This is the cry we are hearing more and more from worried parents who contact us at TCT.
Sometimes it is the parents who come to us with concerns, and other times it may be school or nursery staff who have suggested the possibility.
Increased coverage in the media, and celebrities being given diagnoses’ have added to the chatter about this condition in recent times.
As clinicians and therapists, we would always urge caution and ask that other factors are considered before we would start to look to see whether ADHD as an underlying cause for certain presentations.
For example, when presented with a child who has certain traits or behaviours that may be associated with ADHD, we would want to rule out other causes as part of our assessment.
Firstly, we would always take a detailed history – from pregnancy, to babyhood and early childhood, summarising the child’s life story so far, as there may be other factors at play. We would look at movement opportunities available to the child on a day-to-day basis, and also what is appropriate for a child of that age- because we know if given the opportunity, children love to move!
Another factor to consider is foundation motor skills – does your child have a full range of consolidated skills or is their profile a little immature, patchy or spikey i.e. are they really good at some things and unable to do others?
We often hear comments like:
‘My child fidgets constantly’ – we would want to know what is their core stability like. This will be a contributory factor to fidgeting if not strong.
‘My child is always on the go’ – is this ‘boom-and-bust’ behaviour? The type of movement, where they rush around, have a break, rush around again and need a break. We would consider whether this could be due to reduced endurance/stamina.
‘My child cannot focus’ – we know through our clinical practice that skills needed to sit still, and focus are underpinned by strong and secure foundation movement skills and so we would look to see whether this has a part to play in the reason why they find focus so difficult.
‘My child gets easily distracted’ – We would want to look at lots of factors that impact our ability to pay attention and not be distracted – for example what level of auditory processing they have. If a child’s auditory processing is not developed to a sufficient level for school, then poor skills in this area can easily result in distraction.
‘My child struggles to get to sleep’ – busy brains can be active for a number of reasons, and one common one is anxiety for a variety of reasons. If a child’s anxiety is addressed in a consistent manner, it can calm a busy bedtime brain.
As you can see by the few examples given, there are many other factors we need to explore before considering an underlying diagnosis such as ADHD.
Our work also requires us to consider the ‘three ages’ of a child - their actual age, their cognitive age and their emotional age. When there is disparity, we may often see differences in expected ability vs actual ability and emotional dysregulation or immaturities which can also feed into a child’s difficulties.
When considering ADHD we would always ask:
Have they always been like this?
Could other factors be informing their behaviour?
Do they behave the same way all the time in all environments/settings?
Here are some activities to try with your child to see if it changes their performance or behaviour:
·Chunk activities/tasks - break them up into smaller easily achievable pieces.
Using visual prompts
Be realistic with your expectations and make sure they are age and skill appropriate and therefore setting your child up for success.
Try a movement activity before sitting down to a tabletop activity/eating a meal or doing some homework
Break down tasks to encourage participation.
Be consistent with your approach and ensure all adults around the young person are also consistent.
Allow for your child to fluctuate, we all have better days than others!
Provide opportunities and activities for a child who is full of energy and who enjoys being active- they don’t have to be sport based.
Ideas for an Active Child
ORGANISED SPORTS CLUBS
FOR YOU TO DO AT HOME
Helping with the shopping – reaching, lifting and carrying.
Helping with jobs around the hous. Make them fun – do them to music – e.g hoovering.
If you are lucky enough to live near the coast -Sand sculptures and /or giant sandcastle building at the beach.
If you live near the countryside walk in the woods, climb trees spot different types of animal poo/footprints!!
Dancing – e.g. diversity style, street, modern, contemporary, tap. musical theatre, ballet
Tree spotting – how many different types can you see?
Playground crawl – how many local playgrounds can you visit? Make a scoring system for ones you like best.
Playing a musical instrument
Baking & cooking
Den building inside & out
Make your own obstacle course - inside or out. You don’t need lots of kit – this can be done with furniture and cardboard boxes.
‘Spotting’ games e.g. cars or birds or trees. The I-spy books are great for this.
Walking games – during your walk can you see something beginning with each letter of the alphabet?
Go large – use lining paper for drawings/use a big paintbrush to draw water pictures on an outside wall/use giant garden games.
These activities all use up energy in a focused way - but also allow for building and consolidating foundation motor skills. You can download a copy to print below.
Remember if you are looking into a diagnosis, it is for life and is not to be undertaken lightly. It is important that any assessment is done well, that other factors are considered and that it is gold standard and follows NICE guidelines.
Diagnosis or not, there are lots of ways to support energetic youngsters and help celebrate their love of movement. The suggestions mentioned in this blog are suitable for those who would reach and for those who don’t quite reach the threshold for diagnosis, and you never know, they might be enjoyed by others in the family too!
Full details of TCT's ASD/ADHD assessment/diagnostic services can be found using the link below.