January 4, 2021
Cindy Lopez:
Thank you so much for listening in today, we’re excited to welcome Dr. Glen Elliott back to our podcast series, Voices of Compassion. And if you weren’t able to listen to last week’s episode to kind of get the whole picture, you might want to take a minute to listen to that, and then listen to this episode. However this one stands on its own as well. So, thinking about this second part of ADHD and distance learning last week we looked at parents, what can parents and educators do? What can they expect? And today we’re going to be talking about how ADHD kind of displays itself with distance learning. So, a typical home, Dr. Elliott, a typical home is full of distractions. What can parents and/or students do to help mitigate those distractions?
Glen Elliott:
Yeah, this again is going to depend on the family situation. It’s obviously different if you have four kids versus one child, if you have relatively limited space, which is often the case in the Bay Area. But to the extent possible trying to create a space that is focused for this child on distance learning is really, really essential. Even if that requires getting some folding screens, so you can set off a part of the room for the child to be learning. You’re absolutely right, many of these children will find anything to distract themselves. The other thing that might be worth investing in if you haven’t and this is going to be easier again at home than probably at school, is to look at frankly Amazon, or any site, CHADD.org is another site which is Children of Hyperactivity & Attention Deficit Disorder. Look for things that are called fidgets: you want to look for things that don’t make noise because that’s going to be problematic, but little things that the child, particularly younger children, can manipulate while they’re focusing can be enormously beneficial. And that’s often a problem at school and you’re going to have to experiment because again, you don’t want things that make noise. If it’s something that’s going to be easy to drop the child will go chasing around the room, picking up whatever it is he dropped, but those kinds of ways of keeping the body busy while the mind stays focused on the screen, really can be very, very helpful.
Cindy:
So, Dr. Elliot, we know that you are an expert on ADHD interventions. Can you talk a little bit about, for children if they haven’t been on meds before, would it makes sense to think about it? I know that’s a controversial topic, whether or not you put your child on meds for ADHD. But in this new situation with distance learning, it’s different and they may need to look at that again. Can you make some comments about that?
Glen:
Absolutely. And it actually goes both directions so what some parents who have discovered, whose children already are on medications, is that they may need to adjust the way the medication is being given. Medications, usually particularly for our attention when we’re talking about stimulants and we have sort of short acting and long acting, there are some parents that have discovered that with distance learning, short acting stimulants actually turned out to be more useful because they can focus them much more on periods when the child really needs to be focused. And the lovely thing about the stimulants is they only work for a limited amount of time and then they’re out of the body. So, some parents are discovering that with distance learning, they actually did end up using less medication than they had been before. The flip of that is for children who have never been on medication, this may be the final, extra stress that leads them to feel like that’s worth at least exploring. My own son who only had inattentive ADHD, actually didn’t use medications during high school, even though I would prefer he’d do so. He managed to make it until he got into medical school actually, there was a huge test that he had to take and they actually gave them seven weeks off to study for this test. And he knew there was no way he could spend seven weeks of concentrated study and finally went to a psychiatrist and got a stimulant medication. And it proved to be very, very helpful for him in that situation. He ended up not taking it later on. So I think parents who are fearful that if they cross that threshold that means that they’re never going to be able to go back, they may choose not to go back, they may find that actually their child does so much better and thinks it’s so much easier for him or her that it’s worth doing. But, there’s a novel situation, and sometimes we really have to reassess what’s going on. So if your kid is on medication and things don’t seem to be working well, absolutely go to the prescriber and talk with him or her about what’s not working and whether or not we can make some changes that would make things more effective. If you are pretty convinced that your child has ADHD and you’ve done everything else you can possibly do, but it’s still more effort for him and you then you’d like, then maybe considering medications, you know is worthwhile.
Cindy:
Thank you. I think lots of parents have questions about medicating or not. So thank you for spending a couple of minutes talking about that. So if you’re a parent at home, trying to do the at-home learning thing, what are some ways you could help maximize learning for your child with ADHD at home?
