+ Back to School Anxiety? Teach Kids to Relax

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Experts at Duke University recommend “mindfulness,” a technique borrowed from meditation, to help nervous children relax, HealthDay News reports.

It is especially useful for children who are nervous about transitioning into the new school year.  It can also help them deal with academic and social pressures.

The following exercises can help young practitioners achieve a level of mindfulness:

• Mindful breathing — Ask the child to take time in the morning and evening to pay attention to his or her breathing for 20 inhales and exhales.  Steady breathing has a calming effect on the body.
• Mindful walking — After dinner, take a walk and pay attention to all the sights, sounds and colors.  Encourage the child to use this technique on the playground and at school.
• Mindful listening — At the dinner table, ring a bell or play a note on a musical instrument to capture the family’s attention, then give each person a turn to speak about their day while the rest of the family gives their full attention, to encourage active listening.

Mindfulness helps kids recognize their thoughts, reconnect with their emotions and understand how that impacts their behavior.  Ultimately, if we can heighten awareness of our thoughts, we can modify our emotions and that changes behavior.

Says Michelle Bailey, a pediatrician at Duke Integrative Medicine

Making a transition, whether it’s to a new school, a new teacher or a new grade, signals change.  When adults are stressed, they often turn to smoking or alcohol or food to pacify emotions.  We need to teach kids how to handle stress in a healthy way.

Mindfulness helps kids recognize their thoughts, reconnect with their emotions and understand how that impacts their behavior.  Ultimately, if we can heighten awareness of our thoughts, we can modify our emotions and that changes behavior.

Mindfulness encourages children to live in the moment and not fret as much about future events.  In addition, practicing meditative techniques can help children sleep better, reduce anxiety and stay more focused.

[Note: many clinics and hospitals offer accredited, mindfulness-based, stress-reduction programs.]

source: HealthDay News report on Yahoo.com http://news.yahoo.com

tutoring in Columbus OH:   Adrienne Edwards 614-579-6021   or email  aedwardstutor@columbus.rr.com

+ Guilt and Atonement in Children’s Development

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John Tierney writes in the NY Times about recent research into the mechanisms that help children become considerate, conscientious adults.

A long-term study at the University of Iowa aimed at isolating the effects of two distinct mechanisms.  One is called “effortful self-control:” how well you can think ahead and deliberately suppress impulsive behavior that hurts yourself and others.

The other mechanism is less rational; it is especially valuable for children and adults with poor self-control.  It’s the feeling measured in a “broken toy” experiment with toddlers: guilt, or what children frequently diagnose as a “sinking feeling in my tummy.”

Guilt comes in many varieties and is joked about: Puritan, Catholic, Jewish etc.  But psychologists keep finding evidence of its usefulness. 

There is clearly a downside to too little guilt; there are sociopaths who feel no remorse, but also kindergartners who smack and snatch.

Says Grazyna Kochanska, who has been tracking children’s development for two decades at the University of Iowa, children typically start to feel guilt in their second year of life.

Some children have temperaments that make them prone to guilt, and some become more guilt-prone thanks to parents and other early influences.  Says Dr Kochanska:

Some children respond with acute and intense tension and negative emotions when they are tempted to misbehave, or even anticipate violating norms and rules.  They remember, often subconsciously, how awful they have felt in the past.

 Dr Kochanska’s latest studies are published in the August issue of the Journal of Personality and Social Psychology.  She and colleagues found that 2-year-olds who showed more chagrin during the “broken-toy” experiment went on to have fewer behavioral problems over the next five years.

That was true even for the ones who scored low on tests measuring their ability to focus on tasks and supress strong desires to act impulsively.

According to Dr Kochanska

If you have high guilt, it’s such a rapid response system, and the sensation is so incredibly unpleasant, that effortful control doesn’t much matter.

 But self-control was critical to children in the studies who were low in guilt.  They still behaved well if they had high self-control.

Even if you don’t have that sinking feeling in the tummy, you can still suppress impulses.  You can stop and remember what your parents told you.  You can stop and reflect on the consequences for others and yourself.

What Can a Parent Do?

If your child lacks both self-control and guilt, what can you do?  Should you feel guilty?  Should you feel you’ve done a bad job of parenting?

Researchers have not been able to link any particular pattern of parenting to children’s levels of guilt, says June Tangney, a psychologist at George Mason University who has studied guilt intensively in both children and adults, including prison inmates.

