Today we are gaining insight into occupational therapy (OT) for children with ADHD from Jennifer Kovanis, MS OTR/L, Clinical Director of Premier Children’s Therapy Center in Atlanta.
The diagnosis rate for ADHD among school aged children is approximately 3% according to AOTA. These children have difficulty with attention, modulating their activity level and/or controlling compulsive behaviors.
These issues translate into difficulties in the home, community and at school. Problems seen in daily life include:
- Following adult directions
- Independently getting ready for school
- Completing assignments in school and turning in homework
- Poor regulation of their emotions, especially in response to unexpected situations
Jennifer, please give us an overview of occupational therapy (OT).
Occupational therapists (OTs) and OT assistants are trained to help with developmental, physical and psychological conditions. The goal is to promote active participation in everyday activities that are important to the patient.
OTs can be found in many different venues and specialty areas. Often times they work in healthcare settings such as hospitals, clinics and early intervention centers when an accident or injury causes a loss of skills that were previously part of someone’s life.
OTs also provide services to individuals who are diagnosed with a developmental disability by another healthcare providers such as a pediatrician, physician, psychologist, psychiatrist or development optometrist.
Services can be covered by insurance companies, workers compensation, school systems (if educationally relevant), mental health centers, Medicare/Medicaid or paid privately by individuals or through grants.
What is the OT approach for children with ADHD?
Occupational therapists will evaluate a child’s sensory processing skills, visual motor skill development and level of independence with daily routines.
With this information, OTs decide whether a child would benefit more from individual therapy in a clinic or home setting or consultative services which would provide suggestions for accommodations in the school environment.
Occupational therapists may also coach parents in helping with behavior management strategies related to sensory processing differences.
What can parents do at home with their children?
Home strategies are often given by therapists once they know a child’s strengths and weaknesses. Here are some examples:
1) Use positive reinforcement
Oftentimes these children have been bombarded with negative language. A successful strategy is to catch your child doing a task well or following a direction correctly and praise them in the moment.
For example, “Ella, I see that you remembered to put your backpack on the shelf” or “John, I am so proud of you for getting dressed this morning by yourself”. Good behaviors if noticed, especially by parents, are motivating.
2) Target the behavior, not your child.
Another strategy is to target displeasure with the associated behavior. For example, say “Bill, I do not like when you push your brother, he can get hurt” instead of “Bill I can’t stand it when you don’t follow the rules”.
Be sure to name the behavior and target only the behavior. You will always love your children. It’s the behavior that is the problem.
3) Help your child unwind
Give your child what they are craving to get their arousal level settled. For instance, when children return from school they need to unwind from the rigors of classroom rules, the stress of learning and working to stay on top of their reactions. This is a time when meltdowns are common.
A strategy to use is to get lots of movement activities into play after arriving home. Taking a run, playing outdoors, doing heavy work such as helping with housework (i.e., vacuuming, carrying laundry baskets, loading shelves) can give lots of calming input to their bodies that will help.
For other children, finding a quiet place to have a “chill out” time before homework can be calming.
4) Serve “sensory foods”
Eating foods that require lots of chewing or sucking can provide heavy work for the mouth which is also calming. Foods should be as nutritious as possible. Crunchy veggies (celery, carrots, apples or frozen grapes), hard pretzels, gum, licorice and fruit leather are good choices.
Drinking a healthy smoothie can get those hard to eat supplements down while creating lots of sucking power.
5) Keep their hands occupied
Children, especially those with ADHD, need something to keep their hands busy.
Activities such as kneading dough and other kitchen tasks, playing with hard putty or play-doh, finding fidgets that are quiet or carrying items that fit inside a pocket (such as a stress-relief squeeze toy) are good choices.
6) Therapeutic music
Music can be very calming. Listening to children’s songs, Chakras, deep earth drum sound tracks such as Sacred Earth Drums or classical music such as Mozart or acoustical guitar are good choices.
7) Build your village
Most importantly, it takes a village to help parent a child with the challenges of ADHD.