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The ADHD Child and Summer Camp

 
It is that time of year! Millions of kids across the country will be packing up their knapsacks, waving goodbye to mom and dad, and heading for the hills—literally. Yes, they will be off to summer camp.

What about camp for your ADHD child? Is camp good for him? Is she ready for camp? These are good questions. The answer, of course depends on a multitude of factors. The issues condense to two important areas:

Is your child ready for camp?

Is camp ready for your child?

Is Camp Ready for My Child?

Let’s look at the second question first. This question is really asking if the camp under consideration is one that is appropriate for a child with ADHD. Does the camp have a philosophy of inclusion in which they are interested and equipped to work with children with varying backgrounds and needs. Does the administration and staff have some knowledge about ADHD? Is the staff trained in the needed skills of reinforcement and behavioral management? If your child is taking medication, is the camp able to administer it properly.

Although few in number, camps do exist specifically for children with ADHD. These camps are designed to present a general camping experience for the child while at the same time providing specific therapy and education relating to the ADHD. To find out about such camps in your area you might check with the local chapter or the website of CH.A.D.D. (Children and Adults with Attention Deficit Disorder) or LDA (Leaning Disabilities Association). Also, check with your school counselor. He or she might have a list of summer camps that accommodate children with unique needs.

Is My Child Ready for Camp?

Is your child ready for camp? The answer to this question is somewhat more complicated. Most importantly, the child’s attention deficit should be sufficiently controlled so that he will have a positive and helpful experience. His behavior should be at the point that undue re-direction or behavior modification will not be required.

Look for the following readiness cues: Does your child make friends easily? Does she adapt well to new situations? Does she respond well to adult supervision? Does she enjoy successful sleep-overs at the homes of her friends or relatives?

In addition, if your child hasn’t experienced success in most of these areas, she probably is not ready for sleep-away camp. But she might be ready for a less socially demanding experience such as day camp. If day camp is too big a step, encourage your child to spend a few days with a favorite friend or relative. Then be sure to praise her success at being away from home.

In general, I would suggest that most children with ADHD are not ready for a week-long sleep away camp until ten or older. For many, this time will not come until their early teens. Of course there could be exceptions with the more mature child. Day camp could be a very good alternative for the child with ADHD.

What Are the Benefits of Camp?

Attending camp gives children an opportunity to learn many new skills—how to swim, ride a horse, sail a boat, hit a tennis ball, use a bow and arrow, tie a knot. It also gives them a chance to master important emotional, developmental, and social skills—how to get along with other people, establish peer relationships, tolerate differences, work as a team, and become more independent. Camp also gives parents and kids a chance to practice the art of letting go. The experience lets children develop autonomy and a sense of self-respect. A successful camp experience can be a big boost to self-esteem. For parents, the separation allows them to take a break, care for some of their own needs, and recharge their parenting batteries. They also need to experience autonomy from their child—in preparation for what is to come in the very near future.

How to Prepare the Child for Camp?

Since children can be fearful of the unknown, it is a good idea to share as much information as possible about the camp. If the facility is within driving distance, you might plan a visit ahead of time. Such a visit allows the child to see the place as well as talk with some of the staff. The mystique as well as the fear is thus removed.

If a personal visit is not possible, ask the camp for whatever information they may have: brochures, pictures, videos of the camp.

Above all, talk with the child about his hopes, dreams, and fears about camp. Listen to what he has to say. Discuss any concerns. Certainly, do not belittle the worries and fears. Let the child know that while you think the camp experience will be good for all of you, you will miss him and will look forward to his return. It also helps if the child is able to attend camp with a friend.

 

Redemptive Features of ADHD

Children with ADHD have very real challenges. The disruptiveness of the child’s behavior and the struggles in learning can make life difficult. These dysfunctions tend to drive professionals as well as parents to focus largely on the negative connotations of attention deficits. But redeeming features do exist, even though they may be difficult to see. However, this positive side to ADHD often begins to show itself in adolescence and young adulthood if we look for it.

—The inattention to detail that is so frustrating to student and teacher alike can lead to strengths in conceptual ability. A result can be an enhanced ability to see the big picture. Such individuals can become adept at global problem solving and may be an asset in leadership roles.