She does have some advice for parents. 

The key element is the difference between shame and guilt.  Shame is the feeling that you’re a bad person because of bad behavior; it has repeatedly been found to to be unhealthy.

Guilty feelings focused on the behavior itself, however, can be productive. 

It’s not enough, says Dr Tangney, for parents just to follow the old admonition to criticize the sin but not the sinner.

Most young children really don’t hear the distinction between “Johnny, you did a bad thing,” versus “Johnny, you’re a bad boy.”  They hear “bad kid.”  I think a more active directive approach is needed.

She recommends focusing not just on the bad deed, but more important, on how to make amends.

Both children and adults can be surprisingly clueless about whether and how to make things right.  Little kids are overwhelmed by the spilled mess of milk on the floor.  Parents can teach and support them to say “I’m sorry,” and to clean it up, maybe leaving the kitchen a little cleaner than it was before.

That was the atonement strategy followed by the experimenters in Iowa who tricked the children with the broken toy.

After 60 seconds of angst, during which the child’s reactions could be observed by researchers, the children were asked what had happened.  They were then told that the toy could be easily repaired. 

The researcher would then leave the room with the broken toy and return in half a minute with an intact replica of it.  The experimenter took the blame for having caused the damage, reassuring the children that it wasn’t their fault.  The toy was now as good as new.

And the researchers had modeled how to say “I’m sorry.”

sole source: John Tierney’s article in the NY Times Science section on 8/25/09.   www.nytimes.com    Join the discussion at Tierney Lab          http://tinyurl.com/mmb9ro  – how can parents best instill these good mechanisms in their kids?

tutoring in Columbus OH:   Adrienne Edwards   614-579-6021  or email  aedwardstutor@columbus.rr.com

+ Free Parent Seminars at Marburn Academy

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Parents in central Ohio are fortunate because Marburn Academy in Columbus has expanded their popular Free Community Parent Seminar Series for 2009-2010.

For over eight years, Marburn Academy has been offering parents of children with learning differences access to state-of-the-art identification and remediation information that isn’t available anywhere else in Central Ohio.

Parents who have attended these seminars have learned about the many unique and innovative programs Marburn has introduced to our area. 

They have also gained valuable insight into appropriate instructional approaches that work best for teaching reading, writing, spelling, math, and organizational skills to bright children with learning differences such as dyslexia and ADHD.

Seminar Dates and Topics

• September 8, 2009 — “When Children Struggle With Reading: Is It Dyslexia?”
• October 6, 2009 — “Solving Reading Problems”"
• October 20, 2009 — “Understanding the Problems of ADHD Children” (part 1 of a series)
• November 17, 2009 — “Improving Self-Management Skills for ADHD Students” (part 2 of the series)
• January 12, 2010 — “How to Get High School to Work for ADHD Students (And How to Get ADHD Students to Work in High School)”
• February 9, 2010 — “Early Identification and Early Intervention: Why Wait for Failure?”
• March 2, 2010 — “Correcting Persistent Writing and Spelling Problems:  Sources of/Solutions to the Problem”
• April 6, 2010 — “ADHD Students and the Role of Medication”
• May 4, 2010 — “Solving Math Learning Problems”
• June 15, 2010 — “Understanding the Problems of ADHD Children” (part 1 of a series)
• June 21 — “Improving Self-Management Skills for ADHD Students (part 2 of the series)

Registration is required.  Contact Barbara Davidson at 614-433-0822, ext. 107; or email bdavidson@marburnacademy.org.  The Web site is http://www.marburnacademy.org.

All seminars are held at the school – 1860 Walden Drive, Columbus OH 43229.   They are held on Tuesday evenings from 7:00 -9:00 pm. 

All are free to parents of children who learn differently.  Cost to professionals who attend: $40.00.

tutoring in Columbus OH:   Adrienne Edwards  614-579-6021  or email  aedwardstutor@columbus.rr.com

+ Chronic Stress-Loops in Brain Change Behavior

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In an article in the NY Times, Natalie Angier writes that chronic stress changes the brain, but relaxation can change it back.

In the journal Science this summer, Nuno Sousa of the Life and Health Sciences Research Institute in Portugal says he and his colleagues found that rats, if chronically stressed, lost their elastic rat cunning – they instead fell back on familiar routines and rote responses.  They would, for example, compulsively press a bar for food pellets they had no intention of eating.

