Since my son Nicky was in preschool, he’s always been on the go, go, go. At the time, I was reassured that his behaviors were appropriate for his age.
Presently, Nicky is a 9 year old and in the 4th grade. Since the beginning of the school year, his teacher has shared greatly enjoying Nicky’s outgoing personality, but has concerns for his fidgety, talkative, and often disruptive behaviors.
The structured school environment is especially challenging for Nicky in many ways: sitting behind a desk, following directions, standing in a line, and transitioning from recess back to the classroom. I knew as a parent that it was time to seek professional help when Nicky darted out from behind a school bus on a recent field trip.
Given all these concerns, Nicky and I met with a psychologist for an initial evaluation. The psychologist recommended that Nicky’s teacher and I complete an assessment to rate the frequency of ADHD symptoms we have observed for Nicky in the past 6 months.
With this additional information, the psychologist determined that Nicky met the diagnostic criteria for ADHD, combined presentation. This means that Nicky struggles with both inattention (lack of focus) and hyperactivity (increased bodily movement).
For ongoing care, the psychologist recommended that we work with a licensed social worker named Carrie. Carrie has much experience working with children with ADHD and is trained in cognitive behavioral therapy (CBT), which is an evidence based treatment approach for ADHD.
Carrie shared it is best to focus on behavior change in the two environments Nicky spends the majority of his time in: school and home. Here are some of the therapeutic goals and interventions Carrie recommended for Nicky…
Adapted from the The Child Psychotherapy Treatment Planner, Fifth Edition, the following are therapeutic goals and interventions that can be used for children with ADHD:
Goal: Increase on task behaviors
Interventions:
1. Use an organizational system (calendars, charts, notebooks, or other ways of recording) to track a child’s completion of school assignments and household chores and responsibilities.
2. Develop a routine schedule for child to increase their compliance with school, household, or work related responsibilities.
Goal: Modify parenting strategies as necessary and increase support for parents
Interventions:
1. Parents learn and implement Parent Management Training approach by:
2. Encourage parents to regularly attend and actively participate in ADHD support groups
Goal: Learn and apply strategies to better manage ADHD symptoms
Intervention:
1. “Stop, look, listen, and think” approach
Additional resources: Whole body (holistic) listening and self control skills
1. The character “Listening Larry” can be a great way to explain whole body (holistic) listening skills to kids.
2. Hunter & His Amazing Remote Control can be a useful book and guide to use with kids struggling with ADHD.
These therapeutic interventions have been very helpful in better managing Nicky’s ADHD symptoms. Since adding these, he has had less behavioral incidents at school. I have noticed too that Nicky seems more confident in his own abilities to manage his body and words. With my permission in place, his teacher has been able to collaborate with Carrie to create specific classroom interventions such as a calming corner for him to visit when he’s overstimulated and seat modifications to allow his busy body to keep moving throughout the day.
My message to other parents of children with ADHD: you aren’t alone and help is available. When advocating for your child, It’s best to consult with your child’s pediatrician, a mental health provider, and school staff to see what options are available to support your child in better managing their ADHD symptoms.
References
Copeland, L. A. (2019). Hunter and His Amazing Remote Control. YouthLight, Incorporated. https://www.youthlight.com/product.php?id=12
Jongsma, A. E., Peterson, L. M., McInnis, W. P., & Bruce, T. J. (2014). The Child Psychotherapy Treatment Planner (5th ed.). John Wiley & Sons. https://www.wiley.com/en-ca/The+Child+Psychotherapy+Treatment+Planner%3A+Includes+DSM+5+Updates%2C+5th+Edition-p-9781118418888
NICHQ Vanderbilt Assessment Scales. Retrieved from https://www.nichq.org/sites/default/files/resource-file/NICHQ-Vanderbilt-Assessment-Scales.pdf on September 28, 2022.
Sautter, E., & Wilson, K. (2016). Whole Body Listening Larry at School! SocialThinking.com. https://www.socialthinking.com/whole-body-listening