Parenting a Child with Poor Emotion Regulation

When little people are overwhelmed by big emotions, it’s our job to share our calm, not join their chaos.  ~L.R. Knost

The Intense Child (an understatement)

Do you have one of those “intense” children, a “spirited” one, a bit passionate . . . alright –  a HARD one?  Do you have the kid who falls apart at the drop of a hat, loses his temper at the slightest provocation, and melts down at the least frustration? Your child has poor emotion regulation.  A more common problem lately in our modern world.

Are you in a constant emotional tiptoe around this child because you have learned . . . the hard way . . . after repeated attempts . . . that the typical discipline approaches do not work?   You tried time out, scolding, removing favorite things, removing privileges, threatening, yelling, and maybe even spanking.  All the standard approaches only seem to make the problem worse.

A more typical child with more typical regulation skills can reign it in when a parent sets a boundary, particularly if the parent’s tone indicates that the child has crossed a line.  More regulated children can zip their lip or modify the misbehavior.   If you yell or take a privilege away, those children may slink off to lick their wounds, but they accept the consequence and soon move on.

The poorly regulated child does not.  This child can’t reign it in.  Emotions ride roughshod over her (and over you).  And as soon as YOU indicate frustration or irritation,  things only get worse.  Your irritability meeting her irritability causes some form of combustion and her emotions escalate exponentially.  Whining becomes a full blown meltdown.  Frustration becomes a tantrum.  A punishment becomes THE  . . END . .  OF . . THE . .  WORLD (!!!).

Sigh

And recovery is slow.  This child might tantrum or meltdown for an hour or longer.  He may not recover that day and may fall asleep upset.  He wakes the next day feeling fine, but you are on edge, waiting for the next crisis over nothing.

The possible roots of poor emotion regulation

Intense children require some specialized parenting strategies, some that even seem a little counterintuitive.  However, understanding regulation issues and providing support instead of punishment can put everyone on a better path.

  • First, let’s look for some reasons for being poorly regulated. Knowing the reason does not change things, but it gives a little insight.
    • Trauma – kids who have experienced neglect or abuse will often have very poor regulation of emotions. They can’t help it.  The trauma and neglect created some hair-trigger emotionality.  Also, dysregulation may have been modeled for them.  Children adopted from institutions or from foster care are likely to have a trauma history.  Building their regulation skills will take time
    • Developmental Challenges – Attention Deficit Disorder, Sensory Processing Disorder, Language Disability, Autism – these challenges can drain a child’s coping strategies pretty quickly.
    • Family History of Mood Disorder – if you have a family history of mood disorder, your child may be showing some signs of this.
    • I DON”T KNOW!!! – no trauma, no (noticeable) developmental challenges, no depression or anxiety. This kid is just intense. You think maybe it runs in the family (not your side, of course) as you give a glowering side glance at the spouse.  (You have heard stories from his mother.) Or maybe you recognize this perfectly clearly.  You remember being an intense child (but, surely, you think you weren’t this bad).  Which brings us to . . .

Pesky contributing factors

  • Next, it’s good to know what exacerbates the regulation problem on any given day:
    • Hunger or Thirst – Hunger will make everything worse, but your poorly regulated child cannot even tell that hunger as crept up on him.
    • Fatigue – Once this child is tired, all bets are off. And poorly regulated children can wear out more easily than other children, so the day needs to end earlier.
    • Lack of Exercise – Movement is calming and alerting.  Daily active play, dance, a sport or exercise can be essential, but organized team sports may be too great a demand.  Keep it simple and fun.
    • Over-Stimulation – Too many people, too much noise or too many demands can wear this child out.  These may be situations that a more typical child manages (and enjoys), but the poorly regulated child cannot handle it for too long (even if they love it at the start).

      Many factors can make a child a little gremlin
    • Screen Time – too much screen time can feel like a good thing when your hard-to-manage child is quietly zombied out in front one, but try taking it away and you can be face to face with the regulation problem. Screen time typically makes regulation issues worse.
    • Junk food – Poorly regulated children can be hypersensitive to poor nutrition.  Sugar, food dyes, processed food can contribute to dysregulation.
    • Illness – I knew a child whose first sign of a strep infection was increased irritability and meltdowns. The physical symptoms would show up a day or so later.

You cannot avoid all of these things all of the time (though you can try).  Just be aware that each can contribute to irritability and hypersensitivity.  Be ready to control what you can when some other events are unavoidable.

Now here are some strategies for building regulation.  (You will notice that there is no magic wand.  Building these skills simply takes time and consistent support):

  • MODEL THE COPING YOU WANT TO SEE!!! (this is most important) – This child is irritated, frustrated and exasperated. She has caused you to feel irritated, frustrated and exasperated, but BECOMING irritated, frustrated, or exasperated will only escalate the situation.  If you would like this child to calm down, you have to start by modeling calm.  This does not mean ignore the behavior or encourage the behavior or give into the behavior.  It just means that you will model a calm response.  It helps if you realize that your child does not WANT to be a dysregulated mess and she really can’t control it.