Brain Changes

In addition, the rats’ behavioral oddnesses were reflected by a pair of complementary changes in their underlying neural circuitry.

On the one hand, regions of the brain associated with executive decision making and goal-directed behaviors had shriveled.  Conversely, brain sectors linked to habit formation had bloomed.

In other words, rats were now cognitively disposed to keep doing the same things over and over, to “run laps in the same dead-end rat race rather than seek a pipeline to greener sewers,” writes Angier.  And Dr Sousa says,

“Behaviors become habitual faster in stressed animals than in the controls, and worse, the stressed animals can’t shift back to goal-directed behaviors when that would be the better approach.”

A neurobiologist who studies stress at Stanford, Robert Sapolsky, says

“This is a great model for understanding why we end up in a rut, and then dig ourselves deeper and deeper into that rut.”

In fact, continues Sapolsky, humans are lousy at recognizing when their normal coping mechanisms aren’t working.  We usually try it five more times, when it would have been better to try something new.

While perseverance is an admirable trait — is indeed essential for success in life — if it’s taken too far it becomes “perseveration.”  Perseveration is  uncontrollable repetition.  Taken to extremes, it simply seems perverse.

Dr Sapolsky is the author of “Why Zebras Don’t Get Ulcers.” 

“If  I were to try to break into the world of modern dance, after the first few rejections the logical response might be, practice even more.  But after the 12,000th rejection, maybe I should realize this isn’t a viable career option.”

But It Can Be Reversed

Luckily, it appears that stress-induced changes in behavior and brain can be reversed.  

After four weeks’ vacation in a supportive setting free of bullies, Tasers and dunking in water, the formerly stressed rats looked just like the controls.  They were able to innovate, discriminate and refrain from obsessive behavior.

Atrophied synaptic connections in the decisive regions of the prefrontal cortex resprouted, while the overgrown dendritic vines of the habit-prone sensorimotor striatum retreated.

Says Bruce McEwen, head of the neuroendocrinology lab at Rockefeller University, the new findings offer a particularly elegant demonstration of a principle that researchers have just begun to grasp.

“The brain is a very resilient and plastic organ.  Dendrites and synapses retract and reform, and reversible remondeling can occur throughout life.”

We associate stress with the split-second pace of our wired society.  But the body’s stress response is one of our oldest attributes.  Its basic architecture, with its linked network of neural and endocrine organs that spit out stimulatory and inhibitory hormones and other factors as needed, looks pretty much the same in a human as it does in a goldfish or a red-spotted newt.

Our stress response is itself dynamic.  It was essential for maneuvering through a dynamic world.  We had to dodge predators and chase down prey; we swung through trees; we fought off disease. 

As we go about our days, says McEwen, the biochemical mediators of the stress response rise and fall, flutter and flare.  “Cortisol and adrenaline go up and down.  Our inflammatory cytokines go up and down.”

The target organs of stress hormones likewise “dance to the beat ,” writes Angier.  The heart races and slows, the intestines constrict and relax.  This system of so-called allostasis, of maintaining control through constant change, stands in contrast to the mechanisms of homeostasis that keep the pH level and oxygen concentration in the blood within a narrow and invariant range.

But the dynamism of a person’s stress response makes it vulnerable to disruption, especially when the system is treated too roughly and not according to instructions.

In most animals, a serious threat provokes activation of the stimulatory, sympathetic, “fight or flight” side of the stress response.  But when the danger has passed, the calming parasympathetic circuitry tamps everything back down to baseline flickering.

Humans, however, have a brain that can think too much, that can extract phantom threats on a daily and sometimes hourly basis.  Over time such constant hyperactivation of the stress response can unbalance the entire feedback loop.

Reactions which would be desirable in limited, targeted quantities become hazardous in “promiscuous excess,”  writes Angier.  You need a spike in blood pressure if you’re going to run, to speedily deliver oxygen to your muscles.  But chronically elevated blood pressure is a source of mutiple medical miseries.

We might ask, why should the stressed brain be prone to habit formation? 

Perhaps — to help shunt as many behaviors as possible over to automatic pilot, so we can focus on the crisis at hand.

sole source: NY Times article by Natalie Angier on 8/18/09.  www.nytimes.com   

tutoring in columbus OH:   Adrienne Edwards   614-579-6021   or email  aedwards tutor@columbus.rr.com

+ Beanbags Help Kindergarteners Focus?

