What's in Your Wallet?

     There is a commercial advertising a credit card company that ends with the question, “What’s in your wallet?”  While this is an interesting question, at my house I am more likely to hear, “Where is my wallet?”

            Life with the distractible and disorganized can be discombobulating.  I live with three family members who have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and due to challenges with inattention and forgetfulness often items get lost or misplaced.  Sometimes my kids will ask me if I’ve seen something that’s gone missing.  Since I like things to be organized and put away in a logical place, there are times when I can locate the missing object because I put it away instead of leaving it out where it was dropped. 

            I have systems for cleaning and organizing.  The problem is with implementation and cooperation from the rest of my family.  I have a strong need for things to be put away where they belong so I can find them when I go looking for them.  Just last night I pulled out all the ingredients to make a delicious smoothie, but when I went to get my smoothie maker only part of it was in the cupboard where I keep it.  I had a blender base with the pitcher and a lid, but the ball on a stick part used to help move the mixture around in the pitcher was missing.  I looked in all the places I could think of putting it, but only one place really made sense to me and that was to store all the smoothie maker parts in the same location.  My husband came into the kitchen and joined me in the search for the missing part.

            After looking in the same places I had looked, and striking out just as I had, my husband began looking in places that made no sense to me but just might contain the lost tool so they warranted a look.  Even then we could not locate our smoothie tool, so we…looked in all the same places again!  I’m not sure why we do this, as if the missing item that wasn’t there previously will somehow show up if we look again in the exact same place.  This strategy was also unsuccessful, so we moved on to asking our children if they knew where the missing piece was hiding.

            This is not generally a good strategy, either, because we are talking about distractible people who misplace things all the time and absentmindedly leave things in odd places.  But it was worth a shot, since we had nothing else to go on at that point.  Both children stated where they might have placed it, but neither actually remembered doing so and the item wasn’t where they suggested.  This time, my husband decided to try substituting a silicon spatula in place of the missing tool, with the result that we had delicious smoothies with bits of a chopped spatula mixed in.  I think I swallowed a piece.

            Those types of lost items are frustrating and inconvenient, but not nearly as alarming as missing driver’s licenses, phones, or my personal nemesis the missing wallet.  Not my wallet.  Remember, I have a “wallet place” where my wallet lives and is predictably located when I need it.  My daughter and husband have misplaced their wallets multiple times, though, and it sends me into a far greater panic than they experience.  While my mind is racing with all the possibilities and security risks, they are unsystematically roaming the house looking in odd places for their wallets.  Sometimes they leave the house for a minute and I realize they are checking the car to see if it’s there.  Or maybe on the sidewalk, or in the grass, or…well, you get the idea.

            My daughter will, at times like these, casually ask me if I’ve seen her wallet.  She acts like it’s not really a big deal because it’s bound to turn up sooner or later, and she really believes that! Hunting for her wallet is like a treasure hunt and is only mildly irritating if she doesn’t find the wallet.  I, on the hand, begin mentally listing all the items that will need to be replaced or cancelled.

            My husband is more subtle about searching for his missing wallet or other items, and rarely asks me to help him look anymore.  The reason he doesn’t bother seeking my assistance is because I’m not much help at finding whatever he has lost.  I look in logical (to me) places where I would leave my wallet, for instance, and since I have a “wallet spot” I don’t have too many places to look. 

            Even when my husband doesn’t come out and say that he’s misplaced something of importance, I can recognize the signs.  He enters a room scanning it like a secret service agent taking everything in at a glance.  Then he moves around the room, picking up papers and small portable items while surreptitiously looking under and around them.  He never panics, and never tells himself not to bother looking in strange places because he knows the missing item could be anywhere.  While I fret about possible identity theft, my husband remains unruffled as he continues his quest for the missing wallet.

            I no longer reach the panic stage as quickly as I used to, because more often than not my husband and daughter do find their missing wallets.  Rather than berate themselves for having lost them, they congratulate themselves on another successful recovery.  I would like to avoid the stress of “Where is my wallet?” but I do admire the resiliency of my family members who just don’t sweat it when these events happen.  They take it in stride as casually as a driver stopping for a red light, doing what the situation calls for and moving on.

Speaking of moving on, I just heard my husband in the next room quietly asking himself, “Now where did I put my keys?” 

             I am quite confident that he will find his keys, no matter how strange a hiding spot they are in, because his experience and resiliency will win out.  Keys, your time on the loose is limited.  Give yourselves up!  You will be found.

