Posts

Questions About Medication For Children

For many children, therapy or accommodations are not sufficient to support their needs.  It is often that these children will need child medicationpharmacological intervention to help improve their attentional regulation, impulse control, emotional regulation and/or behavioral self control. Parents should be honest with their pediatrician about medication as well as ask several questions about ensuring the best care.

Questions Parents Should Ask When Determining If Medication Is The Right Choice For Your Child:

  1. What are the side effects of the medication? All medications have side effects and it is important to be aware of what to possibly look out for.
  2. How long should the child be on medication?  It is important to ascertain if the medication is likely a temporarily solution or long-term.
  3. What therapies would be beneficial for the child to participate in while taking medication?  It is often that medication alone is not sufficient. Children will often benefit from specific therapies and interventions to help teach emotional and behavioral regulation.
  4. Who should I tell? My advice about medication is to always inform the academic staff as to when a child starts medication. Many times, the teacher would be able to have a greater watch over the child and monitor whether or not there are experiencing any negative side effects.

Medication is often warranted in a child’s treatment regime. It is always important for parents to ask good questions and work with a treatment team in order to ensure the best success of their child’s social and emotional development.

Family History and Kids with Special Needs

If you have a brother, nephew, uncle or some other member in your family with certain special needs, you will want to be cautious and family tree mindful that many neurodevelopmental conditions have a high genetic component. Recent studies have indicated that genetics account for 70 to 80 percent of the risk of having Attention Deficit Hyperactivity Disorder. A 2004 study indicated that there is considerable evidence that demonstrates that genetics play a major role in the risk of having an anxiety disorder. It is important to realize that the risk factors are high; however, they are not necessarily 100%.  This simply means that just because a parent or relative has a neurodevelopmental disorder, it does not mean that the child will exhibit the condition. What it does indicate is that the child is at a higher risk for the condition.

As a parent, it is important to realize that your child may be at risk for a condition if a relative has that same condition. Do not be alarmed; instead, be aware. Always pay attention to any concerns, seek out advice from your pediatrician, psychologist and/or developmental therapist.

There are numerous possible warning signs for the purpose of this blog;  however, below is what to be on the lookout for:

Anxiety:

• Does the child shy away from peers?
• Does the child have sleep onset  issues?
• Does the child engage in behaviors such as picking, biting nails, pacing, etc.?
• Are there fixed routines that the child engages in?

Click here for more on anxiety

ADHD:

• Does the child have difficulty focusing on work?
• Does the child require a lot of redirection and repetition of information?
• Does the child make careless errors with work?
• Does the child always seem to be on-the-go?

Click here for more on ADHD

Autism Spectrum:

• Does the child struggle with initiating and sustaining appropriate eye contact?
• Are there language delays?
• Does the child avoid seeking out others for interaction?
• Does the child avoid engaging in nonverbal behaviors such as gesturing?

The information above should not be considered to be a diagnostic check sheet, but rather possible concerns that might require further assessment. Parents, if you know that there is a family history of a neurodevelopmental condition and you see any of the above signs or symptoms expressed in your child, it is then time to seek further guidance.

5 Tips to Help With Social Concerns Associated With ADHD

Children with Attention Deficit Hyperactivity Disorder (ADHD) often present concerns interacting with peers and maintaining ADHD boysappropriate social relationships.  These children often present appropriate social skill sets; however, issues with inattention and impulsiveness directly impact their ability to execute these skills on a regular basis.

Below are five strategies to help improve the social interaction of these children:

  1. Keep social situations limited to one or two peers as opposed to having them interact with a large group in which the child will likely become easily distracted.
  2. Try to modify the environment in which the social interaction is going to happen.  Situations in which there are many distractions will likely set the child up for an uncomfortable situation.
  3. If the parent or teacher is in close proximity of the interaction, attempt to actively intervene in situations in which the child is not engaging with peers appropriately.
  4. Before the social interaction occurs, remind the child  about the importance of taking turns, eye contact, personal space, etc.
  5. If the interaction occurred at a friend’s house, follow-up with the other parent afterwards and discuss the interaction.  Use the feedback as a means of providing insight to the child about what was positive about the interaction and what he or she will need to improve upon in the future.

Many children with attention and impulsive behaviors exhibit social interaction issues.  They have a difficult time regulating personal space and picking up nuances in social interactions.  Above are some basic tips that parents and teachers should implement in order to help improve their child’s social relations.  If the child continues to struggle with social interaction, it is recommended that he or she work with a behaviorally-trained social worker as an individual or in a group format to help develop the child’s social skills.

