Managing Childhood ADHD Without Drugs: Coursera ADHD Class Week 11

The last couple weeks of the Coursera class on ADHD focused on how to live with and manage ADHD symptoms without drugs. “Pills don’t teach skills” and whether parents of children with ADHD or adults with ADHD embrace the idea of medical therapy, drugs are not the only treatment approach for helping someone with ADHD thrive.

Students with ADHD need support both at home and within their school environment. In fact, the US Department of Education has put together a fairly comprehensive brochure on how to teach children with ADHD. After giving teachers some guidance on how to identify children with ADHD, it has three separate sections on how to help a child with ADHD be successful in the classroom. Although rumors abound about teachers that, subtly or not so subtly,  have told parents to put their kids on ADHD drugs, that isn’t one of the teaching strategies. Instead the pamphlet focuses on instruction techniques, effective behavioral interventions, and classroom accommodations. It suggests a student with ADHD should sit closer to the teacher and farther from distracting kids. Wow, who would have thought? I know some elementary school teachers are resistant to “special” seating “privileges” for students with ADHD, perhaps referencing this official brochure will help parents get the seemingly minor accommodations their children need. Multiple times the brochure makes the point that children without ADHD also thrive in classrooms that are structured to help children with ADHD. Basically, these are strategies that can help any teacher be more effective regardless of the makeup of their classroom in any given year.

At home, one of the most effective treatments for children with ADHD is teaching their parents better behavior management strategies. By acknowledging that their child has below age-level-norm organizational, self-control,  and coping skills, parents can structure the home environment with scaffolding supports to help the child succeed despite their ADHD symptoms. There are several different training programs for parents. Most have similar elements: stay calm and don’t get emotional, analyze what is working and what isn’t, rely on planning and praise to gain compliance, go to the child to give instructions — use eye contact and touch to get child’s attention before giving instructions, break large tasks into smaller ones, use labels, file cards, and other visual cues and organizers to make tasks less daunting, reduce time delays for consequences (positive and negative), and use warnings, “when-then”, token economies and time outs to guide behavior. Work with the child to create better habits and more effective behaviors. If the child is encouraged to help evaluate the results of the program, it can increase their commitment and desire to change.

One comprehensive parent behavioral training program covered in some detail was one developed by Russell Barkley. Dr. Barkley has written extensively about executive function, defiant children, and how to take charge of ADHD. Putting the effort into learning how to be a better parent for a child with ADHD is very worthwhile. Studies show that not only do children do better with more effective parenting, parental stress is also decreased and satisfaction is increased under these programs.

Adults with ADHD face slightly different challenges than kids with ADHD. Some of these challenges stem from the bad habits and/or negative thought patterns that can develop over a lifetime of living with ADHD. My next post, and the last in this series, will cover psychosocial treatments for adults with ADHD.

Personal Responsibility: Summer Report Card

Summer is almost over. Next week we have our back-to-school night and then school starts just after Labor Day. It is time to evaluate the results of my summer project to push the kids to take on more personal responsibility.

Well, apparently I am not so much a chart person. The chore chart idea only lasted a week and a half. They stopped filling in the charts and I stopped printing out the charts. Grade F for charted chore tracking.

Digging deeper into what exactly they were supposed to do, as defined by the unused charts, things start to look a bit better. On the personal chores list, even without a checklist, the kids consistently were about 90% successful in getting things done. While beds were not made, they used sunscreen enough to avoid burns, practiced piano, and brushed their teeth. They did need more reminders than would be ideal and there was a direct correlation between my reminders and their success. Since I rarely reminded them to make their beds, and they had no personally compelling reason to make them on their own, beds were not made most of the summer. The one exception to this happened about every two weeks when I forbid them from playing or having friends over because their rooms had gotten too messy. At those points the bedrooms were carefully cleaned.

The family chores followed basically the same pattern. They were/are perfectly capable of helping keep the house clean and did so easily when directed. They just didn’t reach the point where they would do it without being asked. I suspect part of this is the fact that since I specifically did not assign chores, each of the three kids waited to see if someone else would jump in and do the work. Reversing the pattern of 11 years, as often as possible I made sure it wasn’t me doing the chores when things were left undone. Instead I stepped in to directly assign chores as needed. Since June I have done the dishes less than 5 times. The kids no longer assume that it is my job. They just hope is isn’t their job. Overall I’m giving the concept of the kids taking on more responsibility for the house a grade of C. They know how to do the work and they are willing to do it, they just aren’t proactively seeing a need and filling it.

Most households with kids specifically assign jobs to each kid and I may have to adopt this strategy for the upcoming school year. However, I’d still rather see them treating the house as their own and doing what needs to be done without being told. Before we go to strictly assigned chores, I’m trying one more strategy. They now have to make a daily list of all household chores to do that day and then collaboratively split the jobs among themselves. We will see how it goes. . .

One chore that received an A+ wasn’t even on my radar back in June. Laundry. I showed the kids how to use the washer and dryer and told the older two, ages 11 and 9, that if they needed clean clothes they knew how to get them. (The youngest, age 7, has helped out with his clothes though he is physically too small to take over 100% of the job.) Over the last month, I haven’t washed the two older kids’ clothes at all.  The kids have proactively carried their clothes to the basement, washed and dried them, and returned the clean clothes back to the bedrooms. They haven’t even called my attention to this extra work they are doing. I guess having clean clothes to wear is a powerful motivator.