Some children, when asked to attend to certain tasks, do so for shorter periods than most. Some are also more energetic. Such children are often said to have Attention Deficit/Hyperactivity Disorder (ADHD).

Although many doctors recommend placing children believed to have ADHD on drugs such as Ritalin and Adderall, many parents refuse to go that route. The evidence that the drugs do not lead to lasting improved academic and social outcomes are major reasons (see my post titled “The Myth of Ritalin’s Effectiveness” for a review of the effectiveness studies). Other major reasons have to do with concerns about known negative side effects and possible long term harm to such young developing brains.

Parents who have a child viewed as having ADHD typically face two challenges–disciplining their child and responding to concerns from their child’s teacher. For parents who choose the drug approach, they may come to believe that at least by drugging their child something is being done to deal with the challenges. They may thus become less motivated to take some other steps because what can be done is being done. If the child misbehaves, the parent may come to believe that the cause is due to the drug not doing what it’s supposed to be doing. Maybe the child needs to go back to the doctor to get the dose tweaked, or another drug needs to be added or substituted.

But for parents who refuse drug treatment, they don’t get confused about all of these drug issues and a clearer path lies before them. As a school psychologist for many years, I’ve walked with parents down this non-drug path on numerous occasions, and here are some suggestions that I found most helpful.

My Four Favorite Suggestions for Parents Concerned about a Child’s Attention Span or Energetic Behavior

1. Search the internet with the following search terms–“ADHD without drugs.” If you do so, you will find many suggestions on how to address your concerns. A daily running program and meditation were just a couple of excellent ideas that I found quickly in a recent search of this sought. Many of the suggestions indicate that they have research support demonstrating that they are effective (see for example APA’s article titled “Easing ADHD without Meds“). What I particularly like about having parents search the internet in this way is that they get to select from a wide range of ideas the ones that make the most sense to them. Moreover, there are always new ideas coming out, and these types of internet searches are regularly updated.

2. Get a copy of The Kazdin Method for Parenting the Defiant Child by Alan Kazdin. Dr. Kazdin is director of the Yale Parenting Center and Conduct Clinic and is a former president of the American Psychological Association. His approach has been well tested in solid research programs with impressive results.

If you can’t afford to buy Dr. Kazdin’s book, you can get a copy at your local library. If your library doesn’t have a copy, walk over to the the librarian and ask to get it through inter-library loan. If you have trouble reading books, it is also available on CD. Listen to these CDs while you are driving, cleaning the house, and washing dishes. You’ll find a goldmine worth of information.

3. Ask your child’s teacher to provide you, each week, a list of the main topics that will be covered in class the following week. Then view at home with your child a lesson on each topic on the Kahn Academy website.

This website is a resource that provides free lessons on all the topics that teachers teach in school. By having your child review each lesson before hearing it for the first time from the teacher, when the teacher actually presents the lesson in school, your child will now be at least somewhat familiar with the topic. This is called “priming” and it has been demonstrated to increase the interest level for learners and increase the likeliness that the topic will end up being mastered. Moreover, once you show your child how the Kahn Academy website works, your child, before each test, can go back to the lesson and make sure he or she has really mastered it.

If you do not have the time to do this with your child, see what you can do to get someone at least four years older than your child to carry out this activity. You may have to pay a young teenager a little, but it will be better than paying for pills.

This approach leads to real learning. Once your child starts to make better academic progress in school, he or she will feel better about school in general.

4. “Casino for teaching calculation fluency” is a card game that I have found works great for kids who have difficulty learning math skills in the usual manner. You can find the rules for the basic casino card game on line by typing in your search engine, “Casino card game rules.” Once you learn the basic rules it will be easy to learn how to apply the game to improve a wide range of math skills.

Basically, the game is played as follows. The dealer deals four cards to each player and four cards face up in the center (these center cards are laid out separately so that all are visible). The aim is to capture cards from a layout on the table, by playing a card from your hand which matches in number a table card or the sum of several table cards. When it’s your turn, if you can’t capture any cards, you have to throw into the center, face-up, one of the cards from your hand. The cards that each player captures are accumulated in his or her pile. The player who ends up with the most captured cards (in the simplest form of the game) is the winner. After each player plays the four cards that are originally dealt, each player is dealt four more cards. The game is over when all the cards in the deck are used up.

To win, a player must learn to do basic addition. Consider this example. Suppose it is my turn and I have in my hand a 9, and on the table, face up, is a 6 and a 3. If I know 6 plus 3 equals 9, I can use my 9 to capture the 6 and the 3. The more cards I capture, the more chances I have of winning. If I am a bit clumsy at addition, this game can motivate me to increase my fluency.

Once your child has learned to add smoothly, you can change the rules of the game to learn more advanced math skills. For example, you can make the new rule as follows: the only way to capture cards is by using subtraction; or multiplication.