    When a child melts down, try not to follow suit
  • Look for any “contributors” and resolve them – Feed the hungry child (but not candy or junk food), water the dehydrated one. Get some rest or go play depending on the situation.  Remove the child from an over-stimulating situation (even if it means calmly carrying her kicking, screaming, flailing self out).
  • Set Boundaries – you don’t have to present this as punitive, just matter of fact. “You can’t be at the party while you are screaming.  Let’s stay here (the car, a back room) until you feel calm or we can go home and try a party another day. It’s okay to not stay and it’s okay to try another day.” Screaming, flailing child may not like this, but really, what else is to be done.  An angry threat of, “We will NEVER go to a party again if you do not calm down RIGHT NOW” is just an empty threat.  Do not even present the consequence as a punishment.  Why say, “you are in this room in time out until you calm down.”  Do not bring up punishment because that does not make anyone feel better.  Just re-iterate that she can’t be at the party when she is so upset.  Then be supportive.  Position yourself between the child and the exit and calmly hold your ground in case your child tries to take matters into her own hands.   (I realize this is really hard to do when you have more than one child and the other children are being good as gold.  If the dysregulation is that bad, most outings will have to be a two parent project).
  • Recognize Any Progress – We don’t want to reward a tantrum or meltdown, but we do want to recognize any improvement.  “Wow, the last time you got upset, you cried for an hour, but this time you were done in 30 minutes.  You are learning to be the boss of those strong emotions.”  You don’t have to give prizes, just praise.  Your child needs a little empowerment over the situation too.
  • Use Humor When You Can – Children who can’t regulate their emotions may simply need something to laugh about. This can defuse a situation.  For example, I once worked with a mother who had a very dysregulated 9-year-old daughter. This child would scream at her younger brother for the slightest provocation (such as stepping into the room), however, she was extremely nurturing with the family pets.  She never hurt or yelled at animals.  I suggested that the next time this girl screamed at her brother, her mother should say, “In this house, we treat everyone like an animal.  If you would not do it to the dogs, you cannot do it to your brother.  Now go pet your brother and help him feel better.”  The mother immediately saw that this would help at least a little, “That would make her laugh.”  A laugh is a foot in the door for a dysregulated child.  I added that if her daughter would not go pet her brother, the mother should.  This gives the attention to her brother and models making up for bad behavior in a fun way even if the daughter will not do it yet.
  • Let It Go – After the meltdown, blow-up, or tantrum is over and dealt with as calmly as possible, let it go. Even if the situation did not resolve entirely (Yep, you did have to leave that party), there is no reason to harp on the situation.  Often, once a dysregulated child is calm, he has moved on as if the problem had not happened.  This can be very frustrating and worrisome to parents because it seems that the child does not realize the impact of his behavior.  That’s true and you can calmly work on that in little bits and pieces, but harping on it for the next hour (or two) will only extend the misery for both of you.  If it is possible to have a productive discussion, by all means, try (“I think next time we should leave the party BEFORE the noise starts to bother us because why stay if it is not fun anymore.  What do you think?).  If the child is calm enough to have that discussion, try it.  But do not lecture.  It will be like lecturing a dyslexic child into reading better.
  • Neutral Time Discussions – Do not be afraid of talking about the meltdowns, tantrums or dysregulation during a peaceful neutral time.  Discussions will not work in those intense moments of meltdown, but may work fine when your child is calm.  Your child is not proud of those meltdowns, so she is not going to bring them up.  Most parents want to avoid any triggers as well, but being able to discuss it shows that the problem is manageable.   A weekly meeting can be held with the agenda of previewing plans for the upcoming week and reviewing the past week and what could go better. What was hard to manage?  What might be tried differently this week?  “Let’s try my idea for a week, then your idea the next week and see what works best.”  This is a chance for a child to air grievances as well.  Be respectful of legitimate grievances, but put not-so-reasonable grievances in perspective (e.g., “yeah, I know having a little brother is rough, but he’s staying.  I think you will appreciate him when you are both older.  We are in this for the long run.”). It’s okay to inject the lighter mood because intense kids typically do not know how.  Model “Don’t Sweat the Small Stuff.”

Do seek more support if needed. If your child’s emotional upheaval is endangering to himself or others, or you simply feel that you need some guidance because your child overwhelms you (as well as himself), then seek some professional help.  Counseling around parenting intense children can give some perspective and precision with strategies.  It also ensures there is not a more serious issue at play (such as a mood disorder).

Kids with poor emotion regulation can be exhausting, but in equal turns, their enthusiasm and passion can be exhilarating.  Teach them that their emotions are powerful and that they can use all that emotional intensity to change the world.  Remind them that it is your job to help them use their powers for the forces of good.  Then laugh and go find them a cape.

Workaround-You can’t fix everything at once

It’s okay to go around a problem instead of solving it.  At least for a bit. I hear it’s called a “workaround.”  I am trying to make it feel like less work, but whatever . . . the point is you don’t have to be fixing everything, all the time!  It’s exhausting for both you and your child.  You can’t just let things slide (well, you can and must some of the time for your sanity), but you can develop some workarounds.

Does your day feel like this? Does your child’s?

Even with just a few learning or behavioral diagnoses, your child can have A LOT of challenging behaviors.  For example, say your child has a “disorder of regulation.”   You have the child who feels EVERY emotion strongly.  Happy is over-excited, angry is furious, and anxious is terrified.   There is no lid on THIS child.  Plus, the sensory system is a little too awake.  Every noise, every touch, every taste, even every smell comes on too strong for this one. Most foods are met with revulsion (no small emotions remember).  Most activities are met with aversion.  And trying paying attention when every emotion, every noise, every touch, every smell, every THING is a distraction.  This child is constantly called out for not getting something done that every other child seems to breeze through.  The teacher is trying to be subtle, but you can sense medication is on her mind.

The challenges of each day seem overwhelming.

This child with little ability to regulate emotions, sensations and attention is hard to wake up and then irritable in the morning. Breakfast is a challenge because of texture issues (the first tears of the day), getting dressed is tough because clothes trigger tactile anxieties. You are now running late for school, but this child does not have a hurry button.  Try using a firm voice and this child thinks you are “yelling” (more tears and curled up into a non-moving ball).  You make it to school, so now this child spends the day distracted and disorganized by the noise and demands.  It is exhausting.  The teacher e-mails about some concerning behaviors . . . again. Lunch in the stinky, clamoring cafeteria is a no-go. No lunch = Hungry.  The afternoon is a wash for your child. This child gets in the car starving and irritable; complaining all the way home. Anything any sibling does in the car is worth lashing out physically and verbally.  There is no desire for soccer, or dance class, or chess club or Scouts.  Your child wants to go HOME!  Once home, television seems to be the only consolation.  Pulling away for homework is a battle, as is homework itself.  In desperation, dinner revolves around what this child might eat.  Maybe a calming bath after dinner will help.  Everyone is exhausted, but it is hard for this child to settle to sleep. By 10, things are finally quiet, but you know that 10pm is too late for a complete night’s sleep for this child.  Tomorrow looms.

If your child has a lot of challenging behaviors, it feels like the day is non-stop management.  And really, you have been told that management of the problems is not enough. You need to fix them.  But being a full-time therapist/mom is not really an option when running a household, managing other kids, and working (as is often the case).  So guilt is your constant companion.

But really, you can’t fix everything at once.  And often you simply can’t fix everything.

It’s okay to set some priorities and find some workarounds for the other problems. Some might be permanent workarounds, some might be temporary while you work on other things.  But keep reminding yourself, “YOU CAN”T FIX EVERYTHING AT ONCE!”  Cut yourself some slack because, really, it is the only way to survive sometimes.