The Hyperactive Slug

Here is a phenomenon that I think I understand until it happens in front of my eyes again and I find myself baffled anew despite what I know. Two of my children have ADHD and the hyperactivity component is strong. My son, Josh, is a fidgeter and a tapper. When he was younger the phrase "ants in his pants" seemed pretty accurate. By the way, if your child is a literal thinker like Josh was, do NOT tell him he has ants in his pants unless you want said pants removed in a panic while the child hops around screaming "Get the ants off! Get the ants off!" Same thing for telling a child that he needs to get his head on straight. I'll never forget the look of confusion and dismay on Josh's face as he slowly reached up to his head to see just how crookedly it was placed on his little shoulders.

My ADHD daughter likes to run across the room and then slide as far as her momentum carries her on my hardwood floors. This is a fun pastime for her and one of the ways she expends excess energy. This behavior has been going on for years, and since she is now legally an adult I'm thinking she may not outgrow this hyperactivity. I can picture her in advanced years, gray hair pulled back in a pony tail, attaching waxed wheels onto her walker and scooting across the nursing home floor. Over and over.

So, okay, as someone who struggles with fatigue problems I admit to being envious of the energy that hyperactive people seem to have in spades. But here is the baffling part - my hyperactive children can go from full-speed to sloth-speed just like that. During our homeschool day, Josh would wiggle and squirm until we took a break. Then he'd run around like a cyclone until I called him back to the table for our next school subject. After reluctantly returning to his chair, Josh would go from full-on energy to extreme lethargy in a matter of seconds. He would slouch and prop his head on his hand as if it took too much effort to hold his head up without support. Often, this child who needed way less sleep than I did would begin to yawn. He appeared to be anything but hyperactive. What's going on?

I've also observed that despite obvious hyperactivity much of the time, when I actually need Josh to move quickly he seems incapable of doing so. In fact, the more Josh is urged to hurry up, the pokier he becomes. Despite encouragement (and some yelling and begging) with increasingly desperate exhortations that we need to leave right away or we will be late, Josh doggedly has one speed, and that speed is slow. Slow, methodical, and plodding are not my idea of hyperactive. The more pressured and hurried Josh feels, the slower he seems to move. Even telling him to "Run!" doesn't work. He might trot a few steps at most and then return to his set pace. It's aggravating, but Josh isn't being deliberately obstinate or difficult. Again, what's going on?

Josh, like many children with learning challenges, had difficulty regulating his state of alertness. He tended to manifest extremes - high energy or slug-level energy, with not much in between. Josh couldn't explain what was happening, because it was all he ever knew so it was his "normal". I tried dietary interventions, thinking he was experiencing some kind of physical crash. Except it was only happening when Josh was asked to engage in tasks that demanded sustained attention and a relatively still body. My dietary interventions had no effect with Josh. I tried having him sit on a hard wooden (uncomfortable) chair so he couldn't get overly relaxed. This, too, had no effect. I offered ice water for him to sip, an inflatable cushion disk or therapy ball to sit on, fidget toys, and other sensory strategies, and over time we were able to find some things that helped some of the time. I'm still looking for anything that actually helps all of the time. It is my dream and quest.

For parents and teachers, it may be helpful to take a look at the "Take Five" Alert Program. It will help with identifying states of alertness and ways to promote regulation of the attention state. In addition it is a useful tool in helping your students understand themselves and how they can make adjustments to meet the needs for both calming and increasing alertness.

God bless our amazing children, who force us to become better teachers than we ever wanted to have to be! But we are better teachers now, because these struggling learners have stretched us far beyond what we thought we knew. We are so much richer because of them.

