Tuesday, March 30, 2021

Punishments Don't Teach Skills

Punishments Don't Teach Skills 

Okay, maybe one: They may teach people how to be better at avoiding punishment.

They may teach people how to fear punishment (or worse, the punisher).

An adult losing their cool and punishing a child may teach that child to do the same when things don't go their way.  

Punishments do not teach skills.  As we explained in another blog post, punishment usually doesn't do what we want it to do, which is change someone's behaviour.  

As experts like Dr. Ross Greene, Alfie Kohn, and many others have been trying to teach us for decades: misbehaviour comes from missing skills.  "Misbehaviour" does not need to be punished.  Children need to be taught, guided, supported, and shown what to do instead.  


First, what is misbehaviour?  

If a child is doing something you don't like, or behaviour another adult doesn't like, first ask why?  

  • Is the adult frustrated because they aren't getting their way?  
  • Is the adult annoyed because the child is not immediately complying with their demand(s)  
  • Are you, or your co-parent, embarrassed by the behaviour?  
  • Does the behaviour actually need to change, or can the environment change to fit the needs of the child?  
  • Are the expectations even realistic for the child's developmental age and stage?  
  • Is the child trying to communicate a need?  
  • What skill(s) is the child missing to be able to follow through with what is expected?  

Punishing a child for any of the above reasons (which are usually the primary reasons) is unfair and, again, ineffective.  

It never fails. 

A parent posts a question in an online forum, for example, asking for advice.  Their child isn't following the rules around screen time, what should they do?  The answers, inevitably, go something like this:  

  • Take away screens forever!  Lock them up for good!  
  • Hide the remotes!   Hide the controllers!
  • Hide the power cord! 
  • Put passwords and padlocks on all of the things!  

Okay... and then what?  An adult will have to monitor and gate-keep all electronic devices and their use for the foreseeable future, until they get tired of it and the child goes back to the same behaviours with no new skills learned?  Alternatively, the child learns how to work around these systems and learns to sneak their screens, instead of ask for them?  

Both are distinct possibilities. 

Let me be clear, I am absolutely not advocating for unlimited screen time (nor am I advocating for a permissive, let them do whatever they want style of parenting).  I am a strong proponent of very limited screen time, especially in young children, and we have quite stringent boundaries around screens in our household.  However, we didn't come to these limits by locking everything up.  We sat down as a family, discussed our concerns, our goals, and discussed the risks and benefits of screen use.  

Do we have perfect harmony, even when we enforce these boundaries?  Absolutely not (I wish!).  We're a family of humans, two of whom are 2e, there are definitely still challenges with pretty much any boundary.  That said, our son is (mostly) much more accepting of limits when he's been included in the conversation: The reasons behind the limits have been discussed and explained, his perspective has been heard, and his feelings respected and validated (note that respecting and validating feelings are not the same as giving in because a child is upset).   


Let's Try Another Example  

My child is disrespectful when I tell him "no", what do I do?

  • Take away his privileges!
  • Force him to write a letter of apology!
  • Don't let him think he rules the roost, put him in his place! 

Facepalm.

Let's look at some possible reasons children may speak to adults in a disrespectful manner: 

Possibility #1: Big Feelings

They're angry, upset, disappointed, or their feelings are hurt.  
(or all of the above at once)

They may not yet know how to express this in a calmer, kinder manner, or their self-regulation may not be developed enough to use these skills when they are experiencing intense emotions.  And many neurodiverse children tend to feel their emotions very intensely.  In particular, children with ADHD can have significant struggles with emotional regulation.  This is due to that delayed Prefrontal Cortex (PFC) development mentioned in our other blog post, and certainly not something over which children have any control.  Jessica McCabe created a great video about ADHD and Emotional Dysregulation on her How to ADHD YouTube channel:  


Possibility #2: Impulsivity 

Remember: Neurodiverse brains develop differently from neurotypical brains, that's why they're called neurodiverse.  Impulsivity is a key feature of ADHD and is caused by differences in the brain's wiring: A significant difference between an ADHD brain and a non-ADHD brain is the weakened or disrupted signal between the Thalamus (responsible for response inhibition) and the Frontal Cortex (responsible for decision-making).  Another biological factor over which we have no control.  

