In our case, in addition to ADHD and learning differences there is a slight twinge of anxiety that creeps into our daily lives.  Our son is really happy at his school and with his school friends.  He also is still very close to his best friend from growing up and is always happy to have him over for a play date.  Outside of this, anxiety tends to creep in and affect everything else.

When our long term favorite babysitter needed to take extra classes in order to finish college, we needed to find a new babysitter for the afternoons before my husband and I are done work.  We ended up hiring two girls from our local college who were very nice and sweet.  The change, however, was too much for our son and he proceeded to lock himself in the back upstairs room of our house every day for a month.  Not a good situation.  We kept hoping that he would get used to the idea and give the girls a chance.  We talked about it with him and tried different strategies to no avail.  I felt horrible for our son in that this kind of change was so traumatic for him.  I also felt badly for the girls and for us.  Juggling work, homework, kids’ activities, laundry and commitments on a daily basis is challenging enough.  Throw in a healthy dose of anxiety and it becomes that much more difficult.  In situations like this, I tend to go through a full range of emotions from sad to supportive to angry.

So when college ended for the year in the beginning of May, we found ourselves with no babysitter and no support in the afternoons.  My husband and I juggled everything together and the kids probably spent a little more time in front of the TV than they should have.  Neither my husband nor I could face just yet the trauma of finding another babysitter.  We also needed to make some decisions about the summer which would determine the amount of hours that we would need from a sitter.

I then had an epiphany when asking a friend about the local college job boards.  He joked that they had gotten a response from an attractive male college polo player that we might want to consider.  His twin nearly teenage girls and an attractive male college polo player was not a good match for them.  I immediately laughed at his joke and we went on with our conversation.

However when I hung up the phone, I thought about a male babysitter.  It could work.  We had always had female nannies and au pairs.  Maybe it was time to consider something different that our son might be comfortable with.

So we met with a friend’s son about babysitting and he started this week.  SUCCESS.  Our son loves having a male babysitter and looks forward to seeing him every day.  (Okay today was only day 3).  No running to the bedroom or back room to hide – just soccer, baseball and giggles.

So maybe this solution was not so creative but it did require for my husband and I to think “out of our box” that we had created regarding babysitting!  So we have a new babysitter but no anxiety, for now.  Hooray!!!!  And so I celebrate a tiny success.

Until next time …. Take care.

The end of the school year is approaching and I don’t know who is more excited about the two week break between school and summer camp, my son or I.  We have not had a break from homework since August 2008.  A key component to overcoming his learning challenges is not only to learn specific strategies for reading, writing and math but repetition, repetition, and more repetition.

He has made tremendous progress this year!  I am so proud of him and his incredible hard work.  We do about 1.5 hours of homework 5 nights a week.  For second grade, this is a lot of work.  If anything, our son is going to have an incredible work ethic.  The words he can now read include anticipation, commissioned, audience and Constantinople!!  Wow – he has done so well.

Recently, the summer reading list came out in our school’s weekly newsletter.  I contacted our son’s teacher in order to get guidance on his independent reading level for the summer.  Well let’s just say it is not where I expected it to be.  Hence “the punch in the gut” in the title of this blog post.  I felt so deflated.  I just wanted to sit down and have a really good cry.

I reached out to his teacher and asked about his independent reading level and now I understand.  Learning challenges like everything else in life is about layers.  This year was a year of building the foundation.  He has strategies for decoding words he doesn’t know.  He has strategies for comprehending the material he is reading.  He has strategies for writing and answering questions.  He has strategies for paying attention and remaining engaged in the classroom.  All of this HAS resulted in tremendous progress.

The next layer that has to be attacked, however, is comprehension.  He is working so hard to decode and read and do, that his brain processing does not really have the room for full comprehension.  As we practice his strategies more, then the strategies themselves will become second nature so that he can grow into comprehending the material he is working with.

So once again I have to remind myself that “my framework” is not what is relevant.  Learning challenges, like everything else in life, is a journey that has to be broken down into manageable pieces.

