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Using Behavior Therapy with the ADHD Child

 

The fundamentals of behavior therapy are easy to understand and implement, even without the help of a therapist. Have you ever given your child a time-out for talking back or a ‘heads-up’ before taking him someplace that is likely to challenge his self-control? Then you already have a sense of how behavior therapy works. The basic idea is to set specific rules governing your child’s behavior (nothing vague or too broad), and to enforce your rules consistently, with positive consequences for following them and negative consequences for infractions. Here are some suggested strategies.

1. Make sure your child understands the rules. Tell a child to “do this” or to “avoid doing that” is not enough to ensure that your child knows the rules clearly. Create lists and post them around the house. Go over the rules to make sure he understands, and review them as necessary.

2. Give clear commands. First, say your child’s name to make sure you have this attention.  Then tell him exactly what you want him to do. If you’re in the checkout line at the grocery store, for instance, you might say, “Steve, stand next to me and don't touch anything.” Finally, state the consequences for disobeying the command---and always follow through.

3. Don’t expect perfection.  Strike a balance between praising your child and offering criticism. A good rule of thumb is to praise your child for doing something well at least five times as often as you criticize bad behavior. You’ll only set your child up for failure if you expect immediate and perfect results. Instead, focus on rewarding small steps---and gradually work your way toward the desired outcome. 

4. Use “when/then” statements to encourage good behavior and reward your child.  If your child asks for permission to do a desirable activity before completing his chores or assignments, say, “Yes, when you finish cleaning the garage, then you can go out with friends.”

5. Set up a point/token system for rewards and consequences. One effective system for encouraging your child to comply with your commands involves a jar and a supply of marbles. Each time your child does what you ask, put a marble in the jar. Each times he doesn’t, take two marbles out of the jar. At the end of the day, he earns a small reward based on the number of marbles that remain in the jar, and then starts over again.

6. Tweak your discipline techniques as your child gets older. Certain measures, including time-outs, may not work as well with tweens and teens as they do with younger kids. If your high-schooler breaks a rule, you might give him a five-minute chore—such as straightening up the family room—rather than a five-minute time-out.  With older children, it’s useful to negotiate the terms and rewards for good behavior. For example, your child may request access to the family car or time spent with friends if he is helpful around the house and does well at school.



Free Behavior and Chore Charts

 


It's Not Defiance--It's ADHD


Is it expecting too much for my child to do as I say?
If you’ve ever caught yourself muttering something like this, consider the skills involved in following directions. Listening, understanding, staying focused on a task—these don’t come easily to kids with ADHD. Your child may be listening to your instructions, only to be distracted by a barking dog outside. If what you’re telling her to do involves several steps, she may remember only one or two.  The specific way in which you give instructions to an ADHDer is a key factor in determining whether she’ll comply. Keep in mind that, even at an age when most youngsters can work independently, children who have ADHD may still need your guidance and support.


SOLUTIONS AT HOME:

Don’t compete with music, video games, or the television when giving instructions.
Turn these off, if necessary, to get your child’s full attention.

Tell your child what to do—and then stop talking.
Many parents continue to explain and elaborate, but this only distracts the child instead of allowing him to comply.

Break complex tasks into small, simple steps.
Give your child a single instruction, and tell her to complete it and report back for another. If the task is an unfamiliar one, demonstrate how it’s done.  When your child becomes adept at following a one-step command (“Turn off the TV”), try her with two steps (“Turn off the TV and put on your pajamas”). Praise her accomplishment, and slowly make your commands more complex.

Create a checklist of daily routines.
Kids with ADHD may need reminders to attend to routine    tasks. A checklist will help your child operate independently. For children who are not yet fluent readers, snap a photo—or draw a picture—to illustrate each step of a regular routine. Getting ready for school, for example, would include pictures of getting dressed, eating breakfast, brushing teeth, and packing a schoolbag. Post the pictures in the proper order to serve as a visual guide.

Make a game out of chores.
Play your child’s favorite song, for instance, and challenge her to put away her toys before it ends.

Inspect your child’s work.
Offer praise when he follows directions or tries his best. Reward deserving efforts with a favorite activity or snack.

If your child gets sidetracked, gently redirect him.
If you asked him to feed the dog but then found him outside playing basketball, say: “Remember, you’re supposed to be feeding Beethoven."

 


 

Autism Spectrum Disorders (ASD)

Therapy Methods

 
 

    Because each individual with ASD is so unique and different, each individual’s therapy plan should be just as specialized.  Common therapies include speech-language therapy, sensory integration, and behavior therapy.  In addition to these therapies, there are a lot of controversial treatments for ASD: each option should be carefully and thoroughly researched before it is begun.  It is important to note that when designing a treatment plan, all therapists work together.

 

Speech-Language Therapy

  • Speech-Language therapy is primarily used to teach conversation skills and improve articulation (say9ing words correctly).
  • Therapy is focused on the pragmatics of language (the social use of language).
  • One of the key aspects of speech therapy is to reward any attempt at communication, which should increase the likelihood of future communication.
  • A child can also be taught other forms of communication such as sign language or picture communication.
  • For the nonverbal child, sign language can be used but can be limited due to difficulty with hand movements and/or imitation skills.

 

Sensory Integration

  • This treatment approach is based on the idea that there are problems with the way an individual processes and organized information from their environment.  This can cause a person to over or under react to sensory stimuli (sounds, pain, light, touch).
  • Individuals can become less sensitive to sensory information through sensory integration.  This allows them to understand information from their environments without feeling overwhelmed.
  • Sensory Integration specifically targets unusual reactions, such as being overly sensitive to touch or under-responsive to pain.  It may also be used to treat children who are overly sensitive to sight, hearing, touch, smell, and tastes.
  • Sensory Integration is usually performed by occupational therapists who design different treatments depending on the particular “sense” that is affected.
  • Sensory Integration is often  used along with other forms of therapy.

 

Intensive Behavior Therapy

  • Behavior therapy is based on the idea that every time a child answers a question or command correctly, they are given a reward.  If the child doesn’t answer correctly, the child is helped to give the correct answer.  For example, a child would be cheered for and given a reward (like an M&M) for the following simple instructions, like to stand up.  If the child does not stand  up, he or she is helped to stand by the therapists.  Punishment is not sued for incorrect answers; more help is offered to the child.
  • All therapists teaching a child use the same language and techniques.  Each skill is taught over and over again until the child has learned that skill.
  • Skills are broken down into their most basic parts in order to make them easier to learn.  For example, you must first teach the command “give” and the picture of an object, like “cat,” before you teach a child to give a picture of a cat.  Once pieces of skills have been learned, they are put together and the child is then taught harder skills.
  • Behavior therapy uses positive reinforcement, which involves verbal praise, physical tough, and rewards (stickers, candy) so that good behaviors will continue to happen while bad behaviors will decrease. Ignoring is used to decrease the chance that a bad behavior will happen again.
  • Therapy has the best results when begun with a child between the ages of 2 and 4 years old, receiving 30 to 40 hours per week of one-on-one therapy. Although this is the ideal situation, behavior therapy has  been shown to help older children and /or children who get fewer therapy hours per week.

 



Early Identification and Treatment of
ADHD * Autism Spectrum Disorders * Speech/Language Disorders

Working together as a team to improve the lives of children in Mississippi

Sponsored in full by The Phil Hardin Foundation