Racial Differences in the Diagnosis of ADHD

A recent study published in the June issue of the Journal of Neurosurgery: Pediatrics indicated that Caucasian children are more likely to receive a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD)ADHD in comparison to minority children.  This study followed more than 17,000 children across the nation from kindergarten through eighth grade and asked their parents whether not their children were ever diagnosed with ADHD.

Findings-Racial Differences in the Diagnosis of ADHD:

The researchers found that Hispanic and Asian children were about half as likely to receive a diagnosis of ADHD as Caucasian children.  African American children were about two thirds less likely to be diagnosed with the condition.

Implications of this Study:

It is important to realize that the study cannot indicate whether or not ADHD is over diagnosed in Caucasian children or under diagnosed in minority children.  However, the numbers are pretty glaring and most definitely indicate a discrepancy in not only diagnosing the condition, but also in the interventions received. Read more

ADHD and Executive Functioning Resource Guide

Are you looking for more information on ADHD or Executive Functioning?  Read on for top picks from our ADHD ResourcesNeuropsychologist.

Top Resources for Information on ADHD and Executive Functioning:

  • Taking Charge of ADHD:  The Complete Authoritative Guide for Parents.  Barkley, Russell (2013): This book provides parents with evidence based interventions regarding ADHD.  It is well written and easily readable, while providing parents and practitioners with the latest research supported information regarding ADHD and various interventions.
  • Executive Skills in Children and Adolescents:  A Practical Guide to Assessment and InterventionDawson, Peg and Guare, Richard (2010): This book is aimed at practitioners that work with children with Executive Functioning concerns.  It may be a little research heavy for some parents; however, it is a wonderful resource for therapists and educators.   It includes basic research on Executive Functioning as well modifications and interventions that can help children and adolescents with a variety of Executive Functioning issues including disorganization, inflexibility, initiation of tasks, and monitoring work. Read more

Concussions are More Common in Teens than Once Thought

A research letter was published in the Journal of American Medical Association on Tuesday, June 25 which concussionsummarized findings from a recent Canadian study examining concussions in teenagers.  The Canadian research team found that concussion rates in adolescents are much higher than previously thought.

What is the prevalence of concussions in teens?

1 out of every 5 teenagers completing the research project indicated that they had sustained a concussion.  These numbers are high, and there are some flaws with generalizing these numbers to the population as a whole.  This was a survey research project in which the examiners asked teenagers a series of questions about head injuries and academic performance.  Although the likelihood of 1 in 5 teenagers having sustained a concussion is probably not realistic, it is known that head injuries are quite common at rates that are greater than suspected in the past.

Why is it important to know the incident rates of concussions?

The importance of knowing about the incident rates of concussions is that there are numerous known behavioral and emotional variables associated with head injuries.  Adolescents who have sustained a head injury are at risk for learning problems, substance abuse, and emotional concerns.

What does this mean as a parent or teacher?  If you notice a teenager exhibiting a sudden change in academic performance, behavior, or emotional regulation, you want to have an evaluation immediately.  Speak to your child’s pediatrician about a possible neurological or neuropsychological evaluation in order to help determine the possible cause for the changes, as one possible reason might be a sustained head injury.

To read the full Chicago Tribune article on this study, click here.  To learn more about North Shore Pediatric Therapy’s Neuropsychology Diagnostic Program for children and teens, click below.

Develop Executive Functioning Skills This Summer

Does your pre-teen have difficulty staying on task? Does he become overwhelmed when presented with a long-term project? Does he have a hard time controlling his emotions and behaviors? Is it a constant struggle for him to clean up his room? If so, your child may have difficulty with executive functioning. Executive functioning skills are the executive functionsfundamental brain-based skills required to execute tasks: getting organized, planning, initiating work, staying on task, controlling impulses, and regulating emotions.  These skills provide the foundation that all children need to negotiate the academic, home, and social demands of childhood.

