Thursday, August 2, 2012

Practicality: When Your Child is Hyper-Active, What is it Really

Let me start off by saying I am not a medical professional. I have no training in psychiatry or any other biological based profession. The following post is merely from my own personal experience. In the end please always consult with your doctor, special educators and therapists.

We hear this word all the time..hyperactive. The reality is, that in a child with special needs hyperactivity is just one of the many challenges. But the problem is trying to figure out whether the issue is attention based, auditory based, learning disability based, social issue based or some other physical manifestation (i.e. occupational therapy needs). The truth is that your child can exhibit hyperactivity, it is the reason behind it that counts. And truth be told, there could be more than one reason for hyperactivity as well.

Both of my boys have adhd, auditory processing issues, learning disabilities and of course social issues. Also know that with age these issues can become muted as they learn to work around their issues as well. In fact while their testing as youngsters showed a huge auditory processing issue, today it does not reach a level of disability. Not because it has "disappeared" but because they have learned to cope (well for the most part anyway). The same with their social issues and attention issues.

Honestly this is when the doctor plays a vital role...Yes doctors always have a role to play (despite my constant complaining about them), but being able to parcel out just what is happening with your child is what they are supposed to do. Their job is to be able to break down every thing that is happening with your child and figure out why they have a particular behavior and help set a program for them. It is essential that teachers and other support staff understand which disability your child is dealing with so that they can figure out the right accommodation for your child as well. How your child learns to cope is different depending on the root cause of the hyperactivity.

In fact hyperactivity can and does look alot like melting down. A child cannot sit still. A child cannot do their work. A child cannot even pick which activity to do because they are overwhelmed by choice. I would have to say the one element that everything does have in common however  is frustration. When dealing with a situation that you cannot comprehend or are slow in processing what is happening, you will become frustrated as you are left behind. If your child cannot process what is being taught and cannot learn there will be a meltdown. If they cannot process the interactions and the requirements of the classroom there will be a meltdown. If they cannot tolerate the noise level, the lighting and sensory issues there will be a meltdown. If they have physical issues that make it difficult to sit in a chair all day, stand or even use a pencil there will be a meltdown.

Knowing what is causing the frustration, the meltdown, and/or the inattention is the first part of getting to the root of the problem. Also take note of something very important, some attention issues do not have a hyperactive element but the inattention is just as devastating to the child's progress. If your child is falling behind but is "well behaved" do not let it pass simply because they are not "trouble makers." Many schools will not deal with attention issues unless there is a behavior element involved. Those children who sit quiet do not always get seen and are ignored and fall through the cracks in the system.

Meanwhile here are some things that we did at home and at school that helped:

1. Remove as much distraction as possible. That is why there is alternative locations for testing. There is minimal distraction in the resource/testing center. Separate cubicles for testing and learning is effective. In fact when CM1 was in his out-of district-autism-program each child in the classroom had their own little cubicle area where they would sit and do their work. We also copied this at home when they had to do homework. Their desks are in an area without television or video games. In fact we created separate little offices for them. I know most people cannot do this, but minimize the distractions in the area that your child needs to do homework.

2. Schedule their time doing homework. Build in breaks. If your child has OT issues they will not be able to sit for a long periods of time. They will need some exercise or just simply to get up and move for awhile. The same for school. Have an OT consult and have them help rearrange the classroom so your child can function better. In fact CM2 used to have such a consult. She came in and gave pointers for the entire classroom not just him alone. It benefited everyone including the teacher. Happier children make for a better learning environment and makes the teacher's job easier too.

3. Understanding instructions may be difficult and lead to acting out. Have the teacher breakdown the instructions in small steps, making certain that your child understands what they are supposed to do. Having them write the directions down and even highlight with different colors each step goes along way in helping your child understand their assignment. Oral instructions quite honestly are a waste of time.

4. Social atmosphere of the classroom and especially the open ended areas like recess and gym need to be heavily monitored. Your child needs to be given exact instructions on what to do and how to do it on the playground. Otherwise instead of playing they might just wonder around the field unable to decide what to do or even how to approach others in play. When CM2 was in kindergarten he couldn't even pick which corner activity to play at unless instructed by a teacher or aide.

5. As your child ages then class notes becomes essential as well as the ability to tape record lectures. The use of laptop computers will help with OT issues. Make sure your child learns to write down everything instead of trying to remember it and have them go over their assignments with the teacher so that they truly understand every part of the project. If it is a huge assignment and something done over weeks or days, ask the teacher to let you know what the assignment is and what it entails. If there is a question or your child gets confused (which they so often do) you will then have the answer for them and be able to provide the needed support at home. (Sadly I found this part rather difficult for some middle school and highschool teachers to understand-the need for parental involvement. I have had more fights in CSE meetings with teachers about this parameter. It's almost as if they take it as an affront that they don't know how to teach. For my own children I stuck to my guns on this issue. But then again, as they grew, noone really questioned what I asked to be done when it came to the boys.)

6. It is important to set out parameters of behavior for your child. Let them know exactly what is expected of them and why. Truthfully this may be hard for them to do without other therapies (OT, speech, social skills. etc). But explaining to them everything that is expected of them and giving them boundaries is a huge beginning to helping them cope. Charts, rewards, bribes if you will is something that helped alot. Concrete evidence of their positive behaviors with an emphasis on the positive is very important. If all you do is criticize a child or tell them they are doing everything wrong, they will grow up to think that they are a failure. But if you find away to help them think positively about themselves, even when they make a mistake,  then they will be driven to try to work harder to succeed in their goals.

Also something really important, coordinate with the school. Consistency is essential if your child is to learn how to learn. Consistency is essential when dealing with the frustration and hyperactivity associated with many of these comorbid issues.

One more thing and this is very important...don't be afraid of medication. If handled properly the medication should not change your child's personality or turn them into zombies. What it does is help them focus so that they can then employ the strategies and therapies that they need in order to learn to cope. But also medication without the therapies and the classroom accommodations does nothing. It all must be done in tandem. Medication is not a panacea even though so many teachers think that's all they need.

Another note, simply because your child does have an autism spectrum disorder does not automatically mean they need medication either. Medication depends upon the underlying comorbid issues your child has to deal with as well. I know many children, now actually young adults, who are medicine free and have always been. Also we chose to put the boys on meds because their comorbid issues were so apparent and overwhelming. It did make a huge amount of difference in their ability to learn and function. That is why it is essential you have an expert help to delineate what is really going on with your child and how debilitating or not debilitating these disabilities happen to be.

Also the medication must be regulated by a psychiatrist  with a background in adolescent disabilities. I know that many neurologists deal with adhd. Find out their background with autism spectrum disorders though. Chose someone who has an overall background in everything your child needs and understands how all the comorbid issues interact.

In the meantime, there was a recent article in the Wall Street Journal about how they are looking at video games as a way to teach skills and help children with hyperactivity. Now we know as parents, that video games are very helpful for children with adhd. Well at least they are still quite effective for mine. In fact in their social skills classes as small children the psychologists used video games to teach general social skills. Glad to see that the scientific community is finally catching onto what us parents learned along time ago. HERE

Until next time,


Elise