The game can be played in groups of 2, 3, or 4. Besides a deck of cards, it will help to learn math if you will get an abacus. Any student having trouble with learning basic arithmetic should be taught how to use an abacus, and should get a great deal of experience using it. It visually displays how our system works, with the ones line, the tens line, and the hundreds line. The manipulations are fun, and they begin to make conceptual sense after regular use. You can buy an abacus on line for just a few dollars and they come with directions.

The abacus is used as follows. Suppose Sue, who is playing Casino with Jill, attempts to use a 7 in her hand to capture a 6 and a 2. She can use the abacus to see if 6 and 2 equals 7. In a short period of time, Sue will learn to add without the abacus.

An interesting psychological aspect of playing this game is that even when it is not the turn of the other players, all the other players are motivated to do the calculation of the person whose turn it is in order to make sure she or he does not cheat. Moreover, whenever a player can’t make a capture, and therefore throws a card from her or his hand onto the table, all the other players start to make calculations in their heads to figure out how the new card can be utilized. Consequently, there is an enormous amount of additional calculations going on than one might think by watching the player whose turn it is. This is a large reason why this game is so effective.

Now, once your child learns the basic rules of the game, usually within a half hour of playing time, the rules can be changed so that your child begins to work on learning fluency of the math facts at his or her level. So, if Sue is learning to be fluent in learning single digit addition facts, the group plays the game in the standard manner.

If Sue is learning fluency in mastering two digit addition facts, the game is changed so two decks of cards are combined. Both decks get a little doctoring. The parent takes out the four jacks from one of the decks and crosses out their J, and writes beside it the number 11. In a similar fashion, queens, and kings have respectively, the numbers 12, and 13 written on them, replacing their Q and K. For the cards in the second deck, their numbers are changed so that they are given numbers that range from 14 to 27. Both sets of cards are shuffled together, and the game is played like the basic version of the game but there is far more addition facts that can be employed in order to capture cards.

For students learning fluency in mastering single digit subtraction facts, the same rules are applied as the single digit addition form of the game but players can only capture cards by applying a subtraction fact. For example, if Fred has a 2 in his hand, and there is an 8 and a 6 faced up on the table, if he recognizes that 8 minus 6 equals 2, he can capture with his 2 both the 8 and the 6.

For students learning fluency in mastering two digit subtraction facts, the same rules are applied as the two digit addition form of the game but players can only capture cards by applying a subtraction fact.

In a similar manner, the game can be played as well so it is designed to teach fluency in basic multiplication or division.

$math is fun$ Math is often a stumbling block for children who have trouble paying attention to topics that bore them. By making learning these skills fun, these skills are quickly learned. When your child then goes to school, his success in math class will greatly improve his or her overall school experience.

Okay then, those are some ideas to help children thought to have ADHD. There are of course far more options to discover.

Until you join us again, have a great week.

Jeff

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional intelligence. To begin at the very first post you can click HERE.

A few years ago I worked as a school psychologist. One day the mother of a 12-year old boy, who we’ll call Pete, explained to me that upon the urging of one of his teachers, she took him to his pediatrician to be evaluated for ADHD. The pediatrician asked this mother a few questions, diagnosed Pete as having ADHD, and then wrote him a prescription for Ritalin. After reading the possible side effects of the drug, the mother became concerned and spoke to Pete’s father.

Pete’s father and mother were divorced. Pete lived with his father on weekends, and the rest of the time he lived with his mother. Upon hearing about the prescription for Ritalin, Pete’s father was very much opposed to his son taking any drug for treating this concern. And so, now the mother wanted to know what I thought should be done.

I explained that before I could make any recommendations, I would have to carry out an evaluation. As a student in the district that I served, there would be no cost to the family. Pete’s mother agreed to the evaluation.

First, I requested that the mother, father and each of Pete’s teachers fill out standardized questionnaires. The results indicated that Pete’s physical education teacher, art teacher and his father viewed his activity level and ability to pay attention as falling within the average range. Pete’s mother and academic class teachers generally saw him as having some problems paying attention. His math teacher, who had been the one to urge Pete’s mother to take him to the pediatrician, rated Pete’s ability to attend to his assignments as being way below average.

After looking at the results of the standardized questionnaire, I spoke to Pete’s father. He confirmed that it was his impression that Pete had no difficulty with either his activity level or paying attention.

“Do you mind describing a typical day that you have with your son?” I asked.

“Well, let’s see. Last Saturday, when we woke up, we went to play golf.”

“Do you walk the course, or ride in a cart?”

“We walk.”

“Pete doesn’t mind?”

“Not at all. He loves doing physical stuff like that.”

“After golf, then what did you do?”

“We went back to my place, I made some sandwiches, and then I read the newspaper while Pete worked on his drawing. He loves to draw, and he’s pretty good. Then we went in the backyard. I have a basketball hoop set up there and we shot around for a while. Then we started to get supper together.”

“Does Pete help you with that?”

“Yes.”

“Does he get distracted in any way when you two work on supper?”

“Not at all. He’s very helpful. Then we ate supper, went down to the basement and played ping pong for maybe an hour. Then we went upstairs and watched a movie.”

