Transcript Document

ADD/ADHD
• Concentration difficulties
have always existed.
• Dr Gerald, psychiatrist,
conducted a survey among
Bushmen and discovered
that the hyperactive hunter
was regarded as a leader
due to his acute senses. This
enabled him to see or smell
the prey before anyone
else.
• Our current social setting
and school system can be a
disadvantage.
• ADD/ADHD can take 3
forms:
– Predominant hyperactivity
and impulsivity
– Predominant attention
deficient
– A combination of
hyperactivity, impulsivity and
attention deficit
SIGNS OF ADD/ADHD
PHILIP
Philip is a boisterous, noisy, over-active,
impulsive, affectionate, quick tempered child,
but never sulks and is usually cheerful. He is
very forgetful and loses all his possessions. He is
very distractible and easily bored, his
handwriting is terrible, he under-achieves in
class, but he loves and excels in sports. Although
he often fights, he is well liked. He suffers from
Eczema and ‘drinks the taps dry’. Philip has all 3
key symptoms.
JAMES
James on the other hand is quiet, withdrawn and
dreamy. He is never in trouble in class but his lack
of enthusiasm and participation is worrying. He is
bored and uninterested in his schoolwork and never
finishes an exercise. His handwriting is terrible and
although he would love to do well at sports for
some reason he cannot shape. He is chronically
anxious with compulsive mannerisms and habits
and is often unwell with sinus and ear infections.
James is ADD but hypo- rather than hyperactive.
LINDA
Linda does well in school. Perhaps if she were to
concentrate all the time she would excel. But
she is not a happy child. She is loud, rough and
very bossy. She is very argumentative, intolerant
and quite aggressive. The other children do not
like her and keep away. Deep down she is
desperate to be liked and have a friend, but she
covers this up with a thick ‘I don’t care’ shell.
Linda has a touch of ADD but her main problem
is hyperactivity and impulsivity.
PHYSICAL SYMPTOMS
• Genetic condition (bright,
ambitious, interesting and
often exciting individuals)
• Symptoms before the age of
7
• Over-activity – shake a foot
etc. does not sit still
• Constant purposeless
activity
• Often underweight
• Allergies
• Always thirsty
• Run/walk on their toes –
wear out socks under the
balls of their feet
• Sensory defensive
• Can be vocal
• Speech difficulties are
common
• Don’t all have sleeping
problems
• Poor motor skills / low
muscle tone (confidence
affected)
• Accident prone
ACADEMIC SYMPTOMS
• Over-activity – so much energy
into sitting still the child has
no energy left to concentrate
• Concentrate if material
interests them (low boredom
threshold)
• Distractibility (noises outside
as well as thoughts going
around in his head)
• Good at Maths difficulty with
Languages (or other way
round)
• Impulsivity
• Procrastination **
• Short term memory problems
which lead to learning
difficulties
• Auditory/visual discrimination
and perceptual difficulties
• Poor organisational abilities
ADD/ADHD is not the child’s fault!
EMOTIONAL SYMPTOMS
• Low frustration threshold
• Lack of persistence
• Lack of motivation (do
minimal)
• Immature for their age
• Social difficulties
(impulsivity, impatience,
intolerance, irritability, urge
to control and
unpredictable behaviour)
• Tantrums
• Insecurity
• LOW SELF ESTEEM
• These children are
‘different’. They perceive
the world differently. Their
thought processes run
along different lines. They
display a deep need to be
‘the same’ as everyone
else, but their behaviour is
often seen as somewhat
weird.
It’s not YOUR child’s fault that he/she is
ADD/ADDHD
CHILDREN AT
CEDARWOOD
Diet
Medication
Therapy
Relationships
DIET
• Avoid aspirin, artificial colourants,
flavourants, certain preservatives
• Supplements are good if your child
suffers from dry skin, respiratory
problems hay fever, asthma,
bronchitis, frequent colds and ear
infections.
• Cut down on refined carbohydrate
i.e. white flour, white rice, sugar
• Feed frequently to keep blood
sugar levels stable
• Must not feel deprived. It is better
to make them feel special!
