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5 Quick Low-Tech Tips to Help Start Your School Year Off Right

Focus-MD | 5 Quick Low-Tech Tips to Help Start Your School Year Off Right

By James Wiley, MD, FAAP

It’s back to school time, and we at Focus-MD do more than just prescribe medicine to treat ADHD — we also like to provide tips and tricks on how to manage life with ADHD. So, to help you and your child start the school year off right, here are five quick low-tech tips:

1. Have extra pencils, erasers, pens, and paper.
These are all inexpensive tools. Make sure you have plenty on-hand so that you don’t hear, “I can’t find my pencil” or “I can’t get started because I don’t have a pencil.”

2. Have these tools in multiple colors.
ADHD brains love color, and a great system to begin to teach your child now is to highlight the important points. This way, when it’s time to go back and study, they’re ready to go.

3. Use a simple index card.
Boys resist using planners, and it frustrates teachers and parents to no end. Boys really do have trouble with planners a lot of times. But, what they will use is a simple index card. Some school uniforms have a pocket, so the index card fits in there nicely. Have them go ahead and write the four or five subjects they’re going to have homework in on that card. And, yes — I know moms are going to accidentally wash some of them, but it’s still good to teach them that technique!

4. Use Post-It notes.
Have your child write themselves notes. Remember that if you write the note, you’re doing the executive function in the reminding. But if the child writes something on the Post-It note, then they can remember without you nagging.

5. And finally, gather the things they’re going to need for school onto a “launch pad.”
Have them create it. Remember, kids don’t play as often in a playhouse that dad builds by himself — they’re going to want to be involved in the creative process. So, if you want your kid to get organized, have them design their own system. One great way is to find a piece of paper or poster board and have them create a space in which they gather the things they’re going to need for that day (AKA a “launch pad”). Whether that be their phone, their shoes — whatever it may be — they begin to learn to put those things together in one place. It works for NASA, and it’ll make your school year go much better.

 

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5 Things Teachers Should Know About ADHD in the Classroom

Focus-Md | 5 Things Teachers Should Know About ADHD in the Classroom

By James Wiley, MD, FAAP

It’s back-to-school time, and as the father and brother of teachers, I get to hear firsthand the joys and struggles educators face in the classroom. One challenge is managing hyperactive and impulsive behavior in the 10% of students that have ADHD. Here are 5 tips that will help you keep your sanity and make your students with ADHD (and their parents) eternally grateful.

1. Let them move
Research is in! Kids with ADHD perform better and learn more if they can wiggle while they work. Help them find less disruptive ways to do just that! A fidget pal — like an eraser or a small stress ball — can be helpful, but some kids will need more. Allowing students to sit on exercise balls has been helpful for some. Consider allowing students to stand at desks in the back of the room or have a walking and listening track if you find you have a kid that has to move. Incorporate stand up and stretch breaks into instruction.

2. Encourage PE and recess
Kids who get recess do better on standardized tests than those who don’t. If you restrict these high-movement times, then be prepared to face the repercussions. The need for the ADHD brain to move is cumulative — that is, it builds over the day. PE and recess allow a pop-off valve for that energy. Restriction from these activities due to behavioral issues or unfinished work is counter-productive.

3. Preferential seating
Some kids with ADHD get distracted visually and need to be in the front. For the ones more distracted by sound, consider letting them sit in the back of the class — these are the kids that are always looking behind them when you place them in the front closer to you so that they can listen better! Separating a child from his/her peers in a chair away from the action can lead to stigmatization and give a subconscious green light for bullying that child. Any changes in seating should be done privately and never in front of the other students or out of frustration. One thought is to move everyone around — that way no one is singled out, and the wiggle worm just happens to land in the seat you want him/her in! Don’t hesitate to rearrange if it doesn’t help.

4. Catch them being good and be specific on the negative behaviors
Kids with ADHD hear a lot of negative messages. When they have success controlling their behavior or completing their work, make sure to notice, and be easy on the frowny faces! Equal is not always fair. Most of God’s children, including the grown-up kind, will work more for encouragement and praise than for correction and discipline. When there are behavioral problems that need to be addressed, BE SPECIFIC. “He was blurting out answers and out of his seat a great deal today” is much more helpful than “Terrible day!” Consider identifying three problem behaviors and giving a daily grade of 1-5, with 1-2 being problematic, 3 being average and 4-5 being great! Parents can then see how their child is doing in the classroom and reinforce or discipline as indicated.

5. Never mention medication in the classroom
Asking a child about medication in the classroom or in front of a peer is a serious violation of privacy. Most teachers reading this will certainly agree! But from what kids say, it happens all too frequently, and it is devastating for them and often leads to problems with medication non-compliance. It’s much better to say, “You seem distracted today” or “You’re active today” than to ask about medication. If there needs to be a conversation about medication, remember to do it in private. Finally, please share concerns about medication side effects or lack of effectiveness of medication with the parent (or physician with parental approval). You are with the child eight hours a day, five days a week for nine months (as you no doubt know!), and your professional opinion counts!

Watch the late Rita Pearson’s Ted Talks video Every Kid Needs a Champion. She says it best.

 

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Stop Being Creative

Focus-MD | Stop Being Creative

By James Wiley, MD, FAAP

Those of us who have ADHD often hear about the gifts that come with it. It’s true — we aren’t normal; we’re gifted. Creativity is one of the most awesome gifts. I’m often astounded by the creations of my patients using a box of random Legos. Art, comedy, music, tech, drama, writing, entrepreneurship, problem-solving ADHD brains are at home here! How bland would the neuro-typical world be without us? Very, I think.

