ADHD in the Young Child: Driven to Redirection: A Guide for Parents and Teachers of Young Children with ADHD

By Cathy Reimers and Bruce A. Brunger

Divided into two sections, this resource provides solutions to common ADHD issues, such as behavior modification and medication control. The first section offers an overview of ADHD and helps clarify the common behaviors associated with it, while the second section provides one-page guides for specific problem areas both at home and in the classroom.

• Language: English
• Publisher: Specialty Press A.D.D. Warehouse
• Release date: Oct 1, 1999
• ISBN: 9781886941878

Book preview

Ph.D.

Introduction

Try to imagine what it takes to control our behavior. We take for granted the ability to stop and think before we act. However, for children with ADHD, such natural abilities are beyond their grasp. They have problems with controlling their behavior, as well as paying attention.

The primary symptoms of ADHD are inattention, impulsiveness, and hyperactivity, which hinder one’s ability to control behavior. ADHD children seem to have a Who cares? attitude, disregarding warnings about the consequences of their actions. It often seems as if their hasty behavior is based on what they are interested in at that moment, rather than considering the outcomes. Thus, ADHD children are considered to be impulsive.

ADHD is commonly described as a lack of self-control. Russell A. Barkley, Ph.D., an expert on ADHD, explains that this disorder involves an impairment in the ability of the individual to inhibit responses to situations or events.

If you believe that young children are the easiest group of people to diagnose with ADHD, think again. In reality, young children are actually the most difficult group to diagnose. Even normal young children commonly display varying degrees of inattention, impulsivity, and overactivity. It is difficult to distinguish when problems in these areas are due to the child’s normal development or whether they are the result of a more chronic disorders. Rather than make an uncertain diagnosis, it is sometimes more prudent to wait and see how the young child with ADHD-like symptoms matures.

It is important to understand what ADHD is and how it looks in the young child for early detection of the disorder. Often, children with ADHD are not diagnosed until later in the elementary school years. By that time, they may have developed additional behavioral and social problems and may be perceived by others as having emotional difficulties, when. These complications could often be traced back to the underlying ADHD issues.

We should attempt to identify and treat children with ADHD as early as possible. However, even with early intervention, we cannot prevent the course of the disorder continuing for many years for most children that are diagnosed with ADHD. Many children do not outgrow ADHD, nor is there a cure for this chronic disorder. To treat children most effectively, a combined treatment approach is often necessary. This usually means behavioral training for parents and the child, family and individual counseling, educational accommodations, and if necessary, medication.

Not only will the ADHD child’s inattention, hyperactivity, and impulsivity appear at school, but such behavior will also interfere with family life, peer interactions, and many other activities in which the child participates. Children with ADHD may also have associated learning disabilities, emotional difficulties, and social and family problems. These must also be recognized and treated.

To make this book a practical guide for parents and teachers, we present typical problems with ADHD behavior that occur at home, at school, and in other situations. We offer remedies to deal with them. Please refer to the illustrated scenarios in this book together with your child to help you and your child learn how to deal with problem behavior.

This book discusses effective tools that you can use to manage the young child with ADHD. The method of redirection, or re-focusing the child’s behavior, is presented. Redirection can be a very effective tool for altering the child’s behavior.

Another technique we will discuss is the use of imaginative play. As part of imaginative play, we expand upon something most young children are naturally comfortable with—creating a pretend friend who can help guide the child and help anchor positive internalized messages.

We also discuss behavior modification, the most popular and commonly employed method of managing behavior. However, it may not be as useful for all children since research indicates that behavior modification may not always manage impulsive behavior successfully.

Similarly, self-instruction (which is a form of behavior modification) is less effective with more severely afflicted children, who are highly impulsive. Nevertheless, for those children who may benefit from using problem-solving and calming strategies, we have included training in this area.

In addition, we review current assessment instruments and discuss the role they play in evaluating children for ADHD. Treatment methods including medications, counseling,, and diets are also discussed in detail. We have also prepared a Parent’s Survival Guide, which features various authors’ ideas and helpful hints to guide parents through the difficult times with their child.

Throughout this book, you will notice an emphasis on redirecting our own thinking to help our ADHD children redirect their behavior. Thus, we have chosen the subtitle, Driven to Redirection, to reflect this approach.

With this practical guidebook in hand, we are confident that you will be better equipped to deal with your feelings and effectively manage the behavior of your ADHD child.