—The inability to be easily satisfied can be associated with ambition and initiative. Could this be one reason why so many individuals with attention deficits have been successful in a wide variety of fields?

—Distractibility is intimately linked to creativity. A student who notices things no one else sees is in a position to detect meaningful interrelationships that elude more disciplined minds.

—A student who is highly impulsive may ultimately evolve into an adult with a strong bent for closure, a person who accomplishes a great deal during the working day.

—It is not unusual to encounter adolescents with attention deficits who have superb sense of humor, appealing personalities, true leadership skills, and striking individuality.

Yes, the struggles that children with ADHD face are real. It is important to intervene and provide healthy management such as academic accommodations, medical treatment, counseling when needed. In doing so we can avoid some of the unhealthy consequences such as poor self-esteem and discouragement.

However, we should have an optimistic anticipation of the ultimate success of the child with ADHD. We should be looking for ways to help the teen discover his or her strengths and help them see that they can turn a weakness into an asset.

 

ADHD in the Pre-school Child

Bobby’s parents were concerned. Following his fourth birthday in the summer he had been enrolled in preschool three months ago. The teacher had already requested several conferences with the parents regarding Bobby=s work and play habits as well as his behavior in the classroom.

His mother brought along a note his teacher had recently sent home: Bobby has trouble sitting for more than two minutes before he is up and running about the classroom. He is restless at circle time and wanders around the room. He disrupts the other children who are trying to work. He cannot concentrate for more than a minute or two on a task because he  is so easily distracted.

 Bobby’s Story

I learned that Bobby was the first child in his family. His mother reported that he had always been difficult to manage at home. Always active and restless, he had difficulty staying at the table through a meal and getting to sleep at night. He acted without thinking and was repeatedly in trouble for things like jumping on the furniture or getting into places that were off limits.

When his cousin of the same age visited, he pushed and shoved and was over-excited. But he was not angry and seemed genuinely sorrowful when confronted about what he had done.

His mother had noted these behaviors but did not know what to make of them since Bobby was here first child. AI thought maybe it was because he was a boy.

Once he began to have persistent trouble at preschool the parents suspected that something was not right. The teacher suggested that he might be hyperactive, the father volunteered.

But I thought he was too young. Doesn’t that problem only occur in older kids?@ his mom asked.

In fact, most children with attention problems and hyperactivity are not recognized until early elementary school.

However, the characteristic symptoms of ADHD are typically present from early in life. Often parents as they present a detailed history of the older child recall that the one with ADHD was different from early in life. These difficult behaviors at the time were not clearly different form the typical toddler and preschool pattern. Because no one could put a finger on these differences, they were ignored, or at least tolerated, during the early years. Confusing the picture is the fact that toddlers and preschoolers are by nature active, impulsive, and easily distracted. So the child with developmental problems may be somewhat difficult to separate out at this age.

But, then, along comes a Bobby whose restlessness, impulsiveness, and pure motor hyperactivity cannot be ignored. Such a child has problems paying attention, following directions, and participating in cooperative play appropriate for their age. They are over stimulated easily in large groups or when excited. In a one-on-one situation they may be more attentive and cooperative but even here the short attention span is likely to be noticeable.

For instance, they may have difficulty sitting still at the table through a meal. They will want you to read to them but may listen for only a few minutes before they are up and running or asking for another book. They may hit, push, and shove impulsively, but yet, they are not angry or mean. One common symptom at this age is an incessant need to talk without any control.

 The Diagnosis

Indeed, Bobby did have attention deficit disorder.

After detailed observations were obtained from his parents and teachers, developmental tests were administered. He was cognitively advanced being particularly strong  in verbal skills. However, his motor skills were mildly delayed. The examiner noted that he had a very hard time keeping Bobby focused on the tasks.

Following this evaluation, Bobby was treated with a small dose of Methylphenidate. There was marked improvement in his activity level and degree of impulsiveness. He was much more controlled in school as well as in the home setting.

