Tag Archives: ADHD

Neurodiversity Means Natural Variety in the Human Brain

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In recent years, it has become more recognized that a shift in societal perspectives is necessary for true inclusion, specifically regarding (but not limited to) autism and ADHD. Historically, autism and ADHD have been pathologized to focus on the way areas for growth impair a person’s “normalness”, rather than the constructive ways that individuals use their unique strengths. Neurodiverse children and adults do experience difficulties related to living in a world that is not accommodating and understanding of differences. The neurodiversity movement does not seek to trivialize how challenging growing up neurodiverse can be, but rather help focus on building shared understanding of the value neurodiverse individuals have just as they are.

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The FUN in Executive FUNction

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Have you ever heard someone say that your brain is not fully developed until age 25? When someone mentions that, it’s usually to explain how teenagers can still make risky decisions, even when they feel like near adults because their “decision making warehouse” in their brain is still making new connections. That’s true! The frontal lobe of your brain is responsible for many of your executive functioning skills! So, what does that have to do with your child? Executive functioning skills that are required for all those complex adult decisions begin with foundational skills that emerge in early childhood that are necessary for your child to pay attention, finish tasks by themselves, and stay in control of their body and reactions. All children need to develop well-rounded executive functioning skills for success in the classroom and at home.

What are executive functioning skills?

Executive functioning refers to a complex collection of skills across areas of neuropsychological development that include how your child’s brain is able to focus on one subject, plan ahead, organize, follow steps in order, follow familiar routines, have self-awareness, hold thoughts in our memory, switch between activities, and control our responses to events. In general, executive functioning skills are responsible for our general external and internal organizational and attentional processing. In general, executive functioning skills help us make a decision or goal, plan how to achieve that goal, carry out the steps in the plan, and check that we were able to do it right.

What does it look like when a child has difficulty with executive functioning skills?

Executive functioning develops typically in children who are participating in learning opportunities with gradually decreased support from an adult, everyday social interactions, games that challenge inhibition or memory, and lots of trial and error with activities. Early signs of difficulty with executive functioning skills may look like any of the following:

  • Having difficulty staying on task and avoiding distractions
  • Becoming easily frustrated, at times resulting in outbursts
  • Needing frequent reminders to slow down with work or think before acting
  • Forgetting directions almost immediately
  • Skipping steps from directions with more than one step
  • Trouble getting started with instructions or finding the materials they need for an activity
  • Disorganized when re-telling a story or event that happened
  • Getting stuck on one idea, or becomes frustrated when having to transition from one activity to another
  • Needing more reminders to complete daily routines than same-aged peers
  • Difficulty adjusting to in the moment changes

What can I do to support my child’s executive functioning?

Infancy:

  • Anticipation games such as peekaboo, “1-2…….3!” with any silly action, and this little piggy
  • Pausing during their favorite familiar fingerplay song for them to fill in the blank with a gesture or word
  • Hiding games with their favorite toys to search beneath a cup or cloth for them

Toddlers:

  • Increasing gross motor challenges such as a one-step obstacle course for them to control their bodies during movement
  • Movement songs and dances that they can follow along with and remember all the steps
  • Exposure to emotion words such as happy, mad, sad, and scared on themselves and on characters in books
  • Completing simple matching puzzles or sorting games

Early Childhood:

  • Have your child “read” a familiar story to you while looking at the pictures
  • Play freeze dance
  • Sing backward counting songs such as the three little ducks and have the child keep track of how many ducks are left
  • Play games where your child has to identify which object is not like the others

School Age:

  • Help follow simple cold meal recipes with a plan ahead of time. Your child can help gather the materials and put them together in the provided order.
  • Play games such as Spot it, Quick Cups, and cooperative board games
  • Play Red Light, Green Light, Musical Chairs, or Simon says to increase the child’s attention and impulse control
  • Play games such as Guess Who, where your child has to keep track of characteristics already said

Executive functioning challenges are common in children with Attention Deficit Hyperactivity Disorder (ADHD), autism, anxiety disorders, and learning disabilities. However, not all children with difficulties in these areas may have one of those diagnoses. If your child is demonstrating persistent problems with some of the skills above, consider contacting one of our occupational therapists, who can provide your family with helpful tips and tricks to build your child’s executive functioning skills.

Questions or concerns?

If you have questions or concerns about your child’s executive functioning skills, please contact us at info@playworkschicago.com or 773-332-9439.

Caroline Stevens, MS, OTR/L
Occupational Therapist

References:

Center on the Developing Child. (2020). Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence. Retrieved November 5, 2020, from https://46y5eh11fhgw3ve3ytpwxt9r-wpengine.netdna-ssl.com/wp-content/uploads/2015/05/Enhancing-and-Practicing-Executive-Function-Skills-with-Children-from-Infancy-to-Adolescence-1.pdf

Cramm, H., Krupa, T., Missiuna, C., Lysaght, R., & Parker, K. (2013). Broadening the Occupational Therapy Toolkit: An Executive Functioning Lens for Occupational Therapy With Children and Youth. Retrieved November 06, 2020, from https://ajot.aota.org/article.aspx?articleid=1863088

Photo Credit: Olav Ahrens Rotne via https://unsplash.com

DR. DR., Give Me The News: What is a Neuropsychological Evaluation?

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A neruo what?! Why does my child need this? Does that mean my child will have a diagnosis? What are they testing for? How long will it take? Will my child need medication? A neuropsychological evaluation can raise many questions and concerns for families. The information below can help provide some clarity about what a neuropsychological evaluation is and if your child would benefit from one.

What is a neuropsychological evaluation?

