Supporting Parents. Fostering Change.

Monthly Archives: November 2013

Dear Cathi,

I am a pediatrician in Reston and I see a lot of kids with ADHD. Some of them require medication and all of them need help coping with the issues around their diagnosis. I have referred patients to your practice for help with social skills and I know you work in a very structured way over a considerable period of time with the whole family, but I wonder if you have any advice for me. Once I tell the family that their child has ADHD, it is hard to know what to say next. Obviously the parents are concerned and with a regular 15 minute appointment, I am not sure how to give them anything valuable to take away. I usually spend that whole time making sure they understand the medication piece, because I feel that has to be a priority. So in your experience, other than being sympathetic, is there something I could offer them? 

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Dr. James,

You are not alone. Many of the physicians we work with have the same problem. They have a brief amount of time to spend with their patients and want to give them something substantial to be able to manage the symptoms of whatever diagnosis they have been given. As a therapist, I appreciate you asking these kinds of questions.

Even with an optimal response to ADHD medications, challenging behaviors persist. Parents need help.  And, as you well know, there is no magic pill that cures all of the behavioral aspects of ADHD.  After 17 years of running a child and family therapy practice, I’ve developed several strategies to help parents foster a peaceful environment at home with their ADHD child.  I have created the following tool to give parents some practical strategies to help keep the peace.

F.O.S.T.E.R. 

FORECAST - Let your child know your expectations of him/her in advance of a potentially challenging situation.  Review and practice these guidelines with your child prior to the event.  In this way, you help him/her manage potential problems proactively rather than reactively.  Focus on what “TO do” rather than on what “NOT to do”.

Try Saying This:  ”Before we go into the restaurant, remember our agreement. 1: Stay in your seat  2. Indoor voice  3. Eat with your mouth closed.  Got it?” 

OPTIMISM - Outside of your home, your child is likely bombarded with criticism and negativity from adults and peers alike.  For this reason, you need to actively praise your child when s/he is doing something right.  Make it a goal to spend more time paying attention to positive behavior than to negative.

Try Saying This:  ”Thank you for doing what I asked the first time I asked you.” “I notice you really working hard on your homework today.” “When you and your sister get along, it makes me feel so happy.”

STRUCTURE - ADHD kids need predictability and routines.  They may not WANT structure but they NEED it.

Try Doing This: Set up consistent morning and bedtime routines to help create a peaceful environment at home.

TO THE POINT - At times you may want to express your frustrations with your ADHD child in a flurry of words and emotions.  This action will likely lead to your child ignoring you.  Instead, when you want to alter behavior, make your statements short and sweet, focused on the behavior.  Wait silently for compliance and impose an immediate consequence if your directive is not followed.

Try Saying This: ”Hands and feet to self.”  Instead of this:  ”How many times do I have to tell you not to hit your sister?!?”

EXPECTATION OF INNOCENCE - Remember that your ADHD child does not behave badly to make you miserable.  Knowing this will help you feel more patient and less upset with your child’s behavior.  Regardless, you will need to set clear limits with your ADHD child.

Try Thinking This: ”Take a deep breath.  She’s not doing this purposely to make me mad. She is frustrated and needs some help.”

RESTRAINT- Stay as neutral as you are able.  When you are upset, your child’s behavior worsens.  Then, the problem becomes yours instead of his/hers.  Take a break if you need one.

Try Thinking This: “Andrew, you are shouting at me.  I have a hard time hearing you when you do that.  Sit on your bottom and speak more quietly so that I can hear you.”

I hope these strategies help you to maximize the time you have with your parents and give them real tools to use with their ADHD children.  If they need additional help, please feel free to give them In Step’s contact information and we will do our best to help.  Our clinicians specialize in working with children and their parents.

All the best,

Cathi Cohen

Posted in ADHD, Dear Cathi | Comments off

Bullying is a huge topic in the news, in your kid’s schools, and in their lives. They have assemblies, campaigns, and zero tolerance policies in place. Obviously, much of what you hear about how to combat bullying is told from the vantage point of the adults. But what do the kids think? “I get teased a lot”.

This is the number one complaint of the kids we see in group therapy. As a practice whose primary focus is children, teens and young adults, we have been collecting informal data over the last seventeen years by treating hundreds of children and their parents in our Stepping Stones social skills groups. Hands down, the issue that troubles our kids the most is bullying.

Of course, our parents want to know how to react when their child tells them about being teased. So we have compiled the top responses from our kids in group to answer that question. Some of it may surprise you!

 

Here is what they DON’T want us to do:

5 Kid Don’ts for Parents

#1 Don’t Overreact: Stepping Stones kids warn parents about getting overly emotional in response to their bullying complaints. Children are often hesitant to talk to their parents about teasing. It’s a difficult subject to discuss and your child may be afraid of being judged. Getting upset may exacerbate your child’s feelings and make him/her feel you don’t have confidence in him/her.

#2 Don’t Say “Just Ignore It”: Kids know that parents say this when they are uncomfortable with the conversation about bullying. If ignoring bullying were a realistic solution, kids would be doing it already.

#3 Don’t Jump In to Solve My Problems: Kids tell us they have two problems with your jumping in to save them. #1 You may make things worse #2 They don’t learn how to solve the problem themselves.

#4 Don’t Tell Me to Fight Back: Many kids that we see in Stepping Stones are not aggressive kids. Fighting back is highly unnatural to them. When you suggest they fight, your child wonders if you think they are weaklings. The kids also say they are worried about getting in trouble and making things worse.

#5 Don’t Blame Me: The kids feel blamed and responsible for being bullied when the first questions you ask are “What did you do first?” or “Why did this happen? What were you doing?”

Does any of that sound familiar? Don’t despair. According to our kids, there are things you can do to help.

 

Here are the DO’S from kids:

5 Kid Do’s for Parents

#1 Do Listen to Me: Kids may talk about being teased in haphazard and vague ways. They may incorporate seemingly unimportant details and leave out ones that you view as critical. Your child is more confident in you understanding how they feel when you listen to the whole story being told their way. Even if they can’t get the words right, they are trying to explain it in a way that will get you to understand their feelings.

#2 Do Tell Me You Understand: Kids want to know that you empathize with them. It’s OK for you to tell them that the bull(ies) are wrong and the situation upsets you. At the same time, you want to express your confidence that you can work on the problem together.

#3 Do Stay Calm: Your child wants to know that you aren’t going to fly off the handle and act in a way that they perceive as making things worse. When you stay calm, they feel you will act in a way that will not make the situation worse.

#4 Do Listen to My Plan: Your child needs your vote of confidence. When you calmly listen to how they are planning to handle a tough situation, it makes them feel like you are an ally. You can make suggestions, but ultimately they want to know you trust their judgment.

#5 Do Know When It Is Time To Act: Your child trusts that you know when it is time to get involved in a bullying situation. When your child is harassed daily in-person or on-line, making it difficult to attend school or is getting physically hurt or threatened, they need to know that you will get involved.

I hope that giving a voice to the do’s and don’ts from the kids who are “in the trenches” has given you a fresh perspective on this subject. Share this information with your own children as a conversation starter and let me know what they have to say!

All the Best,

Cathi Cohen

Posted in Bullying, Parenting | Comments off