Achievement, Productivity
& Behavior
 

Because the part of the brain that screens out distracting stimuli and
inhibits extraneous movement is underactive in people with hyperactivity
(ADHD), there can be significant impairment in school, productivity, work,
and even family life. In mild cases with adequate structure, disruptive, off-
task behavior can be managed without drugs. For others, both medication
and behavioral interventions are needed to tame the beast. Mark any of the
following strategies that you think would be helpful to you or your loved one:

ACADEMICS

• Have students repeat instructions or restate the purpose of the task
  before starting it.

• Vary type, length, format, and color of worksheets. Intersperse
  movement with sedentary activities. Use computer programs when
  possible.

• Teach how to organize information into outlines and charts. Buy
  textbooks so key points can be highlighted.

• Maintain close feedback between home and school. Parents can add
  extra incentives for on-task behavior. Time allowed for highly valued
  privileges (telephone, TV, or video games) can be earned according
  to the percent of time spent on task in school.

• Obtain tutoring to make up for past deficits in (premedication)
  learning or to keep up with current skills. ADD people learn best in
  one-on-one situations.

• Have testing done to identify learning disabilities and arrange special
  training.

• Make specific arrangements for standardized tests such as extended
  time limits or a quieter setting. A letter from the clinician who made
  the ADD diagnosis can help.

• Make distinctions between ADD and intelligence. Even if a car has a
  powerful engine (intelligence), it may need brake fluid (to stop
  unnecessary movement) and a tighter steering wheel (to stay on
  task). Identify positive role models from family or history who have
  had ADD: Thomas Edison, Mozart, and Einstein.

• Get counseling to change defeatist attitudes and improve self-image.

PRODUCTIVITY

• Break large tasks into smaller units. Set deadlines for small parts.
  Reinforce completion of each unit with points that can earn prized
  privileges. Using the computer, running errands, or free wandering
  time can be effective rewards.

• Make lists and prioritize what needs to be done first, second, and
  third. Having small parts on lists to mark off gives a great sense of
  accomplishment.

• Use white boards with colored markers for list making. They are more
  fun and attention-getting and less likely to get lost than paper. Have
  one in every room.

• Use a stopwatch to self-monitor. Estimate how long it will take to
  complete (part of) a job and find out if you’re right. This increases
  motivation to stay on task.

• Use immediate consequences for off-task behavior. Redirect children
  to the task, sit at a time-out desk away from others, or run laps
  during recess. Adults can use self-talk—“I’m off task. I won’t let myself
  use the computer until this gets done.”

• Find the best places for staying focused at school, the office, or
  home. Avoid facing windows and open doors. Place TVs and other
  major distracters where they will not interfere with task completion.

• Identify working conditions that improve productivity. Some people
  work best doing two or three things at once. Others need a minimum
  of distractions.

TIME-OUT

• Think of time-out as interrupting disruptive, off-task behavior rather
  than as punishment. Time-out is important for both ADD adults and
  children

• Identify behaviors ahead of time that require time-outs and make
  agreements about when these will happen. Focus on actions that
  threaten safety or other’s rights.

• Pick a location for time-out with few distractions. Often, this may be
  someplace other than the child’s room. The car can be used for time-
  out when you’re away from home.

• Give a three-count warning for starting time-out if a behavior doesn’t
  stop. If you are an adult, count to yourself, and if you cannot calm
  down, take a time out. Start time-outs before the point of no return is
  passed.

• Hold children on the time-out seat until they can comply for at least
  one minute. Often, this is needed until children realize they cannot
  avoid time-out. Gradually increase time but never for more than one
  minute per year of age. Time-outs that require ADHD children to be
  still for too long can cause worse behavior later.

• Use creative time-out. This may include aerobics (running laps or
  jumping jacks) or very brief time-outs that can build concentration
  and coordination (standing on one foot while holding the other foot
  and pointing to the ceiling with the opposite hand, walking on a
  balance beam, holding a sand timer or glitter wand, balancing a book
  on the head, or breathing exercises). Find out what helps you or your
  child focus best.

• Allow children to choose between (shorter) creative or traditional time-
  outs that are one minute per year of age. Conventional time-out may
  have little impact on ADD children because they are daydreamers
  and can sit still for long periods of time.

BEHAVIOR AND MOODS

• Recognize needs for high-stimulation behavior. Balance moderately
  exciting activities with brief periods of “down time.” Find diverse
  sources of excitement to avoid “addictions” to one thing.

• Develop healthy addictions (crafts, hobbies, or exercise) on which to
  get hooked. This provides structure for the need to keep busy.

• Keep small, tactile objects handy for fidgeting: felt, Velcro, Koosh
  balls

• Arrange 30 minutes of daily “piddle” time to waste guilt-free and
  recharge batteries. However, warn children in advance so they can
  plan for unstructured time.

• Recognize the “ADD blues”: an overreaction to or letdown after an
  engaging event. Refocus on something enjoyable or take out
  frustrations on pillows.

• Praise on-task behaviors—“You didn’t need any reminders today to
  finish . . . .” If you cannot find anything to compliment, break tasks
  into smaller units and force yourself to notice at least two positive
  things a day. If you are an adult, find a coach or contract with a family
  member to praise you when you do things well.

• Reframe tendencies toward mistakes as expertise on foibles. There
  are advantages to not being a perfectionist who falls apart whenever
  a blunder happens.

• Make a list of successes and refer to it to combat hopelessness.
  Have a “success (bulletin) board” in a prominent place in the home
  for both children and adults.

References

Adapted from Beyond Retalin by Stephen Garber, Marianne D. Garber, and
Robyn F. Spizman (Harper Perennial, 1994) and Driven to Distraction by
Edward Hallowell and John Rately (Simon & Schuster, 1995).

Section 504 of the 1973 Rehabilitation Act (Office of Civil Rights, P.O. Box
65808, Washington, DC 20035-5808, 202-514-2151, www.usdoj.gov)
requires schools to accommodate students with disabilities (psychiatric
diagnoses) with suggestions similar to the above.