My grandmother, Madge, had a favorite saying that rolled slowly off her elegantly southern tongue. ‘Suga, (Sugar) there’re two sides to everything, even a piece of toilet paypa (paper).”

And so it is with ADHD-inspired creativity. We always have another idea, so it’s hard to know when to stop imagining/thinking and actually start to do something. Since we can think of so many ways to solve a math problem, we don’t show our work, or we get lost along the way. And since no problem or decision has only a normal, single answer, deciding where to go to dinner can take 20 minutes, and that’s just to decide between Mexican or Chinese — not which restaurant. “Oh, wait we haven’t tried that new burger place…”

I have been challenging myself lately. Stop being creative. At least long enough to do the laundry.

 

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Can ADHD Kill Me?

FocusMD-ADHD-killme-Wiley-blog

By James Wiley, MD ~ @ADDdoc

I often compare the diagnosis and treatment of ADHD to diabetes. When I do, sometimes people remark, “Yeah, but you can die of diabetes.” Diabetes does increase the risk of premature death. ADHD actually does too—especially when it’s diagnosed later in life. In fact, people with ADHD have more than double the risk of premature death. The most common cause of those deaths is accidents.

Researchers at Aarhus University in Denmark recently completed a study in which they analyzed approximately two million people in the Danish National Health Service Register over the course of 32 years. They found that the patients with ADHD faced at least a doubled risk of dying prematurely. They also discovered that the risk was higher for women than men and that later diagnosis was associated with a greater increase in risk as well. In fact, the patients diagnosed with ADHD as adults had four times the risk. Younger patients had only double the risk.

While this news is certainly alarming, it’s no reason to panic. The study offered reassuring information as well. Researchers noted that the relative risk of premature death does not mean that there are a large number of ADHD patients actually dying prematurely. It’s important to keep in mind that the doubled relative risk of premature death only results in a small absolute risk of premature death.

Gaining knowledge from studies like this – about how ADHD affects our health and safety -is critical. It helps us develop awareness that motivates and prepares us to take better care of ourselves. And, yet again, this study reminds us that early diagnosis and medical treatment are the best ways to improve an ADHD patient’s overall health, lifestyle, and well-being. At Focus MD, we think it’s time we all start paying more attention to ADHD.

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Resources:

http://bss.au.dk/currently/news/news-item/artikel/people-with-adhd-are-twice-as-likely-to-die-prematurely/

ADHD Medication: Dangers of a Medication Vacation

Stopping your child’s medication for the summer may not be in their best interest.

For years, pediatricians told parents to give ADHD medication when they had to — on school days during school hours. But times change. We now know that school problems are only the tip of the iceberg for kids with ADHD. They have problems with paying attention, time management, forgetting/never hearing instructions and organization at home and with peers. These issues relate to executive function—the brain running the ‘home office’ of the kid’s life. Poor executive function is why it takes kids with ADHD an hour to shower. Does this scenario sound familiar to you?

“Get in the shower…..get in the shower….Why haven’t you gotten in the shower? 

I’m not going to tell you again to get in the shower.

“GET IN THE SHOWER!!”

Water turns on. 5 minutes later…not in the shower.

 “GET IN THE SHOWER, you’re wasting hot water!”

Shower curtain noise, sounds of water splashing on kid’s head come from the bathroom. 

“FINALLY”, the parent thinks aloud.

“Don’t forget to wash your hair!”   No reply.

Twenty minutes later –“What are you doing in there?  Finish up!”

Ten minutes later—“GET OUT OF THE SHOWER!”

Child is dripping or half dried off when the parent walks in the bathroom.

The wet dog smell hits the parent’s nose. 

“You didn’t wash your hair.”  “Yes, I did.” “NO YOU DIDN’T. Your mother doesn’t buy shampoo that smells like that!”

After argument and yelling kid gets back in shower. Washes hair in 2 seconds and comes out smelling slightly less like a wet dog.

Parent is defeated, helps complete the dry off to the point that PJs can be put on.

Whew! Now all we have to do is read, pack up for school in the morning and deal with getting to bed! 

Good night…

There is significant emerging evidence that folks with ADHD build and improve their executive function with regular medication use. The old saying that ‘pills don’t build skills’ may be right but it may be wrong. Medication delivers improved sustained attention and improved self-control of hyperactivity and impulsive behavior. Kids in environments that foster executive function –stable homes and quality classrooms, for example—build these skills over twelve to twenty-four months. The Focus-MD experience is that the kids who are taking medication daily – including weekends and holidays – seem to benefit most. It is common for a parent to tell me at a follow-up visit, “he has matured,” or “she has just grown up so much.”  They don’t tell me that the kid’s executive function improved but that is what they are saying when they give examples like, “Shower time is not a struggle any more — HE EVEN PICKED UP HIS TOWEL!”

If you are reading this and thinking that it makes sense but you are reluctant to continue medication in the summer it is likely due to one or both of two reasons: Your child’s personality is adversely affected by the medication, or you have appetite/growth concerns. If your child has these issues during the school year, talk to his/her doctor to resolve them. Nine months a year is too long to have these side effects and dose optimization problems. Getting the dose just right can almost always allow your child to grow into a happy, engaged and normally attentive child. Sometimes dose reduction during the summer is a great idea. Stopping medication is not. Talk to your child’s doctor before stopping medication the day after school gets out.

Dr. Wiley is board certified in Pediatrics. He practiced general pediatrics at Dothan Pediatric Clinic in Dothan, AL for almost 20 years before moving to Mobile in 2008 and founding Focus MD.

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