Adult AD/HD Regulating Alertness

One of the things that always puzzled me when my son Josh was younger was how he tended to be extreme in his degrees of alertness. He was very hyperactive much of the time, but when I managed to get him to sit down at the table or on the couch to do school work he became downright lethargic. He'd go from spinning around like the Looney Tune Tasmanian Devil one minute to propping his head on his hand and looking groggy the next. It's as if he couldn't regulate himself to anything in between the two extremes. Now Josh is a young adult, and his AD/HD sister is in her late teens and I see the same issue of regulating attention manifesting in a slightly different way. My AD/HD husband Scott, my son, and my daughter all tend to fall asleep if they are sitting still listening to a lecture. Keep in mind they are not sleep deprived, so I don't think lack of sleep is what's causing it. Every single week in church, they are fine during the music portion of the service. They are fully awake during the meet-and-greet time. But once the sermon begins and they are sitting still and quiet, they close their eyes and fade away. At first I thought it only happened at church, but that's not the case. It happens any time they are required to sit quietly in one spot and just listen. I recently attended a meeting with Scott and Josh to hear a speaker discussing issues that affect adults with AD/HD. In a room with about 20 people, I looked around and saw that only Josh and Scott were in the "I'm not sleeping but my eyes are closed and I LOOK like I'm sleeping" state. So I wonder if this is something many adults with AD/HD struggle with, or if my family's manifestation is somehow unique. When Josh has a fidget ball with him, he is better able to regulate himself and stay awake and alert. When Scott takes notes, it helps him focus. When Beckie doodles, she attends better to what is being said. Yet if none of these strategies are implemented in time, they drift away and miss many points from the presentation being offered to them. They need to plan to use the strategies prior to finding themselves in an attention-challenging situation, but planning does not come naturally for them. By the time the need for a strategy becomes clear they may already be drifting away.

Clark Lawrence

I know this is a very late announcement, but Clark Lawrence will be speaking at the CHADD of Columbus meeting tomorrow, January 24, 2009 at 2:00 in Gahanna, Ohio. His topic will be “Developing a Positive ADD Lifestyle”. Clark is Director of the Executive Function Center in Cincinnati, Ohio.

A discription of his topic:

Positively addressing adult ADD requires more than working on the problem areas (goal-setting, procrastination, etc); people with ADD also need to adopt a lifestyle that works with their ADD to overcome its effects -­ as opposed to continually working against their ADD. This talk will address the lifestyle problems of people with ADD and offer a vision and techniques to create a positive ADD lifestyle

The meeting is being held at Mifflin Presbyterian Church, 123 Granville St., Gahanna, OH 43230

Melinda had the opportunity to interview Dr Lawrence at the 2009 CHADD conference in Cleveland, Oh. Here is the interview.

Homeschool Pumpkin Bread Recipe

This cold time of year reminds me of a time, many years ago, when we had an ice storm here in Ohio. Like many homeschoolers, I like to take advantage of natural events and find ways to incorporate learning into daily activities. So on this particularly icy morning, I went out into the yard and found a stick that was thickly coated in ice. I took it inside and showed it to the children, who were fascinated with seeing the stick that now looked similar to an icicle. We set it in a bowl so we could observe it and see how long it took for the ice to melt. With AD/HD children, simply waiting for ice to melt would be torturous. So we needed to do other things and periodically check in on our stick. We started a cooking activity to make pumpkin bread. I wanted the kids to be actively involved and thought it would be good if they learned some skills and practiced mixing, adding eggs, etc. When it was my son Josh's turn to add an egg, he managed to crack it but somehow the egg ended up on the floor. Amazingly, the yolk stayed intact. After examining it, I invited Josh to poke the yellow part of the egg with his finger to see what would happen. How could I forget in that moment that my son had sensory aversion issues with such textures? He reminded me by quickly putting his hands behind his back and leaning away from the egg. Then he came up with a solution that would satisfy his curiosity about what would happen if the egg were prodded as well as protect his fingers from a slimy assault. We used the icy stick for poking the egg, then cleaned up the mess and discussed how having raw egg on the stick might somehow affect its melting time. I didn't know about the "incidental" learning that took place that day until the next time I made pumpkin bread. I asked the kids if they remembered how to make pumpkin bread and Josh quickly piped up, listing the ingredients and how to mix them together. When he came to the part of the recipe when eggs should be added he said, "Then you get out four eggs and Mommy puts in the first one, then Beth Lee puts in the next one, then I drop one on the floor and poke it with a stick..." Clearly, this is a special family recipe that just might be passed down through the generations. Especially if there are future homeschoolers!

Fidget to Focus

I (Melinda) had the opportunity to interview Sarah Wright, co-author of the book Fidget to Focus. This book has great ideas for children and adults and is packed with practical ways to use fidgeting as a strategy to help increase focus. The book is also useful as a resource when you need to advocate for your child's use of fidget objects like the ones in our Heads Up Fidget Bundles. Fidget items can help those who need them and Sarah helps explain why it's worth giving them a try.

Wipe! Wipe!

