Transcript Confessions of a Madman - University of North Dakota

Thinking Outside the Box:
Insights and strategies for
living & coping with ADHD
Michael Paul Gallo: Minnesota State
University Moorhead
www.mnstate.edu/gallo/
[email protected]
Dedication
Thank
Who am I? Why you
me?
“Only the person who bears the sack knows the burden.”
-Mexican Proverb
Thank you Denny, Dee &
Bigwood Event Staff.
Normal VS Abnormal
Stereotypes
Biases
Expectations
Societal Norms
Irritations
Wrongs and
rights
“There are 2 ways to live your life. One is as
though nothing is a miracle. The other is as
A matter
of isperspective
though
everything
a miracle.”
-Albert Einstein
“Treat others as you would like to have others treat
you.”
“Love others as yourself.”
“I“Treat
would always
others be
as hesitant
they
about
joining
in and
always
would
like you
to treat
thinking,
them.” ‘Am I good enough?
Will the other kids laugh at
me?… Even now I would
prefer to be alone rather than a
team player.”
Does Anybody Really Know
What Time it is?
ADHD brains can have trouble
measuring & monitoring time.
“Always late”
“Slow” “L8Again”
“Lost in space”
“Hurry up!”
“No respect for other people’s time!”
Strategies to Employ
“Increasing hypothetical etiology has focused on the issue of
not permitting sufficient time to think as one of the core
Be patient
& relax
problems
for ADHD.”
Sam
Goldstein,ample
Ph.D. Neurology,
& Behavior Center,
Provide
warnings,Learning
reminders
Salt Lake City, UT
Remember who is the adult
Don’t blame the victim
Use a variety of timers, clocks, and other
methods of measuring the passage of time.
Remove time restrictions whenever possible
Help child to understand this difficulty
To move is to think.
Movement creates & activates
motor memories. -Jane Healey,
Endangered Minds
Do not give up when you still have
something
to give. Nothing is really
Cars & Drivers
over until the moment you stop trying.
“Tootie Ta” Dr.
Jean & Friends
-Anonymous
Movement,
Movement,
Movement
www.mnstate.edu/gallo/
[email protected]
Pop Behaviorism
�Danger of rewards
this and you’ll get that.”
�“D o this and you’ll get that.”
�“Do
Ask yourself what do you want to accomplish with
behaviorism?
“We should seize every opportunity to give
encouragement. Encouragement is oxygen to the soul.”
George Matthew Adams
What my brain needs
Unconditional acceptance
The opportunity to succeed and permission to
fail
Input on how to develop lifelong skills for being
successful.
Stress management techniques
www.mnstate.edu/gallo/
[email protected] 218-236-6293
What my brain needs
Encouragement NOT praise
Directed suggestions for improvement
Feedback positive and constructive.
Opportunity to reflect on my behavior and
thinking…. metacognition
“Just as a snake sheds its skin, we must shed our
past over and over again.”
-Buddah
10 Steps to ADD-Friendly
Habit Building:
1. Tie a new habit to an old one.
“Human beings can alter
2. Make the habit as easy as possible
their lives by altering their
3. Make the habit hard to ignore
attitudes.”
4. Put reminders everywhere
-William James
5. Visualize yourself doing the new
behavior
10 Steps to ADD-Friendly
Habit Building:
“I can’t
do"instant
it” hascorrections.”
never yet
6.
Practice
accomplished
“I
7.
Get back on the anything;
horse and ride
will
try” has performed
8.
Problem-solve
if it's not working
wonders.”
9.
Practice the habit for at least thirty
days
in a row P. Burnham
-George
10. Reward yourself
“When you go in search of honey you must
Cognitive
Strategies
expect
to be Behavioral
stung by bees.”
-Kenneth Kaunda
Employ self talk and repeat instructions
Positive self-talk “I can do it!”, “Remember it takes time to
get it right.” ,“Is there another way I can do this?”
Repeat or rephrase instructions or rules
Use a “whisper-phone”
Repeat important info out loud
Encourage child to speak quietly or “in your head” but
avoid criticism. ** Listen for negative self-messages!
Let child explain rules, instructions, to another child or into
a tape recorder
Private speech & self-regulatory behavior
Private or self-directed speech is the primary means for
transferring regulation of behavior from others to the self
and is the fundamental tool for self-guidance and selfdirection. (Vygotsky 1934/1987)
Self-regulation begins when children integrate adult
prompts, demands, explanations, and strategies into their
private speech.
Children use private speech to control such complex
cognitive processes such as attention, memory, planning,
and self-reflection, and to redirect their own behavior.
“Permission to speak freely captain?” Providing for success
Self-directed utterances increase with task difficulty,
suggesting that children use them to surmount challenges.
(Beaudichon, 1973; Berk & Landau, 1997; Deutsch & Stein,
1972; Murray, 1979)
Children who emit more task-relevant remarks while
working on challenging problems engage in fewer selfstimulating and distracting behaviors, are more attentive, and
gain in task performance. (Behrend, Rosengren, & Perlmutter,
1992; Berk, 1986; Berk & Landau, 1993, 1997; Bivens &
Berk, 1990)
More Strategies & suggestions to consider
Drinking water can
increase brain functions &
ability to focus, flush out
toxins, allow meds to
work more effectively.
