- Make sure what you are dealing with really is ADD.
Make sure someone has tested the child's hearing and vision recently,
and make sure other medical problems have been ruled out. Make sure an
adequate evaluation has been done. Keep questioning until you are
convinced.
- Build your support.
Make sure there is a knowledgeable person with whom you can consult
when you have a problem (learning specialist, child psychiatrist, social
worker, school psychologist, pediatrician -- the person's degree doesn't
really matter. What matters is that he or she knows lots about ADD, has
seen lots of kids with ADD, knows his or her way around a classroom, and
can speak plainly.) Make sure the teachers are working with you.
- Know your limits.
Don't be afraid to ask for help. You should feel comfortable in
asking for help when you feel you need it.
- Remember that ADD kids need structure.
They need their environment to structure externally what they can't
structure internally on their own. Make lists. Children with ADD benefit
greatly from having a table or list to refer to when they get lost in
what they're doing. They need reminders. They need previews. They need
repetition. They need direction. They need limits. They need structure.
- Post rules.
Have them written down and in full view. The children will be
reassured by knowing what is expected of them.
- Repeat directions.
Write down directions. Speak directions. Repeat directions. People
with ADD need to hear things more than once.
- Make frequent eye contact.
You can "bring back" an ADD child with eye contact. Do it
often. A glance can retrieve a child from a daydream or just give silent
reassurance.
- Set limits, boundaries.
This is containing and soothing, not punitive. Do it consistently,
predictably, promptly, and plainly. DON'T get into complicated,
lawyer-like discussions of fairness. These long discussions are just a
diversion. Take charge.
- Have as predictable a schedule as possible.
Post it on the refrigerator, the child's door, bathroom mirror. Refer
to it often. If you are going to vary it, give lots of warning and
preparation. Transitions and unannounced changes are very difficult for
these children. They become discombobulated. Help the kids make their
own schedules for after school in an effort to avoid one of the
hallmarks of ADD: procrastination.
- Take special care to prepare for transitions well in advance.
Announce what is going to happen, then make repeat announcements as
the time approaches.
- Allow for escape valve outlets.
Finding the right outlet will allow the child to leave the room
rather than "lose it," and in so doing begin to learn
important tools of self-observation and self- modulation.
- Provide frequent feedback.
It helps keep them on track, lets them know what is expected of them
and if they are meeting their goals, and can be very encouraging. Notice
the positive steps no matter how small and tell the child what you see.
- Break down large tasks into small tasks.
This is one of the most crucial of all training techniques for
children with ADD. Large tasks quickly overwhelm the child and he
recoils with an emotional "I'll-NEVER-be-able- to-do-THAT"
kind of response.
By breaking the task down into manageable parts, each component
looking small enough to be do-able, the child can sidestep the emotion
of being overwhelmed. In general, these kids can do a lot more than they
think they can. By breaking tasks down, the child can prove this to
himself or herself.
With small children this can be extremely helpful in avoiding
tantrums born of anticipatory frustration. And with older children it
can help them avoid the defeatist attitude that so often gets in their
way. And it helps in many other ways, too. You should do it all the
time.
- Loosen up. Act silly.
Let yourself be playful, have fun, be unconventional, be flamboyant.
Introduce novelty int"the day. People with ADD love novelty. They
respond to it with enthusiasm. It helps keep attention -- the kids'
attention and yours as well. These children are full of life -- they
love to play. And above all they hate being bored. So much of their
"treatment" involves boring stuff like structure, schedules,
lists, and rules, you want t"show them that those things d"not
have to go hand in hand with being a boring person. Every once in a
while, if you can let yourself be a little bit silly, that will help a
lot.
- But watch out for overstimulation.
Like a pot on the fire, ADD can boil over. You need to be able to
reduce the heat in a hurry. The best way of dealing with chaos is to
prevent it in the first place.
- Seek out and underscore success as much as possible.
These kids live with so much failure, they need all the positive
handling they can get. This point cannot be overemphasized: these
children need and benefit from praise. They love encouragement. They
drink it up and grow from it. And without it, they shrink and wither.
Often the most devastating aspect of ADD is not the ADD itself, but the
secondary damage done to oself-esteem. So water these children well with
encouragement and praise.
- Use tricks to improve memory.
They often have problems with what Mel Levine calls "active
working memory," the space available on your mind's table, so to
speak. Any little tricks you can devise -- cues, rhymes, code and the
like -- can help a great deal to enhance memory.
- Announce what you are going to say before you say it. Say it. Then
say what you have said.
Since many ADD children learn better visually than by voice, if you
can write what you're going to say as well as say it, that can be most
helpful. This kind of structuring glues the ideas in place.
- Simplify instructions. Simplify choices.
The simpler the verbiage the more likely it will be comprehended. And
use colorful language. Like color-coding, colorful language keeps
attention.
- Use feedback that helps the child become self-observant.
Children with ADD tend to be poor self-observers. They often have no
idea how they come across or how they have been behaving. Try to give
them this information in a constructive way. Ask questions like,
"Do you know what just happened?" or "How do you think
you might have said that differently?" or "Why do you think
that other girl looked sad when you said what you said?" Ask
questions that promote self-observation.
- Make expectations explicit.
Don't assume anything or leave anything to chance.
- Children with ADD respond to rewards and incentives.
A point system is a possibility as part of behavior modification or a
reward system for younger children. Many are little entrepreneurs.
- Try discreetly to offer specific and explicit advice as a sort of
social coaching.
Many children with ADD are viewed as indifferent or selfish when in
fact they just haven't learned how to interact. This skill does not come
naturally to children, but it can be taught or coached.
If the child has trouble reading social cues -- body language, tone
of voice, timing, and the like -- For example, say, "Before you
tell your story, ask to hear the other person's first."
- Make a game out of things when possible.
Motivation improves ADD.
- Give responsibility back to the child when possible.
Let kids devise their own method for remembering what needs to be
done, or let them ask you for help rather than your telling them they
need it.
- Praise, stroke, approve, encourage, nourish.
Praise, stroke, approve, encourage, nourish. Praise, stroke, approve,
encourage, nourish.
- Be like the conductor of a symphony. Get the orchestra's attention
before beginning.
You may use silence, or the equivalent of tapping your baton, to do
this. Keep the child "in time," pointing to things that need
to be done as you ask for their help.
- Expect to repeat, repeat, repeat.
Do it without getting angry. Anger won't increase their memory.
- Provide for exercise.
One of the best treatments for ADD, in both children and adults, is
exercise, preferably vigorous exercise. Exercise helps work off excess
energy, it helps focus attention, it stimulates certain hormones and
neurochemicals that are beneficial, and it is fun. Make sure the
exercise IS fun, so the child will continue to do it for the rest of his
or her life.
- Always be on the lookout for sparkling moments.
These kids are far more talented and gifted than they often seem.
They are full of creativity, play, spontaneity and good cheer. They
usually have a "special something" that enhances whatever
setting they're in.
Highly recommended:
Driven to Distraction: Recognizing and Copying with Attention
Deficit Disorder from Childhood through Adulthood by Edward M.
Hallowell, MD and John J. Ratey, MD. Touchstone Books, 1992. ISBN
#0-684-80128-0
