Summertime.  A time to be carefree;  a free spirit; a new world explorer.  Or maybe not.

Our son loves to be home.  Given his choice, he would stay home pretty much most of the time — in his pajamas with his hair all messy and toys all around him.  He doesn’t, of course.  He is usually pretty busy between school, sports, OT and so forth.  However, we have had a two week break between the end of school and before summer camp starts.  Getting him out of the house with the babysitter has been a real challenge.

Don’t get me wrong.  In general, the babysitter situation, as I wrote in my last post, is working out well.  We hired a 17 year old boy and our son loves playing soccer, basketball and XBOX with him.  This is good.  However, he does not want to leave the house to go to the playground, or to the batting cages or to the YMCA pool.  I attribute this to his being uncomfortable with anything new which I think is part of his cognitive rigidity aspect of ADHD.  It is difficult for our son to face new situations and changes.

My approach to this has been twofold.  First, try to get a good friend to do the activity with him.  The idea being that a good friend provides our son with the comfortable framework that he needs.  Secondly, I strongly encourage him to try the activity (encourage might be a bit euphemistic) and tell him that if he does like not the activity then, after he tries it, he can come home.  Usually he then goes and has a great time!!

We go through this for every new activity.  It is frustrating, it is annoying and it makes me sad that it is often so difficult for him.  I remember my summer days of free flowing play and exploration and wish that things could be easier for our son.

I often question myself on whether he is just being a homebody or is it a form of anxiety/cognitive rigidity?    My mother’s instinct tells me that it is his anxiety.  And so we soldier on trying to think of new ways to make him comfortable enough to try new activities, situations and sports.  It is a daily battle that I wish was not a battle for him at all.

Do you face a similar situation?  How do you handle it?  Any ideas for me and for others would be greatly appreciated!!

Until next time …. Take care!!

Karen

• Bed time
• Falling asleep
• Staying asleep
• Waking up

Bed time for children with ADHD is challenging because, well, they often just don’t want to stop. However, once in bed, many children and adults with ADHD have trouble falling asleep, staying asleep and then, once asleep, waking up. According to research, prior to puberty 10-15% of children with ADHD have trouble getting to sleep. This is 2x the rate found in children and adolescents who do not have ADHD. The number of individuals with ADHD experiencing trouble getting to sleep dramatically increases with age (oh joy – another thing to look forward to!):

• 50% of children with ADHD have difficulty falling asleep almost every night by age 12 ½
• By age 30, more than 70% of adults with ADHD report that they spend more than 1 hour trying to fall asleep at night

Yikes!! [These figures were found in the February/March 2004 issue of Additude in an article written by William Dobson M.D. entitled, “ADHD Sleep Advice – End Bedtime Battles”.]

Fortunately for us, our son does not have trouble sleeping once we actually get him settled down into bed. It is bed time, itself, that is our challenge right now. So what helps us with bed time?

• Routine, routine, routine – routine is our best friend. We are probably our own worst enemy because on the weekends, we do not stick to the routine but a routine associated with bed time and a routine on the time itself have helped tremendously.
• One on one time with parents – our son still loves to cuddle with mom and dad. Nothing calms him down faster than when we lay down with him and cuddle. We chat quietly about our day and have a few quiet laughs, hugs and kisses. I don’t know if it is the sense of security, the routine or the cuddling that calms him down but it works for us.

Other suggestions for bed time settling down and falling asleep include:

• Turning off the TV and shutting down video games about an hour before bed time. TV and video stimulate all childrens’ nervous systems – imagine what it does to the nervous system of a child with ADHD.
• Avoiding caffeine before bed time. Not only is caffeine a stimulant but it is also a diuretic. Nothing worse than trying to sleep when you really need to pee!
• Having milk and ice cream. Dairy foods contain an amino acid that converts the active ingredients in milk to melatonin and serotonin. Both melatonin and serotonin help the body fall asleep.
• Practicing deep breathing. Practice releasing the tensions, energy and worries from the day and preparing for sleep through deep breathing.
• Taking Melatonin.
• Taking a bedtime medication prescribed by your doctor.
• Using sensory products such as weighted blankets or special tents that give a sense of security.
• Playing nature sound CDs, meditation CDs, white noise or calming music.
• Drinking “Organic Nighty Night” tea (we have actually used this) or other types of soothing teas.
• De-cluttering the child’s room to limit distractions.
• Taking a warm bathes or shower.
• Using lavender in the child’s room to calm.
• Making sure the child has plenty of exercise throughout the day.
• Behavior therapy.

Hopefully within this list you will find some ideas to help you and your child to find a bed time routine which results in a smooth transition from an awake state to an asleep state! (Is there such a thing as a smooth transition with a child with ADHD?)

Trouble with staying asleep is a whole other issue. I would examine food and exercise habits but also consult a doctor to make sure other conditions like sleep apnea or restless leg syndrome are not impeding a good night’s rest.