For more on ADHD, click here

LOVE WHAT YOU READ?  CLICK HERE TO SUBSCRIBE TO OUR BLOGS VIA EMAIL!

Helping Your Child with Word Finding Difficulties

We’ve all had that feeling where our word or thought is on “the tip of the tongue.”  However, when this is recurring and interrupts communication with your child, then it becomes a problem.  Word finding difficulties (also called “word retrieval difficulties”) are not a vocabulary disorder.  Your child understands the definition of the word(s) and has used them before.  Word finding difficulties are the result of difficulties accessing the vocabulary they already have in their repertoire.  Imagine that your child’s vocabulary is like a library.  All the books are there, but your child just may not know where or how to get them.  Word finding difficulties are common in children with ADHD, learning disorders, and language disorders.

Common Signs of Word Finding Difficulty:

  • Using many filler words in place of specific vocabulary: “Where’s my, ah, um, my, um, you know….my backpack?”
  • Whole word/phrase repetition: “Do you know where, where, where my…. backpack is?”
  • Delayed responses: “Where’s my……………..backpack?”
  • Nonspecific language: “It’s on the thing.”

Strategies and Activities to Help Your Child:

  • Give your child time: It is easy to interrupt and fill in your child’s language during moments of word finding.  However, it is important to avoid this and give your child time to think about what he/she wants to say, and independently utilize word finding strategies.
  • Discuss attributes:  ‘Attributes’ are the common features that describe vocabulary – category, function, location, parts, and physical descriptions such as color, shape, and size.  During moments of word finding, encourage your child to describe the common attributes. For example, if your child cannot recall the word “cow,” he/she can provide attributes such as “it’s a big animal that lives on a farm, says moo, and gives us milk.”  As a communication partner, you can prompt your child by saying, “Tell me what it looks like; tell me where you find it.”
  • Sound/Letter cues:  Sometimes providing the initial letter or sound is as helpful to the child as providing the entire word.  As a communication partner, if you know the word your child is thinking of, use this strategy.  When you are unsure, encourage your child to give you the first letter or sound.
  • Word finding games: Word finding games such as Scattergories, Last Word, and Outburst are great games that target word finding skills.  If your child is having word finding difficulties, encourage him/her to use strategies such as identifying the category or function, describing what it looks like, or drawing a picture.

Feel free to share any of your word finding strategies below.  If you think your child has word finding difficulties, contact North Shore Pediatric Therapy and set up a speech-language evaluation.

LOVE WHAT YOU READ?  CLICK HERE TO SUBSCRIBE TO OUR BLOGS VIA EMAIL!

ADHD Parenting Tips

Do you feel as if your child has a difficult time with paying attention and staying organized? Does your child struggle to plan ahead, adhd girlcontrol impulses or complete tasks? Life can be challenging and, at times, frustrating with a child that has ADHD. Some of the keys to positively handling situations such as these are to develop compassion for your child as well as use consistent strategies. Below are some tips to assist you and your family.

6 Tips For Parents of Children With ADHD:

Tip #1: Stay positive and healthy yourself

A positive attitude can go a long way towards modeling healthy behaviors for your child. Focus on taking care of yourself, whether that is through exercising, taking time for an enjoyable activity, reading, enjoying a personal hobby or even taking a relaxing walk with a pet while you focus on breathing. Your state of mind greatly impacts the richness in your interaction with your child. When you are in a positive state, you are also more open and engaged with the child.

Tip #2: Establish structure and stick to it

Discover ways to incorporate a routine and try to simplify your child’s tasks. Consistency is very important so the child knows what to expect and when to expect tasks. Do your best to stay neat and organized in order to better assist the child in modeling healthy behaviors.

Tip #3: Set clear expectations and rules

Communicate clear guidelines and rules so that the child understands what is to be expected of them. It can be helpful to break down the expectations in simple statements or steps as well as write them down for the child to remember and reference.

Tip #4: Encourage movement and sleep

Encourage the child to exercise and become involved in activities that interest them. Make sure that your child is getting an appropriate amount of sleep as insufficient sleep can increase the inattentiveness and may lead to over-stimulation. Other tips include decreasing television time, creating a time before the child goes to bed to “wind down” by engaging in quieter activities. One of my favorite activities is reading a child’s favorite bedtime story or having the child read the story to me.

Tip #5: Help your child eat right

Help your child eat a balanced diet that includes fresh foods, fruits and vegetables. Children with ADHD are more prone to skip meals or eat unbalanced meals. Assist your child with eating healthy so that their bodies are receiving the proper nutrients for an activity. One way in which you can assist him/her with this is to get the child involved in meal planning and decisions for daily/weekly meals.