A child who responds by kicking over his chair, yelling obscenities, and stomping out of the room is clearly lacking some strategies for dealing with disappointment and managing their intense feelings.  They also likely reacted impulsively, meaning without stopping to think first.  This may be because their brain's communication between their thalamus and frontal cortex is not as developed as that of a neurotypical child, which again, would be something over which they have no control.

That's all well and good, but... 

If we're not suggesting punishment or adult-imposed "consequences" for knocking over a chair and calling you a name, then what do we suggest?  

First, if your child has stomped to their room or to some other safe space, awesome!  Why is it awesome that they slammed their door and told you to "go away?" in less-than flowery language?  Because they've taken space to cool off, and if they're in their room writing bad things about you in their journal or listening to angry music then cool, because those are some ways that people regulate.  Even better if they have a "calming kit" or "chill" zone: a safe space they have chosen for themselves (or worked with you to set up), possibly with a soft blanket or pillow, sensory items, books they like to read, or whatever works to help them calm down when they feel overwhelmed.  

Below is an example of one of the calm down menus we have created with our son when he was younger.  These options were developed with him, in conversations while he was calm, and that have been adapted and adjusted as he gets older and develops different preferences, needs, and skills. 

Role Model 

The best way for children to learn how to self-regulate is for the adult to help them do so by providing acknowledgement and validation of their feelings, support and comfort, and then role-modelling healthy ways of dealing with our emotions.  We have some fantastic book and podcast recommendations on another blog post, many of the books listed include strategies for supporting children with emotional regulation and for dealing with challenging behaviours.  

Decide what needs to happen.  

  • Do the adults need to adjust their expectations to be more in line with the child's developmental age and their current skills?  
  • Are there adjustments that can be made to the environment to set the child up for success?
  • What need is the child trying to communicate with their behaviour, and how can we meet that need?  
  • What stressors are in the child's life that are contributing to the behaviour?   
  • What skills need to be taught to allow the child to meet realistic and fair expectations? 
 

Collaborate with your Child 

Once cooler heads prevail, it's time to dig into what is contributing to the behaviour.   

Dr. Ross Greene has an amazing approach called Collaborative and Proactive Solutions (CPS), in which the child and adult(s) come together to identify and communicate their concerns, then work as a team to come up with reasonable and mutually-agreeable solutions.  It's certainly not a panacea: There often need to be multiple conversations, multiple potential options for solutions, and the plan often needs to be re-worked.  This approach teaches children communication, problem-solving, and teamwork skills.  It also allows them to work through their feelings, but not stew in them, as they then focus on possible solutions alongside trusted adults in their lives.  

Dr. Greene's Lives in the Balance website has extensive CPS resources for parents, educators, and other professionals.  


Learn Everything You Can 

Seriously, the old adage that knowledge is power is an old adage for good reason.  

Understanding the "why" behind your child's behaviour not only helps you problem-solve and support them more effectively, it also helps you show them more compassion and empathy.  Become an expert on your child.  If they have ADHD, read all of the things on ADHD (preferably all of the evidence-based, well-researched, well-written things).  The more you understand the biology, psychology, neurology, every-ology about your child, the better you will be able to regulate how you respond to them.  Instead of "why on earth did you do that?!" you'll be able to say to yourself: "I know why they did that. I still don't like it, but at least I know they didn't do it just to be a jerk" (or something along those lines).  

Lose your temper, yell, fail, fall down, dust yourself off, and try again.  

Seriously.  It's going to happen, so expect it and be kind to yourself.  This parenting thing is hard, and it can be even harder with neurodiverse children.  Build yourself a community (however big or small you prefer) of like-minded parents, caring friends and/or family, and supportive people to lean on when you need someone.  

Apologize to your child when you do lose your cool.  This is not showing weakness: Apologizing is showing strength, it is role-modelling taking responsibility and making amends when we mess up, because we all do.  Even the most patient and nurturing of parents have bad days and imperfect families.  We can do everything right and our child might still have a meltdown.  

Because childhood.

Go easy on yourself and on your child because the world will be hard enough on us all.   