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In Danville OH, according to Pamela Schehl at Mount Vernon News, kindergarteners are walking around with beanbags on their heads.

Teachers Lisa Thatcher, Toni Lyons and Lisa Muncie explain  that brain research shows that one’s balance relates to one’s readiness to learn. 

The beanbags on the heads, report the students, help them focus and think.  They seem to work whether the student is sitting, standing or just walking down the hallway.

Thatcher says the beanbags “allow students to take some ownership in being prepared to learn when they enter the classroom.”  The teachers explain that when a pupil begins to lose concentration, the beanbag will slip.  Then the student will realize it’s slipping and will refocus on his or her own initialtive — without having to be redirected by the teacher.

Besides increasing academic performance (and there is data to illustrate), the beanbags strategy has led to overall improved behavior, as well as the children taking greater pride in themselves and what they are doing.

The beanbags are just one part of a comprehensive approach to education called Davis Learning Strategies.

source: http://www.mountvernonnews.com article by Pamela Schehl on 8/18/09. 

tutoring in Columbus OH:   Adrienne Edwards   614-579-6021   or email  aedwardstutor@columbus.rr.com

+ Central Ohio Parents: Special Needs Reminder

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“SPECIAL NEEDS CONNECTIONS”

is a support group for parents of special needs children in Central Ohio. 

The next meeting is

• Thursday, August 20, 2009
• 7:00 to 8:30 pm
• 130 Big Run Road (Molly King’s home)
• in Delaware OH 43015
• SPEAKER is Janet Simpson, Occupational Therapist, Nationwide Children’s Hospital

And childcare is available if needed.  If you need it, please RSVP to Molly. 

Contact Molly at: 740-369-4047 (h) or 614-581-6675 (cell) or mking@nextgenaccess.com.

————————————————

tutoring in Columbus OH:   Adrienne Edwards   614-579-6021   or email  aedwardstutor@columbus.rr.com

+ Teaching “Emotional Intelligence”

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 ”What has Mr. Snail taught us?” asks a teacher, holding up a puppet with a bright red-felt shell. 

“How to come out of my shell when I’m feeling shy,” says a boy seated in front.

“And what about Mr Grasshopper?” she asks.  A little boy shouts “How to pay attention when your body wants to…”  And he demonstrates  a case of the fidgets. 

Around the walls of this school in the Bronx are colorful construction paper displays that highlight essays like “The Things I Love” and “What Makes Me Scream.”

An article on Scholastic.com, whose source was Instructor Magazine, describes how a program called  “Turnaround for Children” works.

PS 32  in the Bronx decided five years ago that its 800 students needed  more than skills and drills.  Nearly all the children come from very poor, stressed and sometimes chaotic families.

Principal Esther Schwartz says, “Before they can begin to learn, our children often need help with basic social skills — sharing or taking a turn.  Many need help regulating their attention, their emotions, or controlling their impulses.”

In the five years since this Bronx school first implemented Turnaround for Children, the percentage of kids deemed proficient in reading has risen from 30 to 70 percent.

Turnaround for Children helps administrators identify troubled kids, and then works with teachers to build academically rigorous and emotionally healthy learning communities.  It does this by making social and emotional skill-building part of the comprehensive curriculum.

“We’ve discovered that social and emotional skill-building goes hand in hand with learning,” says Schwartz.

FIVE SKILLS TO TEACH 

Researchers have begun to identify the soft skills that kids need to succeed at school and in life.  Below are the five most important, with some tips on what you can do in the classroom to help foster the growth of these skills.

1.     Naming Your Feelings 

Most parents, caregivers and teachers provide this instruction almost reflexively.  If a toddler is crying, Mom may ask, “Are you upset because you want that toy?”  This soothes, but it also  provides a lexicon for the highly charged moment. 

With kids from somewhat deprived backgrounds or with older kids, the job of helping a child sort and articulate shades of emotion becomes part of a teacher’s job.

Child psychologist Pam Cantor is chief of Turnaround for Children.  She says the simple, puppet-based program featuring Mr Snail and Mr Grasshopper, developed by her staff and taught once  a week, can help kids name what they’re feeling.  Then they can begin to fend off tantrums and meltdowns. 

If Turnaround for Children isn’t being implemented at your school, you can opt for a less formal approach involving classroom discussion.

For example, if a child refuses to speak during circle time out of shyness, you might say, “That’s okay Andre.  Sometimes I don’t feel like talking either.  But if you want to share later, we’d love to hear from you.”