Cathy L. Reimers, Ph.D.

Bruce A. Brunger

CHAPTER 1

A Day in the Life of Young Children with ADHD

Joey:

The On-Again, Off-Again Child

It is 4:30 a.m. Joey, a 5-year-old, bounds out of bed and runs noisily to his parents bedroom as he does every morning. No matter how early or how late Joey went to bed the night before, he always wakes up at 4:30 a.m. Joey’s parents, Alan and Lisa, often joke that they never need an alarm clock in the house. Alan and Lisa are still sleeping as Joey bursts through the door and pounces on their bed like a cannonball, trying to snuggle in between the twisted maze of blankets, sheets, arms, and legs. With his brown hair disheveled from tossing and turning in his own bed the previous night, Joey sports a mischievous, impish grin. Joey simply cannot lay still. He wiggles, giggles, pokes his parents in their ears, and does his best to wake them up.

Alan and Lisa, rudely awakened from their blissful sleep, try feebly to negotiate a peaceful truce with Joey, but it is no use. Joey isn’t taking prisoners. The only way Joey is going to leave his parents’ bedroom is together with them. Alan and Lisa will either trudge along half-awake to get Joey’s breakfast ready, or storm after Joey to catch him and send him to the corner for waking them up so early.

Joey takes forever getting dressed before having his breakfast. He is always distracted by a toy, a bird singing outside his bedroom window, a spider on the wall, or any other little thing that draws his attention from the task at hand. After waiting in vain for nearly 15 minutes for Joey to get dressed, Alan and Lisa decide not to wait for him anymore and start breakfast without him.

Joey gets upset for being left out. He is certain they are eating some yummy pastry or other sweets without him. He starts whining and throws a tantrum, still in his underwear. Alan and Lisa try their best to ignore Joey’s protests, but Joey escalates things by taking his sideshow from his bedroom to the dining table. At five years of age, Joey is already an expert at pushing his parents’ buttons. In no time at all, Joey manages to frustrate his parents, spoiling breakfast for everyone. Alan can’t take it any longer, and angrily marches Joey back to his room and orders him to get dressed. The classic power struggle begins, as it has every day since Joey could talk.

No! Joey screams, as Alan points to the clothes which Joey should have put on, now strewn all around the room. I don’t want to! Alan can feel his temper boiling, but he tries to be firm. Get dressed right now. I mean it!

Noooooo! Joey shrieks back, sticking out his tongue at his father for added emphasis. Alan then orders Joey to go take some time out in the corner. Joey doesn’t budge, still protesting. Alan has to pick him up off the floor, kicking, screaming, and scratching, and hauls Joey to the other side of the house to the corner, plopping him down with an air of triumphant finality. In Alan’s mind, he has won the contest, but Joey is far from feeling beaten. Alan turns his back to walk away and is blistered by a blood-curdling scream from Joey, who angrily protests being sent to the corner. Joey throws a pillow at his dad, kicks the walls, and blows loud raspberries at his father, derisively yelling after him, I don’t like you! Hah!

Alan turns and walks toward Joey, not willing to be outdone. All right young man, you asked for it. I’m adding 5 more minutes on the time-out clock for that! Joey screams even louder, as Alan shuts the door on the tirade and returns red-faced to the breakfast table.

It has been the same routine, every morning, for the last two years.

Strangely enough, after doing his time in the corner, Joey emerges more calm, cool, and collected. He gets dressed, eats his breakfast almost without incident and gets ready to go to preschool with his mother.

Both father and son keep their distance from each other for the rest of the morning, both feeling that something is wrong, both feeling hurt, but unwilling to face each other. Joey quietly hops in the car with his mom, and heads for school, alone in his thoughts.

Arriving at the preschool, Joey hangs up his coat, and sits glumly in the circle with the rest of his classmates. The vacuous expression on his face catches the attention of his teacher, Ms. Reynoso, who cheerfully tries to involve Joey in the class discussion. Joey almost seems embarrassed by the attention from his teacher and classmates, and becomes less social at first, then relaxes, and later joins in with the songs and other circle activities.

Despite the rough start to his day at home, Joey has a good day at school. Joey’s behavior seems like any other normal kid in class. He happily goes from one activity to another, hangs out with a couple of buddies and generally stays out of trouble. Any trace of the defiance and stubbornness he displayed at home is completely absent.