 

About the Author

Jillian is an ADHD 2e Coach and Child Advocate in Manitoba, Canada.

Jillian has a diploma in Child & Youth Work and a Degree in Psychology, as well as being the parent of an amazing 2e/ADHD child.  

Visit ADHDPro.ca and Facebook.com/ADHD2ePro to learn more.

 

Further Resources 

ADHD 2e Pro has compiled an extensive list of ADHD 2e resources, both local here in Manitoba, and online.  We also have a large recommended reading list on another blog post  that we add to regularly.  

Raising Human Beings, by Dr. Ross Greene

The Power of Showing Up, by Dr. Daniel Siegel and Dr. Tina Bryson 

Connections Over Compliance, by Dr. Lori Desautels 

Parenting with Presence, by Susan Stiffelman

PsychScene Hub :  Neurobiology of ADHD

Understood.org : ADHD and Emotions and Impulsivity in Children 

How to ADHD : ADHD and Emotional Dysregulation

ADDitude Magazine : Impulsivity & Impulsive Behavior

Friday, March 19, 2021

ADHD, Actually

ADHD is about so much more than difficulty sitting still or paying attention.  

So.  Much.  More. 

In light of this being Neurodiversity Celebration Week, we wanted to share some important facts about ADHD.  Unfortunately, despite decades of information being available to anyone and everyone (including doctors, teachers, and the general public), there is still a lot of misinformation out there.  It's ironic (okay, a bit sad and frustrating too) that one of the most common childhood disorders is one of the least well understood. 

The CDC (U.S.) indicates that 9.4% of children aged 2-17 years are diagnosed with ADHD.  Statistics Canada states that 5% of school-aged children (presumably aged 5-17) are diagnosed with ADHD.  The Centre for ADHD Awareness, Canada (CADDAC) states that ADHD is the most prevalent childhood psychiatric disorder in Canada and remains under-recognized and under-diagnosed, despite being the most treatable psychiatric disorder in Canada.

So, what is ADHD, if not a case of "the wiggles"?  If it's not simply a matter of needing to focus more or get more organized, then what exactly is it?  

 

ADHD is Life-Altering

We will only touch upon a couple of the most life-impacting symptoms of ADHD in this blog, but of course, each person's experience with ADHD will be different and there are many other symptoms that affect people's everyday lives.  

Executive Functioning Issues 


Executive functions are a set of mental skills that include working memory, flexible thinking, and self-control.  Executive Functioning is an incredibly board topic, so we will simply share a few resources here.  

Executive Functioning description from the Centre for ADHD Awareness, Canada.  

Executive Functioning explained by Jessica McCabe of the How to ADHD YouTube Channel:



Executive Functioning breakdown by CHADD, based on work by Dr. Thomas Brown and Dr. Russell Barkley.  Dr. Barkley's videos on ADHD are available on YouTube


Two major factors impacting the life of children (and adults) with ADHD both stem from Executive Functioning difficulties:

 

Impulsivity

As defined in our previous blog post, 7 Ways ADHD is Misunderstood, Impulse Control is the ability to pause between the action and reaction.  "Response inhibition refers to the ability to withhold a cognitive or behavioural impulse that may be inaccurate or maladaptive." (Barkley, 2015). 

When people seem to act without thinking, it is not because they're careless or thoughtless.  Certain parts of the ADHD brain develop approximately 30% slower (on average) than a typical brain.  This includes the Prefrontal Cortex (PFC), an area of the brain responsible for impulse control and complex decision-making.   

Click for more information on ADHD & Brain Structure

Difficulties with Emotional Regulation 

Emotional regulation can be very difficult for some people with ADHD, and can have a significant impact on their lives, including their friendships and other relationships.  A child who becomes angry easily and lashes out aggressively is not a "bad" kid, they're not even an aggressive kid, they're a child experiencing emotional dysregulation whose behaviour is being expressed in an aggressive manner in that moment.  

The distinction is important: children are not their behaviour, and when that behaviour stems from a disability or neurodifference, they are not necessarily in control of said behaviour.  A person with ADHD cannot help if they have an underdeveloped amygdala, the part of the brain largely responsible for emotional regulation.