Glen:
A great question and I wish I had a very precise answer. Obviously partly parents need to assess what they’re able to actually do, because again, if you’ve got two other kids that you’re also supposed to be shepherding around, it’s going to be much, much harder to split your time. In general what we know works with kids with ADHD is frequent positive feedback. And also again, depending on if hyperactivity is an issue, frequent breaks. Expecting somebody with ADHD to be able to have six hours worth of education or two, three hour blocks is simply not realistic. Frankly I don’t think it’s realistic for kids in general, whether you’ve got ADHD or not. So some schools recognize that, I think other schools seem to be a little less likely. Having timed breaks for younger kids, sometimes having a timer so that they know, I just have to hold on this much longer. Those are again readily available online particularly when you’re dealing with seven or eight and nine year olds. Having some concrete, hopefully not noisy, countdown. There’s a particular kind of clock that actually has a red band to it and what you’re seeing is the red band gets smaller and smaller; it doesn’t make any noise, it is not going to be a further distraction. One of the interesting features of kids with ADHD is they very much live in the here and now. And what that sort of means is things never change, the now is the way it is and the way it’s always going to be, and having an external device that helps you know that there is an end to this seemingly endless activity can be a real support for them. So, that may be a tool that you know, that that’s worth trying. One of the tempting things is to let sleep slide because the schedule is not as rigid as they would be on a regular school kind of situation, that really is a bad idea. Keeping a regular schedule, having as much predictability as possible and doing some things that you wouldn’t normally be able to do, again obviously it depends a little on sort of what the parent’s responsibilities are. But maybe having lunch together, can be a real opportunity to praise the child for how well the morning went and you know what worries do you have about the afternoon, if any, what do you think’s coming up. And again, supper is another nice time to sort of have that togetherness. Children are often extremely appreciative of non-directional time with families where you’re not spending it saying you need to do this and this and this and this. You’re just there and communicating with them and being a parent.
Cindy:
Those are good reminders. I like that idea of you know, taking a break in the middle of day, having lunch with your child, and that gives you an opportunity as a parent to practice some of that positive praise and reinforcement you were talking about um, because it’s so easy as a parent to get into that kind of mode where you’re seeing everything that’s going wrong and it’s really hard to then kind of stop and reset yourself as a parent to say, okay, I need to respond differently in this situation
Glen:
What we know is that all kids, but kids with ADHD respond much, much more positively to positive interventions then to negative consequences. That’s been shown over and over again. It’s probably true of everybody. I mean, if you think about it all of us would rather have a bonus than have somebody take away part of our shower. But, that often is much harder with kids with ADHD because it takes more effort at times to find something positive to really say.
Cindy:
So speaking of that, giving positive feedback to your kids, thinking about how motivation plays a role with students with ADHD, can you speak to that one a little bit?
Glen:
Sure. So, kids in general need motivation, kids without ADHD often get that motivation on just the idea of mom and dad being happy about my grades, is enough. With kids with ADHD that often isn’t nearly enough. And one of the other characteristics of kids with ADHD is they develop tolerance quickly to interventions. So something that works for a while may stop working because after all they’ve done that, been there, done that. Again, what we know from lots of research is that the offer of a positive reward of some sort, the closer it is to the behavior that you’re trying to improve, the more powerful it is. So, with kids with ADHD saying, if you’re good for all week, then we’re going to do something wonderful on the weekend, there is no way that’s going to work. Again, remembering that every minute is now, that is forever, a week away. So, thinking about you know these breaks that we talked about sort of varying those up, again, this is a wonderful time when you can bring the child in to talk about what’s reasonable. You don’t want to bankrupt yourself, you don’t want to offer a dollar for every hour or whatever, but what would be fun for the kid? For a lot of kids, some level of exercise can be really, really helpful. And it depends on the child, there’s some kids where they jump right into that, there are other kids where that is not something that’s going to be easy for them, but you know, offering to go for a brief walk with them if that’s feasible in the neighborhood and it’s safe, or some sort of a in-house game that requires some physical activity. Even something like some calisthenics might actually make a significant difference in sort of being able to then let them settle down and get back to work.
Cindy Lopez:
Thinking about our podcast, the name of our podcast is Voices of Compassion. How can parents show compassion to their kids with ADHD right now?
Glen:
That’s a great question. And for themselves…
Cindy:
Yes exactly.
Glen:
…I would add. Partly acknowledging that this is a very, very difficult situation for everybody. Again, a great opportunity to have a genuine communication where you’re listening to what the kid’s frustrations are. They may not be what you think they’re going to be, that’s part of the reason for asking is that often we as adults make assumptions, that he hates science and that’s why you know, he won’t pay any attention to the science teacher. And it may be something completely different from that, that if he were able to explain it, you could then begin to think about well, what can we do that would be different that would allow you to do what needs to be done?