Then talk to the child individually about ways to calm his anxiety, such as taking deep breaths.    Finally, try hosting a whole-class discussion about how to overcome shyness.

2.     Building Trusting Relationships

Anthony Bryk of the Carnegie Foundation for the Advancement of Teaching wrote in his now-classic study that trust is the emollient that keeps schools running smoothly.  Nowhere is that more important than in the classroom, in the teacher-student relationship.

When teachers take the time to establish trusting relationships with students, they can see a world of difference.  “It makes learning more powerful,” says Mary Utne O’Brien, psychology professor at the University of Illinois.

“Many teachers bemoan the fact that they don’t feel like they have time to develop those relationships.  I would argue that building trust is the first lesson before any others.” 

O’Brien says small gestures mean a lot.

She suggests that you be predictable, be consistent, and do what you say you will do.  Articulate that you want the children to learn.  Then show them that you’re willing to go the extra mile to ensure that they do.  These acts will help children learn to trust you  — as well as the larger community.

“Children have to trust that their teacher cares about their education.”  Having the capacity to trust allows a child to focus on what’s important — learning.

3.     Staying in Control

Several studies show that the ability to inhibit impulsive mental, verbal and physical responses — and to remain engaged in goal-directed thinking without calling out, fidgeting or responding to provocation  — is key for school success.

In one study, researchers at Pennsylvania State University found that children who had the strongest regulatory abilities tended to do as well –  sometimes better than — less regulated children who had higher IQs.  The same is true of older children.

The study found that the least impulsive and most self-disciplined of the group had better grades and study habits.  They got into more selective high schools than their peers with higher IQs but less controlled behavior.

“By the time children start school, they are expected to sufficiently regulate impusivity in order to engage in learning experiences with teachers and classmates,’  says Clancy Blair, lead researcher.

Depending on the age of your students, introduce simple lessons in controlling impusivity.  This will go a long way toward helping kids learn to focus. 

Learning to self-talk is an excellent way to build self-control.  One common approach is to encourage kids to “think aloud” as they complete a project or problem.  Teach them to say or whisper each step as they perform it.  This process can help boost the kind of silent self-talk that comes naturally to more disciplined kids.

4.     Having Curiosity

Curiosity may be the key to success on a lot of levels, academic and otherwise.  It may be even more important overall than happiness.

Curiosity leads to mindfulness, says Todd Kashdan, professor at George Mason University.  

Mindfulness is the engaged, satisfied state of being one feels when absorbed in a meaningful task, whether it’s achieving an A in a class or organizing a blood drive.  Kashdan is the author of “Curiosity: Discover the Missing Ingredient to a Fulfilling Life.“

According to Kashdan, teachers are in a unique position to foster curiosity in the classroom and put their kids on the road to mindfulness and mental health.

How to do it? 

Rote memorization of facts is the enemy of the curious mind, he says.  Whenever possible, banish rote learning.  Help students understand events in the Civil War from different perspectives.  Discuss whether the Civil War might have been a bad or a good thing for a Southern mill owner, a Northern shipping tycoon, a slave, or the President.  Such discussions promote the kind of thinking that will pay off later.

“Children who are taught there is a difference in perspectives maintain the mental and emotional receptiveness they need to remain curious,” says Kashdan.  “High levels of curiosity translates into a child’s ability to think critically, problem-solve more creatively, and even to recognize different strengths in different kinds of kids.”

If you’re still not wanting to change your Civil War curriculum, think about this, says Kashdan.   As curious kids grow up, they are better able than their less curious classmates to find things to be passionate about.   

5.     Expressing Gratitude

Even for star pupils, school can sometimes be difficult.  Help children balance some of the challenges of learning by giving them the opportunity to express gratitude. 

Expressing gratitude  leads to warmer feelings toward the teacher, as well as higher levels of school engagement.  Even with children who struggle, this translates to better GPAs. 

And a fringe benefit is that grateful kids also experience less envy and are less materialistic.

How does this work? 

Jeffrey Froh, professor of psychology at Hofstra University, says when teachers encourage kids over age 7 to regularly name and describe what they are grateful for in their lives, they begin to see how interconnected they are to other people.  “They see who is helping them.”