His teacher later wrote: Now Bobby is able to realize when he has done something wrong. He more often chooses positive options. He is able to sit and concentrate. He is choosing to ask for work which requires that he sit for 10-15 minutes at time. The amount of detail in his daily journal has changed tremendously. Before, he would draw just few lines with dark color in his interpretation was usually something violent and aggressive. This week, however he is taking his time and the colors and the details of his drawings are bright and clear.

 Management

The management of the young child with ADHD is certainly more difficult and complicated than with older children.

First, as we have discussed, it is not always easy to separate the attention behaviors from those behaviors which are typical of preschoolers. Not only is the initial diagnosis more confusing but it is also more difficult for parents to decide how to respond to a specific behavior.

Secondly, the preschooler is not sufficiently mature cognitively to understand the consequences of his disruptive behaviors. Thus verbal signals are often not well understood or received. Parents find themselves constantly interrupting and re-directing behaviors.

The excessive impulsiveness leads the preschooler to behaviors that can be dangerous to themselves and others. Parents must be on their guard for things like climbing to dangerous heights, playing with matches or fire, running into the street, etc. The children must be watched compulsively.

To complicate all of this, the preschooler’s response to stimulant medication is more erratic and unpredictable. Many physicians simply will not attempt to treat the young child with medication because they have had bad experiences with it or they are uncertain about how to administer it to this age child.

 The Use of Mediation With the Preschooler

Recent studies, however, have verified the fact that, indeed, preschoolers can be effectively and safely treated with stimulants with good response when the medication is managed appropriately for their age. The main problem is the narrow window between effective dose and side effects. However, by starting with a low dose and gradually moving upward, side effects can usually be avoided while finding that effective therapeutic window. While most stimulants are available in pill or capsule form only, there are some liquid form available. However, the liquids are all short-acting and require multiple doses during the day, however.

 Other Management Steps

In addition to medication when needed, other management steps are extremely important.

It is important for the home and school environment to be as calm and under-stimulating as possible while providing opportunities for learning. A consistent routine of living: eating, sleeping, play time, nap time, school, etc is essential.

An effective behavior modification plan is also important. Often behavioral counseling for the parents will be necessary to help them formulate discipline strategies and techniques to hand the specific bothersome behaviors of their preschooler. A developmental psychologist who understands preschoolers in a great help.

The preschooler with ADHD will often benefit from enrollment in a preschool at age three or four. The school should be quiet, structured, yet affirming in its atmosphere. Consistent behavioral management should be used.

Most of all, parents need relief. The supervision of the preschooler with ADHD is a very demanding, full-time job. This job can easily over-whelm the most energetic and well-meaning parents. Parents need to make good use of a competent preschool and mature sitters and relatives to get away and recharge their own batteries. Otherwise, they will collapse, emotionally, if not physically.

When confronted with the preschooler with ADHD we need to remember the natural tendency of ADHD to get better with chronological maturity. It we can provide right combinations of management at this early stage, we set the stage for more healthy growth later.

Medication for ADHD: No Effect on the Heart

In recent years there has been concern that stimulant drugs used to treat ADHD might pose some cardiovascular danger to the children taking them. In fact, this alarm led to the placement of a “black box” warning by the FDA in the package insert for such drugs. This then led to a debate among pediatricians and cardiologists as to the wisdom of obtaining an EKG prior to starting a child on medication. The concerns were real although the data showing a relationship was inconclusive.

Now a new study has soothed these concerns.  This study suggests that there is little, if any, cardiovascular risk with these drugs. An analysis of the cardiovascular safety of the stimulants in a population of more than 1.2 million children and young adults from 4 geographically diverse health plans with more than 2.5 million person years of follow-up found no evidence that these drugs increased the risk of serious cardiovascular events. Study data ranging from 1986 to 2002 was obtained from computerized health records of patients aged 2 to 24 years receiving an ADHD medication such as methylphenidate (Ritalin), Adderall, or other commonly used forms of these drugs.

For each patient receiving an AHDH medication, the investigators randomly selected for comparison two non-user controls from the health plans.  The rate of serious cardiovascular event did not differ significantly among current users of AHDH medications and controls.

