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Successful Coping Strategies for Adults With ADHD

Many adults with ADHD (Attention Deficit/ Hyperactivity Disorder) have become successful academically and professionally. They have enhanced their success by employing a variety of strategies that help them cope with the bothersome symptoms of ADHD

A few years ago, Dr. Robert Wells, Ph.D., studied  strategies practiced by successful men and women with ADHD. He found that those who were more successful in their education and career were more likely to do the following:

Set up rituals to get through repetitive tasks.

Use lists to retain large amounts of information

Control impulsive behaviors by writing down their thoughts and talking them over with

some one.

Choose jobs which have a variety of different tasks each day and that allow them to be in

charge of themselves and their time but that still have structure and quotas.

Learn to delegate.

Some of the individuals listened to “white noise” in the background to help them concentrate. “One guy had the rule of three: He only allowed himself to work on three things at once,” said Dr. Wells, Director of Pediatric Research at Valley Children’s Hospital in Fresno, California.

Many of the less successful subjects could not identify any strategies they used to avoid distractions, to retain information, or to make them feel successful. Only nine per cent of the variability in success could be attributed to differences in intelligence, Dr. Wells added.

Editors Note: This technique of studying adults who have successfully compensated for their developmental challenges would seem to be an area of fruitful study. We do know that many individuals find success and happiness. It helps to know what tools they use to compensate.  As we now know, few, if any, people “outgrow” their ADHD. But they can learn compensatory tools as the subjects of this study point out.

Overcoming—Rather Than Being Overcome by ADHD

Day-to-day experience as well as scientific observation attests to the fact that different children exposed to the same degree of stress or frustration are not all affected in the same manner. Some are stymied and squelched by their obstacles; others thrive as if the obstacle was more of a stimulus than a roadblock. Those of us working with children with ADHD see this frequently.

Peter Wyman, Ph.D. and associates studied this question several years ago. (The Journal of The American Academy of Child Adolescent Psychiatry, 1992:; 31 (5):904-910)

The researchers looked at demographically comparable groups of children exposed to major life-stress. They interviewed both stress-resilient and stress-affected children assessing perceptions of their care-giving environments, peer relationships, and themselves. Four variables correctly classified 74% of the children in one or the other group. Stress-resilient children, compared to the stress-affected children, reported more:

positive relationships with primary care givers (i.e., parents)

stable family environments

consistent family discipline practices

positive expectations for the future.

These findings support the view that care giver-child relationships play a key role in moderating children’s developmental outcome under conditions of high stress.

This study also points out the extreme importance of a positive parent-child relationship in helping a child overcome obstacles. Children with ADHD and leaning disabilities have many reasons to be stressed. Many will grow into healthy, well-adjusted adults in spite of their difficulties. Stable families, applying consistent, loving discipline in an affirming spirit greatly enhance the chance of success

Affirming Creativity in Children With ADHD

The seeds of creativity are planted in the child from creation. But these seeds must be watered and nurtured if they are to grow to their full potential. Creativity can be enhanced or discouraged depending on the way we as parents and teachers react to the child’s initiatives.

So give some of the ideas listed below a try. These easily implements actions will help foster creative thinking and nurture a love of learning on the part of the child. Once you get started, you can add to this list out of your own experience.

1. Help the child chose a topic to write about. Suggest a word length and make it short so as to stay within the child’s attention span. You don’t want to discourage or frustrate him or her. This exercise develops the ability to follow directions. Consider dressing the writing up as a magazine article by encouraging the child to choose pictures she can cut out and paste illustrating the narrative.

2. Using a recorder to develop a story. You can start telling the story. Make it up as you go. It doesn’t have to be perfect. At an exciting point stop and ask the child to pick up the narrative and add to the story. At this point you add more to the story line but quickly give the child a chance to jump back in. Later replay the tape and discuss the story.

3. Explore the backyard or school grounds with a magnifying glass. Have the child make a list of what he finds. Assist him or her in looking up the discovered items in an encyclopedia or on the internet.