Dr. Barkley spoke about ADHD and emotional conflict:


Add Them All Together...  

Impulsivity and emotional regulation are very much interconnected: Combine the experience of intense emotions (due to an underdeveloped amygdala), plus difficulty pausing to evaluate prior to acting (due to an underdeveloped PFC), plus difficulty using memories of previous events to consider the possible consequences of said actions (also due to that underdeveloped PFC causing difficulty with hindsight and working memory)...  those are a lot of brain-based challenges to work against in order to exert "self-control"!  

Dr. Barkley again with a more in-depth explanation: 


Some additional points that we will touch on in future blog posts, but that people must understand about ADHD: 

  • ADHD is not a new disorder!  ADHD is not the result of bad parenting, too much screen time, too much sugar or processed foods (or any other diet), "chemicals", or whatever else people try to blame.  ADHD is a neurobiological disorder that was first described in medical literature all the way back in 1775 (Barkley & Peters, 2012).

  • ADHD is not a mood disorder, a learning disability, a mental illness, nor a behavioural disorder.  ADHD is a neurodevelopmental disorder, a condition that is due to differences in in the development and function of the brain.  


References

Barkley, Russell A. (2015). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis & Treatment. The Guilford Press.  

Barkley RA, Peters H. (2012). The earliest reference to ADHD in the medical literature. Journal of Attention Disorders. 16(8), 623-630.

Brown, Thomas, E. (2013). A New Understanding of ADHD in Children and Adults: Executive Function Impairments. Routledge.

Kofler, M. J., Rapport, M.D., Bolden, J., Server, D.E., Raiker, J.S., & Alderson, R.M. (2011). Working memory deficits and social problems in children with ADHD. Journal of Abnormal Child Psychology, 39, 805-817. 

 

Further Resources:


ADHD 2e Pro : We have compiled extensive lists of both local and online ADHD & 2e Resources on our website.


Celebrate Neurodiversity!  Neurodiversity-Celebration-Week.com 

Understood.org : ADHD and Emotions

The Centre for Addiction and Metal Health (CAMH): Attention Deficit Hyperactivity Disorder (ADHD)

American Academy of Child & Adolescent Psychiatry (AACAP) : ADHD & Brain Structures

Woodburn Pediatric Clinic : ADHD Brain Differences 

Understood.org : Attention and Working Memory 

Centre for ADHD Awareness, Canada (CADDAC) : Executive Functioning and ADHD 

CHADD : Executive Function Skills 

Understood.org : ADHD and the Brain

Boston Children's Hospital: Attention Deficit and Hyperactivity Disorder (ADHD)

CHADD: About ADHD 

Centre for Disease Control (CDC) : What is ADHD?  


About the Author

 

Jillian is an ADHD 2e Coach and Child Advocate in Manitoba, Canada.

Jillian has a diploma in Child & Youth Work and a Degree in Psychology, as well as being the parent of an amazing 2e/ADHD child.

Visit ADHDPro.ca and Facebook.com/ADHD2ePro to learn more.

Friday, March 5, 2021

The School Keeps Calling

"The School Keeps Calling!"

It got to the point where my heart would race every time the phone rang during the school day, and I dreaded picking it up when I saw the school's Caller ID on my phone.  I was getting phone calls or emails from the school 2-3 times per week.  Someone from the school (usually the teacher or principal) would regularly call or email to communicate (ie. complain about) our son's behaviour.  

At first, I was extremely apologetic: "I'm so sorry.  Of course I'll speak to him.  I don't know why that happened.  I will make sure he knows that behaviour is unacceptable" and so on.  I have a CYW diploma and a degree in psychology, I should have answers, I should be able to "solve" these problems.  

Then I started reading and learning (and reading and learning and reading and learning some more).  As I mentioned in a previous blog post, my diploma from 2006 and degree from 2009 just weren't cutting it as far as ADHD knowledge was concerned.  So I sought to become an expert on ADHD, and more importantly, on my son.  

Then I realized something. 

Most of the behaviours the school was calling me about were not entirely his fault, nor were they mine.  I am not saying my son doesn't have responsibility and accountability for his choices, he absolutely does.  However, when the school staff repeatedly call with the same or similar complaints, yet have done little to support him to succeed within the school environment...  well, if they keep doing the same thing and expecting a different result, then who is really responsible here?  