This large, controlled study is reassuring to physicians and their patients. It strongly suggests that routine EKG screening of ADHD patients prior to starting medication is not needed.

This study was published in the New England Journal of Medicine in November, 2011 (365(20): pages 1896-1904)

ADHD–A Family Matter

One in every four children with ADHD has a biological parent who is similarly affected according to Dr. A.J. Zametkin of the National Institutes of Mental Health, Bethesda, Maryland. His excellent review of the family history of attention deficit disorder appeared several years ago in The Journal of the American Medical Association. Dr. Zametkin discussed a family in which 3 generations of males had significant symptoms of ADHD.
The youngest was diagnosed first and treated successfully with medication. On review, it was obvious that his father had attention and organization dysfunctions which continued to interfere with his life as an adult. He was also treated successfully with medication beginning in his forties. Further questioning suggested strongly that the paternal grandfather had symptoms of ADHD. (Zametkin A, JAMA 273:1871-1874, 1995)

Editor’s Note: This study, although from several years ago, points out the importance of discussing the family history when evaluating a child with attention problems or learning disabilities. Strong family patterns do exist. And this is not the first time a parent has learned of his or her own attention deficit after having had a child evaluated.


Over the decade and a half since this study was published, research into the cause of ADHD has shown that heredity is the most dominant factor determining the presence of ADHD. Those of us working with children with ADHD often see families in which the one or both parents will say, “You know when I was a child I was just like my son. I had the same problems. In fact I still have those problems to some degree.”

ADHD and Anxiety

Children of all ages with ADHD (Attention Deficit Hyperactivity Disorder) frequently suffer from varying degrees of anxiety. Anxiety may be provoked for many reasons in the child with ADHD: The frustration coming from having to work harder in order to keep up academically is a common and significant stressor. The incessant negative feedback that is all too common in the life of the child with ADHD creates a numbing pressure. Then the difficultly getting along with peers sets the child a part socially and fosters a sense of not belonging. All of these issues lead to low self-esteem which makes the child with ADHD even more vulnerable to stress.

A study reported recently at the American Neuropsychiatric Association meeting found that stimulants administered for ADHD also help relieve anxiety in the patients. In fact stimulants alone were as effective in treating anxiety as stimulant plus anti-psychotic medication.

The study evaluated 134 children and teens with a mean age of ten years. They were evaluated in terms of the change over time in anxiety scores on the parent-completed Child Behavior Checklist.

Eighty children were on stimulants only. Another 54 were on a stimulant plus antipsychotic drug. Twenty four of the patients had clinically significant anxiety, as determined by a baseline Achenbach anxiety score prior to starting medication. After four months of therapy with stimulant medication, 83% of the children had a reduction in their anxiety scores.

This study did not evaluate the reasons why anxiety was lessened with stimulant treatment. Two possible mechanisms, however, could be responsible. First, it is possible that stimulants have a direct anti-anxiety effect when used to treat ADHD. However, this is not proven. A more likely possibility is that with effective treatment of the ADHD behaviors, the patients experienced less conflict with his or her environment and, therefore, experienced a reduction in anxiety.

Those of us working with children with ADHD should remember that they are often dealing with significant stress and anxiety. We need to look for such complications and address them when needed. It is good to know that effective stimulant therapy, itself, has a measurable anti-anxiety effect.

The ADHD Child and Summer Camp

It is that time of year! Millions of kids across the country will be packing up their knapsacks, waving goodbye to mom and dad, and heading for the hills—literally. Yes, they will be off to summer camp.

What about camp for your ADHD child? Is camp good for him? Is she ready for camp? These are good questions. The answer, of course depends on a multitude of factors. The issues condense to two important areas:

Is your child With ADHD ready for camp?

Is camp ready for your child with ADHD?

Let’s look at the second question first. This question is really asking if the camp under consideration is one that is appropriate for a child with ADHD. Does the camp have a philosophy of inclusion in which they are interested and equipped to work with children with varying backgrounds and needs? Does the administration and staff have some knowledge about ADHD? Is the staff trained in the needed skills of reinforcement and behavioral management? If your child is taking medication, is the camp able to administer it properly.

