ALL NATURAL ADVANTAGE
Natural Healthcare And Advice
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ALL NATURAL ADVANTAGE Natural Healthcare And Advice |
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Addressing
Behavioural Problems
Very
young children with ADHD require close parental supervision, and children in
elementary and middle school need continuous monitoring and support for
schoolwork. Adolescents, particularly those who have been recently diagnosed and
treated, pose a special challenge. They have had a number of years to develop
dysfunctional strategies and require close supervision and support and usually
individual therapy.
The
parent must learn to anticipate problems and develop a tactful approach to
dealing with them. For example, helping a young child get organised for school
in the morning. Bedtime is another problematic time. Given that many children
with ADHD (on or off medication) have difficulty settling down to sleep, a
lengthy and predictable bedtime routine often needs to be in place to help the
child calm down. When both parents work and arrive home after 5 pm, this whole
process requires split-second timing and teamwork to prepare dinner, wash the
dishes, supervise homework, perform the backpack check, and get the child to bed
on time. If a parent is busy or absent, it is important that whoever takes over
knows what the routines and expectations are. Having a child with ADHD spend
time in multiple environments (school, an after-school program, a baby-sitter's
home, and, if the parents are divorced, different homes) can be extremely
disorganizing.
Because
ADHD is such a strongly genetic condition, one or both parents can also have
ADHD, which often makes it extremely difficult for parents to regulate their own
behaviours enough to adhere to such routines, let alone provide the systematic
support that the child requires. Making
sure that the child gets enough to eat, gets enough sleep, and has sufficient
exercise is a crucial part of the treatment. Although medication might help a
sleepy child stay awake during school, chronic sleep deprivation is not
conducive to learning. Eating is another problem: some children on medication
are simply not hungry at dinner and start foraging for food about the time they
are expected to go to bed. Parents often view this as stubbornness or
manipulation, but it usually works better for children to eat if they are
hungry. Making sure that they have eaten breakfast and have a snack in the
afternoon is also helpful because psychostimulant medication can suppress
hunger, and they might not be aware that they need to eat. Telling
them that they are "hyper," "ADHD," or
"disorganized" (particularly if this is communicated in moments of
anger) is much less helpful than defining the dysfunctional behaviour in very
concrete terms ("You have trouble keeping track of your homework, so we
will work out a system together that will make it easier."). One
40-year-old man who had asked to be evaluated after his son was diagnosed with
ADHD pointed out that when he was growing up, he always had the sense that
whatever he was doing was "never enough." It had been made clear to
him that if he just "tried harder" and "did something
different," he would perform better. However, he had no idea what
"trying harder" and "doing something different" meant. This
emphasizes the need to lay out a very clear and explicit program. When
a child tells a parent or a teacher that he or she cannot do something
"because of the ADHD," this should be treated as a serious problem and
addressed immediately; the child usually employs this as a way of not carrying
out an unpleasant task.
The more a
parent or teacher buys into the "I can't do it because I have ADHD"
routine, the more the child will use this excuse. A
child's compliance with a routine should be closely monitored, and reminders as
well as consequences should be provided. Children with ADHD cannot monitor their
own behaviour well, so frequent pleasant and focused reminders when they are
drifting away from the program are helpful. Thus, if a child does not perform
the nightly routine of checking the backpack and forgets homework, a series of
natural consequences might ensue. (However, if the child's teacher does not
respond with an immediate consequence if the homework is not turned in, the
child learns that it is not very important to perform this routine.) When it
comes to long-range projects, parents need to be aware that it is extremely
difficult for a child with ADHD to anticipate and plan a long-term project, so
monitoring homework and providing tactful reminders and assistance ("Let's
plan out how you're going to tackle your book report that is due next
month"; "Have you put the report in your backpack?") are more
helpful than allowing the due date to creep up or to let the child forget the
final version. Teacher
involvement is crucial.
The
teacher is a very important player in this situation. If there is minimal
feedback from the teacher, or it does not occur in a very timely fashion (ie,
the same day), it is almost impossible to improve the situation. A child learns
quickly that if the homework assignment is written illegibly or is
"forgotten," or if he tells his parents convincingly (but
untruthfully) that he "has no homework," or the necessary workbooks or
other materials are not brought home, then the homework cannot be completed. At
7 o'clock in the evening, it is virtually impossible to correct the situation.
This strongly reinforces homework avoidance.
Children
with ADHD benefit enormously from daily communication between the parent and
teacher,
with the focus on fixing responsibility on the child and teaching the child to
monitor his or her own homework. However, this means that the teacher must check
the homework list, might need to remind and monitor what materials the child is
taking home, and provide immediate feedback to the parent if homework is either
not turned in or is substandard. The parent then becomes responsible for
delivering prompt rewards or negative consequences. Be forewarned: training
these behaviours takes a long time and requires great persistence on the part of
parents. Some children perfect the art of "flying under the radar."
One normally intelligent but language-disordered 12-year-old boy was able to
generate such a cloud of confusion around homework that he almost never had to
do it (his family had no idea of the status of his homework). When the parent
and teachers began to communicate very closely and a tight behavioural program
was set up, it required almost 24 months for this child to begin to change his
behaviour. For advice or to book a consultation for your child call (03) 8802 7687 or email me. |
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Disclaimer This website has no financial connection to the supplement or health products industry. The information on this website is provided as a guide to your healthcare options only. The All Natural Advantage website makes no statements, representations or warranties about the accuracy or completeness of, and should not be relied on as a sole source of information. We take no responsibility or liability (including without limitation, liability in negligence) for any expenses, losses, damages or costs you might incur as a result of the information being inaccurate or incomplete in any way, and for any reason including but not limited to, you deciding whether or not to choose specific treatment based on the information. Please contact me or another qualified health professional before embarking on any health treatment program
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