Summertime is a great break from busy schedules overrun by homework, projects, and extracurricular activities, but the decreased structure can cause a child with executive functioning difficulties to lose the skills they have gained during the school year. Research has shown that practice is crucial in the development of executive functioning skills; kids who practice executive skills are not only learning self-management, but also developing the connections in the brain that will support the development of executive skills in later adolescence and adulthood!  Read on for ways to keep your child’s executive functioning skills sharp over summer break.

Tips for developing executive functioning skills all summer:

  • Praise: If you know your child is particularly good at a certain skill (e.g. task initiation), communicate that to your child and encourage him to use it to complete summer tasks.  For example say, “I really like how you got started on your chores before lunch.” This will encourage the maintenance of the particular skill your child has mastered.
  • Calendars: Summer schedules can be vastly different from the rest of the year, so to prevent difficulties with handling the change in schedule, use a calendar.   Calendars are a great visual tool to help a child with time management, planning and prioritizing. It allows him to plan ahead and know what is expected and when.
  • Accountability: Whether your child is participating in sports, dance, or going to camp, have your child be responsible (or partially responsible, depending on age and capability) for his equipment or supplies.  This can help him to maintain his organizational and working memory skills.
  • Summer Cleaning: If your child has difficulty with task initiation and organization in his room, take the time over the summer to organize a different space together (garage, spare closet) so you can problem solve together how to start, what to do, and how to be efficient. This allows your child to practice this daunting task with some guidance from you.   He can then carry this skill over to improve his personal space. You may even find old bins or containers your child can use for his room!
  • Summertime Incentives: Rewards make the effort of learning a skill and the effort of performing a task worthwhile. In the summer, there are a lot of fun activities and more time to do them! Take advantage of this and use these fun activities (extra time on the computer, extra time at the pool, going to a friend’s house) as rewards for the tasks you want your child to complete.

Instead of allowing your child to forget the gains he made in executive functioning skills at school, use the summer to make gains and have fun!  For more help with executive functioning, click below to download your free executive functioning checklist.

 

Summer Training for Fall Gaining

As summer begins, summer plans take shape.  Hopefully these plans involve lots of fun and sunshine.  Summer should be an enjoyable and exciting time for all children and their families, but it is important to remember to also focus on children’s growth and development.  Sometimes during the break from school, skills gained in an educational or summer therapytherapeutic setting can be lost.  It is important to remember that summer is a great time to keep working on skill development, therapeutic goals, and preparing each child for the challenges of the upcoming school year.

Research continues to show that consistent and high intensity therapy (two or three times per week) results in faster and better functional outcomes for daily skills.  With a more relaxed schedule, summer is a perfect time to increase therapy intensity and have fun building the skills children will need for the new school year.

Specific areas of focus in the summer to prepare for school:

North Shore Pediatric Therapy wants to help your child gain the confidence and independence to conquer all age appropriate tasks! Summer spots are limited. Call us at 877-486-4140 and let us know how we can best support you and your child!

4 Ways to Better Handwriting before Pencil Hits Paper

Your child’s handwriting skills will affect his performance in school, beginning as early as preschool.    How your child holds his pencil, sits in his chair, and attends to the task of handwriting can affect your child’s ability to feel successful in completing a handwriting task. 

4 ways you can promote your child’s handwriting skills before his pencil hits the paper: 