Although few in number, camps for children with ADHD and/or other learning difficulties does exist. These camps are designed to present a general camping experience for the child while at the same time providing specific therapy and education relating to the ADHD. To find out about such camps in your area you might check with the local chapter of CH.A.D.D. or LDA (Leaning Disabilities Association). If you are unable to locate a local chapter, contact the national offices of these organizations.  Also, check with your school counselor. He or she might have a list of specialty summer camps.

Is your child ready for camp? The answer to this question is somewhat more complicated. Most importantly, the child’s attention deficit should be sufficiently controlled so that he will have a positive and helpful experience. His behavior should be at the point that undue re-direction or behavior modification will not be required.

While there is no sure way to know, there are a few points that indicate that your child is ready for the camp experience. Look for the following readiness cues: Does your child make friends easily? Does she adapt well to new situations? Does he respond well to adult supervision? Does she enjoy successful sleep-overs at the homes of her friends or relatives?”

If your child hasn’t experienced success in most of these areas, she or he probably is not ready for sleep-away camp. But she might be ready for a less socially demanding experience such as day camp. If day camp is too big a step, encourage your child to spend a few days with a favorite friend or relative. Then be sure to praise her success at being away from home.

In general, I would suggest that most children with ADHD are not ready for a week-long sleep away camp until ten or older. For many, this time will not come until their early teens. Of course there could be exceptions with the more mature child. Day camp could be a very good alternative for the child with ADHD.

What Are the Benefits of Camp?

Attending camp gives children an opportunity to learn many new skills—how to swim, ride a horse, sail a boat, hit a tennis ball, use a bow and arrow, tie a knot. It also gives them a chance to master important emotional, developmental, and social skills—how to get along with other people, establish peer relationships, tolerate differences, work as a team, and become more independent.  Camp also gives parents and kids a chance to practice the art of letting go. The experience lets children develop autonomy and a sense of self-respect. A successful camp experience can be a big boost to self-esteem. For parents, the separation allows them to take a break, care for some of their own needs, and recharge their parenting batteries. They also need to experience autonomy from their child—in preparation for what is to come in the very near future.

How To Prepare the Child for Camp?

Since children can be fearful of the unknown, it is a good idea to share as much information as possible about the camp. If the facility is within driving distance, you might plan a visit ahead of time. Such a visit allows the child to see the place as well as talk with some of the staff. Much of the mystique as well as the fear is thus removed.

If a personal visit is not possible, ask the camp for whatever information they may have: brochures, pictures, videos of the camp.

Above all, talk with the child about his hopes, dreams, and fears about camp. Listen to what he has to say. Discuss any concerns. Certainly, do not belittle the worries and fears. Let the child know that while you think the camp experience will be good for all of you, you will miss him and will look forward to his return. It also helps if the child is able to attend camp with a friend.

Structure of Time and Place

Most children as well as adults, when left on their own, eventually will fit their daily routine into some sort of pattern that allows them to function successfully. Due to their internal disorganization, however, children with ADHD fail to do this effectively. They have difficulty focusing on a goal and aiming at it. Their increased susceptibility to distractions makes it difficult for them to stay focused on what is important at any given time.

The more unstructured, disorganized and distracting the environment, the more the child is disorganized and disoriented as to his goals. This, in turn, leads to confusion and frustration which leads to more disorganized, unsuccessful behavior. Thus in an unstructured, unregulated environment the child is caught up in a spiraling web of deteriorating behavior. The more inconsistent and unpredictable the environment, the more disorganized the child’s behavior becomes. This then induces more disorganization and inconsistency in his environment. The downward spiral of confusion and frustration goes on and on…and on.

An environment that calms, organizes, and structures the child’s life is one of the primary steps in a strategy for success. The following techniques are basic:

1. The first step is to provide a dependable time structure to the child’s day. Some elements

of this are:

a. Getting up the same time every day.

b. Regular daily schedule.

c. Regular routine for school, play naps, etc.

d. Regular time for homework.

e. Regular bedtime.

