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Parenting as Alternative Therapy for Learning and Attention Issues February 7, 2007

Posted by edukfun in add, adhd, attention deficit hyperactivity disorder, attention training, children, parenting.
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The New York Times has a great article about parenting as an alternative or supplement to therapy for Children’s Mental Disorders.  What I liked about the article is how well this idea applies to the families we work with every day here in Boca Raton, FL.  Take a look.

Parenting as Therapy for Child’s Mental Disorders

http://query.nytimes.com/gst/fullpage.html?sec=health&res=9506E7DC1131F931A15751C1A9609C8B63
“But like most other parents, the couple preferred to avoid drug treatment, if possible. Instead, with the guidance of psychologists at the University of Buffalo, they altered the way they interacted with Peter and his younger brother, Scott. And over the course of a difficult year, they brought about a transformation in their son. He still has days when he gets into trouble, like any other 10-year-old, but he no longer exhibits the level of restless distractibility that earned him a psychiatric diagnosis.
”People are so stressed out, and it’s so much easier to say, ‘Here, take this pill and go to your room; leave me alone,’ ” Lisa Popczynski said….”But what I would say is that if you are willing to take on the responsibility of extra parenting, you can make a big difference.”

The way families interact can bring about a transformation in a child.  The catch is that the transformation can be a good one or a harmful one.  A chaotic, confrontational home life can cause any child to develop attention and behavior issues.  Children with Learning Disabilities, Attention Deficit Disorder (ADD), Attention Deficit Hyperactivity Disorder (ADHD) or Aspergers syndrome (commonly misspelled Aspbergers or Asbergers; humorously as Assburgers) are especially sensitive.
The lesson here, I think, is that regardless of what treatment plan or educational plan is in place for a child, a faster, greater, longer-lasting transformation can be achieved if an emphasis on improving parenting is made.

Parents face a real challenge in altering their parenting styles to suit their individual children.  Here are some suggestions that may help:

  1. Make the decision to ignore harmless “odd” behavior.  Save your energy for the situations that count the most. 
  2. Cut yourself some slack.  Make time, as few as ten minutes a day, to sit quietly in a still room and relax with deep breathing. 
  3. Avoid anxiousness-generating thoughts.
  4. Phrase requests in terms of what your child is really interested in.  They may not care about school or homework, but they’ll climb the walls if they miss their favorite TV show.
  5. Keep the focus on empowering the child to get what they want.  “You better do your homework or I’m going to take away your computer,” doesn’t work for a child with attention issues.  He or she just can’t keep that thought in mind.  Instead, try, “As soon as your homework is done, you can watch TV.  Isn’t your show on in half an hour?  Let’s get started.”
  6. Children with Attentional issues need lots of reminders.  Post reminders all over the house: on doors, the fridge, bathroom mirror, backpacks, etc.  Use checklists to empower the child to responsibility.
  7. They will get off-task.  Practice judgement-free redirection.  “Quit goofing off and do your homework,” is harmful.  “Focus on your homework, please,” or “Only 15 minutes until your show is on.  How’s that homework coming?”  Try not to take it personally: your child really wants to do well, they just need help.
  8. Don’t react to negative behavior.  Ignore what you want to go away, and praise like crazy when they do something you like. 

Feel free to chime in with your own suggestions. 

Good luck!
Allen Dobkin

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Comments»

1. Sue - February 18, 2007

All fine and good advice for any parent of any child. Reinforce the positive, BUT if a child has ADHD you may find it impossible to keep them still, let alone able to focus, let alone pick up a pencil. Even if you can get them to sit down, look at their book and hold their pencil the chances are they can’t get more than a couple of words down in the time that the other children will have written two whole sides. The level of distractability is not only frustrating for the parent/teacher but overtly debilitating for the child. Their self confidence takes a hammering from their own perceived failures. When children this severe are medicated their sense of relief is palpable to all observers. My son at 7 years was expected to flunk all his SATs exams and the diagnosis of ADHD came about a month before them. He was put on the lowest possible dose of methyphenidate hydrochloride and promptly achieved the highest grades in every subject. He has continued to cope with his studies and we never have any arguments over homework. We put in an effort to help him with comprehension exercises with which he struggles and to consistently revise maths topics he finds it easy to forget after apparently having mastered them. It takes a few minutes of revision to have his understanding again.

In severe cases of ADHD it is cruel to force the child against their will to struggle to achieve the impossible and fail repeatedly. Their brains can unscramble and focus if they are given a little help in doing so. The behavioural treatment is also necessary but ‘complementary’. Without first achieving the focus and receptivity to discipline, instruction, learning and completing tasks you won’t get far.

Prior to medication we also started a wholefood diet and cut additives and have continued to investigate potential allergens but that was never more helpful than just providing more healthy eating. Neither food nor fish oil never caused any noticeable change in behaviour.

Furthermore I take issue with the notion that the development of ADHD is in any way linked to ‘chaotic’ home life/family dynamics or poor parenting. However it is true that ADHD certainly contributes to and indeed can be a direct cause of chaos and stress in the home.

