As we go along further, you will see that we take the position that children do best when we consider them as individuals and understand their unique developmental profile, their strengths and weaknesses, particularly in these core abilities and, most important, to help them get to higher and higher levels of thinking. You will also see some of the methods and exercises we use to strengthen weak areas.
With such efforts we can help children get over the tendency to be sensory seeking or on the move all the time or help them master their overreactivity to certain sights and sounds. We can also help them to plan and sequence their actions more effectively and improve their basic bodily and motor skills - for example, their ability to take notes and write, using fine motor skills. We can help them not only become more coordinated but also carry out complex actions like in a ballet or a dance.
When we look at Stephanie, we have to ask whether Stephanie is characteristic of many children with ADHD. We have just completed a study of children who showed the symptoms of ADHD on all the checklists and met the criteria of ADHD in diagnostic manuals and other research checklist systems. We found that although their symptoms of inattention and high activity were often the same, each one had a slightly different way of taking in sensations, planning actions, sequencing, and so forth. Brain With ADD
They had different sensory profiles, different levels of thinking, different levels of self-awareness. We found that children with this common set of symptoms showed enormous varieties in the underlying pathways. This raises a question: Do we want to find the underlying causes and strengthen the core abilities, or do we want to focus on only the surface symptoms?
When we look at human beings, we can't look at just one function in isolation because they are all related. We can't look only at attention because it's related to motor development, sensor/reactions, thinking, and the role of emotions. We like to use the metaphor of a tree. The roots are the reasons for both healthy development and for the many different symptoms of ADHD, like challenges in the ability to take in what we see and hear, how we plan actions and react to sensations. The tree trunk is our thinking ability, how strong it is and how high it can grow. Then the branches and leaves are the various abilities, like reading, writing, math, science, and the many nonacademic abilities. This model for ADHD works very well. We want to strengthen the roots and the trunk.
Over a period of two years, Stephanie flowered with an approach that provided Stephanie's parents with fun exercises they could do every day that strengthened her core capacities. As Stephanie grew older, she also developed a skill that is vital for children and adults with ADHD. She became more self-aware. She learned to evaluate herself: "I don't need to be in a hurry" or "I'm paying attention better." She learned to reflect on her feelings: "I like Betty better than Harriet because Betty is more like me or our families are alike." In school this kind of reflective thinking was vital: "This wasn't a very good essay" or "I'm having a harder time listening today because of ..." If a child can learn to see the big picture, the child then has a framework in her mind that helps put problems into perspective. The ability to think reflectively allows children to fill in the pieces even if they don't hear everything the teacher says. This is an ability that is more important than just paying attention.
How many children make the progress we have seen in Stephanie? In my practice, I have found that if the vast majority of parents and schools and children cooperate, and even if it's only the parents and children, we see growth overall in focus and attention.
Organizing and Planning Actions
As we discussed, children can have difficulty in paying attention for a wide variety of reasons, from being underreactive to sensations, to craving sensation, to being overreactive, to difficulties processing information and problems planning their actions. Most children with ADHD and ADD have some combination of these problems. A study is currently under way to document the variety of patterns that contribute to this one "common pathway": difficulty in paying attention and hyperactivity. In this post, we will examine one of these patterns, involving the motor system.
Weaknesses in motor skills, motor planning, and sequencing are frequently found in children with ADHD. Most require some level of work in each of these three areas. We can work with each child on all these areas simultaneously. The swiftness with which they master the exercises or games or playful activities in each will determine how much work we need to do. Brain With ADD
Motor Skills
A child may have trouble with basic motor skills: being able to move left, right, forward, and backward, and doing so with growing dexterity and coordination. To help strengthen these skills for younger children, I like to recommend a series of activities starting with the Evolution Game, with wormlike or snakelike crawling or slithering on the ground, then moving on all fours, then different kinds of balancing on all fours, and then balancing in upright positions. After that we can work on children's ability to coordinate what they see and hear with how they move - left, right, forward, backward, according to different sights and sounds and doing it more quickly. Then we can begin to work on eye-hand coordination and foot-eye coordination, doing it to rhythm and music and with timing exercises. Fantasy play and pretending to be a bird or an action figure can make these games more fun for children. For older children, we can also use the Evolution Game, but sports and dance may be a more enjoyable way for them to learn to master movement patterns.
Motor skills are fundamental to paying attention. You have to have control over your body to be able to focus on any activity. Although some children with low muscle tone are able to concentrate very well and some children who have excellent motor skills might have trouble with concentration, work on these skills generally helps with attention problems. They are a very important foundation piece for general development and help most children learn to attend and focus better. To learn more, you can check out Brain With ADD.
