Following a post on “Spanking, how to do without?”, A mother of a child with AD / HD told me about her suffering: how to best support a child with AD / HD? I am not specialized in this cognitive disorder. Still, I learned a lot in the context of my professional activities, and I can attest to the approach I adopted with a child with ADD (without hyperactivity) that I accompany in his learning. School.
His mother has put in place several tools to ensure a firm and benevolent framework:
- routines (in the form of photos/pictograms of the gestures to be made for each highlight of the day),
- words about emotions (this 7-year-old can tell when he goes from green to orange, even to read, and he warns us to give us time to take a break),
- yes to emotions and no to behavior ( you have the right to be angry but not to hit, I will never let you hit or insult me )
- rehabilitation of attention through games and activities (Chenelière editions offer complete things although a little expensive).
This child was dropped out of school because school generated too much suffering, and he is now educated as a family. I intervene a few hours a week for fundamental learning, and he is in informal/autonomous learning the rest of the time. Being able to follow one’s passions and interests has helped to regulate his oppositional disturbances. He will go to a Montessori school next year. I do not claim that this solution is a model to follow at all costs. Still, I wanted to testify to expose the difficulties faced by parents of children with AD / HD (often singled out for their lack of firmness or then misunderstood in their daily difficulties) and possible solutions.
What is AD / HD?
An attempt at definition
In this paper, we read that the deficit attention disorder with or without hyperactivity (ADD / ADHD) is a neurobiological disorder that can cause attention problems, hyperactivity, or impulsivity and be accompanied by several related difficulties, inappropriate taking into account the age (troubles of locating in time, sleep disorders, difficulty in organizing data, mood disorders, oppositional disorders…).
AD / HD is not a disease in itself; it is a neurobiological disorder characterized by differences in the brain’s functioning that influence behavior and emotions.
It appears that AD / HD is overdiagnosed in some areas but underdiagnosed in many others. There would be a few areas where this diagnosis is made in an unusually large number of children. Still, there is also a large number where doctors do not have the expertise to properly diagnose this disorder.
ADHD is not a personal opinion but a medical diagnosis defined by clear symptoms and solid research results.
Characteristics of ADHD
Many characteristics can indicate the presence of AD / HD. There are several different symptoms. In some patients, there may be few symptoms; in others, many symptoms. In general, these characteristics are grouped into the following general categories:
- inattention,
- hyperactivity,
- impulsiveness,
- socio-emotional disorders (changing mood, high susceptibility, sensitivity, frequent sensory disturbances),
- and executive functions.
As time goes on, we will find that many of the features or signs of AD / HD are present in most of us at certain times and under certain circumstances. Diagnosis involves gathering information to determine the intensity, duration, and severity of symptoms and their negative impact on a person’s life.
A diagnosis of ADD / HD is only made after a thorough workup carried out by a professional (generally a neuro pediatrician) and is considered valid after five years.
A child with AD / HD is rarely an isolated disorder: in almost one in two cases, other disorders are associated with AD / HD in more than half of the cases (source: Jeanne Siaud Faccin, 2015). The disorders that most often accompany AD / HD in children and adolescents are learning disabilities (dyspraxia, dyslexia, etc.), behavioral disorders (oppositional disorders, provocation, conduct disorders), depression (in approximately one in three children with AD / HD), anxiety (in 25% to 50% of cases according to Jeanne Siaud-Facchin).
What priority should arrangements be made at home and school for children with AD / HD?
Support for neurodevelopmental disorders (ADHD and “dys”) includes four main areas :
1. Above all, take charge of the aggravating factors: sleep disorders, poor lifestyle (diet, sport) can increase a neurodevelopmental disorder. Regarding AD / HD, sleep disorders can even be a differential diagnosis. Everyone knows that their attention drops when they lack sleep and that this lack can also induce irritability and nervousness accompanied by some restlessness. Thus, initially, it is a question of evaluating the sleep and hygiene of these children’s life.
2. Next, it is about helping the child to ” compensate” for his difficulties . In the case of ADHD, it is a question of setting up routines and rituals with him to allow him to avoid forgetting; it is about helping him become aware of his “attention span” (time during which he can stay focused) and teaching him to take short breaks when doing his homework; it is a question of setting up with him an environment favorable to concentration, without “distractors” (not to install his office in front of a window, to avoid the collection of posters in front of the office…).