I tend to believe that having trouble waking up is probably correlated to the earlier phases of sleep like having trouble falling asleep or staying asleep. We definitely have trouble waking our son up some mornings but it is usually when he is tired. He needs more sleep towards the end of the week versus the beginning of the week because he works so hard at school and at home with homework. We give him a hot shower every morning and wrap him in warm towels when he gets out of the shower (wouldn’t it be nice if we all could have warm towels in the morning) and that helps him in waking up!

In the academic world, the correlation between ADHD and sleep disorders is one which needs to be further explored. What is known is that sleep problems are rampant in people who have ADHD. However, the big unanswered question is whether sleep problems are secondary to having ADHD or whether sleep disorders are another cause of ADHD. Right now, there is no answer. What is known is that the proper amount of sleep is important for anyone. Children with ADHD, however, need their sleep even more because the lack of sleep can make a life that is challenging even more so.

I hope this article is helpful in giving you some ideas to try in establishing a way to help your child transition more peacefully from being awake to being asleep.

As always, take care …. Until next time.
Karen

One of the challenges associated with ADHD and ADD is “executive functioning”. I have talked about this before. This like so many other things is a confusing element to ADHD but one that I feel is really important to be aware of and necessary to understand the challenges of your child holistically. In fact, many experts in the field of ADHD/ADD are starting to suggest that ADHD be re-conceptualized as an “executive disorder” and deemphasize the focus on hyperactivity and attention. Problems with executive functioning are not limited, however, to only those with ADHD or ADD. Executive dysfunction sometimes is the only problem and sometimes is part of a larger problem.

The easiest way to think of executive functioning is that it is the administrative or managerial part of the human brain. Executive functioning has to do with organization, planning, self-control, and time management, for instance. Like anything else, any individual with executive functioning issues will have areas of strength and areas of weakness within the broad spectrum of executive functioning.

The reason I am writing this blog post is not only to raise awareness of executive functioning or dysfunction but also to state that executive dysfunction requires teaching, support and practice in order to be effectively addressed. There are things that you can do to help your child in the short term and there are processes to help teach them how to handle different situations and opportunities. Supporting your child in the areas of executive functioning is often required into high school and college. Like anything else, better executive functioning occurs with ongoing practice and support.

For me, one of the hardest challenges I have is gauging what is appropriate and when. I need to keep in mind that we have to understand our son’s strengths and weaknesses overall and to work with those strengths and weaknesses on an ongoing basis. The conquering of certain skill sets can only be achieved with consistent practice and it takes time. Thinking in terms of support of executive functioning in this way has helped me a lot to establish a mindset for myself in helping our son.

I have heard this often in my ongoing research but I feel that it is important to stress that our son is not defined by his challenges. Our son is an amazing child who is fun and funny and full of energy and life. He has his strengths and weaknesses like we all do. All of our efforts are focused on supporting who he is so that he can continue to experience success and grow into a confident young man.

I am just learning about the process of supporting executive functioning. It turns out that we have already been implementing strategies to help our son especially in the area of transitions. For instance, we use the 5 minute warning, 3 minute warning and 1 minute warning for all changes in activity so that he has time to adjust. It turns out that “transitions” fall within the area of “Cognitive Flexibility”. Cognitive Flexibility is defined as the ability to problem solve in a flexible, dynamic way and/or the ability to address new situations. So as we learn more, I will share what I have learned with you.

Until then …. Take care.

Becky
I am… wife to a wonderful husband, mother to 2 awesome boys, daughter to fabulous parents, sister to 2 phenomenal women, friend to many… and a child of God.

Do They Know?

http://thepealfamily.blogspot.com/2009/09/do-they-know.html

The other day, as I was watching all the kids get on the school bus outside our front door, I dreamed about having a “normal” kid… a kid who gets themselves ready in the morning without 100 reminders or redirections… a kid who does their homework without complaining and completes it in a normal amount of time… a kid who doesn’t have a meltdown every time he doesn’t get his way… and the list goes on and on.

Then I wondered… Do they know?

Do the other parents know what we go through on a daily basis, just to get ready for school?
Do the other parents know what we go through every night when we have to do homework?
Do they realize how good they really have it? Do they appreciate their kids?

I love my kids with all my heart and I wouldn’t trade them for the world… but some days I just wish for some semblance of normalcy. What is our “normal” you may ask – here are just a few glimpses of what it is like to be a parent of a kid with ADHD:

- Simple tasks like getting dressed, making a bed, or brushing their teeth require numerous reminders and redirections and it takes 10 times longer than it should.
- Sometimes I just help them get dressed, eventhough they can do it by themselves, just so that it won’t take so long.

Read the rest of this entry at: http://thepealfamily.blogspot.com/2009/09/do-they-know.html

Description of the Film from the totallyadd.com website. The description can be found at: http://totallyadd.com/about/the-film/

ADD & Loving It?! is a refreshing, witty and inspiring documentary about adult Attention Deficit Disorder (also known as Attention Deficit Hyperactivity Disorder, or ADHD). The one-hour film, which will be broadcast on Canwest Global Television in the fall, is hosted by actor/comedian Patrick McKenna and written, produced and directed by fellow comedian, Rick Green.