Such a regular, dependable routine does several things for the child. Each planned activity presents him or her a framework on which he can hang his day. The set routine gives him short‑term goals to work towards. The time structure acts like handrails on the stairs which help the child keep his behavior more goal-directed. Having certain activities to do at specific times makes him less likely to wander off into distracting, bothersome behavior.

In implementing such a time structure, the parent first decides on what would be a desirable daily pattern that fits the parents, as well as the child’s, needs. At this point, it would be helpful to sketch out the daily schedule. The parents need to make sure the key elements (getting up, meals, school, bed time) are such that they can enforce them consistently. They then discuss the schedule with the child.

The parents do not have to make a big production out of this scheduling task. They might simply say something like this: “This is going to be our schedule. Let’s discuss it.” If the child is old enough, the schedule can be written and posted in his room or some other conspicuous place. An older child (seven or eight or older) might participate in determining the contents of the schedule. Once the schedule has been determined, the parent enforces it consistently, but gently.

This does not mean that the family must live a totally monotonous, unchanging life for the sake of this one child. But the day‑to‑day routine of the child should be as consistent as possible within the family’s power to make it so. Certainly, there will be times when a break in the routine is needed. When change in this regular routine is necessary, however, it helps to prepare the child ahead of time and clearly state what you expect of him or her.

2. The next step is the structure of place.

“A place for everything and everything in its place,” is more than a motto for the person with ADHD. It is a necessity. A search for a lost baseball glove can be a frustrating experience for a normal ten‑year‑old. But for a ten-year-old with ADHD, it can be a disaster, ending in an emotional explosion. Such problems can be prevented by helping the child organize his world (at least his room and his belongings) so that there is a place for everything.

This could involve other elements such as:

a. A regular, non‑distracting, place to do homework.

b. Labels on drawers and shelves to help the child locate the contents. (Some parents have successfully used color codes on drawers and shelves.)

c. In strange new surroundings, such as on vacation, new school, or visiting friends, it helps to take the child on a tour and show him the layout and locations of important particulars of the area.

These are simple steps but can make a big difference in the life of the child with ADHD—and that of his parents.

Redemptive Features of ADHD

Could there be positive aspects to having ADHD?

One would think so. As a biological condition, ADHD has been around for eons. To persist in the human family, there would likely be some benefits to the individual with these traits.

The negative effects that ADHD symptoms have on socialization and productivity are well known and very real. These disruptive features tend to capture the focus of professionals as well as parents because of the limitations they bring to the child’s life. But redeeming features do exist, even though they may be difficult to see when the child is failing in school and loosing friends.

Some potential beneficial side effects of ADHD are:

The inattention to detail that can be so frustrating to the student, the teacher, and the parent can result in an enhanced conceptual ability which helps the child see the “big picture.” This “big picture” view can result in strengths in global problem solving.

The inability to be easily satisfied can be associated with ambition and initiative. Could this be one reason why Thomas Edison kept tinkering with all sorts of projects leading to his  ownership of thousands of patents for innovative and useful products?

Distractibility is intimately linked to creativity. A student who notices things no one else sees is in a position to detect meaningful interrelationships that elude more disciplined minds.

A certain level of impulsiveness can result in a willingness to try new things, to go out on a limb for a project or cause that is important.

Individuals with ADHD often have a superb sense of humor, appealing personalities, true leadership skills, and striking individuality.

Parents and professionals working with children with ADHD are well aware how limiting the varied symptoms of ADHD can be when they are unmanaged and run amok. In fact, when a person, child or adult, is overwhelmed by inattention, disorganization, impulsiveness, they are set up for failure. But with proper management, these symptoms can be controlled. The ultimate future for children with ADHD can be bright. So we should not give up but use strategies that result in success. The chief purpose of  Strategies Unlimited is to provide practical steps in achieving this goal so that we can see the bright side and enjoy the journey.

Classroom Strategies: Teaching the Child with ADHD

I have great admiration for the dedicated teacher. And most teachers I know are teaching because they love children and like being around them. They have a sense of satisfaction when they see their students learn, grow and succeed.