  1. Address his posture: Your child’s posture at the table is directly associated with his fine motor control.  He Handwriting skillsdoes not just use his hand muscles to write—his core muscles are important too.  Make sure that the height of his chair allows for his feet to be placed flat on the floor.  Ideally, you want your child to be sitting so that there is a 90° angle at his knees and his hips.  This will put his body in a position that supports good handwriting.  Sitting on a wedge cushion (move ‘n sit cushion, air-filled cushion) that provides vestibular activation can sometimes help to improve his posture. 
  2. Address his grasp:  Your child’s pencil grasp can hinder or support his ability to write neatly.  Encourage your child to hold his pencil between the tips of his thumb and pointer finger.  The pencil should rest on the side of the tip of his middle finger.  Keeping the space between his thumb and pointer finger (the web space) open will ensure that he is utilizing his muscles in the most efficient manner and will reduce fine motor fatigue.  Sometimes, utilizing an adaptive grip on his pencil can help him to maintain the grasp with decreased difficulty. 
  3. Address his attention:  Your child’s attention can support or detract from his ability to accurately complete a handwriting task.  To support his attention, minimize the distractions in the room.  Your Read more

ADHD and Learning: Attention Deficit Hyperactivity Disorder’s Impact on Learning

Many children with a diagnosis of Attention Deficit Hyperactivity Disorder exhibit significant concerns with regard to their academic

ADHD and learning diability

achievement.  Research has demonstrated that a lot of children with the diagnosis also have a co-existing diagnosis of a learning disability.  However, even children without a separate learning disability diagnosis are also at risk for struggling with their academic achievement.

The hallmark feature of ADHD is inattention.  If a child has significant inattention and distractibility, he or she is unable to listen to the teacher and follow directions.  These children often present with impulsivity or hyperactivity, which can result in concerns with behavioral functioning in the classroom environment.

Another area of concern for children with ADHD is poor executive functioning which could have an impact on a child’s academic performance.  Executive functioning is the child’s ability to organize work, transition between tasks, develop effective problem solving strategies, and monitor one’s work.  Read more

Benefits of a Slant Board

There are many reasons to invest in a slant board for your child, including benefits in handwriting.  A slant board typically consists of aslant board flat surface positioned at an angle with clips or anchors to hold materials (such as paper and books) in place.  They come in a variety of sizes and angles, and some are even adjustable. 

Below are several benefits of slant boards for your child for use both in and out of the classroom:

  • Promotes fine and visual motor skills- The angled position of the slant board promotes better placement of the shoulder, arm and hand.  It is therefore providing a better position to work on skills such as writing and drawing.  The position of the board also brings the paper closer to the child and makes it easier to see.
  •  Promotes an efficient marker grasp- The best hand position for handwriting and holding a writing utensil is in wrist flexion. The angled position of the slant board promotes this position, which provides better support for holding a pencil appropriately.  This position may also assist in applying just the right amount of muscle force in holding a pencil.
  •  Provides an easier to reach work surface-For children who have difficulty reaching the entire paper while flat on a desk, the slant board provides an easier distance to reach from the top to the bottom of the page, while also keeping the paper stabilized.
  • Helps with posture- Typically, writing or reading on a flat surface utilizes an inefficient posture, as seen through slumped body position, elevated shoulders, and looking down consistently. The slant board brings the line of vision higher, which encourages looking down to promote an upright posture.
  • Allows visual tracking for reading Placing a book or other reading material on a slant board may reduce eye strain. The child does not need to refocus their eyes as they scan through a page since all text remains at the same angle.

There are many slant boards on the market to choose from! It is best to choose one made of stable material and with an adjustable slant. The slant board can be used at home or at school, or anywhere that you child engages in writing, reading or drawing!

 To watch a 2 minute video on how to improve handwriting in children, click here!


How To Make a Weighted Animal

Here at North Shore Pediatric Therapy, we utilize weighted objects for a countless number of activities. They can be used as a self-regulation strategy, providing deep proprioceptive input to your child’s muscles and joints.  Various weighted materials, including vests, belts, blankets, wrist-weights and ankle-weights, are utilized in the clinic multiple times throughout the sock puppetsday. For all of you crafty parents, as well as those who (like me) are “creatively challenged,” below are some DIY instructions to follow so that you can create your very own, personalized weighted animal.

