Have We Taken The Wrong Approach To Treating Kids With ADHD?

ADHD SEEN IN 11 OF US CHILDREN

It wasn’t until I began to accept these interfering behaviors as “learning differences” rather than “disabilities” that I began to run with it and try to redirect that energy into a positive learning environment.

Medical professionals and educators have been in search of an effective treatment option to achieve less movement and more focus for kids with ADHD.  I was more interested in why they moved and how movement helped them learn.  I saw very early on that some kids were better at reading when standing, or lying upside down, hanging off a sofa, or along the top of that sofa.  Sometimes they had the best attention when face down on my floor, running a car across the rug.  I had one boy who used to spend the entire session with me flipping a ping pong ball up in the air a few inches and catching it.  As long as he was in motion, he was attending. Parents always told me how amazing it was that their child could learn so much from me. They thought I was magical.  While this is good for my reputation, it is frustrating that the only setting where they can be successful is in my treatment room.

A recent Huffington Post article explores the idea: “Have We Taken The Wrong Approach To Treating Kids With ADHD?”

Read On: http://www.huffingtonpost.com/2015/04/22/kids-adhd-treatment_n_7110910.html

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Hey, Kids, Look at Me When We’re Talking

Everywhere you turn there are articles about the dangers of screen technology. Recent articles have focused primarily on the dangers it poses to our children; children as young as toddlers and preschoolers. But, is it all bad?

There are an increasing number of professionals and studies coming out about the benefits of engaging in screen technology.  Benefits such as earlier visual perception and cognitive gain have been cited among other skills as being achievable as a result of this technology.  So where does that leave us?  As parents, a decision must be made about how much time your child will spend on this technology.  While specific guidelines citing how many minutes is not my style, I urge you to keep the following in mind:

  1. Your child needs to have a large amount of face to face social interaction with peers and people of varying ages.
  2. Your child should look at you when you are talking to each other.
  3. Your child should be engaging in imaginative play without the assistance of technology as an entertainment tool.
  4. You should always discuss what you did when you were using technology.
  5. Your child should be expected to behave appropriately in large group situations (restaurants, family gatherings, etc.) without the assistance of technology.

A recent New York Times Article, “Hey Kids, Look At Me When We’re Talking” presented a great way to get started.

http://www.nytimes.com/2015/04/19/fashion/hey-kids-look-at-me-when-were-talking.html?smprod=nytcore-ipad&smid=nytcore-ipad-share&_r=2

Dyslexia is not about effort

I have encountered many kids of different ages who maintain A’s and B’s despite their disabilities simply because their parents work extremely hard helping them to keep up. It always amazes me when I ask a parent how long it takes for their 8 or 10 year old to do their homework and the parent reports it takes 2 to 3 hours a night while it should only take 30 to 40 minutes.

So what’s the problem? Why does it take so long to do homework? Is it focus on the task? Is it difficulty recalling what was taught? Is it lack of understanding the assignment? Is it that it takes time for the parent to learn the lesson and reteach it? Is it low frustration tolerance requiring frequent breaks?

More often than not, dyslexia results from an auditory processing deficit.  If a child hears, but does not interpret the message quickly enough or doesn’t interpret it accurately, proper information cannot be stored for later retrieval.  For many children, every time they listen in a group or with background noise, they cannot fully process what they hear.  Is it any wonder: they have struggled when learning to read? They cannot associate sounds to symbols correctly?  They cannot recall spelling rules?  They can’t follow directions? They don’t understand what they read?

Below is a link to a wonderful, article written by a high school freshman who is Dyslexic, about her struggles with reading and learning.

http://www.huffingtonpost.com/anna-koppelman/the-gigantic-parts-of-my-dyslexia-have-shrunk—-except-the-shame_b_6855402.html

Is it Lack of Empathy or Sensory Dysregulation?