Provide word of inspiration
and encouragement. Many
children with ADHD suffer
from low self esteem and
negative self-messages like
“I’m so stupid.”
More Strategies & suggestions to consider
Build your own rhythm
instruments to help the child get
in-sync with herself and others.
PLAY with the child. Play is
therapy for the mind, builds
self-confidence, creates social
contacts, helps develop small
motor skills, helps the child
increase language skills and
self-control.
More Strategies & suggestions to
consider
Music can help calm,
focus, energize, and
inspire. Provide a variety of
types of music including
classical, jazz, rock,
country, new age.
Read aloud to calm,
help focus, provide
language model,
inspire.
Current Facts to Consider
Best predictors of successful adult outcome for ADHD
children & adolescents connected to family variables
including:
Family socio-economic status
Parental mental wellbeing
Stress levels at home
Educational level of parents
Variables include child’s intelligence and child’s
conduct problems
Empirically Proven Treatments
Education for parents about ADHD
Parent training in regards to behavior management
Problem solving & communication skill training with teens
Pharmacological therapies
Teacher education & training
Parent support groups
Cognitive behavioral strategies
Academic skills training
Multi-modal therapy
Modifying Antecedent
Conditions
Changing the setting of the activity preceding disruptive
behavior or inattention
Modify teaching style to fit learning style
Modify the physical environment of classroom
Consider location of student - near window? Near annoying
peer? Near door? Nearby noise?
The POWER of complex sociodratic play
Barkley (1997) has recently characterized ADHD as a
biological deficit in behavioral inhibition, which interferes
with a child’s ability to use language to self-regulate
behavior.
In their observations of 3-5 year olds, Kraft and Berk (1998)
reported that open-ended activities – especially sociodramatic
play - were associated with high rates of self-directed
utterances. The extent to which children engaged in makebelieve play involving interaction with peers was the strongest
correlate of private speech and, in particular, task-relevant,
self-guiding comments.
“People need loving the most when they
What
did
forget?
deserve it the
least.”
-Mary Crowley
•[email protected]
•www.mnstate.edu/gallo
•W: 218-477-4331 H:218-236-6293
•Questions?
•Personal stories: chair, tape, retard
•Talking to self
•Sense of humor
Medication… Drugs
“Should Children Receive Medication for Symptoms of
ADHD?” by Sherlyn Ezell Powell & Eileen Welch @ U of
Louisiana Monroe.
Dan Ezell & Colleen E Klein @ U of Central Florida-Brevard
Campus
Linda Smith @ Teacher Prep Academy U of Tennessee
Chattanooga
2003 Peabody Journal of Education,78(3), 107-115.
Findings: Meds
“ADHD is underdefined and meds are underutilized.
Study of 3,4000 children only 12% of those who
met diagnostic criteria were receiving appropriate
treatment, including meds.” (Cohen, 1999)
Inattentive type of ADHD, many who are girls, are never
diagnosed and considered to be just lazy or unmotivated.
(Widmeyer Group & Chesapeake Institute, 2000)
Types of Meds
Psychostimulants:
•Ritalin
•Dexedrine
•Cylert
•Adderall
Types of Meds
Antidepressants
Tofranil
Wellbutrin
prozac
Clonidine
Catapres
Antipsychotic Medication
* Mellaril * Thorazine * Haldol
Notes on various medications
* Bupropion (Wellbutrin) - antidepressant, has demonstrated
beneficial effect on ADHD children & adolescents.
- Controlled trials differ on whether it is as effective as
stimulants
Clonidine (Catapres®) and Guanfacine (Tenex®)
ADHD children with tics, aggressive, explosive, exciteable,
hard to get to sleep.
Small, poorly controlled trials
Concern about lethal toxicity of clonidine used in combination
with methylphenidate.
NIMH 14 month study results:
1998
For medication-treated children 82% were normalized
For psychosocial treatment group w/no meds, 67% were
normalized & no longer met ADHD diagnostic criteria
The combined treatment of meds/psychosocial was superior
to medication alone or community treatment for symptoms
related to anxiety, academic, academic underachievement,
poor social skills.
Close involvement and feedback to parents and teachers
seems essential to the child’s improvement and academic
success.
Side Effects: Ritalin
According to the Physicians Desk Reference:
•Nervousness *insomnia * hypersensitivity
•Anorexia * nausea * dizziness
•Palpitations *headache *drowsiness
•Changes in blood pressure & pulse rate
•Angina * Cardiac arhythmia *Abdominal pain
•Weight loss *Tics *Toxic psychosis
•Loss of appetite
Will the real Michael Paul Gallo
please step forward!
• Faculty Member at
MSUM Elementary
and Early
Childhood
Education
Department
• Offering personal
perspective /
insight into ADHD
A little help from my
friends…
Paper Partner: For your
paper partner, look for
someone who is strong on
organizing papers and
filing.
Body Double: Sometimes all
you need is the presence of
someone else – a body double –
in order to start organizing and
keep organizing. A body double
doesn’t have to do anything but
keep you company while you
organize. Their presence is a
support and a reminder that you
are there to focus on a
particular organizing task.
Time Tutor: Your time
tutor should be someone
who gets to places on time,
seems to have a reasonable
schedule, and
accomplishes pretty much
what they need to do in the
course of a day
Clutter Companion:
Choose someone who
is good at organizing
possessions, clutter,
closets, and storage
areas in the home as
your clutter companion.