ADD & Loving It?! explores and explains the disorder by following Patrick’s journey for a diagnosis so he can confirm what he’s always suspected – that he has ADD. Along the way, Patrick and his wife Janis open up about their challenges and struggles, something Janis admits “we’ve spent our whole lives trying to hide.”

Patrick notes, “Some people think the diagnosis is the kiss of death, while others think there’s no such thing; it’s nothing, it’s all made up.” But after talking with the experts and with ordinary people, as well as drawing from his own experience, he confirms that ADD is real. It’s genetic, it can destroy lives, and adults with ADD have a higher rate of accidents, addictions, suicide, bankruptcy, divorce, illegal drug use and financial problems.

Patrick uses his gift of comedy to demonstrate the three characteristics of ADD – inattention, impulsivity and hyperactivity. He uncovers the 18 symptoms used to diagnose ADD in childhood, and illustrates how these traits develop by adulthood. After all, adults learn not to bounce in their chairs during meetings, while kids in grade three rarely go bankrupt.

Janis guides Patrick through several ADD quizzes and their banter sets a warm, loving tone for the film. Patrick’s high score leads ADD expert Dr. Umesh Jain to diagnose Patrick with ADD. Patrick is stunned but begins to see his life from a whole new perspective and recognizes how much his ADD has cost him and his family. And realization becomes motivation. Now that he knows he has ADD, he can deal with it.

The experts interviewed are among the top names in the field of ADD in North America – Stephen Kurtz, Kate Kelly, Edward Hallowell, Annick Vincent and Margaret Weiss to name a few. No film has ever assembled such a powerhouse team. As each expert explains the details about ADD, he or she is backed up by at least two or three others. What you will see and hear is information from the most reliable sources on the topic of adult ADD.

The film creates recognition and laughter. That in itself is healing, especially for those struggling in isolation. Research has shown that laughter does improve health. While laughter may not be the best or the only medicine, it’s certainly the easiest to swallow.

“Although we’ve had counselling, and I’ve talked about it until I was blue in the face, it wasn’t until my fiancé saw your documentary that he “got it.” … I’ve never been able to put the whole picture together for him.” Focus Group Participant

In the end, Patrick realizes that he had resisted being diagnosed and getting treatment because “pretty much everything I knew was told to me by people who had no idea either.” He finds his own answer to the film title’s question, “You can’t love your ADD. But you can have ADD and love life.”

1. Predominantly hyperactive-impulsive
2. Predominantly inattentive
3. Combined hyperactive-impulsive and inattentive

The most prominent features of ADHD include:

1. An inability to control behavior or impulses.
2. An inability to delay gratification.
3. Excessive physical activity that is unrelated to the activity at hand.
4. Poor ability to sustain attention or to persist with tasks.
 
Each individual with ADHD is different with their own set of strengths and challenges. However, in addition to the hyperactivity or the inattentiveness, the ADHD child often has challenges in a group of skills called executive functions. According to Wikipedia, executive functions is a “concept used by psychologists and neuroscientists to describe a loosely defined collection of brain processes which are responsible for planning, cognitive flexibility, abstract thinking, rule acquisition, initiating appropriate actions and inhibiting inappropriate actions, and selecting relevant sensory information”.
 
Often with the ADHD child, the impairment is more than them being hyperactive or inattentive. Other possible ramifications or symptoms of the child with ADHD include challenges, limitations or problems with:

1. Organization

10. Great variability in task or work performance.

Bottom line, the disorder is complicated and manifests itself in many ways. In addition to all of this, there is a high incidence of learning issues as well as anxiety and depression for those with ADHD.
 
I believe that it is up to the family to educate the teachers and administers on the wide range of challenges their child faces due to ADHD. Do not assume that they know or understand. Remember that you know your child best. However the ideal situation occurs when the parents, teachers and administrators work together to creatively deploy and teach strategies that address the child’s weaknesses. Strategies like lists, reminders, previews, and repetition help the child with ADHD address the realities of the disorder and teach ways to cope with the challenges of the disorder. That ideal situation cannot occur, however, until teachers and administrators are educated. We all need to do our part to make that happen.
 
 
I close with a Bill of Rights that I found on a blog of a mother who son, 18, was diagnosed with ADHD at age 6. Her name is Angel, she lives in South Africa and shares her story of raising her son (among other topics) at http://www.angelsmind.co.za.

 
 
ADHD Bill of Rights

1.“Help me to focus…” Please teach me through my sense of ‘touch’, I need ‘hands on’ and ‘body movement’.

Author unknown

 

To learn more about the ADHD Executive Functioning Research that has been conducted please see:

Great summary chart of the Executive Function Domains can be found at http://www.lehighpsych.com/art_adhd.htm

Dr. Thomas E Brown
http://www.drthomasebrown.com/brown_model/index.html

Dr. Russell Barkley
http://www.russellbarkley.org/adhd-nature-of-self-control-book.htm

http://www.chrisdendy.com/executive.htm

http://www.thehelpgroup.org/pdf/adhd-dys/Brown_ADHD.pdf