- Raising a Child with ADHD
- What is EMDR?
- When Dieting Becomes Dangerous
- Parenting....The Challenge
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Raising a Child with ADHD
ADHD is a deficit in planning, organizing, and carrying out complex behavior over a long period of time. The ADHD child is not suffering from lack of skill or knowledge, so showing the child how to do something to correct problems and then sitting back expecting this to be done is not likely to be successful. Instead, you must:
Give clear instructions every time
Rearrange tasks to make them more interesting and motivating
Redirect the child's behavior toward future goals vs. immediate gratification
Establish a behavior management program with rewards, privileges and consequences and use it consistently
Provide immediate rewards for a completed task or adherence to rules
Ten Guiding Principles for Raising a Child with ADHD
- Give Your Child More Immediate Feedback and Consequences
ADHD children seem more under the control of the moment than normal children. You must therefore become part of that moment or you will have little influence over your ADHD child.
If you want the child to stay on task, you must arrange for positive feedback and consequences that will make the task rewarding, as well as mild negative consequences for shifting off task.
When attempting to change negative behaviors, you must provide quick rewards and feedback for behaving well and swift negative consequences for acting inappropriately. Tell the child what he has done wrong (rather than yelling), then remove a privilege.
- Give Your Child More Frequent Feedback
ADHD children need fast and frequent feedback. Rather than waiting to praise a child who has trouble finishing math homework in a reasonable amount of time, instruct the child that she can now earn points for completing each math problem in a specified time, and that she will be fined points for each problem not done.
Find a way to remind yourself to catch your child doing something right and compliment her each and every time you do.
- Use Larger and More Powerful Consequences
Your ADHD child will need more powerful consequences than other children to encourage her to perform work, follow rules, or behave well. These can include physical affection, privileges, special treats, tokens or points, or material rewards -- even money. Common wisdom dictates than children should not be "bribed", replacing intrinsic rewards like the desire to please, or the pride of doing a job well. However, intrinsic rewards are much less likely to influence ADHD children to start working, inhibit their urge to do in appropriate things, and to persist in their tasks. This is the nature of the ADHD disability.
- Use Incentives Before Punishment
It is common for parents to resort to punishment when a child misbehaves or disobeys. This may be all right for the non-ADHD child, who misbehaves only occasionally and thus receives a small amount of punishment. It is not all right for the ADHD child, who is likely to misbehave much more often and could receive a great deal of negative consequences. This could result in resentment and hostility. Eventually the child will develop a negative self image and may actively avoid you, even find ways to strike back for the excessive punishment.
When you want to change a particular undesirable behavior, first decide what positive behavior you want to replace it with, and watch for its occurrence. When that happens, praise and reward it. Once this new behavior has been rewarded -- through earning points or tokens -- consistently for at least one week, try to use only mild punishment, delivered consistently and selectively, that is, for only this particular behavior. Do not punish your child for everything else he or she is doing wrong. Your behavioral management system will help to keep you and your child on target.
Remember the rule: Positives Before Negatives!!
- Strive for Consistency
Applying consistency means four important things: (1) being consistent over time, (2) not giving up too soon when you are just starting a behavior change program, (3) responding in the same fashion even when the setting changes, and (4) making sure that both parents are using the same methods.
Being unpredictable or capricious in your enforcement of the rules is a common invitation to failure. So is losing hope when your new method of management fails to yield dramatic, immediate results. Give it a try for 2-3 weeks before considering any adjustments to a behavior management program.
- Act, Don't Yak!
Your ADHD child does not lack intelligence, skill, or reasoning, so simply talking to the child won't change the underlying neurological problem that makes him so uninhibited. He is much less sensitive to your reasoning than is a non-ADHD child and more sensitive to the consequences and feedback you use. If you act quickly and frequently your ADHD child will behave better for you. Keep talking, and all you will get is aggravation, not compliance.
- Plan Ahead for Problem Situations
Develop a plan ahead of time before you enter a store, church, or other outside environment with your ADHD child, and share the plan with your child, with the intention of avoiding trouble.
Step 1: Stop just before entering the site of a potential problem.
Step 2: Review with your child two or three rules, like: "Stay next to me, don't ask for anything, and do as I say." Short and sweet. Then ask the child to repeat these simple rules back.
Step 3: Set up the reward or incentive -- stopping for ice cream on the way home, or the like.
Step 4: Explain the punishment, like a loss of points or a privilege. Do not threaten anything that you are unwilling to carry out.
Step 5: Follow your plan and remember to give your child immediate and frequent feedback while there. If you must, punish your child swiftly for any acts that violate the rules.
- Keep a Disability Perspective
Commonly, parents may lose all perspective on the problems faced by the ADHD child. They may become frustrated, even enraged when their attempts at management do not work. They may even stoop to the level of the child and argue about the issue or retaliate as another child might do. You must remember at all times, you are the adult, the disabled child's teacher and coach. If either of you is to keep your wits about you, it clearly has to be you.
- Don't Personalize Your Child's Problems or Disorder
No one is keeping score. Stay calm if possible, maintain a sense of humor about the problem, and try to follow the principles listed here when you respond to your child. Take time outs for yourself when necessary, to gain control over your feelings.
- Practice Forgiveness
This is the most important and most difficult principle to implement consistently.
First, take a moment at the end of the day to review and forgive your child for transgressions. Your child cannot always control what she does and it only compounds the problem if you harbor bitterness toward her.
