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Dear Teacher: Working with My Son’s Tics

Dear Teacher: Working with My Son’s Tics | Focus-MD


This is the last part of the letter written by the mother of 9-year-old Josh to his teacher to give her some background knowledge on his dyslexia and ADHD. Here, she discusses his tics and how to best work with him in the classroom.


Dear Teacher,

Since we’ve given you an overview of Josh’s dyslexia and ADHD conditions, I’d like to also give you some information on his tics and how to work with him most effectively to make it a great year for the both of you.

Josh has occasional tics that are characterized by a brief hesitation accompanied by a rolling of his eyes. He may lose thought of what he was saying or doing during a tic, but he typically picks up where he left off.

Here are a few things to note about Josh’s tics and how to best work with him:

  • Acknowledgement of tics — Josh has not yet acknowledged his tic to us, so we do not make a big deal of them or draw attention to them. Essentially, we treat them like a blink.
  • Frequency of tics — Josh’s tics happen much more frequently during moments of high emotion, such as times of excitement, nervousness, anger, and frustration. We predict that his tics will be quite prevalent during the first week of school with the many new experiences.
  • Outbursts — Josh suffers in silence until he doesn’t. We do not expect many meltdowns/outbursts this year. But, when he does have an outburst, it will most likely not be about what it appears. Josh tends to stew about something until it results in an outburst that is not violent but is a clear refusal to do what he is told. They will likely surprise you and throw you for a loop!
  • Tolerance — We have and suggest a “zero tolerance” policy for obstinate behavior and outbursts. We know this can be difficult if the event is pulling on your heartstrings. We suggest clearly stating that the behavior is not acceptable and will keep him from participating in whatever class events are going on. If that does not calm the storm, he could be sent to the resource room to “get himself together.”
  • Initial challenges — Josh will tell you that he cannot or does not know how to do things for which he does not want to push through the initial challenge or frustration. It can be hard to decode this. We ask that you please require him to try. When he gains the confidence that he can do something that he thought he was incapable of, that smile will fill the room bigger than any other and will empower him to try again!

We want to thank you for being willing to take this time to learn about our son. We are grateful for your efforts and want you to know that we are always available to chat, meet, and collaborate. Our goal is the best and most productive learning experience for Josh, in the respect of you and your efforts to teach Josh and his classmates. Thank you very much!




Josh’s mother took care to explain to his teacher how to best understand his conditions and how to work with him. With the start of the new school year, it is important to monitor changes in your child’s behavior and bring him or her to our office to readjust medications if needed. Contact us to help you and your child make this year a successful one!


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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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6 Tips for Productive Studying with ADHD

Doing homework and studying with ADHD can be more manageable when your child embraces techniques that help him to keep his mind focused on the task at hand. Traditional study methods of long study streaks and sitting at desks can have your child spending more time distracted than being productive. That leaves no one happy and everyone frustrated. Here are some of our tips to make homework easier:

1. Move around
Having your child walk around while studying can help him to focus better.

2. Speak out-loud
When your child studies aloud, then her mind is more actively engaging with the material which means that it is harder for her mind to wander from what she is studying.

3. Fidget
It is hard for students with ADHD to concentrate for long periods of time without moving around during school. “Fidget tools” can help students fiddle with something without distracting the class. Some fidget tools are stress balls made with sand filled balloons, unfilled balloons, smooth rocks, or pliable wax. Students can hold these tools at their desk and fiddle with them whenever they want to.

4. Change position
Even while remaining sitting, have your child sit in different positions. Sitting disks or exercise balls allow your child to move around while remaining sitting, but the movements are more natural and less distracting than standing up to readjust.

5. Work in increments
Studying in short bursts can help your child to be more productive at shorter time increments.

6. Change subjects frequently
Have your child move onto the next subject as soon as he becomes easily distracted with one subject. This way your child can continue to engage with the schoolwork instead of spending a majority of time being distracted.

While focusing on uninteresting topics can be torture for anyone, embracing ADHD study methods can make homework and studying easier and more enjoyable for all of us who struggle to concentrate.

If you think you or a loved one may have ADHD and would like to be tested, call your local Focus-MD office.

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