He is working hard, he is making progress and he likes school.  It is all good.  So I was able to give myself a swift kick in the a—and remind myself of how proud I am of him.  I also decided that I am going to get ice cream for every night of those two weeks where we have a break!!

So until next time …. Take care.

I certainly hope that my posts help each of you with ideas and suggestions for approaching your day to day life.  I know that often just the process of writing the blog post helps me to think through the day to day situations that we face as a family. 

In a previous post I wrote about ADHD and anger.  I explored how anger management is a challenge for those with ADHD because, like behavior regulation challenges – a hallmark of ADHD, anger management is a regulation of the emotions.  Because of the impaired nature of the Executive Functioning in those with ADHD, emotions are often more intense and more challenging to regulate.  As a result, I look at how our son handles frustration and anger as not a discipline issue but an opportunity to teach him how to handle frustration and anger constructively.

Hand in hand with the anger and frustration is often hitting.  To tell the truth, I have had concerns about our son’s hitting and have tried to teach him to use his words instead of his hands/body in expressing his anger and frustration.  His hitting kind of remained a fuzzy situation that has bothered me in the back of my head but it is not something I had really spent a great deal of time focusing on.  As I prepared to write this post, I thought through the reason for that.

First of all, we do not have any troubles with him hitting other kids. Well, except for his sister, which I really attribute to the typical sibling interaction.  I fondly remember my brother and I beating the c—p out of each other through high school!!  Secondly, we have no discipline challenges with him at school whatsoever.  So what I realize bothers me is that he does lash out at his father and myself from time to time.

So I have done some research on the topic and have discovered that aggressive behavior is common in young children.  Until a child reaches something like the age of six or so, he is not developmentally mature enough to curb his or her impulse to hit.  Our son is older than six but his ability to handle frustration maturely is still in development and the fact that he largely directs it at his father and I is okay for me for now. 

Why do I think it is okay, for now?  I think that developmentally he is not able to fully control his emotions yet. In addition, we are a safe place for him to direct his anger and frustration – he is working so hard that I think he needs a safe place to express his frustrations.  Finally, he often is least able to handle his frustration or anger when he is tired or when he has spent too much time in front of the tv or video games.   It is up to my husband and I to make sure that he is getting enough sleep and exercise and that we help guide him when he is in overtired situations.  I often verbalize that you are angry and frustrated because you are tired and dad and I need to make sure that you get enough sleep tonight.

What have we done to help him address those situations when he wants to hit?

•  Figure out another outlet for his anger.  We have chosen an “anger” pillow that he can take out his frustrations on.

•  Teaching him words to associate with a situation.  We literally practice the phrases, “you are making me angry”, “I am really frustrated right now” or “I need the anger pillow.”  I am also careful to make sure that I use the phrases myself – “I am really frustrated because I can follow your crumb trail from the kitchen to the living room.

• Recognizing his feelings and verbalizing them.  “I know that you are upset because I am not allowing you to play your DS.  In order for you to be healthy, you need to play and get fresh air. 

• Reinforce verbally that hitting is wrong.  It is as simple as saying over and over again, “you are not allowed to hit.”  I also have our son look at the person that was hit and apologize sincerely. 

• Reinforce when you see frustration and anger handled appropriately.  “I am so proud of you for using the anger pillow instead of hitting me.”  I have, with fits and starts in the past, tried to do reward charts but I have found that our son reacts most positively when rewarded immediately.  So I often praise immediately, offer a treat or say let’s do this together as a reward for your great behavior.

So after writing this blog post, I have found that I am less concerned about his hitting than I used to be at the back of my mind and I have resolved with renewed vigor to keep doing the steps outlined above.

Let me know your thoughts and what works for you.

Until next time …… take care.

BED TIME. Does reading these two words give you nightmares as a parent of a child with ADHD? Apparently it is VERY common for children with ADHD (and adults with ADHD too) to resist bed time. It is a nightly challenge for us in our household.
When thinking about ADHD and sleep, it might be helpful to think what I call the 4 stages of sleep:

• 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

The outbursts, the tantrums, the eruptions … day in and day out. It is so stressful. Is it ODD? What is it? Should I be concerned?