4 Steps To Create Your Very Own Weighted Animal:

Step 1: Find an old knee-high sock. You can choose a sock that is your child’s favorite color or has their favorite cartoon characters on it.
Step 2: Fill the sock with a grainy material, such as rice or sand. Put enough rice in your sock so it is four-fifths of the way full. Tie the open end of the sock closed. There should be enough rice in the sock so when it is draped across your child’s shoulders, it droops down onto their chest. This activity has the added benefit of incorporating direction-following and tactile play into your daily routine.
Step 3: Finally, decorate the sock with “googley eyes” and markers. The sky is the limit as far as whether your sock animal has polka-dots, stripes, zig-zags or checkers.
Step 4: Kick back and relax with your very own personalized weighted animal.

These strategies can be utilized when your child is feeling frustrated or having a difficult time organizing their thoughts. Your child’s weighted animal can also be used for strengthening. When at home, have your child carry the animal around the house or encourage them to sustain various Yoga poses while holding their animal friend. The added resistance while sustaining these poses will only help build muscle strength and improve motor planning. Whether your weighted animal is used as a self-regulation strategy or a strengthening tool, it is up to you and your child’s interests. In either case, creating the animal is a wonderful craft to save for a rainy day and a great way to get the whole family involved. Make one, make two or make a whole zoo of weighted animals. Your child’s new friend is sure to be a hit and cherished companion for years to come.

8 Tips to Ease Homework Time Stress

For many families of middle and high school students, evening time becomes a stress-filled time for everyone. This is due to the fact homework stressthat tired and over-scheduled kids fight to focus to complete their homework. Fortunately, this time can become much more relaxed and productive with a few tweaks to routines and tips to help students to manage their time and work better.

8 Tips to Ease Homework Time Stress:

  1. Start with goals: Prior to making any changes to a homework routine that is not working, sit down with your child to identify their goals around their homework time.  Do they need to create more time?  Focus more effectively?  Remove distractions?  Get started earlier?  A meaningful plan can then be created from these goals with all family members on board.
  2. Create a dedicated space:  All too often, kids complete their homework with a host of distractions nearby: T.V., Internet, phones or other family members doing other things other than work.  Homework is best completed in a quiet space that is free of all distractions.  If the Internet is needed for research, this should be done during a specific time set aside for this purpose. Phones and televisions should be off.
  3. Create a plan: Before tackling any homework assignment, kids should set up a schedule that includes what assignments need to be completed and an estimate of how long each assignment should take to complete. These assignments should then be ordered according to their due date and difficulty level.
  4. Break down big assignments: When creating the homework plan for the evening, it is important to also take into consideration of any long term assignments that have been given. Divide these assignments into several (3-10, depending on the assignment) parts to complete over the course of the time until the assignment is due. Then, the big project is easily absorbed into the week, instead of being a shock the day before it’s due.
  5. Take regular breaks: Kids are unable to focus for longer than 45-50 minutes at a stretch. Plan 10-minute breaks into each hour of homework. The best breaks include some physical movement and/or fresh air.
  6. Keep track of paper: Students should keep assignments and notes for each class in a separate folder or section of a notebook. After completing each assignment at home, papers should go directly back into the appropriate folder.
  7. Identify circadian rhythms: Is your early bird trying to complete homework at 10:00 p.m.? Is your night owl frantically trying to finish homework the morning before school? Work with your child’s natural cycles in order to determine the best homework time for them, given other commitments. An early bird may benefit from rising an hour earlier to get work completed.  A night owl may focus best getting starting after dinner.
  8. Study Smart: Kids learn in many different ways. For example, take a look at Gardner’s Multiple Intelligence Theory in order to identify the way your child learns best. Tailor study time to their strengths. For example, interpersonal learners prefer to interact while learning, therefore, quizzing aloud and studying in groups would suit them well.
If homework time continues to be a struggle for your family, contact one of our Academic Specialists at North Shore Pediatric Therapy. Our Academic Specialists can create a homework time plan specific to your child and family’s needs.