necessarily have full control over. On the other hand, how can a teacher like myself allow these behaviors to go unchecked and set a bad example for the rest of my students that I:
a) am a pushover,
b) expect and encourage disruptive behaviour, or
c) am oblivious to the environment in my own classroom.

So then how do we as educators overcome this double edge sword?

First, teachers need to understand that often, children with ADHD don’t always realize why they’re in trouble. For example, when the teacher tells Sarah not to interrupt and she says, “I didn’t,” it sounds like she’s being argumentative or making excuses. In fact, Sarah may have no idea she was interrupting. So from her point of view, she can’t understand, first, why she was accused of something she didn’t do, and second, why the teacher won’t let her defend herself.

In one study, a group of non-ADHD children and those with ADHD were given fictional scenarios of disruptive behavior and asked to explain what was going on. A significant difference emerged: Most children thought that the child in the example could have controlled his behavior if he chose to; those with ADHD thought the fictional child couldn’t control the behavior, and they identified outside forces that provoked it–for example, “His friends bug him all the time.” (source-From The Attention Deficit Answer Book: The Best Medications and Parenting Strategies for Your Child by Alan Wachtel, M.D. Copyright � 1998)

From the perspective of someone with ADHD, this view makes perfect sense. They know that in many cases they themselves can’t control their own behavior. So it’s not surprising that they feel persecuted when a teacher, parent, or peer blames them for their actions. If you got blamed because it happened to pour rain at your soccer game you’d feel persecuted too!

In the classroom, I think the teacher must walk the fine line between responsibility and blame. It’s important for the teacher to impart a sense of responsibility to the child for his actions, and to help him understand the consequences of those acts–but to do it in a way that doesn’t make the child feel persecuted.

It’s a tough challenge. One way to approach it is by acknowledging the difficulties while expressing confidence in the child’s ability to overcome them and offering a concrete strategy for doing so. For example, the teacher might tell a child, “I know it’s hard for you to sit still on the bus. I think it will be easier if you sit next to me so that I can remind you to sit down.” Even though the outcome may be the same, that approach sends a much more positive message than simply telling the child to sit next to you on the bus.

How have you approached discipline in the classroom/and or at home for undesirable behaviour? Do you feel that acknowledging your perspective has allowed you to accept disciplinary measures more readily and to learn from them and not take offense?

ADHD Awareness Windsor Workshop – October 18, 2013

LDAWE Guest Blog Post by: Dr. Sharon Burey

ADHD AWARENESS DAY WORKSHOP

OCTOBER 18, 2013 in WINDSOR, ONTARIO

FREE EVENT

Hi. My name is Dr. Sharon Burey and I am a Consultant Behavioural Pediatrician. This is my very first blog ever! I am really excited about stretching myself and joining the Learning Disabilities Association of Windsor-Essex in providing top-notch experiences, information and stories about ADHD and Learning Disabilities.

After practicing pediatrics for some time and specializing in children who have learning and behaviour problems, I realized that most of the action ― that is anything that is substantially going to improve health outcomes ― happens outside of the office. This was the driving force behind the creation of ADHD Awareness Windsor. I realized that partnering with service providers within the community, such as the Learning Disabilities Association of Windsor-Essex, would provide a more complete path to wellness for my patients and their families. It was also exciting getting out of the office and working in the community. For more information about ADHD Windsor, please visit our website www.ADHDWindsor.com.

I believe that healing and wellness take place not just in homes and hospitals and doctors’ offices but in the community. The community is a place where we all live. The community represents our beliefs, our hopes and our dreams about our own lives and the lives of our children. The community normalizes a belief system of healing and wellness for the societies in which we live. The community’s beliefs about healing and wellness have a role in shaping our personal beliefs about healing and wellness. And so it is, that over the past several years of ADHD Awareness workshops we have seen improved knowledge and help-seeking behaviour in our community when it comes to ADHD. The results of surveys filled out by attendees each year as well as yearly reports can be found at www.ADHDWindsor.com.

I would like to take this opportunity to invite you to this year’s ADHD Awareness event. It will take place on Friday of October 18th at the Caboto Club in Windsor, Ontario. You may register at the website noted above. The event is free. This year we will have Dr. Yousha Mirza, a local Child and Adolescent Psychiatrist, as our keynote speaker. Community partners who provide services for children with ADHD and Learning Disabilities will be available to answer your questions and provide you with information. This is a very important opportunity for all parents and caregivers of children and adolescents with ADHD to touch base with our service providers. The support networks that we create in our own lives make the difference between success and failure.

One of the most extensive studies on the best treatments for ADHD was the Multimodal Treatment (MTA) 1 study for ADHD in children. One of the most important findings was that it was the children who received the most support ― medical, social, academic, psychological and financial ― who did best.

We now know that medication is just one part of the management of ADHD. In fact, there are a number of children who do not do well on any medication; in those cases other treatments have to be marshaled. New research on exercise, lifestyle and diet shows that these factors are extremely important in modifying the effect of ADHD on children and adolescents and their families.

I’d like to hear your thoughts. Please feel free to leave comments or just vote yes or no.

Take care of yourselves and I hope to see you on October 18, 2013!

References

1. Molina, Brooke S.G.; et. al. The MTA at 8 Years: Prospective Follow-up of Children Treated for Combined-Type ADHD in a Multisite Study. Journal of the American Academy of Child & Adolescent Psychiatry 2009, Vol 48 (5):484-500.