Homeschool Flashback #3 Writing Skills

Take a look at this paper. What kind of information does it tell you? Right off the bat you can see that this child, my son Josh, has difficulty with writing tasks. His letters stay on the lines pretty well and he is doing a good job of leaving spaces between words. Margins are still a bit challenging. He remembers to capitalize the first letter at the beginning of a sentence. His spelling needs to develop. But look how hard he is working just to get the ideas out of his head, through his hand and onto his paper. Some of the letters are darker from the force of his pencil on the paper. Others are lighter, indicating an inconsistency in his ability to grade the force of pressure he uses when putting pencil to paper. Sometimes the letters or entire words have been traced multiple times. Why would he trace some letters several times but not others? Could this be indicative of a neurological issue? Is he even aware that he is perseverating on some of the letters? If you could observe him during the process of writing you would see that he does not form the letters consistently from one word to the next. Sometimes his "i" starts at the top and is drawn in a downward motion. Other times he starts on the line and writes with an upward motion. When he is in tracing mode, he might write it both ways several times. Imagine if you were writing and had to stop and think how to form the letters because you didn't have an established pattern. Josh was dealing with multiple challenges just to get a few of his thoughts down on paper. Here's how I tried to help him. I did some of the Brain Gym activities to help information flow more easily between his right and left brain hemispheres. I had him use mechanical pencils, which kept the degree of sharpness more stable than other types of pencils. He tried different pencil grips to see if they would help his hand to relax so the writing could flow more easily. I made sure Josh had adequate arm support and was using his non-dominant hand to stabilize the paper. He tried writing with a slant board. I wondered if his letter and number tracing could be due to anxiety or OCD, but that was ruled out. Eventually, Josh was able to tell me that he was processing and trying to internally organize himself as he traced. I stopped trying so hard to get him to write in cursive, and decided to be satisfied if he was able to sign his name easily and could write in cursive if it became necessary. I also wrote him occasional notes in cursive writing to be sure he was able to read them. For the most part, though, we concentrated on printing. With all of these interventions, I did see improvement in his writing. It became more fluid and automatic, but if he concentrated too much on making his printing very neat his writing became laboriously slow. When I introduced keyboarding, he greatly preferred it to paper and pencil writing. Although I tried multiple typing programs to help Josh learn touch typing, he resisted them all and has his own method of typing. It works for him, and today as a young adult he is a prolific writer. He is planning to start a blog, and I hope to be able to share that with you soon so that you can be encouraged by the growth of this previously-struggling writer.

"My Ball Died"

When I heard the words "My ball died" coming out of the mouth of a preschool boy I was seeing for speech therapy, I tried not to show alarm. "Tommy" didn't seem to be too upset, but he was clearly trying to tell me about something that mattered to him. I had not heard of any recent loss in this boy's life, but then again I only saw him once a week for speech therapy and didn't know about every single person in his life. I wanted to be compassionate and allow him to talk about what was on his mind. Tommy already had a very hard time expressing himself due to speech articulation (pronunciation) errors. Even to those familiar with Tommy's speech patterns, his speech intelligibility was poor. When I repeated his words back to him for clarification, he responded vigorously with head shakes and repeated insistently, "No. My ball died." Some children, when hearing their incorrect speech production repeated back to them, will recognize that what they are saying does not match the message they are trying to convey. As a result, some children will alter how they are pronouncing words in order to increase their intelligibility. Tommy was not one of those children. He kept saying the same thing in exactly the same way, over and over again with no change. Tommy still did not appear distressed, but was making eye contact and eagerly awaiting my response. As a speech therapist, I have been asked how to respond when you just don't understand what a child is trying to say. I think the correct response is usually dependent on the situation. If the child is just chatting to make a connection with another person, then it may be more critical to be responsive and caring than to determine exactly what has been said. Sometimes asking the child "Can you show me?" helps them use nonverbal means to get their meaning across. This is limited to messages that can actually be pointed out or demonstrated, though, so much of the time it isn't a very effective strategy. The strategy of pretending to understand the child can backfire, because you may be consenting to something you don't intend to or the child may try to continue the conversation and sooner or later the fact that you are faking comprehension will become obvious. Could this affect your relationship with the child? Another option when a child is clearly trying to convey a message to you is to begin asking questions to see if you can narrow down the possible topics the child is talking about. Even with barely intelligible children, knowing the context of what they are talking about makes it easier to discern what they are attempting to say. In Tommy's case, I started by asking him if someone in his family had died. Tommy looked uncertain, so I started naming possibilities by using yes/no questions since Tommy was able to respond accurately to them. "Did your grandpa die?" "Did your dog die?" and so on. Tommy continued to shake his head "no". When this line of questioning lead nowhere, I tried asking about his toys. "Did you lose a ball?" "Did something happen to your ball?" Again I was met with repeated head shakes and the verbal assertion, always pronounced exactly the same way, "My ball died." Tommy wasn't giving up on me, but continued to make eye contact with a hopeful expression on his face. I was feeling more and more inadequate to help this sweet child who apparently had some kind of loss to grieve. Through the open window of the room we were using for speech therapy, we could hear the sounds of children playing. Following a particularly loud vocal outburst from one of the children outside, Tommy cocked his head, grinned, and happily pronounced, "My ball died!" He certainly didn't look upset about a death, but instead looked at me in triumph as if he had just proven a point. Given the context, the words, and Tommy's speech sound error pattern, things began to fall into place. Hesitantly, I asked another question, "Is your brother outside?" Tommy responded with enthusiastic head nods, repeating once again with a look of utter satisfaction, "My ball died." Okay. So no one died and nothing was lost or irreparably damaged. What a relief! For whatever reason, it was very important to Tommy that I acknowledged that his brother was outside. Although it had to be frustrating for him when he couldn't quickly or easily convey his message, he was eventually rewarded for his persistence and I was relieved to discover that in fact, no ball had actually died.