Medication and Therapies
• Need medication for
academic reasons
• Ritalin stimulates the
production of dopamine
•
•
•
•
•
•
Better marks
Reduces impulsivity
Improves handwriting
Improves short term memory
Improves sociability
Self confidence
• Antidepressants e.g. Tofranil
• Eat nutritious meals before
having medication
•
•
•
•
•
Speech Therapy
Occupational Therapy
Physiotherapy
Play Therapy
Extramural activities
THE MANUAL THAT NEVER CAME
WITH YOUR CHILD
BEHAVIOUR MODIFICATION
• Spanking works in the short term but often involves
embarrassment, isolation, rejection and fear and should be
avoided at all costs!
• Behaviour modification focuses on rewarding the positive
» We are motivated by praise
» We are motivated to work for rewards (children 4-10 are
externally motivated)
» 10-13 motivated to avoid disapproval and rules dictate
Example:
• Every morning brings the same battle – getting
dressed. Your child fiddles and dawdles and
makes the whole family late. What can you do?
•
•
•
•
•
Nag
Scream
Threaten & punish
You ignore
You smack
BEHAVIOUR MODIFICATION
• Target the inappropriate behaviour i.e. brushing
your teeth after breakfast
• Negotiate the rewards
• Link praise to the reward – shift to higher level of
moral development
• Reward the action
• 1st stage: instant rewards (first week)
• 2nd stage: delayed gratification (save money for Friday)
• 3rd stage: intermittent rewards –praise often (one day) –
want to please and follow rules
• 4th stage: stopping one and starting another – a month to
become a habit, keep praising
STAR CHARTS
• Star charts are aimed at behaviours that cannot be
timed. One behaviour at a time. E.g. putting clothes in
the wash basket, hanging up towels
• Negotiate reward
• Put star chart on the wall – small after 5, small after 10
and their main reward of 20 stars
• Only get a star if they complete the criteria completely
– label the feeling for them ‘you think you are cross
with me for not getting the star but instead you are
disappointed with yourself for not getting the star – it
will just take one day longer that’s all
• Use for 3-4 weeks
STAR CHART
ORGANISING THE BEDROOM
BOX IT
MAINTAINING
THE
STRUCTURE
• Do not shout at your child.
Rather say, ‘Wow it looks like
you have had fun today. Lets
pack your toys away so you can
have fun tomorrow.’
• Don’t pack everything away
yourself
• Don’t stand and issue verbal
instructions
• Every day for a week then ask
questions such as what’s next?
• Then begin process off and
come back and praise
• 3 -4 weeks to develop a habit
THE MORNING/EVENING ROUTINE
Hurry up,
you’ll be late
for school!
If you don’t
hurry up we are
going to leave
without you
Mom,
where
are my
takkies?
For the
twentieth
time, go and
brush your
teeth!
Why must I
nag you all
the time?
AVOID POWER STRUGGLES
•
•
•
•
Stay consistent and predictable
5 minutes is 5 minutes
Use countdowns to prepare children for a change in activity
Use the either/or approach e.g.: either you bath now or
you won’t get tuck money tomorrow
MORNING ROUTINE
• Do as much as possible the night before
• A picture says a thousand words
EVENING ROUTINE
MAINTAINING THE ROUTINES
• You will have teething
problems, you will fight, you
will forget. Whatever the
reason the first 3 weeks can
be terrifying! But the long
term benefits are
enormous.