On the other hand, they are frustrated and personally defeated when one of their students fails to achieve and succeed. Thus the presence of a child with ADHD (Attention Deficit/ Hyperactivity Disorder) in a class tends to stir up a mixture of reactions in a conscientious teacher. He or she wants to help, but is thwarted by lack of time, too many students, or a lack of materials or training. This easily leads to frustration and hopelessness.

One fourth-grade teacher spoke not only for herself, but also many colleagues, when she discussed a child with ADHD in her class. “Jimmy is a puzzle. I want to help him but I’ve been frustrated at every turn.”

In this short note we cannot offer solutions to all the problems of attention, hyperactivity, or organization that besets the child with ADHD. But there are some tried and proven methods that help. From time to time we will share methods and tools gleaned from experienced teachers. Hopefully, they will make the job of teaching the child with ADHD or learning disabilities a little less frustrating and more rewarding.

From long experience, we know that children with hyperactivity and attention deficits function much better in an organized, structured atmosphere. Not only does such an atmosphere facilitate the child’s performance in the present, this atmosphere also encourages the child to internalize this imposed organization so that, in time, he or she becomes more self-controlled.

The following suggestions regarding classroom management have been derived from the available literature, current research findings, and clinical observations, as well as teaching experience. The goal of these strategies is to help the child internalize control of attention, impulsiveness, and activity, thus improving work habits and general behavior. The methods are designed to help the child develop more conscious control. Each teacher will not, and should not, employ each and every technique presented. This is simply a sampling of practical techniques which can help with certain problem behaviors. The teacher can pick those he or she thinks may work for him or her with the child in question.

Classroom Strategies Useful With ADHD Children

1. Seat the student near the teacher’s desk in a reassuring non-threatening way.

2. Call the student’s name before addressing him or asking him to recite.

3. Stand near the child when giving instructions.

4. Physical features of the work environment influence the activity and lack of focus level and the following guidelines should be followed:

a. Reduce the visual stimuli in the child’s visual field (place construction paper over windows; reduce the presence of posters, pictures, etc.)

b. Lighting should be of medium intensity, no flickering or bright lights.

c. Try to schedule work so that the child is not being expected to concentrate when there is a lot of distracting noise in the hallway.

d. For children with significant attention deficits, create a private study office by screening off the work area.

5. A child with ADHD will often have difficulty finishing work. Give shorter assignments with immediate feedback of results. Multiple short assignments work better than one long assignment.

6. Work from small units to larger units in the quantity of work required, the complexity of the task, and time required to complete tasks.

a. Shorten assignments.

b. Start with easily accomplished tasks.

c. Build assignments in terms of length and complexity.

d. Plan interruptions of long assignments.

e. Cut work sheets, e.g. arithmetic, into long strips, present each strip individually.

f. Vary activity.

g. Break assignments and experiences into smaller units.

h. Gradually increase quantity and complexity of timed units.

i. Do not make large leaps either forward or backward at any one time.

7. Use techniques, such as assignment cards, that help improve short-term memory.

8. Use unique, distinct visual and auditory stimuli.

a. Cue the child to distinguish features of each stimulus in reading or arithmetic by: underlining, color coding, and/or specific verbal direction.

b. Use a multi-sensory approach to allow rehearsal of the material, i.e. speaking orally, writing down key words, drawing pictures, etc.

9. Provide an opportunity to express motor restlessness in appropriate ways. When possible you may allow the child to work standing or moving about at times; the use of a round table that child can move about may help. Incorporating adequate physical education that allows for gross body movement without involving competitive sports can be helpful.

Summary

Yes, there are no easy answers to treating and teaching children with ADHD. These children are often lovable and attractive, while at the same time frustrating and exhausting to the teacher. One or two such children in a regular classroom without help for the teacher can be stressful for everyone. Open, free communication between teacher, parent, physician, and educational diagnostician is of critical importance if success is to be realized.

While the institution of a well structured, organized environment at home and school will allow many hyperactive children to function reasonably well, others will need additional modes of therapy such as medication or a prescribed behavior modification plan. However, the teacher is always a key member of the management team.

Additional teaching tools to help with the Child with ADHD can be found in Dr. Grant’s book, ADHD—Strategies for Success which can be ordered from this website.

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