First, set some priorities on the most challenging behaviors. These might include:

  • No physical hitting or hurting others – Have a pre-set plan for hitting/hurting with a simple consequence that has been discussed in advance. Use your calm voice because meeting disregulation with anger likely doubles the disregulation (this child really can’t help it).The plan needs to include noticing every possible time the child does not hit (but might have) and compliment that. This may sound like, “I hear from your voice that you found that irritating, but you did not hit.  Be proud of yourself for that.”
  • Limiting screen time to two 30 minute segments in a day – Too much screen time makes regulation issues worse.  So screen time might include some time in the morning, once the child is ready for school, and in the afternoon for a bit. It would be helpful to have a timer on the device so that it shuts itself off without a parent having to intervene.
  • Not bickering with siblings (wouldn’t that be heaven) – This is a team effort and will take team discussion, but is a worthy goal. Bickering can likely be reduced.  Start with some “data collection.”  When does bickering happen the most – in the car, at breakfast, at bedtime?  See if there is a contributing factor – someone is hungry, someone can’t bear to be nudged when over-tired, someone is hot?  Try to fix that contributing factor first.  Then have a frank discussion of what can be done to reducing the fighting (do this when everyone is calm and NOT fighting).  Then start practicing and complimenting.  Its best to point out the “no bickering” times because the kids have to learn to recognize and appreciate those as well.

Some of you are snorting, “My child could undermine any one of those in under two minutes.”  Yes, I know.  It’s hard.  And if it is that hard, do see a parenting therapist.  Parenting tough kids requires some professional support.

But the real point of this post is “the workaround.”  Sometimes we need to just go-around the problem for at least awhile.  Some examples include:

  • Wearing the “wrong” clothes – For the sensory child, just skip clothes with tags, internal pockets, tight elastic, rough seems. For the apraxic child, skip buttons, zippers or anything complicated.  Heck, skip variety.  Find the clothes your child is comfortable wearing and get enough to last all week. A lot of clothing issues dissipate in adolescence with the strong desire to fit in and wear what everyone else is wearing.
  • Getting dressed in the morning – Mornings are rushed and many kids can stall on getting dressed. Simply eliminate that problem in pre-adolescent children by letting them sleep in their comfy sensory clothes.  After an evening bath, put on some comfy leggings, sweat pants, or gym shorts; add a comfy top and you are done for 24 hours.   Before the age of body odor, the clothes can be slept in and not be stinky.  In the morning, there is one less things to worry about.
  • Doing ALL of the homework (or any of it frankly) – Depending on your child’s challenges, the end of the day may be a point of exhaustion. None of us do our best work at that time.  Talk to the teacher and ask for permission to “sign off” on what was possible on any given night.  Sometimes that may be nothing.  That’s ok.  If your child is exhausted, what learning is happening?  Compliment your child on any work completed because sometimes any work is an accomplishment.
  • Eating a wide range of foods – Yes, I believe in eating from all the food groups, but that is not the same as eating a wide variety of foods. Cut yourself and your child some slack if you both need a break.  Do let your child know that fruits and vegetables, as well as proteins, are important and will be on their plates every day.  But then only put what they will eat at this time.  Don’t push the “just one bite” of other foods.  If they will only eat two fruits (and one of those is apple sauce), so be it.  Those foods should show up twice a day at least.  If there is only one vegetable (carrot sticks), then so be it.  Meals may be repetitive for this child, just make sure they are easy for you.  Continue to remind children that you will continue to help them get used to textures and it will get better. Useful “pre-tasting’ strategies include having them just touch new foods, handle new foods (e.g., can you grab me a tomato out of the fridge please), and stir or pour new foods.  If the problem is really bad, an occupational or feeding therapist may be needed.
  • Eating in the cafeteria – It’s loud. It smells funny. And you might touch something slimy.  It is hard to have a calm, enjoyable meal (even though 200 other children seem to be doing it, sort of). See if your child can have lunch elsewhere.  Maybe a friend can come along.
  • Skip the after school activities – If your child is exhausted and dreads after school activities, just skip them right now. Therapies, yes.  Those should be geared to your child’s needs and abilities.  But soccer or piano or swim team, maybe not. For some kids, the right activity is a life saver and a treat.  If you find it, great.  But be willing to forego the ‘well-rounded’ child until you find the right activities. There is a lot to be said for downtime.  It promotes creativity.

There are as many workarounds as there are kids.  You have to find the right ones for your child and your family.  You may also have to let go of some strongly held beliefs about meals, pajamas, and being well-rounded.  When your child is different, you do things differently.  It does not mean you can’t slowly nudge your child towards more typical expectations.

But cut yourself (and your child) some slack.

(And Child Decoded is here to help)

Emotion regulation and the art of the spin

Sometimes, parenting is all about the “art of the spin.”

In every life, a little rain must fall.  For child with challenges, it can rain a lot.  How do we help our children through challenges, set-backs and frustrations?  This can be particularly challenging for children who struggle with emotion regulation. Children who cannot regulate their emotions may (over-)react to problems multiple times a day.  It takes constant practice to help them reset their heads and take things in stride.

I recently got an e-mail from a mother I know. She wrote:

I am writing to you about Abby. We had a really, really difficult first week at first grade. Abby is a bright, energetic and happy little kid. (I know this child.  Effervescent is the word that comes to mind.  She is adorable.)  Abby has Sensory Processing Disorder.  She has a sensory diet and we are diligent about keeping up with it.  There is a plan in place at school for this. Abby is great about knowing what she needs. She self manages fairly well and is pretty cooperative about doing movement, asking for noise reducing headphones, etc. Another thing about Abby is that she likes to do things perfectly (despite teaching her otherwise.) She is a BIG rule follower, particularly at school.  She loves school.

Abby started first grade this year and came home the first day saying, “First grade ROCKS!” All was well until Tuesday. At recess, Abby made a bad choice. She told a lie to a teacher about a peer whom she felt was mean to a friend. This is very out of character for Abby and something she has never done before. When the teacher figured out that Abby’s story was not adding up and asked Abby if what she said was true, Abby wet her pants on the spot (something that has NEVER happened). The fear must have surged through her body.

Because of the lie, Abby had to ‘flip a card’ which is the behavior system her school uses. Abby has NEVER had to flip a card and this is her 4th year at the school. Trying to prepare her, I have said to her periodically, “Some day you will flip a card and it will not be the end of the world. You will learn something and we will move on.”  She would always say, “Mom, don’t worry, I’m never going to flip, I LIKE to follow the rules.” To say Abby was crushed by her mistake is an understatement.  The school had to call me to take her home.

Abby was crying so hard she couldn’t breathe. She begged me not to tell anyone, including her dad. She was so embarrassed. She took her own dessert away and wrote her apology letters to her teachers. The next morning all was well until it was time to go to school and then tears, lots. She went to school crying.  To make matters worse, unbeknownst to me, her teacher decided that the movement schedule would be changed and a new aide was to do them. This aide is certainly nice enough, but knows nothing about giving a sensory break. Abby cried on and off all day and frankly looked glassed over when I picked her up. She hadn’t eaten a bit of her lunch.