Some of you probably thought this post would be about potty training, but no. This is for all of you with children who don't like to get their hands dirty. Some children are oblivious to messes and don't mind having a dirty hand or face. Other kids become distressed if even one finger has come into contact with a substance they don't like to feel. I have worked with children who remind me of Monk, the obsessive compulsive detective who calls for his assistant to hand him a wipe whenever he shakes hands or touches something he deems undesirable. Recently I was sitting with a young boy who was eating a snack, and he got some frosting on his hand. In a near panic, he turned to me saying, "Wipe! Wipe!" and held out his hand for help in removing the frosting as quickly as possible. Right next to him was another child totally indifferent to the feel of frosting covering her face and hands, happily licking the frosting from each finger. My son Josh was in the "Wipe!" camp when he was young, and my daughter Beckie was such a sensory seeker that she deliberately smeared food on her face and hands and loved messy art projects. Both of them needed to work on sensory processing and awareness, but today I am going to suggest a strategy for the sensory avoidant, "Wipe!" children. I didn't want to overwhelm or traumatize my avoidant son, making future attempts to increase his tolerance even more challenging. But I did want to expand Josh's acceptance of various textures, smells, and sensations. I knew I couldn't just put materials out for him to explore and expect a different response from him. Josh was already doing what came naturally to him, and that was to limit or avoid his exposure to certain materials. So I put finger paints, pudding, hair gel, etc. into Ziploc bags. For some of the bags I added in small objects such as decorative erasers for added input as the materials were investigated and experienced through touch. Sometimes I double bagged to prevent leakage, and in addition to sealing the bag I added a layer or two of packing tape along the seal. Then I modeled tracing a finger over the bag, poking it with my finger, smashing it with my palm, etc. and encouraged my son to do likewise. Touching substances through a bag felt safer to him, and the limited boundaries of a Ziploc bag appeared more manageable to his young mind. Since Josh was also sensitive to smells, the bags eliminated or at least minimized odors. As Josh became comfortable with the materials in the bags, I would gradually introduce a small amount of the material without a bag. With repeated exposure over time, Josh learned to process all the sensory input and no longer avoided touching materials directly. I found, with Josh and other children I have worked with, that many children are more willing to touch a substance that I present to them on my own hand instead of on a table or piece of paper. I'm not sure if that's because seeing it on me implies that it is safe to touch, or if it's the skin to skin contact that is reassuring, but in any case it's worth trying with your kids to see if it helps them as you expose them to a greater variety of sensory input.

Turn Your Recorder On

My son, Josh, and my youngest daughter, Beckie, both have auditory processing difficulties. Although when they were officially evaluated by an audiologist they had some differences in the auditory tasks in which they struggled, they both demonstrated poor working memory. This means that although their hearing acuity is fine, they process the incoming auditory input in an atypical manner and they are unable to hold information in their minds long enough to remember it all and act on it. So they might remember the first thing they heard, or the last thing they heard, but if it's a long segment they are likely to lose information. I used strategies like pairing visual information with auditory information, and I utilized gestures and demonstrations nearly all the time. I had them look at me before I gave them directions. I had them repeat back to me what they heard so I would know if they were not complying with me or if they never got the information in the first place. This is an important strategy for parents and teachers, because you should not be disciplining a child for not doing what you've asked if he never received the information completely in the first place. I also did activities specifically to work on improving auditory memory and attention. One activity I did with all my children was have them repeat back exactly what I said to them, increasing the length of the segment a little at a time. For example, I would say something like, "The cat walked to his bowl." We would practice that until they could say say it verbatim. The next sentence would be, "The white cat walked to his empty bowl." The next sentence might be, "The white cat slowly walked to his empty bowl, hoping to find it full of food." This stretched their attention span and challenged their auditory memory skills a little at a time. I also reminded the children to make a mental picture about what they were hearing, since the internal visual cues would help them remember details. One day, while doing this activity, I noticed that Josh was tapping himself on the temple every time I started with, "Ready? Listen to this." I thought to myself, "Great! Now on top of the AD/HD, sensory processing difficulties and auditory processing problems, I've given this kid tics!" I wasn't sure I really wanted to know the answer, but I finally asked Josh if he realized he was tapping himself on the head every time it was his turn to repeat something. He promptly said, "Yes! I'm turning my recorder on!" My little hands-on guy could relate to pushing a button to record something, so he had implemented a tactile strategy for himself. (Whew! Big sigh of relief for me since his head tapping wasn't caused by tics after all and I hadn't done anything to cause them or mess up my kid!) Once a child comes up with their own strategy, we can use it knowing that it makes sense to them. After Josh showed me that he identified with "turning the recorder on" I generalized that strategy for other listening tasks. When teaching any subject, I would prompt Josh to turn his recorder on because the next point was very important. Before giving him a multi-step direction, I would prompt him to turn his recorder on and picture himself doing the task. His strategy became my strategy with him, because Josh taught me something that worked for him.

Homeschooling Your Struggling Learner

My friend and colleague, Kathy Kuhl, has written an excellent book (Homeschooling Your Struggling Learner) that provides practical strategies for struggling learners as well as being a wealth of encouragement. Kuhl interviewed homeschooling families with children representing a variety of special needs such as autism, AD/HD, learning disabilities, and more. Many hours were spent interviewing, researching, and compiling information into this reader-friendly and very organized book. Kathy's book is available at Heads Up by clicking on the "book" category on the web site. I had the pleasure of presenting with Kathy at a conference last October, and while we were there we grabbed a few minutes to do this interview. So here it is, the first "Kuhl and Boring" video presentation for your enjoyment!