The only dark cloud in an otherwise sunny day at school is when Joey impulsively decides to demolish a classmate’s tower, which is made of building blocks. He has no real reason for doing it, other than an urge to see how the blocks would fall. Joey’s action starts a fight, which results in Joey being sent to take some time out in a chair. Again, Joey doesn’t go quietly. He screams, kicks the chair, and throws it across the floor. Ms. Reynoso quietly responds by bringing the chair back and has Joey sit in it for a few minutes.

When Lisa comes to pick up Joey at the end of the school day, he bounces up to her, proudly waving some hastily-drawn, gloomy pictures that he made in class. I had a good day at school today, Mommy! says Joey, obviously pleased with himself. His pictures are all drawn in dismal colors, all featuring angry or sad-faced characters in fighting poses and he shows them off proudly. He is a chatterbox of excitement during the ride home, talking about his school day. However, Joey grows progressively quieter as they get closer to home.

Joey has a pleasant afternoon at home, playing nicely with his little brother and sister. When Alan arrives home later, Joey rushes up to him to proudly show his gloomy pictures. Alan tries not to show his disappointment at the pictures, and even helps Joey tape them up on the wall in his bedroom.

Alan is still feeling remorseful about the stand-off with Joey earlier that day. He tries to avoid anything that might turn into another argument or power struggle. Lisa tells Alan about Joey’s good behavior throughout the day and reminds Alan to catch Joey doing good. Alan smiles to himself and wonders how he can catch Joey doing good when he always seems to be getting into trouble.

At dinnertime, Joey starts to fidget. He touches his food with the back of his hand, sticks rice up his nose, and blows bubbles in his milk. Lisa and Alan make repeated requests for Joey to mind his table manners. Then Joey starts making silly noises at the table, rolling his eyes, sticking food out on his tongue, and lying down on his chair.

This sets Alan off again. Joey, knock it off, will you? How many times do we have to tell you? Joey is getting giddy at this point and won’t settle down.

Alan has had enough. Without a word, Alan picks up Joey and marches to Joey’s room. This time, Joey isn’t screaming or yelling. He continues to make silly noises in his room while his parents finish dinner.

After dinner, the family settles down to watch a children’s video together. Alan watches the TV, but his mind is elsewhere. He is anxious and agitated. After a while, Alan goes to the bathroom, closes the door, and looks hard at himself in the mirror. My God, why is Joey always acting like this? Alan says to himself as he puts on some shaving cream. Why does everything have to be such a knock-down, drag-out power-struggle with that kid?

And then, suddenly, everything breaks down.

Alan, usually a very self-controlled man, feels powerless as waves of anger and helplessness wash over him. His arms start to quiver, then his lips, then his knees weaken.

Shakily, he grabs hold of the edge of the bathroom sink, still fixing his stare into the mirror, eye-to-eye with himself. Tears pour down his face, streaming through the shaving cream.

Alan comes face-to-face with mixed emotions that he has repressed until now, a confirmation of something ugly and terrifying that has lurked in the back of his mind for the last three years: He doesn’t like, indeed, almost hates, his son Joey.

Before he knows it, Alan hears himself sobbing, quietly at first, then it all gushes out—a deep, visceral cry that wracks his whole frame. His whole body shaking, Alan hangs his head over the bathroom sink. The shaving cream drips off his face into the basin, mixed with tears and great drops of sweat, as Alan’s cries rip from his throat.

Alan’s mind is racing. My God, I hate Joey...I really HATE him! But why? He’s my son! I shouldn’t be feeling like this! But I can’t take this anymore...why does everything have to be such a struggle with him? Why can’t he just obey and be a good kid? God, I can’t stand myself for feeling like this! What am I gonna do?

Out in the living room, Lisa thought something terrible had happened when she heard Alan’s first groan erupt from the bathroom. She ran over to the bathroom, and peeked inside, only to find her husband hunched over the sink, speechless. This is a side of Alan she has never seen in their 10 years of marriage and it frightens her.

Are you all right, honey? she asks nervously. Alan, shaking his head, can only muster a feeble wave to her, indicating that he wants to be left alone. By now, Joey, his four-year-old little brother, and 16-month-old little sister had run up to the bathroom door. Mommy, why is daddy crying? they ask innocently.

Embarrassed, Alan is still unable