As Dr. Ross Greene would say, kids do well when they can.  (I discuss the issue of ineffective "punishment" in another blog post).  Essentially if a child is lacking skills and adults are not liking the resulting behaviour, but the adults are not actively teaching those missing skills, then how can we blame the child for not having them?  

As parents, we were truly doing everything we possibly could from home to support our son.  We sought the advice of outside experts: we went to a child psychologist and occupational therapist.  I read ALL OF THE BOOKS, listened to podcasts, followed the advice from the school's clinical team, and was trying to teach our son the skills he needed to succeed.  However, it was the stress and rigidity of the school environment that were contributing to and really triggering a lot of his behaviours, and we had no control over that.  Schools are very often loud, busy, and can be very overwhelming, especially for children with sensory hypersensitivities.  Children with ADHD often have co-morbid sensory processing disorders, or experience sensory overload.  When an ADHD brain is less able to filter out the external noise, or has trouble deciding which input to attend do (so it attends to it all!), this can be incredibly overwhelming.  

Schools often have unrealistic expectations for children's developmental abilities, especially when it comes to children with ADHD or other neurological disabilities.  Sitting in a desk for 5 hours per day at ages 5-8 is neither healthy nor realistic for most children, let alone those with hyperactivity.  When children are not given the ability to move their bodies, take movement breaks, and self-regulate with physical play, then it sets them up for failure.  We expect them to sit down, learn, attend, be quiet, and listen while their bodies and brains are begging for physical outlets and activities.  

Schools can often have very rigid rules that are "equally" (but not actually because adults are human too) applied to all students in the effort to be "fair" to all.  However, if all children develop differently and are at different stages of development and have different skills and abilities...  how is it fair to have the exact same expectations across the board?  I get that it's impossible to have a separate set of rules for each individual student, and even those would have to change day-to-day based on the child's functioning and development.  That is also completely unrealistic.  However, many schools are currently teaching students about flexible thinking and growth mindset.  How can the adults expect the children to practice flexible thinking if the adults are not role-modelling those skills?  

Short answer: they shouldn't.  

Examples of posters that may be on some classroom walls: 


The flexible thinking curriculum is fantastic, actually, don't get me wrong.  For it to be effective, however, it requires the adults to role-model and set the example first and foremost.

You Don't Have All The Answers.  


You don't have all the answers, and guess what?  You're not supposed to.  Nobody does.  The whole "it takes a village" thing is true, and right now your child's school is part of your village.  The adults who interact with and support your child at school need to communicate with you what they observe, what they are trying that is working or not working, what they think your child needs to be successful, and what they are doing to make that happen.
"Your child's school is part of your village."
If you are repeatedly receiving communications from your school about the same or similar recurring issues and you don't feel they are doing enough on their end to help your child, here are some options:  
  • First, document the phone calls and emails.  You can make yourself a chart with the date, time, and subject or concern expressed to you to keep track of exactly how often you're being contacted and how often the same concerns are being brought to your attention. 
  • If you notice a pattern, now you can bring that to the school's attention.  You can ask for a meeting with the classroom teacher and administrator (or school psychologist, or guidance counsellor, or social worker, or someone who has regular contact with your child at school and may have helpful insights to offer). 
  • At the meeting, or in your communications with the school, ask for information about what is happening before the behaviour (the antecedents, triggers, environment, context, etc.).  If they do not know, then they cannot effectively support a child if they do not dig down to look beneath the behaviour for the underlying causes and contributing factors.  That is their next step.  