4. When the child asks you a question, don’t automatically give an answer. Respond with, “What do you think?” Treat the answers with respect even when you may add or correct information.

5. While driving, begin a “What if?” game. Start with a sentence such as, “What if you went to school one day, and the teacher said you were all going on a trip in a submarine?” Let the child continue adding all the “what ifs” she can imagine. Once the story gets going, prompt the child for more details. Ask why, how, who, when, etc?

6. Don’t belittle or treat lightly any question. As Lucy said to Charlie Brown, “There are no dumb questions, only dumb answers.” For some questions you will have no answer. A good response is simply, “I don’t know. What do you think?” And then add, “Let’s look it up. Where do you think we might find an answer to that question?”

7. Have the child color, draw, or paint any picture he or she wants. Then tell a story about it.

8. Introduce your child to the computer. De-emphasize games; rather, show him or her how to use the computer to accomplish tasks. For instance, help the child to learn basic word processing and encourage them to write stories. Help them to use the thesaurus and spell check. Realizing that there is more than one way to say something is liberating.

It may come as a surprise to some to realize that many children with ADHD are bright and creative. Their distractible, and distracting, behavior frequently disguises these positive qualities. One theory would suggest that while the ADHD child easily misses details due to inattention, his wide-ranging and rapidly moving focus allows him to make true “leaps of logic” and discover new ideas.

The kinds of activities listed above are “attention-giving” activities which help the child with attention deficits and learning disabilities overcome some of their natural randomness.

Driving Competence of Teens with ADHD

We know from experience that adolescents and young adults with Attention Deficit Hyperactivity Disorder (ADHD) are more likely to be involved in car crashes and moving traffic violations.

In an attempt to define this relationship even more, a recent study looked at 25 clinic-referred young adults ages 17-30 with ADHD and 23 controls matched for age, gender, and educational level. Each individual was interviewed to determine his or her driving history. Official state driving records were also reviewed. The subjects’ driving abilities were assessed using a computerized program; driving knowledge was tested by a Driver Performance Analysis System. The two groups did not differ on intelligence testing.

All ADHD subjects had been cited at least once for speeding—twice the rate for controls. Teens with ADHD had had their licenses suspended or revoked significantly more often than controls and were nearly four times more likely to have been involved as drivers in a crash. Problems in driving associated with ADHD were not found to be in the areas of driving knowledge but in actual performance of motor vehicle operation.

The most anxious moment in the life of parents is watching their newly licensed teen drive out of the driveway in the family car. They know that their son or daughter is moving out into a scary, complex world. This anxiety is compounded when the teen has ADHD.

No doubt, the more common characteristics of ADHD such as distractibility, impulsiveness, and increased risk taking make the teen with ADHD more vulnerable drivers. So what can be done to help our teens be safer behind the wheel?

While there are no guarantees, we can tip the scales in the direction of safety by honestly facing the challenges:

♦We openly discuss with our teen how his or her ADHD symptoms can affect driving. We can talk about their vulnerability to distractions and role play as to how to overcome common distractions.

♦At the right time we enroll our potential driver in a good driving education program to make sure he or she has the benefit of comprehensive driving knowledge and skills.

♦Realistically, many teens with ADHD will not be ready to drive at 16 or 17 and may need to wait until they are older to get that coveted license.

♦The teen that continues to have a high level of symptoms, especially of inattentiveness and impulsiveness may need to continue medication into the driving years in order to have sufficient control in order to be a safe drive.

♦Once the teen is driving, parents should monitor closely their driving habits and help them see areas in which they need to focus their attention and work on improving.

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.

ADHD, Medication, and Growth

Over the years, there has been concern that children with ADHD taking stimulants do not grow normally due to the appetite effects of the medication.  Various studies over the years have looked at this issue and the results suggest that there are little, if any, stunting of growth from the stimulants. But questions persist in some circles.