Never underestimate him!

My apologies for not posting yet this month. I have been battling the flu since February 1st and the germs seemed to be winning for awhile. I'm making a strong comeback now, though!
Do you have a child who has difficulty following novel directions? My son, Josh, has ADHD and auditory processing difficulties. He has significant learning challenges and struggles to remember what he hears. He has a tendency to take things literally, with sometimes interesting results. Other times he draws the wrong conclusion and inadvertently changes the expected outcome. For example, once I found a recipe that sounded interesting. You put all the ingredients for an omelet into a sealed ziploc bag and cook it in boiling water. I thought this would be great, especially for those of us who have picky eaters, because everyone could choose which ingredients to include. My husband and I could include onions in ours, but our daughter has not yet learned to appreciate onions so she could omit them from her omelet. I compiled a few different omelet variations into separate ziploc bags and made sure they were sealed tightly. I put the water on to boil, and went into the next room to work with my daughter on a computer assignment. Josh went into the kitchen and shouted to me that the water was boiling. I asked him to carefully put the bags into the boiling water for me and to use the tongs that were sitting on the counter. Using one of his strategies, Josh requested clarification that I wanted all the bags put into the water. I confirmed that and a few minutes later went to check on my omelets. Surprise! What I found looked more like egg drop soup than omelets. At first I thought the bags must have split open while they were boiling. Then I saw the emptied bags off to the side and realized that Josh had meticulously opened each one and poured the contents into the boiling water, thus defeating the attempt to keep the ingredients separate for different omelets. Josh saw the flabbergasted expression on my face and asked if something was wrong. I explained that when I had asked him to "Put the bags into the water" I meant the entire bags. Josh said he thought about it, but that idea didn't make sense to him and he had never seen me put any bags into boiling water so he decided he was supposed to just dump everything in. I thought I had been clear in my instructions, but I told Josh I would try to be more specific in the future. He grinned at me and said, "Never underestimate my incompetence, Mom!" I love that kid and his sense of humor.

Energetic, Impulsive, and Distractible

My daughter, Beckie, is an amazing girl. She has worked through most of her sensory processing and auditory processing difficulties. She is funny, kind, and is doing well at her part-time job teaching martial arts. Beckie also has a diagnosis of ADHD, combined type. Girls are less likely than boys to be considered hyperactive, but my Beckie has that component with a capital H. I love her energy! Even now that she is an older teen, her hyperactivity is still apparent. Beckie has learned strategies to help her focus over the years, and she knows ways to help burn up her excess energy. She teaches martial arts for several hours each week. She rides her bike or walks to neighborhood destinations. When she was younger, Beckie used to race cars from our house to the end of the block, running barefoot down the sidewalk just for the pure joy of it. At home these days she listens to music on her iPod and paces or runs through the house. Our first floor is structured in such a way that Beckie can basically run laps around it. Since we have hardwood floors, she can also get a running start and go for a nice slide across the floor. It's kind of hard on her socks, but that energy has to be expended somehow and the sliding across the floor is relatively tame. We laugh together about the time I asked her if her hair dryer had stopped working, because she was running around the house with her hair only halfway dried. Beckie explained to me that her long hair takes several minutes to dry and she had to take a break from the monotony of drying her hair so she could move around a bit. Her attention span is short, but intense. She studies very hard, but not for hours on end. After concentrating for a period of in-depth studying, Beckie tells me her brain needs to take a break and do something different for awhile. I'm actually glad that she recognizes what she needs and finds strategies that work for her. Is she distractible with a short attention span? Yes, but she can focus and sustain her attention when needed. Is she hyperactive? Absolutely, but her extra energy is often a plus. There are times when Beckie acts impulsively. For example, she walks into a room, sees me there, and grabs me for a hug. Sometimes she will spontaneously start giving me a back rub as she is going by, and it is the best 10-second back rub I've ever had! True, it only lasts a few seconds before she is on her way, but I do enjoy those brief moments. Beckie faces challenges from being so energetic, impulsive, and distractible. But it's not all bad. There's something wonderful about Beckie's ability to spontaneously show affection and respond with enthusiasm to so many different things. She is growing as the individual she is meant to be, without the burden of trying to completely change her natural inclinations.