I found out then about the change in the movement break plan. I was LIVID! To change a plan that a sensory kid has had in place for ages on the heels of probably the most traumatic event she’d experienced (in her eyes) without consulting the occupational therapist or with me, her mom. So Abby was a complete disaster and didn’t even have a good way to even attempt to get back on track. I respectfully asked that the plan be reinstated until we could meet formally to consider changes in her educational plan.

Despite this, Abby has cried every day at school since then. I ended up taking her home early on Friday. Her teacher was out, the sub wasn’t managing well, and Abby was crying hysterically.

We spent a day “calming down” and working hard.  Physical activity always resets her mind.  I felt like she was pretty well reorganized, so I tried to talk with her about the week.  As soon as I broached it, she started to cry uncontrollably. She doesn’t want to go out for 3rd recess anymore (which is where the card flip and pants wetting happened) She just kept saying “I don’t need 3 recesses anymore.” She does not want to go to school anymore.

Abby has always been a little anxious and I always wondered if it was just part of her SPD or if it was something more. At this moment, I am thinking it’s something more and don’t know what to do. My child is a mess. Can you guide me? Thank you so much.

Building Emotion Regulation with a little spin

So I answered:

Wow, poor kid.  But there are things we can do. Sometimes the sensory regulation issue has an emotion regulation issue.  You tried to prep her for the inevitable, but she was pretty sure it would never happen.  Now the emotion that surged up is too high to regulate.

Certainly, getting caught in a mistake AND wetting yourself would be traumatizing for a child who loved school and was sure she would never have to “flip a card.”  And in the first week!

My thoughts are for some scripting around the reality . .  .  . and a little spin.

Sometimes you have to put a new spin on her perceptions.

The next time you bring it up, start with, “I am so thankful this happened.”  (huh!)  “No one gets through life without making a mistake and most of us make lots of them, it is good to get some practice with them.  I am so glad it was a 1st grade mistake and not a teenager mistake.  Those are bigger and harder to fix.  This one was easy.  You apologized and it is done. You handled it very maturely.”

Keep a matter-of-fact tone for yourself

As upset as Abby is, if you match Abby for gravity of the situation, she may think it really is as serious as she is making it out to be. Model that this was a small mistake.  They happen every day.

The two spins are:

  • I am glad it happened – For a child who has made a (in her eyes, terrible and unforgiveable) mistake, how can anyone be GLAD it happened?  But as we all know, mistakes will happen and we need practice with picking ourselves up, dusting ourselves off, and moving on.  Spin it as something as important as good grades (because it is).
  • You handled it very maturely – Well, there was that wetting accident and multiple bouts of hysterical crying, but there was also an apology in writing.  That was the mature thing for a six-year-old to do in the midst of being a very upset little girl.  Not many of us think to make amends when that upset.

(Just to note, this spin does not downplay the feelings, the spin is to give additional perspective to the event.   The additional perspective will hopefully help reset the feelings.)

And Use YOUR Mistakes!

The Queen (my daughter) was very intense with her emotions and was pretty famous/infamous at school for her breakdowns after any perceived mistakes.  One thing that helped her was hearing about the mistakes I had made.  “Do you want to hear the 5 mistakes I have made today alone?”  The answer was always a breathless, “YES!”  I also covered the WORST mistakes I ever made (keep to your G-rated ones if you go there with smaller children).  The Queen particularly likes the story of the time I called my mother stupid IN FRONT OF HER FRIENDS. My mother was not amused and let me know it.  My horror and embarrassment were immediate and epic.  The Queen was re-assured that I had survived my own feelings.  I had to tell that story every time she made a mistake for several years.  It got old, but it worked for her.  “Tell me about the time you called your mother stupid.”  Since I had survived that, she could survive whatever mistake she had made. (By the way, my mother, as the Queen knows, is a wonderful person who did not deserve my 12-year-old impulsive flippancy in front of her friends).

Plan for the Next Mistake

After mistakes are shared, parents can also discuss the inevitability of the next mistakes. “What do you think your next mistake will be?”  “I wonder what my next mistake will be?”  “I have got some guesses already.”  We all have stuff in our day that can go south on us due to lack of planning, putting too much on the plate, or just getting tired and irritable.  Include our funny mistakes.  Our mistakes are easy to come by.  Then we discuss solutions, but often, it is just moving on.

Other Supports

Abby seems to have really tipped herself over with this.  I told her mother to consider providing more support if possible for a little bit:

  • Joining her for part of 3rd recess by adding some mommy time in the day with a little volunteer time if possible.
  • I recommended Lilly’s Purple Plastic Purse by Kevin Henkes.  It is a similar story of a big mistake made by a little person, complete with notes of apology as well.
  • For supplements, Epsom Salt baths which helps us absorb magnesium might be of some benefit. Magnesium is calming and is depleted in times of stress.  There is also Rescue Remedy, a Bach flower remedy, which is to calm stress reactions.  These strategies may help a little. Being a psychologist, I typically recommend that parents run any supplements past their pediatrician.

Taking Support to the Next Level

I told Abby’s mom if things did not settle in the next few days, check in with the school social worker or psychologist for strategies.  If that does not help, some short-term counseling might be needed.  A good child therapist can help build emotion regulation skills.

Epilogue

A few days later, I heard from Abby’s mom.  “Hi! I just wanted to give you a quick update. I tried almost everything you recommended and she has been tear free for two days. Will continue the coping strategies. Great to have my happy girl back! Thank you so, so much.”

I glad it was good advice, but I am sure time helped a little too. However, with an intense (albeit adorable) child, there will be years of practice off and on down the road.

Putting a good spin on something is just one strategy, but an important one, when building emotion regulation.  The right “spin” on things can help her move forward more quickly.

Your Child’s Diagnosis-or Not

I don’t diagnose.  I mean . .  . I CAN diagnose, but I often don’t.  I am a developmental neuropsychologist and I do reassure parents that I can diagnose any possible learning disability.  But frankly, it’s not the point of my evaluation.  I don’t see my evaluations as diagnostic evaluations, but as comprehensive developmental evaluations with a good dash of neuropsychology.

What’s the difference?

Many evaluations in my field are diagnostic evaluations.  The goal of the evaluation is to converge on a diagnosis (or several) from the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (the DSM-5 for short).  This is the manual psychiatrists and psychologists use to make mental health diagnoses, including developmental and learning disabilities.  It is bible-sized, about as dense, and a little dry.