Tip #6: Teach your child how to make friends

Children with attention or hyperactivity difficulties sometimes have a difficult time making and keeping friends. Work with your child in order to improve their social skills by role-playing and choosing playmates carefully who also have similar language or physical skills.

To learn more about ADHD click here

 

Reference: www.helpguide.org/mental/adhd_add_parenting_strategies.htm, Authors: Melinda Smith, M.A., and Jeanne Segal, Ph.D

LOVE WHAT YOU READ?  CLICK HERE TO SUBSCRIBE TO OUR BLOGS VIA EMAIL!

Diagnosing ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurological conditions that affects between 3 to 6 percent of school-aged boy jumping on couch children.  Children with this condition exhibit significant issues with their ability to pay attention to tasks, inhibit their impulses and/or regulate their behavior.   In order for the diagnosis to be made, one has to witness significant impairment in regards to attentional regulation and/or activity level within multiple settings.  This means that the child must exhibit the concerns within the home, school, after-school program, sports team, etc.  In reality, the diagnosis can be made by a pediatrician or health care provider that is able to ascertain levels of functioning in the various domains by observing behavior or collecting parent and teacher report forms.

In the Neuropsychology Department at North Shore Pediatric Therapy, we focus on a comprehensive evaluation of a child’s functioning, including cognitive functioning, academic achievement, attentional regulation, executive functioning and social/emotional functioning.  Now, if the diagnosis can be made by a parent and teacher report, one must ask why a comprehensive evaluation should be mandated.  The answer to this is that over 45% of children that have been diagnosed with ADHD meet clinical criteria for multiple neurodevelopmental conditions.  Children with ADHD often present learning disabilities, emotional concerns and deficits with social regulation.  Sole treatment of the inattention may improve attentional regulation; however, there are other unaddressed concerns that may still linger.

Research has continuously demonstrated that the most common treatment of ADHD is a combination of pharmacological intervention, behavioral therapy, parent training, and teacher education.  Pharmacological intervention consists of stimulant medications that help to improve the child’s ability to attend to tasks.  A recent research article, which was even reported in an October edition of the Chicago Tribune, indicated that the majority of children who have been diagnosed with ADHD and are prescribed medication report significant improvement within their daily lives.  In the past, the main identification of improvement within children with ADHD was based upon teacher report.  Parents can now feel comfortable when asking their child if medication is helping. Behavior therapy focuses on the modification of the child’s environment to improve the frequency and duration of positive, on-task behaviors while extinguishing negative behaviors.  Parent and teacher education has a primary intent on discussing expectations within the home and school settings as well as possible modifications to ensure success.


Schedule Your        ADHDConsultation No

LOVE WHAT YOU READ?  CLICK HERE TO SUBSCRIBE TO OUR BLOGS VIA EMAIL!

Tips to Help a child with ADHD in the School Setting | Pediatric Therapy Tv

In today’s Webisode, a pediatric neuropsychologist explains strategies to assist a child with ADHD disorder in an academic environment. We will provide you with the basic principles you can apply to any child with ADHD in the classroom setting.  For more on ADHD, click here.

In this video you will learn:

  • Simple strategies to help a child with ADHD in the classroom
  • What type of environment would be helpful for a child with ADHD in the school setting
  • What a cue system is, and how it can help

Video Transcription:

Announcer: From Chicago’s leading experts in pediatrics to a worldwide
audience, this is Pediatric Therapy TV, where we provide experience and
innovation to maximize your child’s potential. Now your host, here’s Robyn.

Robyn: Hello, and welcome to Pediatric Therapy TV. I’m your host, Robyn
Ackerman, and today I’m standing here with Pediatric Neuropsychologist, Dr.
Greg Stasi. Doctor, what are some tips you can give to teachers to help a
child with ADHD in the school setting.

Dr. Greg: Sure. We see with children with ADHD that we often have
disorganization so it’s very important to have organized structure for the
child. Keep things simple. One folder going home, one side work for home,
one side work to school. The desk, check it to make sure it’s organized,
the materials are all there.

Preferential seating is important, too. The child should be within close
proximity to the teacher, that we need this child to be able to pay
attention and get back on task as needed. And a final tip is to develop a
cueing system consisting of verbal and visual cues to help redirect the
child as needed. For example, the child and the parents may sit down with
the teacher at the beginning of the school year and create a cue word, such
as bananas and when the teacher says this, that means that Johnny’s not
paying attention and Johnny knows that he has to make eye contact with the
teacher.