Picky Eaters and Trusting Tomatoes

It seems that most kids have their favorite foods, and other foods they think are yucky. These food preferences do not present a problem for most children, because they eat a variety of foods and can get their nutritional needs met through different foods they willingly eat. For parents of picky eaters, however, you know the challenges, frustrations, and anxiety that can occur when a child has a limited number of foods they will accept. In addition to restricting the number of food items, some children refuse to eat unless the food is presented on the same plate each time and the drink must always be in the same cup. There are children who can tell the difference between brands of food, so even if you find a food the child will eat they may refuse it if you offer a different brand. For example, a child who eats chicken nuggets might refuse to eat them unless they come from McDonalds. For some picky eaters, the shape of the food is also important. They may eat round waffles, but not even taste waffles that are square. For some picky eaters, the color of the food matters to them. My son, Josh, has come a long way with his sensory processing and has expanded his diet to include most foods. Even as a young adult, though, Josh still has moments of uncertainty when he is presented with an unfamiliar food item. Just last week we were able to harvest some of our heirloom tomatoes. These tomatoes have a great flavor, but can be unusual in their colors and shapes. Josh loves red tomatoes and will eat them the way others eat apples. When Josh saw the yellow tomato I was offering him he was taken aback. I believe his exact words to me were, "Yellow tomatoes? Why are they yellow? I don't trust yellow." Trust can be a huge factor for picky eaters. Sometimes parents try to force the child to taste new foods and their pleas and threats backfire and result in even greater resistance. This is especially true if a child thinks he might be forced to do something that is uncomfortable or aversive despite his protests. Understandably, parents are concerned about their child's diet and the need for balanced nutrition. When a child only eats a few foods day after day, it's anxiety provoking. Worse yet, some children suddenly decide that a food they have eaten regularly is now on their long list of unacceptable foods that they will no longer eat. Mealtimes can become unpleasant and a battle ground for concerned parents who are trying to get their picky eaters to just take a bite of food. If mealtimes are that difficult at home, how can you ever go out to eat or eat at a friend's house? It's frustrating and worrisome. Books such as Just Take a Bite offer suggestions and strategies to expand a child's diet. One suggestion offered is to have your child help you prepare the food. That way he can see exactly what you put in the recipe. Another tip is to work gradually toward accepting new foods. Some children react so strongly that they become distressed just seeing a food item on the table that is not on their list of acceptable foods. A goal would be for the child to tolerate the food near them, then on their plate. Even at that point, professionals don't recommend that you insist that the child eat the food. It is a gradual process, with multiple presentations of the refused food over time. It's progress if a child will allow a new food to touch his lips. I used to tell my children that they didn't have to like a food, but I did want them to at least taste it. This may be a helpful strategy for a child with few or mild food aversions, but for the more extreme picky eater it won't be adequate. This degree of resistance goes beyond what typical children do. Considering that mealtimes happen every day, multiple times, it's no wonder that parents feel desperate to help their picky eaters.

More Tootsie Roll Magic for Executive Functions

When a child is disorganized and distractible, he needs more direct instruction in learning executive function skills. So how do you teach what seems to come naturally to some people? How do you teach a child if you share these struggles with them? Just how many Tootsie Rolls must be doled out before a child learns and generalizes a skill?!?

