evaluation(s) so they can develop an effective individualized education plan (for other accommodations) for the child. An IEP notes the child’s current levels of educational performance, states annual goals and how recommendations would be tailored to the child’s individual circumstances.
For example, to help students regulate their bodies and minds, schools may provide a stand-up desk and movement breaks, such as sending is a discreet way to allow the child to leave the classroom without feeling embarrassed. Implementing accommodations that promote concentration include allowing the student to sit at the front of the class, chewing gum, using a bean bag chair for reading, keeping assignments up-to-date in a weekly planner, and providing a squeeze ball for body- mind regulation. Adding additional supports may boost student self- esteem and reduce feeling alone in their discomfort, such as providing access to the school counselor for individual or group lunches with other students with ADHD or support from an educational paraprofessional. Parent or school counselor consultation can also help the teacher learn more about the child’s particular situation and how to best accommodate him or her in the classroom to improve the child’s focus and reduce any potential disturbances for the rest of the class.
accommodations to the learning environment or physical space to accommodations may include, but not be limited to, reducing the amount of homework without changing the level or content; providing quiet places to work or to take tests; breaking assignments or tests into smaller sections, changing the format, or giving more time to complete them; and having the school counselor work with the student on academic or
When recommendations from evaluations have been implemented, the child’s behavior often improves. The holistic and child-centered combination of individualized accommodations for school, play therapy, and occupational therapy, coupled with parents’ efforts to implement constructing successful attitudes and behaviors.
Effective Teaming with Parents The importance of working collaboratively with parents and other caregivers cannot be overstated and should be explained to parents at the beginning of the intake. Children will enjoy better results if parents are involved in their treatment. Ideally, monthly meetings with parents will
Setting realistic expectations with caregivers regarding treatment goals for their child promotes a trusting relationship with the therapist. Compassionate and active listening to the parents’ worries about their child and making appropriate recommendations for managing behavior
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at home advances the team approach. Additionally, treatment that incorporates psychoeducation to explain how various stressors impact the child is essential. With psychoeducation, parents may better understand why their child behaves in ways that they did not previously understand, thereby enabling them to become more effective with meetings and advocating for their child in other settings.
Filial therapy may offer another method for managing one’s relationship with a child who manifests ADHD behaviors. Child-Parent Relationship Therapy (CPRT, Bratton, Landreth, Kellam, & Blackard, 2006) helps improve the relationship between a parent and child during once weekly, 30-minute, home-based play times. By focusing on the child instead of his or her emotional or behavioral dysregulation, play therapists teach parents how to establish a safe, accepting environment where the child is more inclined to communicate his or her emotions, needs, and desires. As a result, children may develop better self-esteem and increased behavioral dysregulation express themselves more effectively due to the accepting, trusting atmosphere established with their parents.
A Clinician’s Template for Multi-layered Work The following suggestions provide a starting point for clinicians and parents beginning multi-layered work with children diagnosed with ADHD. Choosing options that strategically, clinically, and methodically treat the child within his or her environment will promote continuity of care. However, the child’s tolerance level needs to be considered when proceeding with these suggestions, because children and their parents often enter therapy overwhelmed and at a crisis point, with no understanding of why their child’s behavior at school at and home is anxiety regarding meeting the clinician and allow time to explore the play area. This gentle style epitomizes the theoretical basis of Rogers’s personality theory and Landreth’s child-centered approach.
It also
promotes safety for the child. • Create a comprehensive psychosocial assessment that includes a treatment plan and goals that have been developed with the parents and the child. • Obtain signed informed consent to coordinate with professionals from other disciplines. • Write introductory letters to the pediatrician, neuropsychologist, school counselor, and others, as needed, to solicit their cooperation in treatment. evaluation with
neuro- and other psychologists, occupational
therapists, speech and language specialists, etc., and provide referrals to parents as needed. • Request a neuropsychological evaluation to determine IQ, learning disabilities or weaknesses, learning style, other diagnoses, and to make informed recommendations for home and school. • Request a school-based OT evaluation to determine if sensory integration problems exist. Provide a list of private OT providers, if needed. • Refer to a pediatrician or to a child psychiatrist if medication is warranted.
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