The DSM gets updated every decade or so.  Some diagnoses are removed, some are added, some are refined and made clearer (some are made muddier).  Our understanding of mental health, cognitive issues, developmental problems and learning challenges continues to evolve at a bumpy, uneven pace.   The DSM tries to keep up.

And this is one reason why I do not focus my evaluation on a DSM diagnosis.  I like the DSM. I own it.  I pull it off the shelf regularly.  I will make a formal diagnosis from the DSM-5 when it is necessary and/or when it is helpful.  (It is necessary for college and, sometimes, other school accommodations.  It is necessary for insurance submissions. It is necessary to enter certain treatment programs.)  And sometimes it is helpful. Sometimes the child is a perfect fit for the diagnosis (or diagnoses) and the treatment protocol.  Giving the diagnosis will help everyone support the child through well-studied and accepted protocols.

But frankly, there are just not that many diagnoses to choose from.  Developmental and learning disorders are categorized as Neurodevelopmental Disorders.  You get six basic choices – Intellectual Disability, Communication Disorders, Autism Spectrum Disorder, Attention Deficit/Hyperactivity Disorder, Specific Learning Disability, and Motor Disorders. There are more specific subcategories within these labels. There is also a category that is basically “Other” in case nothing else fits.

A child (or teen) can also be diagnosed with a mood disorder (depression, bipolar disorder), anxiety disorder, oppositional defiant disorder, attachment disorder or other more typically “mental health” disorder, but these are in other sections of the DSM.  I typically roam around in the Neurodevelopmental section with occasional forays to the other areas.

But, you ask, why do I resist making a diagnosis?

Here are a few of my problems with simply converging on a diagnosis:

  1. There is the use of the words “Disorder” and “Disability.”  Some of the challenges I see are not a great fit for certain classrooms, but do I consider this a “disorder.”  Maybe it is just a type of normal. For example, we love (and often envy) highly energetic adults, but we are not as thrilled with highly energetic children.  However what may be a drawback now, may be an asset later.  I discuss this with parents and we make a decision to either make a diagnosis (because it does fit well enough and would be useful in some way) or describe the child’s strengths and weaknesses (or both).  The recommendations will likely be the same either way because those are based on lots of other data collected, not just the diagnosis.
  2. There are only 6 general categories. Sometimes I think we are too narrowly defining our range of possibilities for the billions of people (and their styles) on this earth.  Even using more than one category may not fully describe the child I evaluated.  In addition, I really want to paint a picture of this child, not converge on diagnoses.
  3. Not all of my preferred options are in there. Sensory Processing Disorder (or atypical sensory processing) being a good example. That diagnosis was proposed (strongly) for inclusion in the DSM-5, but it did not make the cut.  Sometimes, sensory issues are a leading contributor to attention problems in the child I evaluated.  So if a diagnosis is necessary, I have to make an AD/HD diagnosis (or Oppositional Defiant Disorder or Intermittent Explosive Disorder or something that fits) with an added explanation of the factors causing the problems.  Sometimes I don’t make the DSM diagnosis and focus on what I think it actually going on.  I feel like the diagnosis will actually be misleading.
  4. The diagnosis might become a label. If you lead with the diagnosis – Autism, Attention Deficit Disorder, Intellectual Disability – people may only see the label, not the child.  They may form a mental bias based on the label and not expect a child to be able to learn or change because they do not see a certain skill as within the scope of that label.
  5. The DSM diagnoses still do not connect brain to body very well. It tries to and does discuss various medical factors that may contribute to some diagnoses.  But sometimes there is a diagnosis, such as Oppositional Defiant Disorder, that totally fails to take into account sensory or other physiological factors that take a part in the presentation.

I have reviewed several evaluations lately that collected a lot of information and converged neatly onto a diagnosis.  The diagnosis was justified by the outward presentation of the child and the scores obtained on tests.  In fact, it was the only diagnosis in the DSM-5 that would have fit.  But the diagnosis was not helpful.  The diagnosis did not drive treatment in a way that supported the child.  It was necessary to dig under that diagnosis and find the contributing factors that led to that diagnosis.  Treating or supporting those factors were helpful to the child.

So yes, I can make a diagnosis and I will when it is needed.  But I will also continue to see evaluations as an art, as well as a science.  I want my work to be more than industry standards.  I want to paint a helpful picture.  I want to try to get to the bottom of things.

Writing Disabilities and Dysgraphia-Getting Thoughts onto Paper

It starts with a call from a parent

Here is one of my more common conversations with parents who are calling about a possible evaluation of their child’s academic needs –

A mother (90% of the time, it is the mother who contacts me) on phone, “It is about my son (99% of the time, this particular issue is in a boy).  He seems very bright, but . . .”

I fill in with, “he is having trouble getting his thoughts on paper.”

There is a slight pause, and then the mother says, “How did you know?”

Bright (highly intelligent, gifted and talented) boys and handwriting challenges seem to go together like bread and butter, salt and pepper, picnics and ants.  Maybe the latter is the best comparison.  Things seem sooooo good.  This child loves learning.  His intellectual curiousity is endless.  He seems to absorb information as he breathes.  (The parent at this point is saying, “Yes, yes, you must have met him.”)

But writing is not about what information the child is taking in, it is about the information he is putting out onto the paper.  And his head is moving at 90 miles an hour, buzzing with facts, ideas, hypotheses, and opinions, BUT his hand, his poor hand, is only moving at 5 miles an hour.  Just think about how frustrating that must be.  The mismatch is a recipe for failure.

Writing demands come early

The demands for good writing come early in the educational process now.  Fifty years ago, a young child focused on letter formation, penmanship and spelling in the early grades.  Paragraph writing did not come until higher grades.  But now, a child in kindergarten will be expected to learn to write a sentence.  A first grader may be expected to write a story.

I remember when my daughter (the Queen) was in first grade.  She came home with a writing prompt.  The page had a picture of a girl holding a box with a bow on it.  The prompt said to write a story about what’s in the box.  A STORY?!?  The Queen was still inverting letters and struggled to spell most words.  She could not write a sentence with any ease, much less a story.  Undeterred, she smiled with excitement, “I’m gonna write a chapter book!”  Great, there were going to be tears too.  Within a minute came the first shout from the kitchen table, “HOW DO YOU SPELL ‘CHAPTER 1’?”  It was going to be a long night.  The tears came by Chapter 2.  In case you need to know, there were bugs and spiders in the box.  It was a very dramatic story. . . and short.

Why do we do this to little children?  Making them write beyond their capacity does not make them better writers.  And I don’t blame teachers.  They are just trying to hit the standards set before them.   But here we are with heavy writing demands for little hands that are not yet neurologically ready to hold and manage a pencil.  This is particularly true for little boys who tend to develop fine motor in their finger tips at a slower rate than girls.

