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For People with ADHD & Those Who Love Them |
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Cogmed Working Memory Training Outline: Everything You Want To Know About ADHD
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Return to ADDvisor Volume 2 2000 Index Number 2, January 15, 2000In this issue: 1. Further Reactions to the NIMH Study 2. 1-2-3 Magic
FURTHER REACTIONS TO THE NIMH STUDY
In reviewing the reactions to the NIMH Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (MTA), it is clear that community providers need to incorporate the study findings into their standards of care. The study indicates that medication management (finding the proper medication and dose and followed by monthly visits) and a combined treatment approach (medication management with intensive behavioral treatment) are the two most effective treatments for ADHD. Intensive behavioral treatment includes parent, child and school components with the therapists involvement gradually reduced over time. Parent training and monitoring of effective behavior techniques is critical. Barkley and others have published programs for training parents that have consistently yielded positive results. Coordination with the school is also necessary to manipulate the environment in a positive manner for the child. Another interesting result of the study was that the combined treatment approach proved superior in many instances when targeting oppositional/aggressive symptoms, internalizing symptoms, teacher rated social skills, parent-child relations and reading achievement. These results point to the conclusion that any treatment for ADHD must include intensive parental and school involvement if the ADHD child is to be successful. It is in this spirit that we have created the ADDvisor, our parent training by phone program. By increasing parental knowledge and building parental advocacy skills, ADHD children and teens have a much greater opportunity for success.
1-2-3 MAGIC
One of the most effective time out procedures for children from preschool through the elementary grades that I have seen was developed by Thomas Phelan. It is called 1-2-3 Magic. What I like most about this procedure is that it is simple to administer. Parents often find that by following the clear steps, they note significant improvement in their children’s behavior. The overriding philosophy that Dr. Phelan employs is that children are basically like wild animals and that you need to be the lion tamer. A lion tamer does not beg and plead with the lion to behave. (Unless of course the tamer would like to be eaten) By treating the interaction this way, it is often easier for a parent to remain calm. There are essentially 2 rules that a parent needs to master. One is the no talking rule. This means that when administering a time out, you say as little as possible. Offer no explanations to the child. Do not engage in arguments, discussions, pleading, etc. The second rule is the no emotion rule. This is a tough one. When your child has done the same thing over and over again and you are about to tear your hair out, displaying no emotion is a major challenge. If you feel you cannot control yourself, give yourself a time out (go to YOUR room) until you feel calm enough to deal with the problem. Once you have gained control of yourself, you then calmly administer the procedure (which has been explained to your child previously in a family meeting). First, you tell your child what you want them to stop doing and say, "That’s 1". If they stop, you are done. If not, say "That’s 2" If then they stop, you are done. If they still continue to argue, plead or whatever they are trying to do, say, "That’s 3. Take 5" This means they need to go to their room for 5 minutes. (Actually, I tailor the time to the age of the child. 2 minutes for a 2 year old, 3 for a 3 year old, on up to a 5 year old and older who all get 5 minutes in their room. Once the time out is over, the matter is dropped. No lectures, recriminations, scoldings, whatever. If your child asks for an explanation, you may give it to them but if they start to argue, return to the time out procedure. Further elaboration on this technique can be found in Dr. Phelan’s book and/or video or attend our free class on January 26th. CONTACT INFORMATION _______________________ Alan R. Graham, Ph.D. Bill Benninger, Ph.D. ADDvisor.com Voice: 1-866-ADDvisor Fax: 847-824-2386 Email: Alan@ADDvisor.com Bill@ADDvisor.com Web: www.ADDvisor.com (c) Copyright 2000 ADDvisor.com, Ltd. All rights reserved The above material may be retransmitted or distributed to whomever you wish as long as not a single word is changed, added or deleted, including the contact information. However, you may not copy it to a web site. Republication of "The ADDvisor" in paper media is encouraged and permitted by organizations and associations which serve parents of ADHD children at the national, state and/or local level as long as the issue is reprinted in its entirety without charge and includes the contact information. With advance permission, we are happy to edit an issue to fit your space requirements. Republication is also encouraged under other circumstances, however, the advance permission of ADDvisor.com, Ltd. must be obtained in the event that changes in the text are desired or republication is to be made by individuals or by organizations other than those mentioned above.
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Questions or comments? Send e mail to Alan@ADDvisor.com
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