“When he watches a movie with you, does he appear to have difficulty sitting through it?”

“Not usually. Occasionally, the movie strikes him as boring. After the movie, he went to bed.”

“Does he have any trouble sleeping when he stays with you?”

“No. We do a lot of physical stuff that tuckers him out, and he ends up sleeping soundly.”

I then spoke with Pete’s mom. Consistent with how she filled out the standardized questionnaire, she confirmed that it was her impression that Pete did have difficulty paying attention.

“Do you mind describing a typical day that you have with your son?” I asked her.

“Well, yesterday, I got him up at 7 so he could catch the school bus on time. He complained the whole time he got ready. He hates the ride to school.”

“How long a ride is it?”

“An hour, and he says he doesn’t get along with the kids he rides with.”

“I see. He has to sit on the bus for an hour with kids he doesn’t like, then he’s in school sitting most of the time doing school work. Then he takes the bus home, sitting for another hour with kids he doesn’t like. For a boy his age who loves to do physical activity stuff, I could see how this could be hard for him.”

“Yeah, but other kids do it.”

“Most do. Please tell me what happened when he got home.”

“Well, I got home a little after he did. I started preparing supper, and that’s when I have him doing his homework. I sit him at the kitchen table where I can keep an eye on him while I prepare the meal. And he gets very distracted. He starts an assignment one minute, and I look over and I catch him doodling. Over and over again he gets distracted.”

“I see. After sitting most of the day, you have him sit and do his homework?”

“Yes. That’s when I can best keep my eyes on him.”

“How about the rest of the evening?”

“He’s fine then. Besides doing his homework, the only other time I have trouble with him is when I try to get him to clean up his room. He starts to do it, but when I look in a few minutes later, he has become distracted with something else.”

Next, I interviewed Pete. After some pleasant discussion I said, “Your math teacher says you have trouble paying attention in class. What’s up with that?”

“Aaaaa, he makes us fill out these worksheets doing the same problems over and over again. If I know how to do it, why do I have to keep doing 20 more of them? It’s so boring.”

“I see. Say, I hear that you like to draw. Would you mind drawing something for me.?”

Pete’s eyes light up. “Sure. What do you want me to draw?”

“Anything you like.”

Pete begins, and I notice he appears to become completely absorbed in the task. I start to try to distract him by making some extraneous sounds. He glances up to see what the commotion is all about, sees it’s nothing serious, and resumes work on his drawing.

A half hour later, he shows me what he has created. It’s an imaginative otherworldly drawing with spaceships and fascinating creatures. There is an excellent sense of shadowing. It’s far superior to anything I can create in the drawing department.

When I finished my evaluation, I informed the parents that in my opinion it is not in Pete’s best interest to view the concern that has been expressed about his attention as due to ADHD. A more apt description is to view Pete as having an “Attention Priority Difference.” School work was not a huge priority for him. He much preferred to draw and do more physically active tasks than is currently provided at school. These preferences may turn out to be his greatest values. He may someday find work that he truly loves in a field where his artistic interest and talent are crucial. And his interest in physical activity may keep him far more healthier than the many sedentary Americans who are at an increased risk of a number of real illnesses.

“Well,” said the mother, “will Ritalin help Pete with his Attention Priority Difference?”

To which I replied, “Consider an analogous situation. Suppose we identified a group of children who are not doing as well as most kids in physical education. Would it make sense to make up a pathological sounding term for these low-performing students, such as “Muscular Deficit Disorder” and then have doctors prescribe steroids for them?

“In my view, people have different interests and talents. This is a wonderful thing, not something that should be pathologized. We don’t just need every person in America sitting in ivory towers. We need, as well, artists, computer experts, magnificent athletes, hairdressers, and on and on.

“When I hear of a child placed on Ritalin, I become concerned about the child’s stomach, nerves, and brain. Drugs that have been said to be safe have turned out to be far more toxic than anyone ever dreamed of. I become concerned about the social misery that goes along with being singled out as a child that must take a pill to fix him. More than a few kids have told me that this became a dreaded experience.

“I believe that teaching children to turn to drugs when they are dissatisfied with their behavior or mood runs counter to a healthy lifestyle.

“I prefer to put forth a view that encourages us to teach our youth about the blessings of keeping our bodies in lifelong possession of its full youthful state by keeping their blood free of stimulants and narcotics. I wish to teach our kids that it is possible that the morning sun, air and dew can be sufficient powerful intoxicants. Doing something that puts a smile on the lips of a loved one, accomplishing a valued challenging task, providing assistance to another human being—these are the directions I wish we would point to when we guide a child toward a more fulfilling life.”

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Some people will enjoy reading this blog by beginning with the first post and then moving forward to the next more recent one; then to the next one; and so on. This permits readers to catch up on some ideas that were presented earlier and to move through all of the ideas in a systematic fashion to develop their emotional and social intelligence. To begin at the very first post you can click HERE.