The answer to the “should I be concerned question” is both yes and no. Yes, because any child needs to be taught how to handle situations and frustrations with a healthy response. No, because if you look at the problem through the lens of ADHD, it is another symptom of the disorder.

Believe me, I often stress over the angry outbursts and tantrums. They raise my stress level and there are days that they make me exhausted beyond belief. I have found, however, that a shift in my mental framework towards the angry outbursts help. Let me explain.

I thoroughly believe at this point that ADHD is a neurological disorder that impacts the executive functioning within the frontal lobe of the brain. I have written on numerous occasions that this can manifest itself in many different ways. Most associated with ADHD is either hyperactivity or inattention. Both are forms of behavior regulation. Hyperactivity is the inability to control or limit one’s activity and inattention is the inability to maintain attention when there is no interest in an activity or the activity is too challenging (i.e. too frustrating).

So why have I consistently put anger in a different category?

I have even done research into ODD, being concerned that his anger is an indication of ODD. (About 1/3^rd of kids with ADHD do develop some form of ODD) Well, duh, it dawned on me that really anger or lack of handling anger is just another form of regulation. It is emotional regulation versus behavioral regulation but it is really just another form of regulation.

So I have another one of those enlightened moments that seems so stupid after the fact. Gee why did I not realize that anger is just another regulation/management issue that is so challenging for someone with ADHD?

I have noticed that when our son spends more time watching TV or playing video games that he seems to be an angrier child. Exercise is important for any child but can be the difference between a reasonable child and a tantrum child for someone with ADHD. I even say to my son, “Wow, you have watched too much TV/played too many video games – you are angry boy. “ This helps him to identify what is going on and helps him to stop and think.

We still need to teach our son how to handle situations that make him upset or frustrated. It helps me, though, to think of it as a situation that needs to be managed (exercise and fresh air) and taught and not as a discipline problem.

I hope this approach helps you too.

Until next time …. Take care.

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.
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This post can be found at: http://jozikids.co.za/blog/2009/11/27/adhd-and-the-holidays/

ADHD and the holidays

By Angel Swemmer, a  mom to a teenage-almost-adult ADHDer and what I write is purely my opinion on things I feel strongly about, based on my experience as an ADHDer parent. Author of the blog Angelsmind

Are you dreading the holidays?

Does the thought of spending time with friends and family scare the bejeebers out of you?

Well, if your ADHDer is anything like mine, then he (or she) is a handful at the best of times and I don’t blame you.

Like me, you probably also have- or have had- a dilemma with friends and family battling to deal with your ADHDer, or struggling to understand that ADHD is a disability.  And if you medicate your ADHDer then you’ve probably also had flak for doing so. Maybe your parents or family members “…don’t believe in ADHD…” and don’t agree with how you are treating the condition. Perhaps you even have close family and friends whom you haven’t even told about your child’s ADHD- for whatever reason…

The holidays make all this a lot more difficult than usual.

As it is, a simple Sunday lunch with the family can be a nightmare for ADHDers and their parents. In the holidays- even if you do not actually go away- you will most likely be spending a lot of time with close friends and family over the silly-season, so you can multiply the nightmare comparison by a factor of 10, at least.

You’d think an ADHDer would thrive in this season of noise and colour and excitement, but what it really does is make them needier when it comes to their demand for immediate gratification- and it makes them come across as even more hyper and disruptive than usual. ADHDers battle socially. They don’t read social cues and they cannot read body language. The bright lights, colours, crowds and the pressure to meet holiday deadlines and interact socially, quickly sends an ADHDer’s brain into overload. And this is when they become difficult to handle even for people who love and understand him.

One of the first things that fall by the wayside when Christmas holidays start is the daily routine. You sleep late, eat later, eat “junk”, shop, gallivant, visit friends and family, and in some families you no longer medicate* your ADHDer.