It starts with the pencil grip

If the little fingers do not have good wiring to “feel” the pencil, then little hands try to compensate. This is why you will get the “thumb overlap” pencil grip where the thumb overlaps the pointer finger.  The poor kid is pressing his thumb against his forefinger so he can feel the pencil.  In fact, you get a lot of funky pencil grips in kids who are pushed to writing too early without proper foundation.  That foundation would be a slower start for writing and more work on basic grip and penmanship.    For many, this lag in development becomes a permanent roadblock.

And we also have to consider those children who have fine motor weaknesses that are more than just a lag and mismatch.  It does not matter how patient and individualized you are in your teaching, some children will not have good fine motor control for writing.

Poor pencil grips are tiring

 

 

Some are too tight, some too awkward, some require moving the entire hand to write, not just the fingers.

A lot of you are probably sighing, “Well, it is too late now.  He is twelve and his pencil grip is not great and his writing is worse and his resistance is becoming legendary.”  The “reluctant reader” is nothing compared to the “resistant writer.”

So how do we build skills and when do we accommodate?

First, I should mention, if a child’s writing ability is well below his intelligence (and educational exposure), he can be diagnosed with dysgraphia (a writing disability).  If you think your child’s writing meets that criteria, then seek an evaluation (through your school district or privately).  From there, a formal plan can be developed with the school, either through an Individual Education Plan or a 504 Plan.

Whether your child is simply a “resistant writer” because it feels slow and cumbersome or he actually meets criteria for a writing disability, there are things to be done.

  • Occupational therapy can be done to improve fine visual motor skills. Many OT’s can specifically help with handwriting.

 

  • Help your child develop proficiency with computer keyboarding (“typing” for the old school folks). Good typing skills have become so important in this technological age that we are sacrificing cursive handwriting for it.  As a child continues through school, such skills will prove invaluable.  He can take advantage of spell checking programs, he can easily go back to correct errors, and it will circumvent any persistent handwriting difficulties.  Many typing tutor software programs are available.

 

  • As any resistant writer will tell you, thinking and writing are two very different things (yet we require kids to do both at once). Many a tired child will ask a (tired) parent, “Can’t I just TELL you what I know?”  For the child who struggles with the inconsistency between his fast mind and his slower handwriting, his parents (and teachers) might want to consider dictation.   The child can dictate his key ideas to an adult for a paper. Sticky notes can be used to jot down his thoughts, and then they can be re-arranged in a “storyboard” format.  He can then use this “outline” to develop his paragraph or essay.  This helps a child separate his quick thinking from slower writing.  Once the thoughts are out of his head, he can also walk away from the task for a break without his ideas getting away. This strategy will also build a mental habit of thinking through his thoughts before he begins to write.  Do not expect a child to do his own outline because he cannot write fast enough.  That is a skill for another day when he is older (hopefully by college).

 

  • Parents and children can experiment with voice recognition software. This will allow students to dictate directly to the computer.  Writing papers this way is still a skill to be learned.  Don’t expect this to be a miracle cure-all, but it could definitely have its place for some kids.  Teachers may know some programs that are being used in their school for this.

 

  • Kids should also be instructed in simple recipes for writing. For example, for book reports, a child may need a basic format in which he will address 3-4 questions, such as 1)  Name the book and the author, 2)  Tell what the book was about,  3)  Tell about your favorite part of the book, and 4)  Comment on whether you would recommend this book to someone.  He should use this format repeatedly.  A new step or question can be added with each grade level he reaches.   I remind kids and parents that this is how journalists write.  They do not invent writing every time they put pen to paper.  They are trained in formats and rubrics for different situations.  Ask the teacher for some recommendations.

 

  • In a pinch (which happens more often than not on tired evenings), just scribe for your child.  The child dictates his thoughts and you write them down.  No note taking or outline or key phrases, just take the dictation in its entirety and be done. Let the teacher know that this is how you will be approaching writing for most homework (if you suspect that will be the case). For the very writing impaired, this may be an ongoing need.  I know a young man who had a scribe for an academic accommodation all the way into graduate school.  (He was getting his MBA using both a reader and a scribe for severe dyslexia and dysgraphia.)

And while the ability to write is being built, we can provide some additional accommodations.

With the dawn of the printing press and wide spread literacy, we became a world where we read to learn and write to show that learning.  While those habits are well-ingrained, we can also start to think outside of them.  Kids with reading disabilities can use audio-books and videos to acquire learning.  Kids with writing disabilities can show knowledge in other ways as well.

Unless learning to write is the goal of the task, it is okay to go around writing demands instead of trying to plow (suffer) through them.

  • Try alternative test formats instead of essay tests to collect knowledge. Fill-in-the-blank, multiple choice and oral testing are all other possible methods.

 

  • Oral presentations can be used in lieu of written papers. Some kids can do a great job just telling the teacher or class about what they know.  And oral presentations are an important skill too.

 

  • Let a child do a project using another strength, such as music, engineering or art, to show knowledge of a subject. I love the project where a child reads a book then, instead of writing a book report, develops a playlist of songs that go with the book.  (I do not have the skills to do this as I seem to be musically impaired, but it is a great project for some kids.)

 

We push writing early and hard right now.  But bright (highly intelligent, gifted and talented) children can have asynchronous development.  Some skills are surging forward and others are dragging behind.   Nowhere can this be more apparent than in the discrepancy between a child’s cognitive ability and his fine motor ability.  Know this, then find other ways to express knowledge while letting the hand mature into a support for the mind.

Good tripod grip, lovely penmanship, and a teenage boy at that. (It IS possible)

Spelling Skills, Spelling Disability, Spelling Accommodations

We are in a new age for spelling.  A hundred years ago (or even 50) spelling was important.  Everyone wrote by hand and some had typewriters.  Spelling was up to the writer and poor spelling was a sign that you were sloppy or maybe not very literate.  Learning disabilities were unknown or poorly understood.  As with any learning disability,  poor spellers were likely punished for their weakness and left feeling stupid.

A Newer Age

Enter a newer age, where we can fully realize that poor spellers are not illiterate, lazy or unintelligent.  They just lack a specific ability (and remember, we all have a weakness of our own somewhere).  So with the recognition of spelling or writing disabilities came accommodations.  Poor spellers were given modified spelling tests and they were not penalized for spelling errors.  And spelling devices were invented.  Suddenly, there were devices like the Franklin Speller where a poor speller could type in a word and the device would list several correct words that the writer might be trying to spell.