Second, concentrate on forgiving others who may have dismissed your child as lazy or morally defective. Take any corrective action that's needed, continue to advocate for your child, and let go of the criticism from others.
Third, practice forgiving yourself for any mistakes you have made in attempting to manage your ADHD child that day. ADHD children have the capacity to bring out the worst in us as parents. Replace any self-blame you may have with a frank evaluation of how you might improve and make a personal commitment to strive to get it right tomorrow.
-adapted from Taking Charge of ADHD
Russell A. Barkley, Ph.D.
What is EMDR?
EMDR, which stands for Eye Movement Desensitization and Reprocessing, came into being in 1989, when a psychologist named Francine Shapiro was walking in the park one day. She noticed that the disturbing thing she was thinking about went away after her eyes moved back and forth spontaneously. This was the seed for developing a specific method to process traumatic memories and dysfunctional beliefs about one's self.
The client is asked to hold the image of a specific memory, the negative belief about one's self, the accompanying emotions and body sensations, while focusing on a light moving back and forth, or the therapist's finger. What does this do? The exact mechanism is not fully understood, but we believe it may facilitate information processing between the right and left brain hemispheres, or something similar to what happens in REM sleep when we dream. Other forms of bilateral stimulation may be used, such as alternating tones, or alternating tactile sensations from tapping, or a device held in the hands.
As the client proceeds in the process, many things can happen. They may experience parts of the memory more vividly, and new insights may occur. They may see the incident from a different perspective, connect to feelings they were not able to experience before, or feel various sensations in their body. Often, after this kind of processing has occurred, there is a reduction of distress, and openness to new beliefs about one's self that are more positive and adaptive. Behavioral shifts may then occur naturally.
To date, there have been more controlled studies of EMDR than any other type of treatment for trauma. Although some of the results are not yet conclusive, many of them support EMDR as an effective treatment. The International Society for Traumatic Stress and the American Psychological Association have accepted EMDR as an effective treatment for Post Traumatic Stress. Over 30,000 clinicians worldwide have now been trained in EMDR. See www.emdr.com for more information.
It is ironical that in this age of meta-communications: pagers, cell phones, e-mail, etc, there is less time and focus on personal connections and that family relationships are suffering.
It is impossible to create an atmosphere of intimacy and love over the Internet, because words are not feelings. Nonverbal communication is often more meaningful than the words. A hug or a smile can be healing and create a bond that is more enduring than any poetically correct e-mail
These days, I see a lot of lonely isolated people, even those in family constellations. We all seem to be so busy with being "busy" that there is not time for just "being". Spending time with those you love seems to have lost its importance in contrast to achieving and "doing".
The family especially is experiencing this loss of human interactions. A recent study (Gottman, "Marital Therapy") showed that only one third of U.S. families eat dinner together on a regular basis. Excuses being long work hours, travel, kids activities or just not time to prepare meals.
When family members are home together they often are engaged in singular activities: mom on the phone, dad on the computer, Johnny on his game boy and Jenny on the Internet. As a family therapist, I have for several years been concerned at this degeneration of family interactions. Not only is the marital relationship impacted, but also the children find difficulty establishing a sense of security and trust.
Edward Hallowell in his book, Connect says it best:
"Life is loss. For all we gain we also lose…A friend, a day, a
chance, finally life itself…to oppose the pain or loss, we use
human glue, the force of love. The force of love creates our
many different connections. This is what saves us all."
-Susan K. Fairey, MFT
When Dieting Becomes Dangerous
The world has gone weight crazy. Consider the following startling facts:
Americans spend 33 billion a year on losing weight.
50% of all women and 25% of all men are constantly dieting.
9 out of 10 people who lose weight on a diet gain it back.
14% of high school girls who try to lose weight use vomiting as a weight management technique.
80% of 11-year old girls feel they are overweight and are on a diet.
20% (1 out of 5) of females between 13 & 40 suffer from an eating disorder.
Too often the struggle to be thin leads to an eating disorder, such as anorexia or bulimia. When left untreated, this can be life threatening. Anorexia is a serious obsession with self-starvation characterized by body weight less than 85% of that expected for height. This disorder is typified by a distorted body image in which the sufferer views her body as fat despite objective data to the contrary. Bulimia is characterized by binge-purge cycles. Periods of compulsive overeating may be followed by purging behaviors that often include vomiting, restrictive dieting, and use of laxatives, diuretics, and excessive exercise.
Eating disordered people are not sick or crazy, but they do have a serious problem that has negative physical, psychological, and social consequences. Should you or someone you know show some of the following symptoms, dieting may have gone out of control.
A noticeable gain or loss in weight unrelated to a medical condition.
Compulsive or severe dieting, ritualistic eating behaviors, secretive bingeing, or prolonged fasting.
Self-induced purging, or laxative, diuretic or diet pill abuse.
Consistent preoccupation with body image and weight.
Excessive or compulsive exercising.
Increased isolation, depression, or irritability.
These indicators signal that the search for control and good self-image has become self-defeating. The solution (dieting, etc.) has now become the problem and professional intervention is often necessary.
Recovery from an eating disorder is a rewarding process involving building self-esteem, increasing emotional awareness, and learning effective communication skills. Returning eating to its natural function is the ultimate goal. This is achieved by understanding the underlying reasons for disordered eating and learning healthier ways to deal with them. You can find out more about eating disorders from the National Association of Anorexia Nervosa and Associated Disorders, at: http://www.ANAD.org
Diane C. Petroni, Ph.D., MFT
Are we teaching our kids to not need us? (be independent?)
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