Autistic children are generally diagnosed with Sensory Integration Disorders or Sensory Dysregulation. What does this mean? It means that they often overreact or underreact to sensory stimuli. When I feel something soft, I may run my hands over it a few times and enjoy the tactile experience, but I can stop myself from having to repeat the action over and over again. I can make a judgment call as to when I should repeat the experience. In other words, I have typical regulation skills. Not so with most Autistic and Asperger’s children. They seek the sensory stimulation but do not have the regulation skills to control where, when and how much they engage in the experience.
Humans contain 5 senses: hearing, seeing, smelling, touching and tasting. If a person has dysregulation of some or all of the senses, it may lead to a strong need to repeat or even avoid a sensory experience. If someone’s hearing is quite acute and they hear sounds more intensely than others, exposure to those sounds may cause them to react strongly or withdraw from a situation. If they crave oral stimulation, it might make them put all sorts of different textured objects in the mouth. It may result in aversion to foods or obsession with certain textured foods because of both texture and taste. The point is that we all have different levels of sensory arousal, which is what makes us all individuals. However, most typical children have similar levels to each other and despite their sensory levels, they are able to regulate their behavior in relation to sensory experiences because they know and practice what is most appropriate for their current environment. Typical children may go so far as to inhibit their sensory desires in an effort to act appropriately in a given situation.
What does this mean to the Speech Language Pathologist? We deal with modeling appropriate social pragmatic behavior and language on a daily basis. Some of us do this in small groups or individually, but it is always on the agenda. All too often I find that others think Autistic and Asperger’s children do not recognize or empathize with their peers. Yet I have sometimes found they do empathize, quite strongly. Sometimes they feel so strongly, they do not want to discuss it or deal with it because it is too upsetting. So I have always felt that the inappropriate social emotional reactions are more a result of sensory dysregulation than lack of empathy.

In a recent article entitled, “Theory Finds That Individuals With Asperger’s Syndrome Don’t Lack Empathy – In Fact If Anything They Empathize Too Much” , it was reported by Henry and Kamila Markram of the Swiss Federal Institute of Technology in Lausanne, the theory suggests that the fundamental problem in autism-spectrum disorders is not a social deficiency but, rather, a hypersensitivity to experience, which includes an overwhelming fear response. Virtually all people with autism spectrum disorder, or ASD, report various types of over-sensitivity and intense fear. The Markrams argue that social difficulties of those with autism spectrum disorders stem from trying to cope with a world where someone has turned the volume on all the senses and feelings up past 10.

Avoiding the Disastrous Play Date
By Janet M. Krebs

“I am so upset because my child was not invited to Charlie’s birthday party. They invited everyone in the class except my son.“ This is a painful scenario which plagues many a parent, particularly if their child has language or behavioral issues. Children with social pragmatic language disorders often have difficulty making friends. They don’t receive the same number of play date invitations. They may be excluded from birthday parties and other group social functions. If it wasn’t for the parent, they might spend their non-school time alone. There is little that is more painful for the parent to absorb than the social rejection of their child.
As a facilitator of social pragmatic language therapy programs, I often see desperate parents who push their child to play with someone, no matter how appropriate or inappropriate this child is. Once parents see their child connecting with another peer they will throw themselves into cultivating a relationship so their child can have a friend. Very often, the need for this friendship is more to satisfy the parent’s need than the child’s need. In order to avoid another failed social relationship, I generally set down very specific rules to the parents of children I treat.
1. Ask your child in private if they would like to play with this child before you make a date.
2. Encourage your child to invite this child to have a play date.
3. Have the first encounter in neutral territory (park, mall, museum, bowling, movies, etc)
4. Keep it short. An hour or an hour and a half is plenty for the first date.
5. Suggest an agenda to your child ahead of time complete with contingencies if the other child is not in agreement about the activities.
6. Maintain a presence throughout the play date, but try not to interfere unless you can easily call your child aside and make a quiet suggestion to help over a bump in the road.
7. If having a second play date, try to import some of the successful experiences from the first date.
8. Review the play date with your child afterwards and discuss the successes that occurred.

It is often a hard lesson to learn that the reason your child has connected with another child in a social therapy group is because the group interaction is facilitated by a knowledgeable professional. In the absence of this professional, the interaction with another child might not turn out to be such a positive experience. If you keep this information in mind, your child will be more likely to have a positive play date.