I recommend the book "Smart But Scattered" by Peg Dawson and Richard Guare. Billed as "The revolutionary Executive Skills approach way to helping kids reach their potential", it is packed with practical ways to identify and address issues related to executive functioning. I found a copy at my library and it is available on Amazon.com as well. As for concerns about too many Tootsie Rolls, I feel your dental pain. Here's the upside with our distractible kids...they love/crave/need variety so the rewards not only can be changed, they should be changed now and then. And if your family is like mine, you do not need more trinkets cluttering up your house. For example, you could use a reward to work toward a larger prize by having two zip-loc bags side by side marked in some way to make them distinctly different. A small set of Legos goes in one bag, with one piece being transferred into the "I did it!" bag with each completed task. You could tape the picture of the completed object on this bag for added motivation. When all the pieces have been transferred the child can make whatever the set was designed to make, or if your child is like my son he can make something completely different! This is also a great way for your child to earn back toys that have not been put away or have been forgotten under the bed or in the bottom of a toy box. In any case, the child is getting rewarded for completing tasks and learning patience while working toward a larger goal or prize. The rewards don't have to be big or expensive, just rewarding. I used to sing the song "I'm proud of you" (from Mr. Roger's Neighborhood) to my kids when they did something well. It cost me nothing and took only a minute, but the children got the acknowledgment they needed. The entire song went like this: “Proud of you, I’m proud of you! I hope that you are proud of you, too.” The song repeats one time and it’s over. To this day, my children remember this song. Since you may not always be physically with your child when she completes a task, try recording a celebratory song on an inexpensive recording device and have her play it for herself when she completes a task. She can keep it in her pocket or you can leave it at the task completion spot. Again, if things tend to get buried or misplaced at your house try using industrial Velcro to keep it in one place. And now...(drum roll)...for the distractible adult here are a couple tips we've tried over the years. First, and only moderately successful but better than nothing, when my easily-distracted husband sets out to do a task I remind him of his goal and loudly hum the theme from Mission Impossible. "You're in, you're out!" I helpfully remind him as he heads out the door. The other tip I've used on those especially scattered, brain fog days is to wear a recording device and tell myself what I need to remember. I record a message, then when I get to the top of the stairs or in another room (yep, it could have evaporated from my brain already) I listen to the message. Usually it's something simple like "I'm going upstairs to get my sewing scissors." Sometimes I throw in an encouraging message like "You're the woman!" just to keep my motivation strong. Check your cell phone for an application that allows you to do voice recordings. That might be a good technology tool for distractible teenagers to use. It's faster than writing things down and we almost always have our cell phones nearby. Plus, cell phones are less likely to be lost than scraps of paper with hastily scrawled notes on them.

Sea Monkeys

When my daughter Beckie was younger she decided she wanted to raise sea monkeys. Since sea monkey eggs can remain dormant for years, they are available in kits for you to raise. The packaging is attractive for children, and I've even seen necklaces that allow you to wear a sea monkey in a little water globe around your neck. Doesn't that sound cute? It certainly appealed to Beckie, and the sea monkeys on the packaging looked animated and eager. Although she followed the directions on how to activate the sea monkeys eggs so they would hatch, the first attempt failed and Beckie had no sea monkeys. Undeterred, she went for it again and the second attempt resulted in several live sea monkeys. Guess what? They weren't nearly as cute as the cartoon sea monkeys on the box. In fact, Beckie's older sister Beth started calling them "Sea Scaries". Sea monkeys are basically a type of shrimp. Shrimp are not that cute. Beckie, however, was proud of her sea monkey family and was determined to see them grow and reproduce to a zillion generations. Since Beckie has AD/HD, it is hard for her to remember to do tasks on a consistent basis. She wanted to check on her sea monkeys daily, and her solution was to keep them in the kitchen. She knew she would be in the kitchen every day, and would see them and have that visual reminder to check on them. This worked great for her. For my part, it was extremely unappetizing to me to see the sea monkeys skulking around their little habitat while I prepared meals. I just trained myself not to look at them after awhile. Beckie's sea monkeys grew, and even had sea monkey babies once. Unfortunately for Beckie, she is only one of three family members with AD/HD and clutter is a big problem in every room in our house. I can't clean as fast as they can unclean, so piles of stuff end up in the kitchen. One fateful day, Beckie's Dad knocked the sea monkeys over and they flooded the kitchen counter. Rather than trying to scoop them back into their little habitat, Dad just dragged a trash can over and swept them all into the trash can. RIP little sea monkeys. Thinking his work there was done, Dad moved on to something else and didn't think to mention the "terrible accident" to Beckie. When Beckie discovered the empty sea monkey container she was understandably distressed. Her strategy to keep them in the kitchen worked for her, but they were not safe from other family members who dump things in the kitchen. Her Dad's strategy was to clean up the mess in the quickest and easiest way possible. The sea monkeys were the casualty. Beckie decided it was safer to have fish in a bowl that mounts onto her bedroom wall, and she has happily lived with her fish pets without having to worry about the bowl getting knocked over.

The Magic of Tootsie Rolls

My daughter, Beckie, has AD/HD. Now that she's a teenager, her primary challenges are with the executive functions (EF) like planning, organization, and working memory. She also continues to need more prompts and external rewards than her peers without EF challenges.

Beckie and her sister have been sharing a hair dryer for years. It is important to Beth, the older sister, to have the hair dryer put away after use. Beckie couldn't care less if the hair dryer gets put away, so there is little internal motivation on her part to do so. Remember, anything that requires extra steps is not popular with our kids or adults with AD/HD. Additionally, they need more frequent rewards than their "neurotypical" peers. This need often extends into adulthood.

