Teaching Life Skills to Children and Teens with ADHD

Vincent Monastra is a clinical psychologist who specializes in ADHD. He runs a clinic where he teaches life skills classes to help these individuals become more successful. His book, Teaching Life Skills to Children and Teens with ADHD, contains a series of lesson outlines drawn from his classes. He uses three principles throughout the series to help caregivers teach and reinforce these skills:

• positive practice- requiring individuals to practice what they didn't do. If they were supposed to brush their teeth, they must do so when they are "caught" not having done so. If they were supposed to clean their room- things stop until the room is clean.
• positive punishment- requires children to do some positive action when they fail to meet the expectation. If they do not clean their room independently, they might now have to do both the room cleaning and another chore.
• time stands still- all "fun" activity stops until the positive practice and positive punishment tasks are complete.

This means that the child who was supposed to write assignments in his planner and didn't needs to call a responsible friend or check a reliable on-line source to complete the planner. Then they might need to read an article (see here or here for two examples) and explain the rationale for using a planner. They might also need to brainstorm new prompts to help them remember to do so. Until this is completed, they do not get to do anything else- no Lego, video games, cell phone social media, sports, TV,...

While I love the concept and for me, a mom who was home when the kids got home and stayed home through bedtime, I could enact such practices relatively easily. I also am very stubborn and not willing to give in to the whining of my children. Not every parent has the ability to be present to ensure these things happen not are they willing to endue the tantrums, shouting, door slamming, etc. that children sometimes resort to when they are thwarted from doing what they want. I also am crazy consistent which was immensely helpful for my son with ASD, but certainly not something many parents with their busy schedules always demonstrate.

One of the key things Dr. Monastra begins with is the importance of three things: sleep, nutrition and exercise. This is a triad that many people bring up but is, apparently, hard to enforce. Teens should get 9 hours of sleep- it could be a nap and or it could be just going to bed early. Many parents do not enforce such bedtimes because they want to spend time with their children, extracurricular schedules interfere, the children say they are not sleep ( and they truly might not be), TV and social media in the bedroom is difficult to control. Parents can put controls on cell phone use, remove TVs from bedrooms, and reduce the number of outside commitments their children engage in, but must be prepared for push back. Ultimately, to borrow a Larry Winget phrase, parents must "put on their big boy pants" and do the unpleasant parts of parenting.

From a nutrition standpoint, he emphasizes the importance of protein in the morning. It helps provide long term energy and the components for creating neurotransmitters that allow the brain to work and learn and later sleep. This means things like yogurt, cheese, peanut butter, or bacon in the morning for breakfast or a snack. My son was an incredibly fussy eater. He would not eat breakfast. Snacks at midmorning were essential for him to function effectively at school. This might be the case for other children as well. Getting children to try nonpreferred foods (for my son texture and temperature were both important elements in food, many foods would be turned down permanently if there was a violation in one of these areas) is important. We can give in and only feed children honey buns, but we are doing them no favors by taking the easy way out.

Exercise. In John Medina's Attack of the Teenage Brain (see my blogs here and here), they also talk about the critical importance of exercise to mental health of all children. Those with ADHD are especially vulnerable to the need for exercise. Some studies have shown that after aerobic exercise, children show far less hyperactivity and impulsivity in the classroom. Brains need oxygen to function properly. Students who sit all day are not getting enough oxygen to their brains. They need to get up and get moving in order to learn. One of my favorite studies showed that students who had daily PE had better academic results even if they lost "academic learning time." We need to get our kids up and moving because it helps them regulate their behavior and learn more effectively.

I completely understand why Monastra requires parents to stay with their children during class. This is not a one-sided, one and done exercise. Parents need to learn skills to help their children do better. Enduring the pain now will help children be more successful later. It is worth it.