• Week 1: Instant rewards
• Week 2: Delayed
rewards
• Week 3: Intermittent
Rewards
WEEKLY
PLANNERS
• Main reason is to schedule
time for homework each
afternoon and to know
what activities he/she is
doing on a given day
• Make own planner
– 1. Fill in the non-negotiables
(therapy sessions,
homework)
– Choose a colour for the
different activities
– 2. rest, change and eat
– 3. Homework (work before
play makes for a happy day)
– 4. Free time
MONTHLY
PLANNERS
• Big picture of all family
members
• A3 - Don’t laminate –
smudge
• Birthday parties, school
holidays, haircuts,
dentists
• Have 3 months up at a
time
• Learn a lot such as in 2
days time……
HOMEWORK DIARIES
• Nothing written down
• Too little written down
• Written down under the
wrong day or month
• Can’t read it
OR
• Pen
• Listen
• Relevant worksheets/books
aren’t packed
• Has to be done speedily
before moving onto next
lesson
THE ULTIMATE HOMEWORK DIARY
THE FILE
• A large 3 ring binder file
• Four A4 dividers in different colours
• Coloured plastic A4 envelopes in 3 different
shades
• Plastic filing pockets
• A zip-fastened pencil bag
• A bulldog clip
• A notepad
THE PENCIL CASE
• By attaching one to the file, there is less chance
that it will be left lying around
• Only absolute necessities are kept in the pencil
case
»
»
»
»
»
»
»
»
2 blue pens
2 pencils
1 sharpener
1 eraser
1 small ruler
2 coloured pencils
Tissues
A highlighter (older children)
THREE MAIN SECTIONS
• Plastic envelopes are divided into:
• Work to be done (number of envelopes may vary)
• Completed work (signed letters also go here)
• Papers to save (project tasks, study guides etc.)
• In the plastic sleeves – have information that your child needs to help with
his/her homework
MAKING HOMEWORK A HABIT
• Schedule a daily homework
time
• Setting
•
•
•
•
Desk and chair
Lighting
Dustbin
Stationery
–
–
–
–
–
–
–
–
–
2 blue pens
2 pencils
30cm ruler
Sharpener
Eraser
2 coloured pens
12 coloured pencils
1 glue
I pair of scissors
DOING THE HOMEWORK IS THE
CHILD’S RESPONSIBILITY
Step 1
• Check together what is for homework
• Categorise
• Break down into small manageable bits
Step 2
• Get out all the correct books
Step 3
• Begin
• Some may need a timer
Step 4
• Tick off task completed
Step 5
• Put completed work into ‘completed work’
section
Step 6
• Bring homework diary for signing
TACKLING TESTS
• Eating the elephant one
bite at a time!
• Break the study material
into small bits
– Get the big picture
– Keywords, colour, symbols
and mnemonics
– Use the keywords in a
sentence
– One summary page (mind
maps, tables, lists)
– Revise the summaries
– Set questions on the work
– Link it to snakes and ladders
– Confident
FUN WITH GAMES
(Games are like onions, they have layers of benefits)
• Games teach social skills: following rules,
taking turns, winning and losing gracefully.
• They have emotional benefits
• They build bonds
• They develop foundation skills
MAKE SPELLING SPECIAL
• Need: scrap paper, snakes and ladders,
coloured pencils
• Make 2 packs of blank cards on 2 different
coloured pieces of paper. Each pack must have
all the spelling words.
• Check the spelling
• Snap, Bingo, Matching game, Memory Game,
Snakes and Ladders
• Add: Rhyming the words, plurals, opposites
BINGO
HANDLING TV
• TV has become a family member - the entertainer and the
stress reliever. Intrudes into our lives.
• 2-3 hours a day is excessive
• It affects:
» Weight
» Physical development
» Sleep patterns
» Eye movement
» Listening skills
» Language development
• Play games instead
• No television in a child’s bedroom
• Use television as a treat and choose the programmes with
care
FEED YOUR
CHILD’S BRAIN
• Car = water, oil and petrol
• Human= water, omega oils, low GI
carbohydrates and protein (Beetle or a BMW)
• Water: 70% of body, delivers oxygen,
transports nutrients, removes waste products,
regulates temperature. Drink 4 cups of water
daily.
• Omega 3 and 6 Oils: essential for brain
development. Omega 3 = salmon, herring,
anchovies, eggs walnuts (x2 week)
FEED YOUR CHILD’S BRAIN
• Protein: growth and maintenance of the body.
Children should have protein at every meal.
Rather eat 4 or 5 small nutritious meals a day.
• Low GI Foods: balances blood glucose levels e.g.:
oats, Provita, Pronutro, low fat yoghourt, baked
beans, apples, pears, peaches, homemade
popcorn
• BREAKFAST IS ESSENTIAL! Not sugar frosted
cereal
• Keep thinking: Water, Oil and Petrol and you
won’t go wrong
QUESTIONS AND
COMMENTS