I think cutting back on expectations is also reasonable, I know parents have worried about falling behind. But I think there’s a general belief in the education system that right now the reality is that we’re going to try to feed kids information as best we can, but we’re not going to be able to keep up the pace that we have in the past. And that may be even more true with kids with ADHD than others. So, I mean, some of this has to be coordinated with the teacher. Many of these kids have 504 plans, which for those not familiar with that language is a sort of an unfunded mandate that schools have to sort of accommodate needs of kids with ADHD. And one way that one could ask for that, particularly if there’s already a plan in place, is to say right now just getting him through classes is hard. Can we cut out the homework because that’s just more time on the screen and he doesn’t really need that right now. Again, finding out what’s hardest for the child, and that requires discussion, can help to shape that so that it actually helps.It’s a little bit off topic, but it’s related, sometimes parents will sort of routinely say, well, my kid’s got ADHD, so he needs more times for tests. Often there are a large number of kids with ADHD where giving them more time to take a test is absolutely useless because they’re always the first one done. And what you really need is time to check the fact that they did the front page part of the page, but they didn’t turn it over and notice that there’s a back part that also needed to be filled in. You as parents know more than anybody else about what your child is able to do or likely to do.
There’s good evidence to suggest that anything that can reduce the amount of time that the child feels like he or she is forced to do an activity that has very low intrinsic interest to them, is going to markedly decrease the amount of conflict you dealt with with that child.
Cindy:
Thank you for all those helpful tips and reminders. And I especially like what you said in terms of, listen to your child, like take a minute and ask them about it and listen to them. And when I asked you this question too, I said, how can parents show compassion for their kids? And you said something about self-compassion too, so why don’t you remark on that a little bit? Cause I know that parents are probably feeling like, you know, they’re overwhelmed and feeling like they’re not doing anything well, so if you have some words to say there?
Glen:
Yeah, I don’t have any gold standard proven this is the way to do it, but certainly even though it feels impossible, particularly if you’ve got multiple kids, taking some time for yourself, if their, you know, partners are available to be able to split the load some. Taking some time that you can regroup your own energies and do something that’s pleasurable for you really can be very refreshing and it isn’t necessarily you know hours, just an opportunity to listen to some music that you really like, or just reading a book for a while. Something that you find enjoyable might really get your energy back up to go back into the fray.
Cindy:
Yeah, thank you. Thanks for that reminder. So, Dr. Elliott parting question: if there was one takeaway that you wanted the listeners to really walk away with after hearing both of your episodes on ADHD and distance learning what would you say?
Glen:
Well, I think the key thing here is – several things. That you’re not alone. There are lots of families that are having this problem and if you’re feeling stuck, reach out. There are self-help groups both at Children’s Health Council and online where you can share your frustrations, but also you may get really helpful ideas about what to do. There’s some reading materials that we’re going to provide as part of this that also gives resources that you know, may click with you. Don’t feel like because it’s not working, it can’t possibly work. The other sort of flip side of that is don’t keep doing the same thing over and over again and expect a different result. If you’re really stuck, it’s time to reach out and ask for help. However that is, with another family with similar issues or with you know, your parents, if they are going to be helpful, but somebody who can do a restart and think about other ways that perhaps uh, you can approach the problem. Even though it feels like it is lasting forever, it will not last forever. And thinking about sort of what will we do when this is over can be kind of a nice sharing experience as well.
Cindy:
Yeah, thank you, Dr. Elliot, again for sharing your experience and knowledge with us around ADHD and giving parents some hints and tips about what they can do at home right now. You know, this ADHD and distance learning thing is new for everyone. So we really appreciate you sharing your wisdom with us. And parents remember as Dr. Elliott just mentioned, like you’re not alone. We are all in this together. There are resources. At CHC there are resources, we have some free virtual parent support groups. We have free webinars, podcasts like this one. And please reach out. And reach out if it, even if it’s not to CHC, reach out to a trusted friend or family member that you can talk to. So thank you again for investing your time with us to listen to this podcast and thank you, Dr. Elliott.
Glen:
Appreciate being invited.
Cindy:
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