The hair dryer wars went on for a while, with hard feelings on both sides. Since the girls were not able to work out their differences and the hostility was escalating, we met as a family to problem solve together. If something didn't change, the hair dryer wouldn't be the only thing to blow at our house. At one point in the discussion, Beth told Beckie she just needed to remember to put the hair dryer away. "After all, you are a teenager. It's not like I'm going to give you a Skittle every time you remember to put it away. You just have to make yourself do it."

When I heard Beth say that, it was a light bulb moment for me. Having recently attended a conference on Executive Functions, it was fresh in my mind how the presenters shared that many with EF struggles will continue to be externally motivated throughout their lives. Since the EF challenges continue throughout the lifespan, affected individuals also continue to need more encouragement, praise, recognition, and rewards than those without EF struggles. This explains why my husband, who regularly makes the coffee, asks me how it is sometimes before I've even taken a sip. My first thought is, "Um, it's fine. It's always fine?"

I've come to realize that my husband needs that frequent positive reinforcement because making coffee and doing other chores is not intrinsically satisfying to him. He needs to know that his efforts are appreciated. Once I understood that, and realized that my son with AD/HD is the same way, I trained myself to make a point to express thanks for even mundane, everyday things. They need that. I can easily give them that. So when Beth made the comment about Skittles, I realized that Beckie was getting no reward when she remembered to put the hair dryer away. She honestly tried to remember, but since having the hair dryer put away was meaningless to her and she is highly distractible she often forgot. Since it wasn't important to her in the first place, she experienced no internal satisfaction when she completed the task.

I devised a simple plan to help Beckie be more successful, and hopefully end the hairdryer war or at least reach a truce. Knowing that she loves Tootsie Rolls, I bought a bag of miniature Tootsie Rolls and put them in a small bowl in the bathroom. I told Beckie that every time she remembered to put the hair dryer away, she could have one Tootsie Roll. Beckie thought it was a great idea.

Now some of you are thinking, "Why should a teenager need a treat to do what she is supposed to do? Won't that just keep her dependent on external rewards?" Good questions. Here's what I think. By showing Beckie a simple way to motivate and reward herself, she is learning a strategy that she can eventually use on her own. Because her EF difficulties are likely to continue into adulthood, she absolutely needs to figure out ways to reward herself. Would it bother you as much if she were buying the Tootsie Rolls herself and using them as rewards for completing tasks? Probably not, because most of us do this in one form or another. I'm just showing Beckie an example of what she can do to keep herself motivated and on task. In the future, she will know how to do this for herself.

Asking Beckie to try to remember to do a task that was not important to her just didn't work. She meant to, intended to, sometimes did remember to, but not with adequate consistency. Now, every time she goes into the bathroom, she sees the little bowl of Tootsie Rolls. It is a visual reminder and incentive several times a day, even though she only dries her hair once a day. She is aware that one of those treats will be hers if she remembers to put the hair dryer away. Guess how many times she has forgotten to put it away since the Tootsie Roll plan has been in place? Zero! She has not forgotten to put that hair dryer away a single time, and it has been several weeks since we implemented the plan. Did this teenager benefit by an external reward system? The results would indicate an absolute YES!

The hair dryer war seems to have ended peacefully, and Beckie has had great success while learning a strategy that will serve her throughout her life. She reports that she feels she has met the challenge, although she adds with a grin that once in a while she has forgotten to take a Tootsie Roll reward.