2. edukfun - February 18, 2007

Sue,

You are absolutely correct. There is a wide variety of severity in ADHD. Certainly in your son’s case, the medication was needed and helpful. It is interesting to note how a child with a strong hyperactivity component is quick to be diagnosed and prescribed, but the “space cadet” who is just quietly in dreamland is overlooked until much later.

I don’t think I suggested that chaotic family life is linked to the development of ADHD. It sure can make it worse, though. The last thing a child with ADHD needs is anxiety from home. They have enough to deal with, with or without medications.

As for the article’s suggestion that some parents are quick to give their children medications, that too varies from case to case. There are many instances where there is a clear need for medication, it is properly prescribed, and results in improvement. However, there can be problems when doctors do not agree on a diagnosis, or when doctors prescribe combinations of medication for children when there is no evidence that such combinations are helpful.

Diagnosis Disagreement:
http://www.nytimes.com/2006/11/11/health/psychology/11kids.html?ex=1171947600&en=8887028935214782&ei=5070
Pill Cocktails:
http://www.nytimes.com/2006/11/23/health/23kids.html?ei=5070&en=3bacd18b3c841c91&ex=1171947600&adxnnl=1&adxnnlx=1171812482-hExvScUEKNOzk0MEa65tOQ

Parents of course rely on the expertise of their doctor, but doctors are under a great deal of pressure from pharmaceutical companies to diagnose and prescribe. Not all chaotic behavior is cause by ADHD, but if the doctor recommends an alternative to pills for ADHD, then he may lose out on some perks. Here is an example:

http://www.mercola.com/2000/jan/23/drug_co_gifts_affect_doctor_practice.htm

So, yes, there are many cases where medication is a life-saver for children and families dealing with ADHD. There are, however, a myriad of reasons why a family might choose or wind up giving their child a dangerous or unhealthy combination of medications for which there is no evidence of efficacy. An alternative treatment to ADHD, whether diet, parenting, talk therapy or magic crystals must also provide evidence of effectiveness. The difference is that eating a healthier diet, seeing a counselor or even wearing a useless trinket may not be effective, but has no dangerous or potentially life threatening side effects.

Sue, please come back and give us your insight in the future. You have a great perspective and our readers will benefit from your input.

Sincerely,
Allen Dobkin

3. Hassie Mae Zitnik - April 5, 2007

Aloha,

My child is 13 years old, he has been challanged with schoolwork since the 4th grade. I recently had an appointment with a doctor who has advised us to try Methylphenidate Hydrochloride 5 mg oral tablets. He has been in a private school and we have paid for tutoring to try and keep him up to speed. This has been his worst year ever (7th grade). I have since pulled him out of private school and he is now in public school. The private school did not have any resources to help my son and the public school will. Do I give him a chance without medication? Do I try it for a month and see if there is any improvement? Are there long term side effects I should worry about? Will he retain and comprehend information on this drug? He has a hard time figuring out what he just read and forgetting how to do math problems. Will this drug have immediate effects? My husband and I are in disagreement in regards to the medication, I feel something needs to be done. This has been my son’s worst year (7th grade) and I am fearful he will only lose ground if something is not done to help him. He has been in a private school since the 3rd grade and has had tutoring outside of the school to keep him up to speed. I have removed him from private school, they could not and would not help him bring his grades up and I have put him in public school. Any information you can give me would help me.

Aloha a huihou,
Hassie Mae Zitnik

4. edukfun - April 5, 2007

Hassie Mae,

You have legitimate concerns. Transitioning into middle school is one of the toughest times for a child and is often where a student who has gotten by will fall behind.

“He has a hard time figuring out what he just read and forgetting how to do math problems.” This sounds symptomatic of Visual Learning Disabilities–have you had him tested? He could easily have worked around a LD to get him to this point.

“Are there long term side effects I should worry about? ”
“Will this drug have immediate effects?”
“Will he retain and comprehend information on this drug?”
These questions your doctor must answer.

Public schools are required to provide whatever is needed for your son’s education, and that is good. However, they can be a quagmire. You will need to stay on top of the school to see that they are following their own recommendations!

Overall — don’t panic! Your son will still be able to graduate and live a normal life…ADD–with or without meds–is not a death sentence, and is sometimes misdiagnosed in place of a learning disability. Please note that there is no pill to sell you to treat a visual learning disability.

Here is my advice:
1. Interrogate your doctor about every little concern you have about the medications.
2. Have your son tested for learning disabilities to eliminate them as a possible cause.
3. Be in regular contact with his school to ensure that the accommodations he needs are being made.

Best wishes,
Allen Dobkin

5. Great Parenting Advice, especially for ADHD « Train your (child’s) brain for success! - April 23, 2007

[…] “Praise specific behaviors.” – If you like what they are doing, you need to be clear about what you like. Do you like that they are putting away their toys, or that they did so without being asked to? The kid can’t tell unless you tell him. Do you like that they got an “A” or that they studied for the exam? Be careful what you praise for: there are some dangers to praise that are addressed here. […]


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