A neuropsychological evaluation is a test completed by a licensed clinical psychologist and may include additional providers, such as an occupational therapist or social worker, from a multi-disciplinary team approach. The team will interview the child’s parents, in addition to any other adults that may be able to provide feedback about the child (e.g. therapist, teacher). The evaluation is a series of tests, both written and verbal, which are completed over the course of several sessions and all appointments can vary in length of time. These tests help to better understand the brain development, strengths, and weaknesses of that individual.

What does/can it test?

The evaluation is recommended for children over the age of five. The initial and primary concerns will determine the exact tests administered throughout the evaluation. Generally, tests assess academic functioning, attention and executive functioning skills, and motor functioning. These skills are essential for children to establish and develop in order to fully function in a classroom setting independently. The evaluation also monitors the child’s sensory profile in addition to their social-emotional development.

What about the diagnosis?

It is possible that your child might receive a diagnosis after the evaluation (e.g. ADHD, anxiety, autism spectrum disorder). Any diagnosing information will come from the Diagnostic and Statistical Manual of Mental Disorders, 5ThEdition (DSM-5). This information can often be difficult for families to accept and understand what it actually means. Receiving a diagnosis does not always mean that your child will have that diagnosis forever; however, many neurological disorders are often influenced by brain structure. A diagnosis can provide answers, information, and recommendations for your child and family. The information can better support your child’s care team to provide an Individualized Educational Plan (IEP) within the classroom setting and additional therapeutic services which may only be available through insurance. If your child is recommended medication at the evaluation, talk with your current treatment team of providers and your child’s primary care doctor, to see if and when beginning medication is the right step for your child.

Who can it help?

These evaluations can help provide the child, family, and support teams with a detailed description or a “blue print” of how the child’s brain works. These reports include specific recommendations for each child at home, in the classroom, and within the community as needed. Sharing your child’s neuropsychological report with their school, doctor, and therapists will ensure your child’s care team is working collaboratively to achieve the targeted goals.

Questions or concerns?

If you have questions or concerns about your child’s diagnosis, please contact us at info@playworkschicago.com or 773-332-9439.

Kelly Scafidi, MSW, LCSW, DT
Licensed Clinical Social Worker
Developmental Therapist

Photo Credit: Berzin via pixabay.com

ADHD and the Classroom: Strategies for a Successful Day

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An Environment for Success

How can teachers setup their classroom to create a positive learning environment?

An organized classroom promotes organization habits among students and makes the teacher’s job easier.

  • Ensure that the children’s chairs and desks are arranged in a way that allows for flexibility to fit group instruction as well as small group work.
  • It is helpful for students to have a supply center, which allows them to independently prepare and manage their materials. It may contain items such as scissors, hole punchers, pencil sharpeners, etc. Provide visual cues for gathering materials needed for projects. Keep containers, such as shower caddies, handy to transport materials back and forth to the supply center.
  • A homework center allows for a designated area where homework-related activities to be centralized and turned in.

Homework Management

How can teachers develop effective systems for managing homework?

A clear routine and system for assigning, collecting, and storing homework will make managing homework assignments easier.

  • Designate a regular place for recording homework, whether a portion of the chalkboard, whiteboard, or online so that it is easily accessible to all students.
  • Establish a regular time for assigning homework. It may be beneficial to assign homework at the beginning of a lesson, so that students are not writing the assignment down as class is ending. This also allows for time to answer any questions regarding the assignment and can greatly increase homework completion rates.
  • Keep a master planner and homework log in which all assignments are recorded by the teacher or a responsible student. This can be a class resource for students who are absent or are missing assignments.
  • Extra handouts can be kept in a folder, a file organizer, or online. This way, students who miss or lose assignments have the responsibility of obtaining the necessary papers.
  • Designate a physical structure, such as a paper tray, to collect homework rather than using class time to collect papers.
  • Establish a regular time for collecting homework. Consider using a “5 in 5” reminder, requiring students to complete 5 tasks in the first 5 minutes of class, such as turning in homework and writing down new assignments.
  • File graded work in individual hanging folders to decrease class time devoted to handing out papers.
  • To encourage organization, have students designate sections of their binder for (1) homework to be complete, (2) graded work, (3) notes, and (4) handouts. Consider periodic checks and provide feedback.
  • Have students track their grades on grade logs to provide them with the opportunity to calculate grades and reflect on performance.
  • At the end of a grading period, encourage students to clean out their binders, and discuss which papers are worth keeping and why. Encourage them to invest in an accordion file or crate for hanging files to keep important papers.

Time Management

How can teachers structure classroom time efficiently and teach students time management skills?

  • Timers (such as the Time Timer or sand timers) provide students with a concrete visual reminder of the amount of time remaining for a task. They are a great tool for group work, timed tests, or silent reading.
  • Post a daily schedule in a visible place to establish the day’s plan. Present the schedule to the students, and refer to the schedule when making modifications to model time management skills.
  • Display a monthly calendar to provide students with regular visual reminders of upcoming events. These calendars are also beneficial for modeling backwards planning.
  • Carve out time for organization. Devote a short amount of time for students at the end of the day to reflect on their learning, manage their materials, prioritize homework assignments, and make a plan for their completion.

Materials Management

How can teachers help students manage their materials?

  • Designate a short amount of time once a week for students to dump out and reorganize backpacks and clean up lockers.
  • When students finish tests or tasks early encourage them to use the downtime to organize their materials.
  • Have students use labels, racks, or dividers to keep items clean and organized.

 

Jen Brown, MS, OTR/L
Director of Occupational Therapy Services

Resources:

Rush NeuroBehavioral Center. (2006, 2007). Executive Functions Curriculum.