Facial Recognition and Social Implications

Most of us have times when it's hard to recall someone's name, although we recognize the face. We readily admit, "I'm terrible with names" as a disclaimer when we first meet someone so he won't be offended in the future if his name slips out of our grasp. This difficulty with name recall is both common and understandable. Unless an individual's name makes it from our working memory into our long term memory, and pretty quickly, we are not likely to remember it in the future. For most of us, it is easier to recall the visual information and appearance of another person's face than the auditory information of a name. Sometimes we recognize someone but can't remember the context in which we met them. Church? Community activity? Friend of a friend? Because this is such a common experience, most people are pretty forgiving if we've forgotten the name but at least show recognition that we have met before. Often, there is mutual forgetfulness and the other person does not remember our names, either. No harm done.
My son, Josh, has significant working memory challenges. I realized over time that my son not only was unable to recall names, neither could he readily recall faces. He had no difficulty recognizing those of us he interacted with on a regular basis, but for those he saw infrequently he honestly had no memory or context for knowing them. It would be unsettling for him when virtual strangers (to his mind) would call him by name and initiate a conversation. Josh has never been good at faking anything, so he would genuinely ask, "Do I know you?" or "I'm sorry, but have we met?" Unfortunately, this attempt to be polite and seek clarification had negative social implications. People naturally feel hurt when others don't remember them, especially people whom they remember quite clearly and have shared past experiences. I remember a mother of one of my daughter's friends coming up to me and telling me that Josh asked who she was and she told him "I've only known you for YEARS." It was true, but months would go by in between each brief contact and Josh never transferred the information to his long-term memory so each contact was starting fresh - for him. If I told Josh who people were and when he had seen them before, it sometimes jogged a vague memory for him.
There is a name for this "face blindness", and the term is "prosopagnosia". In severe cases, individuals have difficulty recognizing their own family members, friends, and even themselves. Many people with autism, PDD, and Asperger Syndrome experience prosopagnosia. I guess Josh had a fairly mild version, and I wondered if what registered in his mind's eye was like a snapshot of faces, rather than the more dynamic version of faces changing to reflect a variety of emotions. Since Josh used to have difficulty recognizing different emotions expressed on faces, I thought maybe he only had one still picture in his mind and if it didn't match what he saw there was no recall. I don't know for sure, and Josh has improved over the years. It's too bad that there's not facial recognition software we could install in our brains to help us make the connections. I have worked with many children with autism who focus on part of something rather than seeing the whole. If this happens when a child looks at a face, he may see just the nose, or only the mouth, and not how those parts comprise a face. I have had children stare at an object I've held in front of my face, without recognizing that there was a person holding the object. If a face is viewed as individual component parts without seeing the whole, that face is not likely to be recognized in the future.
For our verbal children with the language skills to express themselves, we can teach them strategies to ease the social tension. Having someone admit "I know lots of people have trouble remembering names, but I even have trouble remembering faces sometimes" may prepare others in advance so they won't be offended or surprised when they have to reintroduce themselves. For our nonverbal or less verbal children, we can advocate for them by explaining the challenges of prosopagnosia and reassure others that it is not a personal slight when our children don't acknowledge them with recognition. My hope is that when we explain that there is a neurological glitch, others will be more flexible and accepting and won't misinterpret our struggling learner's behaviors in a negative way.

Tickle My Back, Mom!

My youngest child, Beckie, has always been cuddly and affectionate. As a newborn, she quieted as soon as I picked her up and held her cheek next to mine. I thought she recognized my voice, but it was the skin-to skin contact at least as much as my words to her that seemed to calm her. As she grew, I noticed that when others picked her up her little hands immediately started fingering the material of the holder's clothing. She gently explored the feel of earrings, necklaces, scarves, and even daddy's whiskers. At age three, I took her with me to a craft show. Knowing how she loved to touch different textures, before we went in to the show I reminded her to look with her eyes and not her hands. She looked both sad and surprised as she protested, "But Mommy, to look IS to touch." Those were her exact words, and it confirmed that I had a very tactile learner and that I needed to allow her to touch some of the items that caught her interest. I ended up telling her that if she saw something she wanted to feel, she could ask me first and I would find out from the vendor if Beckie could touch the objects to see how they felt in her hand. As she grew older still, I heard the same request every day during our homeschool time when I was reading to the children: "Tickle my back, Mom!" If you are familiar with sensory integration (AKA sensory processing), you know that tickling can be aversive and irritating to some children. In Beckie's case, she was sensory seeking and had lower registration for tactile input so the tickling was alerting to her. When she is just listening and not actively moving, it is hard for her to focus. Her AD/HD leads her into daydreaming and distractions. She recognized this about herself, and one strategy she found that seemed to help was to have her back tickled. The light touch was enough to help her stay alert and focus on listening to what I was reading. I became adept at one-hand holding or propping a book, depending on the size of the book, and using my other hand to trace lightly over Beckie's back. I tried using a wooden backscratcher once, but that didn't have the same effect for Beckie. I tried a backscratcher with metal scratchers, but that was also not acceptable to Beckie. When I became too absorbed by what I was reading or needed a drink of water and would thus cease the tickling, Beckie noticed immediately and either wiggled against me to prompt me back to task or grabbed my hand and placed it where it clearly belonged - on her back again! Sensory input can be calming or alerting, and each individual's response to input varies. Often, as in Beckie's case, our children show us over and over what they need and what works for them. Be observant and sensitive to individual differences, and take advantage of the strategies that work.

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.