3. The third axis is the taking into account the functioning of the child in his mode of learning. For many children with AD / HD, hyperactivity helps stimulate cerebral wakefulness and compensate for lack of attentional control. Thus, some of these children concentrate better when they are in motion (wriggle in their chair, learn while walking, etc.). It also needs to protect his need for quiet in the classroom (respect the need when he is standing or moving rather than in a seated position); however, it is not always possible to do this when others occupy space. But we can offer in class cushions (see on the Hop toys site ) that allow the student to move while reducing the noise-induced (chair squeaking).
4. The fourth axis is the prevention/management of complications of the disorder: performance anxiety, demotivation, and secondary school dropout, learning difficulties and repeated failures in schooling, risk-taking, and consumption of toxic products in adolescence. It is essential to listen to the child and get him to verbalize his disappointments and suffering. It is also crucial to value their efforts; these children are often criticized and accused of “lazy”, “bad students”, while these are children who HAVE made efforts but who were discouraged with it. Time.
These four main areas of support are valid at school and home.
The consequences on family life: how to help the child suffering from AD / HD (and his parents)?
Daily :
– Explain the disorder and its consequences to the child: some of his acts are not the expression of ill will but the unintended consequences of his disorder; other children are affected by the same disorder as him, and that is will lessen with age
– Talking about the disorder in the family (brothers and sisters, entourage …)
– One locker at a time
-Train the child in the form of a stop-think-go: first, I stop, I stop, then I think, and only after, I act. According to Jeanne Siaud Facchin, the idea is to set up a new automatism in the form of a game.
– Feedback on the immediate experience using a code (word or gesture): the adults and the child agree on a sign that will alert the child during inappropriate behavior. The intention is to help the child become aware of what is happening, encouraging him to readjust immediately when it happens.
– Compensate for deficits: adapt the environment to give it the possibility of moving without disturbing others (this can be a small indoor trampoline in the bedroom, fidgets as offered by the Hop toys site, a punching bag, etc.), put in place of routines thanks to pictograms …)
– Encourage appropriate behaviors and the little things that make everyday life easier through positive reinforcement
– An emotional education work (see ideas here or here, books that can be used as supports)
– Mindfulness: numerous studies validate the benefits of mindfulness on attentional capacities and motor agitation. Regularly practicing mindfulness meditation can give children with AD / HD access to all their resources.
– Re-education of attention (in a professional setting or not): this can involve games of differences to be found or any game that requires attention to detail (finding a character similar to another, finding the right one shadow of an object among several proposals …)
Regarding school work:
– Teach the child to organize and ritualize himself: prepare his schoolbag in the evening with a checklist.
-Organize a work environment conducive to concentration without “distractors”: the desk should not be facing a window or a myriad of photos/posters, the bedroom door rather closed when working.
-Allow the child to learn his lessons while standing or walking if that helps (agitation stimulates “cerebral awakening” and promotes concentration).
-Monitor your lifestyle :
- several studies show the positive impact of regular physical activity on memory and concentration.
- Encourage the child to eat omega 3, recognized as having a positive impact on impulsivity (they are found in particular in fatty fish).
- Avoid screens at night because they interfere with falling asleep (the blue light from screens is perceived by the brain as daylight and prevents melatonin secretion, which allows you to fall asleep).
-Value your efforts and progress, often encourage (notice what is done correctly)
And many other measures, but here are some examples.
At school: possible arrangements
-Avoid distractions: place the student in the first row, alone or next to a calm student.
– Overcome the difficulty of staying attentive and listening: ask the student to repeat the important information dictated; use visual aids.
-Manage oversights: tolerate oversights, help them organize themselves (set up rituals: at the end of each class, check the contents of their binder, item by item), offer them a “checklist”.
– Satisfy the need to move: allow him to collect copies, erase paintings…. (double interest, enhancing the student in passing).
-Learn him to keep only the minimum on his desk (the kit stays in his bag, for example) to prevent him from scattering or playing with his things.
– Split the work and cut it into short periods
-Give more time for exercises and checks
– Agree on a code system: the teacher makes a sign to bring the child back to what to do.
-Accept the tools/objects that allow the child to manage himself independently ( fidgets, for example)
These measures can be the subject of a PAP ( personalized reception project ), set up by the school doctor and the teaching team. An accompanying person for students with disabilities (AESH) can accompany children with AD / HD following the submission of a file to the MDPH (departmental house for the disabled).
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