All Behaviour Is (Still) Communication


If a child's behaviour is maladaptive, disruptive, harmful, or otherwise unexpected, then that behaviour is telling us something.  Something is not working for that child and if the adults want the behaviour to change, then they need to change the environment and provide the supports the child needs to succeed.
  • If your school needs help identifying your child's patterns or triggers, you can ask them to fill in an ABC chart any time they contact you about your child's behaviour (or any time they notice the same or similar difficulties coming up).  
  • That said, there are certainly some significant limitations to any behavioural tracking.  The biggest problem is that they oversimplify by boiling the antecedent down to one trigger when human behaviour and emotions are so much more complex than that. 
  • The missing piece is communicating with the child once everyone is calm to learn more about their experience.  We need to find out more about their day, week, even month, to see what is building up for them, contributing to their struggles, and/or creating vulnerabilities.    
  • The documentation is really just to get the school starting to look a little deeper than the surface behaviour.  It can improve communication between family and school, and if not, it at least creates a paper trail for all the times they contact home without having taken steps to support the student. 
  • If the school is on board and ready to take their support to the next level, we very highly recommend the Collaborative & Proactive Solutions (CPS) model.  Your child's school administration should have heard of CPS, but in case they haven't, information for schools is available on the Lives in the Balance website.  This is a much deeper, and more child-centred, approach to problem solving and developing relevant and effective supports that will actually help the student.  

Extremely important:  Any home-school communication should be for adult information-gathering purposes only.  The intent is to spot patterns, identify triggers, and identify and develop the supports that would be most needed for that child.  Home-school communication should never be used for school staff to "tattle" to parents about the child's behaviour, it should never be used as part of a behaviour "modification" program, and most importantly, it should never be used with the expectation that the parent then punishes the child at home for something that happened at school.  Visit our website for more information on effective behaviour "tracking".  

Now that is out of the way, here is a sample ABC Chart (click to enlarge):


Once the relevant information has been gathered, then patterns can be identified, and relevant supports can be put into place.  If the behaviour difficulties are such that the school is calling home once a week or more, it would be wise to have a Behaviour "Intervention" Plan put into place.  

That said, the BIP example outlined on the Government of Manitoba's website is ...not great.  It focuses too much on the student's behaviour and not enough on the underlying contributing factors.  It does outline skill development and touches a little bit on relationship-building, so that's a start.  

We don't have a sample BIP posted yet (sounds like another blog post in the making!), but we do have a blog post about Individualized Education Plans (IEPs), now called Student-Specific Plans (SSPs) with examples of effective student-planning that are also highly relevant and applicable to a BIP.  

In fact, if your child has ADHD, and that ADHD impacts their functioning in school (spoiler alert: it does), then your child is entitled to an SSP - but, like, a good one.  An effective SSP should focus on what accommodations the student needs in order to do their best, what supports they may need to be on a level playing field with their peers, and should include S.M.A.R.T. goals that are intended to allow the student to thrive.  An SSP (or BIP, or IEP, or any-p) should not include goals that simply make things easier for school staff and should not focus on the child changing or stopping behaviour without very specific steps identifying the lagging skills and how the adults in the student's life will support them to build those skills.

You Are SO Not Alone 


If your heart starts racing any time your phone rings, or if you dread emails from your child's teacher or principal, remember: this is not all on you.  Your child is at school for more than 30 hours per week.  Parents have very little, if any, control over what happens during their child's school day.  Yes, you are an extremely important part of your child's support team, and you know your child best.  Yes, you can do things at home and with outside professionals to support your child.  Yes, you can work collaboratively with your child's school team to set everyone up for success.  

Your child's school is part of your proverbial village.  If they have difficulty with your child's behaviour during their school day, then it's up to them to look beneath the surface behaviours.  Only then can they expect you to work with them, and they with your child, to develop supports and solutions.  Only then will your child truly get the support they need and deserve.

Please visit our website for a list of ADHD Resources available in Manitoba.  If you need assistance advocating for your child, contact us and we can recommend and provide resources or arrange services.  


About the Author

Jillian is an ADHD 2e Coach and Child Advocate in Manitoba, Canada.

Jillian has a diploma in Child & Youth Work and a Degree in Psychology, as well as being the parent of an amazing 2e/ADHD child.

Visit ADHDPro.ca and Facebook.com/ADHD2ePro to learn more.

If you need help educating your child's school, your family, or with general ADHD coaching or advocacy, please feel free to contact us.  




Dr. Alan Lagimodiere, the PC's new Indigenous Reconciliation and Northern Relations Minister

This was a rough draft in preparation for a full blog post.  Please read the full article here .   Manitoba’s New Indigenous Reconciliation...