Read the rest of the article here: http://jozikids.co.za/blog/2009/11/27/adhd-and-the-holidays/

One of the areas where I constantly struggle is helping our son find his areas of talents or what I like to call, his essence. Our children are like my husband and I. We are good at a lot of things but not outstanding at any one thing. We are good athletics, we enjoy music, we like books and politics, we enjoy giving back to the community and so forth. We are not the next Rembrandt, Tchaikovsky, Michael Jordan or Mother Teresa. Nothing is glaringly obvious.

Couple this with the fact that most of the time and effort with our son is currently focused on academics. He is absolutely exhausted when he comes home from school. He works hard, thank goodness, and cooperates with his teachers and, new this year, he actually LIKES school. I have so much to be thankful about. But some days when he gets home from school, he looks like he has been through a war.

We value play time and are mindful of balancing work with play time. But we have over an hour of homework each night and it is very difficult to fit everything in. He does play sports on Saturdays and seems to enjoy it but it is not clear to us that sports is his THING either.

Why do I worry about this so much? Our primary goal with our son with everything we are doing is to develop is self confidence and his self esteem. That is starting to develop academically because we are able to send him to a school when he can learn differently than the mainstream and be successful. I want him so much to experience success in something outside of school that he truly loves.

Getting him to try new things is not easy. He gets anxious and worried about new activities. Often when we start up a new sports season, he has trouble with the first few weeks of the activity – it is a transitioning issue.

Maybe this worry is more about me than him? I just want so badly for something to come easily to him that he truly truly loves … given that he has to work so hard in the other areas of his life.

So this blog post is not a Karen offering a suggestion blog post – it is one where I am reaching out to you for help. Do you have any suggestions or thoughts?

• How do we fit in the time for him to explore his interests?
• When is the right time to pursue drum lessons or karate or whatever else?
• Is maintaining a balance between play time and work time enough for laying the groundwork for future interests?
• Do I need to just chill out and believe that with self-confidence and academic “success”, he will figure it all out?

Would love to hear from you regarding how you enable the “essence” of your child to shine through all of the struggles!!!

MEET CHARLIE OUR GUINEA PIG

As many of you know, having a child with ADHD or working memory issues creates a challenge when trying to get them to take responsibility for multi-instruction tasks. We have had a difficult time getting our son to be independent and to take on responsibility. Some of this is probably our fault. He works so hard with his learning disabilities and ADD that we probably baby him too much otherwise. However, he was begging – BEGGING for a guinea pig. Even though we really did not have ANY desire to have another pet in the house (we have a Havanese dog and a Beta fish), we decided to use the opportunity to teach responsibility and to increase his independence.

At the pet store, we made a very hard deal with my son. He had to take responsibility for caring for the guinea pig with my help. If he did not, then we were going to give the guinea pig away and he was going to have to pay us back for the cost out of his allowance. We emphasized the deal several times and made him repeat it back to us several times before we even bought the guinea pig. So we bought the guinea pig and named him Charlie.
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According to discussions I have had with many doctors and therapists, no one should have to suffer through terrible side effects of ADHD medication. There are many medications to choose from and each one reacts differently to an individual’s body chemistry.

Putting your child on medication for ADHD or ADD is not an easy decision or one that should take lightly. I, however, have seen firsthand the power of what the medication can do for a child. It can have absolutely amazing results. I said on a recent post, “It’s almost like his brain is a lock and medicine is the key.” Unfortunately, however, medication is not effective for everyone. Some experts say that medication is not effective for some 20-30% of the ADHD population.

My family had many discussions with doctors and therapists before we decided to put our son on medication. Two critical pieces of advice that we were told over and over again are advice that I feel everyone considering medication for their child should know. First, each child responds individually to each medication and that it will probably take time and experimentation to find the right medication for your child. Secondly, it is absolutely not necessary to tolerate side effects which last for more than a few days.

There are many choices of ADHD medication both stimulant and non-stimulant based. If a child is having side effects from the medication which continue for more than a few days, consult your doctor and try another medication. Do not tolerate side effects – this is what we were told by both our doctor and the many therapists we spoke with which was about ten therapists – all extremely experienced with ADHD.
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