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En español: Educación y Atención Temprana --
Promoviendo Un Comportamiento Positivo:
¿No puedes sentarte
quieto y prestar atención? |
This article originally appeared in the March-April 2008 issue
of the Children's Advocate, published by Action Alliance for Children.
Use the Children's Advocate in your work! Feel free to reprint this article, as a handout or in your own publication -- just credit us (see above) and be sure to send us a copy.
Early Care and Education --
Promoting Positive Behavior
Cant sit still and pay attention?
Kids with attention deficit disorder and hyperactivity can learn to control their impulses—but they need special support
By Cecelia Leong
We needed somebody to help us!” exclaimed teacher Martha Hernandez as she recalled one of the hardest years she ever had teaching at City Terrace School in Los Angeles. The 15-year veteran and her co-teacher were overwhelmed by that year’s Head Start class. In addition to two children with serious mental health problems—schizophrenia and severe autism—two others, “Nick” and “Manuel,” were diagnosed with ADD or ADHD during the year.
At first Nick fidgeted constantly at circle time. Manuel could not keep his attention on anything, even his snack. He would flit from one activity to another and never settle down to play. Neither child could focus on a story long enough to answer simple questions about what happened. In outdoor time they created chaos by grabbing toys or breaking safety rules. Before they got outside support through their parent agency, PACE Los Angeles Head Start, Hernandez says she and her teaching partner “cried like babies” after every class.
Hernandez first called PACE LA’s mental health coordinator, who observed the class and agreed that these children—and their teachers—needed extra help.
Team effort
The Los Angeles Child Guidance Clinic (LACGC), with a grant from First 5, sent in a two-person mental health team. After an in-class assessment and home visits, the LACGC team sat down with Hernandez, her co-teacher, and the parents to make plans. “It’s a team effort,” says Sara Morales, the LACGC behavioral interventionist. “It’s better if parents are on the same page. The child has a greater chance of succeeding.”
Sometimes it was difficult for the parents. Hernandez recalls when one of the boys complained to his mother because he didn’t get a sticker that day. At first Mom sympathized. But then Hernandez explained the situation and asked for her support, “to help your son.” Over time the mother came to appreciate and support the teachers’ approach, later writing Hernandez “a beautiful letter” to thank her.
Opportunities to move
With very active children, says Jocelyn Tucker, who teaches behavior management at UC Riverside, “we need to realize they have to—not just like to—run, jump, move,” and need “music, dancing, lots of (physical activity)—hopping, jumping, running.” Also, she notes, children love to help: “For children who have a reservoir of energy to burn, give them busy work to get the energy out,” like moving heavy books from one side of the room to the other.
Help in focusing
The teachers at PACE LA Head Start tried different ways to help each child focus. They identified each child’s strengths and interests, so they could provide activities the child would want to focus on. The team noticed that Manuel liked farm animals. So Hernandez worked with him one-on-one on activities like painting pictures of cows while other staff worked with the other children. As Manuel got better at concentrating on activities he enjoyed, Hernandez encouraged him to invite other children to help.
Help in sitting still
“For many of our kids who have hyperactivity, something just doesn’t feel right when you’re sitting still,” says Alameda-based educational therapist Dr. Jamie Candelaria-Greene. “Getting up, wiggling a foot, touching things, moving—this is calming for a child with ADHD. They are seeking stimulation from outside to get that ‘just right, feel right’ feeling.”
Morales often gives children like Nick or Manuel a squishy ball to hold and squeeze during circle time. “The ball gives the child the sensation he wants,” she says. “It’s also calming and helps the child focus.”
Step by step
Hernandez was frustrated that Manuel and Nick couldn’t follow directions. After she taught the class how to make a collage, the other children got to work, but Manuel and Nick couldn’t remember how to begin. When children have short attention spans, Morales advises teachers and parents to limit the number of words they use, otherwise the child might be mentally “gone” before you are halfway through your sentence. “Say things like ‘follow me’ and wait to make sure the child actually does it before going on to the next step.” So for both boys, the teachers broke down projects into steps. When the class made a rainbow, the teachers gave directions color by color. When Nick wanted to make a box out of construction paper, Hernandez sat down and showed him one step at a time. “He felt so proud that he began making boxes for all his classmates.”
Rewarding impulse control
To recognize and encourage kids to control their impulsive behavior, Morales and Hernandez used a sticker chart. If Nick shared during outside time, he would get a smiley face sticker. If Manuel met the goal of sitting still for five minutes, he got a sticker. Morales, who uses both positive and negative reinforcement, says, “Negative consequences should not be punitive—don’t say a child can’t go outside to play (because children need outdoor time) but it may be ‘you didn’t meet your goal so you don’t get computer time on Friday.’”
It took many months of work before the team saw real changes in the classroom. But the year that began so badly ended on a much better note. “The cooperation of the group made the children successful,” says Hernandez. “We ended the year helping all these kids.”
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How do you know it’s ADD/ADHD?
Not every young child who has trouble sitting still or paying attention has ADD/ADHD. Dr. Candelaria-Greene recommends that families and teachers explore other possible reasons for these behaviors, such as:
- Physical factors—food allergies, diseases like hyperthyroidism and diabetes, or over-sensitivity to touch, sound, lights, etc.
- Emotional factors—depression, anxiety, or family stress, such as divorce, death, or housing problems
To diagnose ADD/ADHD in young children, says Dr. Candelaria-Greene, an experienced person needs to observe the child in different environments. You can’t make a good diagnosis in one visit!
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ADHD resources
- To identify mental health resources or get an assessment, contact your local school district or county First 5, www.f5ac.org/regionlist.asp
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Extra resources from the Children’s Advocate bulletin
- ADHD in the Young Child discusses ADHD and offers tips to help early care and education teachers and parents manage the behavior of children with ADHD. $21. Available from Redleaf Press, 800-423-8309
- I Have Always Felt Different, a report from the Journal of Pediatric Nursing, interviews college students diagnosed with ADHD as children about how it affected their life at home, school, and friendships.
To stay informed about new and upcoming Children’s Advocate articles, related resources, and advocacy opportunities, sign up for our Children’s Advocate bulletin
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Thanks to the United Way of the Bay Area and
the David B. Gold Foundation
for their support of this series.
www.uwba.org
www.goldfoundation.org
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