Robyn: All right, those are some great tips. Thank you so much, and thank
you to our viewers for watching. And remember, keep on blossoming.

Announcer: This has been Pediatric Therapy TV, where we bring peace of mind
to your family with the best in educational programming. To subscribe to
our broadcast, read our blogs, or learn more, visit our website at
learnmore.me. That’s learnmore.me.

ADHD Treatment Options

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental conditions. The United States Center for Disease Control has recently indicated that approximately ten percent of the school age population has been diagnosed with ADHD (CDC, 2010).ADHD

Typical symptoms that are exhibited in a child with ADHD include:

  • a lack of attention to details
  • difficulty following instructions
  • poor impulse control
  • hyperactivity
  • issues with regard to self-regulation

Research On ADHD Treatment:

The National Institute of Mental Health (NIMH) conducted the largest on-going research studies (MTA: Multimodal Treatment of Attention Deficit Hyperactivity Study) examining the efficacy of various treatment modalities for ADHD. This study consisted of over six hundred children who were diagnosed with ADHD.

Each child was assigned randomly to one of four treatment groups:

  • intensive medication management alone
  • intensive behavioral treatment alone
  • a combination of both
  • or routine community care which served as a control group

Outcomes Of The ADHD Study:

What the study found was that combination behavioral treatment and medication management were significantly superior to behavioral treatment alone in reducing symptoms of ADHD (Dec 1999, Archives of General Psychiatry). The results also highlighted that these improvements in functioning (with combination behavioral and medication therapy) lasted for upwards of 14 months. A final important finding from the study indicated that combination treatment (behavioral therapy and medication) was superior in treating other areas of daily functioning such as anxiety/depression, academic achievement, social skills, and family interactions in comparison to medication or behavior therapy alone.

ADHD treatment Options:

As the above study indicates, pharmacological intervention is oftentimes the first treatment of choice for a child with a diagnosis of ADHD. However, medication alone is not the only solution as was evident in the study. Behavior therapy, which focuses on teaching children appropriate self regulation skills by modifying the environment so that appropriate on-task behaviors are reinforced while negative, off-task behaviors are extinguished, is a vital component of a treatment plan. Many times parents do not want to go with medication as a primary treatment and would rather try behavioral therapy or working with a social worker to help develop socialization skills.

Many children with ADHD exhibit issues with their daily social functioning. It is important to realize that these social deficits are not because of a lack of inherent social skills but because of the impact that issues with attention to the social world and impulsivity have on their daily social interactions. The focus of the intervention then needs to be on how to change the child’s daily environment so that he or she is set up for success. Many times this will include modifications in the classroom setting to help improve on-task behaviors and self regulation. Another intervention that is often needed for a child with a diagnosis of ADHD is parent and teacher education. It is important to work with parents and teachers so that they can have a better grasp as to why they are observing particular behaviors.

In summary, the empirical research has indicated that a combination of pharmacological intervention and behavioral treatment is the number one intervention for a child with a diagnosis of ADHD. However, there are other options that are less invasive such as behavioral therapy in isolation, parent/teacher education, and/or social work support to help improve daily social interactions.

For more on ADHD, click here

Love What You Read?  Click Here To Subscribe To Our Blogs Via Email! 

Sensory Strategies for Kids with ADHD

Sensory strategies are one of the most common and least invasive suggestions made to assist children with Attention Deficit Hyperactivity Disorder  (ADHD) function more successfully in their day to day lives. Because of the increased awareness surrounding ADHD, it has become a popular topic for many adhd boyprofessionals. While this means that there is an ever-growing supply of research and increasing amount of resources for parents, teachers and medical professionals to reference; it also has the potential to be both overwhelming and confusing. Many of the professionals researching ADHD publish articles, books, and research papers with strategies they have found to be beneficial to children with ADHD. This has potential to be very informative and helpful but there is no unified terminology being used, and thus, the same suggestions are being made using different terms, creating a difficult system to navigate. Sensory strategies are included in some form in almost all approaches suggested for children with ADHD. Sensory strategies are also often referred to as “movement strategies,” or other similar titles, but provide the same suggestions and at their core are truly sensory strategies.