A recent study performed at Massachusetts General Hospital in Boston and reported in the Journal of Pediatrics (October 2010) clarifies the growth tendencies of children with ADHD. This study looked at the growth patterns of over 240 boys and girls with ADHD and compared their growth with that of matched controls without ADHD.

The subjects were observed over a ten year period. No difference was noted in the trajectory of growth in height or weight in the children with ADHD compared with those without ADHD. In addition, there were no significant difference in height growth in those treated with stimulants and those who were not. Nor were there any associations between duration of stimulant treatment and growth patterns.

This carefully done study demonstrates that kids with ADHD, whether treated with medication or not, grow at the same rate as the non-ADHD population.

Editor’s Note: This study is re-assuring to parents and to physicians treating children with stimulants. In spite of this, it is important for children taking stimulants to be seen by their physician on a regular basis with monitoring of appetite and growth factors. Among other observations, their height and weight should be measured and plotted on a growth curve regularly. If there is any evidence in loss of appetite or fall off in the growth pattern, the physician and parents can make appropriate adjustments in type, amount, or timing of the medication.

ADHD and Reading Disability

It is well-known that boys and girls with ADHD (Attention Deficit Hyperactivity Disorder) often underachieve in school. While the symptoms of short attention span and impulsiveness, and disorganization will affect academic performance, it has also been suspected that there is an increase incidence of true learning disability, especially in the area of reading, in children with ADHD. Now a study reported in the October issue of Pediatrics provides evidence that ADHD and reading disability often do exist together.

In this report from the Mayo Clinic, the medical and school histories of over 5000 boys and girls were evaluated. Three hundred and seventy-nine of these children fulfilled the criteria for ADHD. Compared to boys and girls without ADHD, those with ADHD were significantly more likely to be male. The incidence of reading disability was twice as high in children with ADHD as in those without ADHD symptoms. Girls with ADHD were more likely than boys with ADHD to have reading problems.

This large study confirms that there is an increased risk of reading problems in children with ADHD. In light of this, the study authors point out the importance of evaluating children with ADHD for reading disability and providing remedial help to those who need it.

In the ADHD Strategies for Success Book, we point out that the Number 3 step in effective management is Educational Intervention. We state, “Most children with attention deficits will usually have specific educational needs—needs which will require varying levels of evaluation and individualized instruction and/or classroom modification.

While many children with ADHD have no evidence of language-based learning disability, there are many in which ADHD and a learning disability co-exist. I have seen children who have gone for years without treatment for their ADHD because all their academic problems were blamed on their language dysfunction. The attention problems and poor organization were thought to be secondary. On the other hand, I know of children who have not received serious evaluation of their reading and spelling under-achievement because their poor grades were blamed on their attention deficit disorder.  When a child has been diagnosed with either ADHD or language processing dysfunction, the child should be carefully observe for evidence of the other condition.

Association of ADHD to Obesity

A large of study of over 12,000 people in the U.S. has suggested an association of ADHD and obesity in children and young adults. In an analysis that controlled for age, sex, race, ethnicity, education, depression, alcohol use, smoking, and physical activity, survey participants with ADHD had a significant 63% increased risk of being obese compared with those without these symptoms. People with only inattention (ADD) had a smaller increase risk of 23%.  In the study, the more intense and widespread the symptoms of hyperactivity and impulsiveness, the worse the obesity risk.

The study did not evaluate the reasons for this association of ADHD and obesity. However, one of the characteristics of ADHD is impulsiveness. It is possible impulsive eating, maybe related to increased stress of coping with ADHD symptoms could contribute to the increased risk. Further study is needed to get a better picture of the cause of the obesity and how to prevent it. Also it would be of interest to know if optimum treatment with medication and cognitive behavior therapy would reduce this risk. I suspicion is that it would to the degree that intervention helped in the control of impulsiveness.