That sounds downright cumbersome now.

Because now, we are in the next age.  Kids are taught to type earlier and earlier (at the expense of good handwriting, but that is another blog entry).  The computer (or Smartphone or word processor) has spell checking programs and auto correct.  These programs aren’t perfect, but they are pretty good.  Yes, a poor speller can absolutely challenge the spell checking program.  And yes, auto correct fails are not uncommon and can often be either hilarious or embarrassing.  But they do help tremendously.  I am impressed with how easily even young children can highlight a mis-spelled word, hit a drop down menu, and pick what they need.

So do we care about spelling?

Yes, we do care.  We are still reading and writing to communicate and will likely continue to do so more and more (even if it is by electronic writing and not on paper). Good basic spelling will be needed.  However there will still be kids (and adults) who are poor spellers.  So how do we spot them and what can we do to help?

Who has weaknesses in spelling?

  • People with dyslexia. Dyslexia is a weakness in phonological processing.  The person has difficulty hearing the individual sounds in words, so struggles to learn to sound out words for reading and spelling.  Even with good reading remediation, spelling often remains a weakness.  I tell people that, at least with reading a word, all the letters are in front of you to see.  When spelling, the dyslexia person has to look inside their head to see if they can find all the sounds. It’s hard.
  • People with visual processing weaknesses. For people who have trouble with visual scanning or visual convergence or people who have atypical visual processing such that letters seem to waiver, move, and even disappear (special shout out to people with Irlen Syndrome), spelling remains one challenge among others in the reading and writing domain.  There are so many demands on their plate when writing that spelling is at risk at all times.
  • People with Attention Deficit Disorder. Weak attention during early grades may cause them to miss spelling patterns as they are taught.  Weak attention in higher grades means there is only so much “band width” when writing.  Spelling may need to be sacrificed for getting good thoughts on paper.  When weighing good thoughts against good spelling, I will take the good thoughts.
  • People with Executive Function weakness. Very similar to attention deficit disorder, but the problem is not in basic attention.  Even when “paying attention,” they may miss important spelling patterns.  Some kids with EF are just not good with patterns.  And again, in higher grades, they may sacrifice spelling for other writing demands.
  • Visual Motor Weaknesses. Often typing can relieve some of the visual motor demand of handwriting, but typing is still a visual motor demand.  Any hand writing or typed work may include spelling errors.
  • Other stuff. Because the brain is big and complex, so there is always something else that can crop up and trash spelling.

  What to do about spelling weaknesses:

  • Remediation
    • Remediation with many of the programs for reading disabilities can help with the phonological skills needed for spelling, but do not expect spelling issues to fully resolve even if reading seems to.  Remediation should aim for consistent spelling of high frequency words.
    • I do think handwriting words builds a better motor memory for the word than typing it (though handwriting the words may be ineffective for kids with significant visual motor weaknesses).
  • Accommodations-Make sure your child’s weakness is identified and given accommodation at school.
    • A child can be given modified spelling lists that focus in high frequency words
    • A child should not be penalized for spelling errors outside of the modified spelling list (and even that should be open to negotiation). A student with a spelling disability should be able to focus on their thoughts and organizing them on paper without having to worry about spelling
    • A student can be given a list of high frequency words for a particular unit or subject matter when testing, so that they can copy the word out accurately for tests or essays.
    • A student can be given access to technology at allows them to compensate for the spelling weakness.
  • TECHNOLOGY!!! (Our new best friend)
    • Word processing, keyboarding, typing. Whatever you want to call it, have a child start gaining proficiency in it early. They will need to use spell-checker programs and auto-correct.  Hopefully, they have enough reading/spelling remediation to enable them to recognize errors due to synonyms or other similarities (e.g., “quiet” spelled “quite”).
    • Voice Recognition software. Some students and teachers are moving more quickly to dictation software that allows students to dictate their thoughts to the computer for written work.  Writing a paper this way is a skill unto itself, but probably a more reasonable skill for some kids than writing or even typing.

Emphasize Strengths Over Weaknesses

I remember reading an essay by John Irving, the author of The World According to Garp and A Prayer for Owen Meany.  John Irving was a poor student and a terrible speller.  He grew up in a time and in a private school where poor spelling was a sign of many things, none of them good.  He hung in there to write incredible novels where his genius could shine through.  I wonder if any of his teachers saw that coming. Don’t let poor spelling block a child’s other strengths (whatever they may be).  Those strengths will be their future.

(On a side note, my teenager does not think she needs to learn to drive because self-driving cars will be hitting the streets in a few years.  I wonder how many critical life skills will be obsolete in a few years and what new critical life skills will take their place?)

Reading for PLEASURE! Encouraging the reluctant reader

 

Summer reading – It’s the thing.  For some of us, it is the highlight of summer. And for some of our kids, it is (one of) the highlights of their summer.  And we love that because we know it is making them smarter while they are having some much-coveted down-time.  But so many kids are “reluctant readers.”  And “reluctant” can be an under-statement.  Some kids hate reading (but really, they just think they do).

I was not that child.  I loved reading. I mean LOVED IT!  I loved the summer reading program at the library.  I would max out the prizes in one week.  I read the 3 books that I could check out, then read the books that each of my siblings checked out, then I walked down to the neighbors (who also had five kids) and read every book there.  I did that each week all summer.  HEA—VEN—LY!!! As a parent, I couldn’t wait to share this world with my child.  But, as fates would have it, I got a reluctant reader.  So many of us do.

So what to do about the Reluctant Reader?

So you have a child who does not like to read (due to reading disability or simply because they have not found the pleasure in it). It happens.  My parents only got one avid reader out of the five kids.  (Three out of the four read more as adults, but I have a brother who says, “Nah, I don’t even text.”)   My mother kept promoting it all those years.  She loved reading, so modeled it pretty well (for a busy mother of five).  She converted the shed into a children’s library.  Any kid on the block could come hang out to read. She read to us and also had the babysitter read to us.  She kept promoting it without forcing it.   Progress was made (in small, hard-won increments).

As I began to parent, I certainly wanted my child to love books the way I did.  Fingers crossed.  And my daughter (referred to as the Queen because she skipped the princess stage altogether) did (sort of) love books.  She was very visual and loved detailed images.  She was engrossed with picture books from babyhood.  She liked to be read to.  She could recognize all of her letters before she was two (this took me by surprise as I was not teaching them, but we did read alphabet books).