Sensory Strategies for kids with ADHD:

  • Allowing the child to take a 2-3 minute break every 10-15 minutes. This break should involve intense movement when possible, such as jumping jacks, pushups, jumping on a trampoline, etc. When intense movement is not appropriate, breaks may involve the student walking to the drinking fountain, getting up to sharpen his/her pencil and/or walking to the bathroom.
    • If an assigned task involves intense academic work, such as testing, lengthy projects or problem-solving assignments the child should be given the opportunity to take a longer break (approximately 10 minutes) to allow time for more intense physical exercise.
  • Provide a toy or item for the child to manipulate during solitary work. These items are often referred to as “fidgets,” and provide the child with an outlet to release their restlessness. Rather than continuously moving his/her body, the child can move his/her hands quietly in their lap or on their desk while manipulating the fidget.
  • Another way to incorporate physical work into settings where children are expected to be able to sit and attend to a task is to adapt the child’s seat. There are a variety of seating options available that involve the child working to maintain balance and an upright posture. Exercise balls are often provided in the classroom as an alternative to a standard chair, this allows the child to slightly move and requires him/her to use their core muscles to maintain seated. A T-stool is a flat, bench-like seat that is mounted on a single upright post. This provides similar sensory input to the child, without the possible temptations surrounding a ball. Rocking chairs have also been used both at a child’s desk and during circle time, and prevent much of the “disruptive” behaviors that teachers often observe during these quiet sitting periods of the day.
  • Gum is often not allowed in the school setting, but it can be an invaluable tool to a child with ADHD. Oral-motor input is something many children crave, hence why so many kids stick their pencils in their mouths or chew on their clothing. Providing gum to a child with ADHD provides them an outlet for their restlessness. The constant chewing/movement of the jaw and flavor options can act as an alerting stimuli as well as a grounding force, helping the child have the ability to better focus on the task at hand.

These sensory strategies can be implemented in the classroom, at home and in most other settings where a child is expected to be able to sit and attend to a task (church, Sunday school, music lessons, camp, etc.). Incorporating these strategies into particularly difficult parts of the day can also have an immense positive impact on the child; for example, incorporating physical exercise into transitional periods may lessen the stress that these times put on both the child and the adult. These sensory strategies are not strict rules to abide by, but are general guidelines to be expanded upon or adapted to fit each child’s individual needs.






The Importance of Teaching Self-Advocacy Skills to Children with ADHD

Attention Deficit Hyperactivity Disorder is a neurological condition associated with under activation of the frontal lobe. This area of the brain is also associated  boy with ADHDwith the executive functioning skills such as organization, time management; planning, impulse control, cognitive flexibility, and ability to self monitor one’s work. Children with ADHD without a doubt demonstrate poor executive functioning. These children have difficulty initiating action on tasks, organizing materials appropriately, managing time effectively, etc. These are all skills that can be developed and improved; however, they are also areas that need be accommodated in order for the child to perform to his or her ultimate potential. Many articles and blogs (link to my past blogs on EF) have been published regarding teaching executive functioning skills. There is also ample work out that there that provides accommodations that teachers may utilize in the classroom setting. We can teach the child the skills, we can accommodate the child; however, if the child is not a self advocate than it is all for naught.

 Step 1 To Teaching Children To Advocate For Themselves:

The first stage to begin to develop self advocacy skills is for the child to be able to recognize that he or she exhibits weaknesses or deficits with particular skill sets. Explain to the child (in child friendly terms) what it means to lack organization skills, have difficulty planning, and struggle with time management. Use daily examples from the child’s life (e.g. how long did homework take last night? How long should have it taken?). Once the child identifies that there is a problem he or she can then work on solving the problem.

Step 1 To Teaching Children To Advocate For Themselves:

The next step is to target one task at a time. Work with the child to create a list of areas that can be improved (e.g. morning routine, homework, organizing his/her room). Once the list is created, have the child number them in order from the biggest problem to the smallest problem. Self advocacy skills are developed by the child being able to develop the solution to the problems through Socratic dialogue with parent and not by parent simply providing a list of what needs to be done (e.g., what do you have to do first? …., well, that is one step, but is there something that needs to go before that?). This process is time consuming and will create headaches for many parents on a daily basis. However, if you ultimately want the child to develop the skill set, he or she must develop the solutions. After the first problematic behavior is tackled, the parents and child should then target the second one on the list in a similar manner. There are many strategies and devices (use of timers, checklists, etc) that are way too exhaustive to be explained in this blog that are wonderful tools to help with task completion; however, the first step is for the child to identify that he or she needs help.

The ultimate goal of childhood is to develop independence and skills necessary to live in society. One of the most important skills to develop is self-advocacy; to be able to identify that one has a problem and also to know when to seek others out for help and guidance.

If You Would Like To Receive Our Blogs In Your Email: Please Sign-Up Here!