Rise in Prevalence of ADHD in Children

A new government study finds that nearly one in ten children has some form of ADHD. This is a significant increase from a few years ago. ADHD, or attention deficit hyperactivity disorder, makes it hard for kids to pay attention and control impulses and organize tasks.

The new estimate comes from a survey released by the Centers for Disease Control. The study found that there has been an increase of about 22% in ADHD since 2003. The researchers calculate that about 5.4 million children have ADHD.

The cause of this increase is uncertain although the researchers speculated that it may be due to better screening by schools and doctors—and just a general increase in awareness of ADHD by the general public. Whether these new estimates are accurate or not, they do point to the significance of ADHD. Over the years, repeated studies document that ADHD is the most common developmental disorder affecting children. Attention Deficit Disorder is a frequent reason why a child may under perform academically or be seen as having behavior problems.

Another important fact pointed out by this study: It is critical that children with ADHD be recognized and accurately diagnosed because, thankfully, there are reliable and effective methods of management and treatment. (See additional articles on this website.)

ADHD: The Importance of Reinforcement

We hear, see, and feel things that are kept in our awareness for a short period of time and then forgotten. These things are not really learned. In order for a stimulus to be committed to the long term memory and, therefore, learned, reinforcement must occur. Reinforcement is the process by which our conscious and unconscious mind is given a reason, or motivation, for committing a stimulus, thought, or concept to long term memory. Since the child with Attention Deficit Hyperactivity Disorder (ADHD) have trouble with focusing on stimuli, proper reinforcement is critical in successful management of their ADHD symptoms.

Reinforcement is a complex and highly varied process. One of the most significant reinforcers for children is the internal, built‑in drive to learn so characteristic of all children. Children innately want to learn about their world. A high percentage of all stimuli impinging on their senses is assimilated and committed to long term memory, i.e. learned. This innate drive to learn persists in children until it is turned off by some negative reinforcement.

Negative reinforcement occurs when learning is made unrewarding, unpleasant, boring, or anxiety‑provoking. Under such circumstances a child may begin to lose his internal motivation. For instance, the young child eagerly wants to talk with his parents and others about all the exciting things he is learning–that the tree is tall, the sky is blue, that bugs crawl. If his enthusiasm is met with continual indifference, he eventually will grow less interested himself in learning. The first grader is usually ready to learn to read. But if he finds the effort confusing and frustrating and finds he is not making progress (As occurs in many children with ADHD), learning to read becomes unrewarding and he eventually will quit trying.

The human mind has fantastic potential for learning, for absorbing facts, and making leaps into new concepts. Each child has this innate drive to learn from the time his eyes begin to explore the environment, to his reaching for a rattle, taking his first step, saying that first word, to exploring the world of physics. This internal reinforcer, to remain strong, needs to be supplemented with external reinforcement for maximum learning to occur. This external reinforcement may take many forms. Certainly among the most powerful reinforcers are the social ones such as recognition, encouragement, and praise.

The knowledge that actions on his part will get him something he wants, such as more free time, treats, money, or participation in a special activity, is a strong reinforcer.

Rewards must be immediate and tangible to the child to be effective. We should reward each little step toward the right goal, not wait to give one big reward for total perfection. As learning is reinforced, the material becomes more and more indelibly imprinted on the conscious and subconscious mind of the child.

A word of caution in regards to rewards or positive reinforcement. It is important not to over do rewards and praise. If we continually praise or give too frequent rewards then the positive reinforcement looses its value to children. In fact, they can come to expect praise all the time and when they do not get it, they can act out or pull back on their performance. Also, praise must be genuine. It should be given for real progress, not given promiscuously. We reward actual behavior. We say, “You worked really hard on that paper. Good job!” rather than say, “You are such a smart boy.”

We should remember that the strongest reinforcer of all is success. Success breeds success. As the child is able to accomplish tasks and sense personal fulfillment, he wants to repeat this pleasant experience. Thus it is important to patiently work with the child with ADHD or other learning problem in a creative and patient way which will help him or her experiences academic, personal, and social success.

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