The early signs were good

Things looked good, but alas no.  The Queen summed it up perfectly when she was about five years old.  I was reading a book to her that she seemed to find thoroughly interesting.  At the end, she turned to me and said in all seriousness, “Why am I not published yet.”  The Queen was a creator.  The creative works of others only primed her own creative juices.  Why should she be reading when someone could be reading a book by her?

And so began my struggle of how to encourage the reluctant reader.  For all her early prowess with letter recognition, reading words and text emerged slowly.  The Queen was never behind in reading, but she was never ahead either. And since she was a Queen, I could not actually order her to do anything.  Well, I could try to order her to read, but her exasperated look and half-hearted attempt did not really accomplish anything.

Stealth Parenting

SO, based on my experiences, I would encourage the stealth approach for parents of reluctant readers.   (These tips will help for kids with reading disabilities, but I will have another blog entry with more specific recommendations about those specific challenges)

First, and most important – You will not win if you force the reluctant reader to read.  This will make reading a chore . . . work . . . drudgery. “My mom MAKES ME READ!”  Remember, reading for pleasure must be pleasurable, so find any literature that is appealing. Look for books of high interest.  This means of high interest to the child, not you.  Do some “stealth parenting.”

  • Libraries are a great start for exploring this. There are a lot of books to look through and, unlike a bookstore, you can sample a huge range of literature without breaking the bank. And trust me, it can take a lot of sampling before some kids find what they like. Just hang out on a Saturday morning and let your child explore.  Don’t place limits.  They may pick books that seem too young for them (they can be independent with that book) or too old for them (you can read it to them).  It may turn out that they love the subject matter.  Now you have a clue about what may engage them.  You can look for more age-appropriate books from there.

 

  • Don’t overlook magazines. Short text with lots of picture support can be really appealing.  National Geographic Kids, Time for Kids, Sports Illustrated Kids – there are many mainstream magazines scaled for kids.  Make these available. Don’t require reading, but do point out interesting articles.  The regular National Geographic (or any magazine) may also be appealing if the photography is great. If your child has a particular interest, go to a really good bookstore.  The specialty magazine selection is outstanding.  There may be a skateboarding magazine that rocks his world and makes him dream big.  It is okay if he only looks at the pictures.  Eventually, there will be some picture that intrigues him enough to check the text.  If your child cannot read it on his own, read it to them.

 

  • And don’t overlook comic books. Comics are great for the reluctant reader.  The storyline is short with lots of picture support.  And if you check out the text, you will find it is not overly simplistic.  Comics, like The Far Side, can have hilarious sophistication when making fun of scientific and cultural norms.  Captain Underpants can hit an irreverent tone that brings many a child glee.  If your kid laughs or rushes to show you a really funny part, you have found the elusive “reading for pleasure” zone.  You can build from there.
She fell asleep reading a (comic) book. I wish the bedding matched.
  • It is important to make a reading area at home.  Have a reading area with boxes or baskets full of library books, books you own, magazines and any other reading material (including books or magazines you are reading).

 

  • Make your own books. If you have a creative child who would rather do something rather than sit and read, then have her create the summer scrapbook.  Each day (or a few days a week) have your child make a drawing about some summer adventure.  Either one of you can add the text.  Put these in a binder and read through it throughout the summer and again at the end.  If your child cannot draw well enough to suit their own standards, have them make collages from magazine pictures and photos.

 

  • Model reading as pleasure.  Make a time daily (or at least 3-4 days a week) when everyone sits down to read.  Everyone is allowed to read or look at any literature of their choosing (make sure it is print material for the reluctant reader as online reading is not quite the same and distractions are very accessible).  If you have a child who refuses to read at this time, ask them to work on the scrapbook (“That would be a really big help for me because I really want us to have those memories”). Be sure to provide good magazines for finding the best pictures for the scrapbook. (Stealthy, huh.)

Success (of sorts)

These are the strategies I refined over the years with the Queen.  AND SHE BECAME AN AVID READER WHO DEVOURS NOVELS LIKE CANDY!!!  Okay, no, that did not happen.  She has never even read Harry Potter though they all sit on a shelf awaiting her (or maybe a grandchild?).  However, she did become a reader.  She became someone with favorite books and favorite topics.  Like me, she loves comics.  She loves The Far Side, Calvin and Hobbes, and Zits.  She liked non-fiction stories of kids who overcame difficulties (notice the past tense there).  She likes the sciences and loves aerospace and astrophysics.  By 5th grade, she would peruse college-level literature in those areas.  She wasn’t (and largely still isn’t) a front to back reader.  She reads parts of books based on interests and mood, but she always has something she is interested in. She reads daily.  I will take that.

She reads her phone just fine

 

 

And she published her first book this year. Here it is on Amazon if that works better for you.

Homework

I like the teacher who gives you something to take home and think about besides homework.-Lily Tomlin

Labor Day is over, so just about anyone going back to school is now there. And where there is school, there is usually homework.  Although research is not clear on the benefits of homework, about 70% of teachers assign homework.  So it’s probably coming your child’s way.  I, for one, do believe in the value of some homework, even if simply to introduce the idea that some things done in the classroom might have value outside of the classroom.  Let’s face it; it’s useful to know how to work with fractions in daily living, not to mention basic reading and writing.  Kids might as well be helped to learn to use those skills outside of the supervised classroom.  Plus, why are we teaching civics, history, social studies and literature if we do not care whether kids learn to be thinking members of society.  And finally, there will be homework in college, so if you are planning on your kids going to college (and graduating), they should be able to handle some homework.

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August 2014 News about kids, ADHD and the classroom

Just a quick entry.  It is back to school and exciting for most.  For some parents, it is a time of anxiety because for some kids, it is an acute loss of freedom of movement that they desperately need.  As school starts, lets remember that movement is great and classroom structure is supportive.

Here is a reminder that exercise may be critical for kids with ADHD (adults too).

And because exercise won’t be enough,  here are some classroom strategies for helping kids with ADHD.

 

Back-to-School Knots

I was, on the whole, considerably discouraged by my school days. It was not pleasant to feel oneself so completely outclassed and left behind at the beginning of the race.  Winston Churchill

Yeay! It’s back-to-school time!

Back to a schedule. Back to knowing where your kids are for most of the day.  Back to a modicum of predictability (till someone throws up).  We see all the happy mommies and daddies ushering their kids onto the playground, finding their new teacher, helping haul in the school supplies.  It’s all happy.

But not really.

There are parents trying to smile, but their stomachs are in knots.  They know from experience (last year or for multiple years) that all is not happy.  They want it to be happy.  They want to be there smiling and excited like the other parents.  They are putting on a brave face for their kids. Best foot forward, hope for the best, this year will be different . . . please.

Continue reading “Back-to-School Knots”