Not everyone benefits equally.  “Some kids have more baseline gratitude than  others,” says Froh.  Certain children take to gratitude easily, but  for some it continues to be an effort.  “But when you make the discussion of gratitude in the classroom more fluid and regular, everyone benefits a little,” says Froh.

Start by sharing your own thank yous:  “Thanks for walking to lunch so quietly.”  “Thank you for picking up your candy wrapper!” 

By modeling gratitude — articulating how people are helping you and your feelings of warmth toward them for their help — you can support children in becoming more grateful themselves.

source:  from Scholastic.com, article whose source was Instructor Magazine.  No author noted.   http://www.2.scholastic.com

tutoring in Columbus OH:   Adrienne Edwards   614-579-6021   or email  aedwardstutor@columbus.rr.com  

+ AileyCamp: Dance and Life Lessons Each Summer

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Alvin Ailey’s Dance Theater has run dance camps for kids since 1989.  The summer camps target kids with academic, social and domestic challenges — criteria that often determin a child’s risk of dropping out of school. 

An important aspect of AileyCamp’s program is in providing positive adult and peer role models.  Another is to  give campers an invaluable opportunity to explore their creativity, to learn to master their bodies, and to strengthen their respect for themselves and others within a supportive framework that gives them a foundation for the future.

The camp curriculum includes daily technique classes in ballet, Horton-based modern dance, jazz, and tap. 

Campers also participate in personal development and creative communications classes.

Topics of discussion during the personal development classes include goal setting, self-government, nutrition, conflict resolution, career development and self-image building.

Techniques of performance and creative communication deepen the students’ awareness of their potential for self-expression.

AileyCamp Tool is a special follow-up program for campers, with the goal of reinforcing and expanding upon the meaningful experiences of the summer program. 

Noted educator Howard Gardner said,

“The most important moment in a child’s education is the ‘crystallizing experience’ — the experience that helps a young person focus, engage and deeply connect to something he or she cares about.”

In 2009, AileyCamps were held in Los Angeles, Atlanta, Kansas City (where it all began in 1989), Berkely, New York City, Staten Island, Boston, Bridgeport, Chicago and Miami.

Visit the Alvin Ailey Dance Theater site at http://www.alvinailey.org/page.php?p=arti&v=16&sec=programs

tutoring in Columbus OH:   Adrienne Edwards   614-579-6021   or email  aedwardstutor@columbus.rr.com

+ Helping Children Hospitalized for Rages

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Temper outbursts, sometimes called rages, have been associated with mania, Tourette disorder, intermittent explosive and conduct disorders,  and Autism/Aspergers, as well as other disorders.

The term “rage” implies that outbursts consist solely of high-intensity anger, but in fact, experts know little about their content or structure.

Researchers at Stony Brook University School of Medicine studied 130 children aged 7 to 11, one fifth female. 

Researchers were Gabrielle Carlson, MD, a professor of psychiatry at Stony Brook School of Medicine; Michael Potegal, PhD, University of Minnesota associate professor of pediatrics and neurology; and Paul Grover, RN, who is a parent educator in the department of nursing at Stony Brook University Hospital.

 Diagnostic and behavioral data was collected over 18 months.  A rage observed in the hospital setting was defined as having started when the child became loudly verbally defiant and out of control when asked to do or stop doing something by the staff.

The outburst was observed at 5, 15, 30, 45, 60, 90 and 120 minutes after onset by the nursing staff.  Behaviors coded during each rage included

• verbal acts — whining, verbal threats, cursing, yelling, screaming
• discrete physical acts — stamping, posturing, pulling, throwing things, biting, scratching, punching the wall, hitting, kicking
• expressive psychomotor behaviors — tearful/sad, anxious/fearful, withdrawn/unresponsive

Researchers note that of observations in the hospital, manic behaviors were not seen.

During the study  the most common behaviors observed were angry behaviors (93 percent).   Tears and anxiety occurred in fewer than half.  An episode of rage generally lasted 45 minutes, although it could vary from longer than 60 minutes (19 percent) to less than 30 minutes (19 percent).

The number of rages correlated positively with length of stay in the hospital; rage episodes added at least 2 weeks to the duration of hospitalization.  Most children improved with a combination of behavior modification, family treatment, appropriate academic intervention, and medication.

The inpatient behavior modification approach focuses on teaching children self-control, as well as helping parents learn suitable responses to their child’s behavior.

Hospitalized children who behave appropriately earn points toward fun activities and increased time for home visits.

Time Out

It’s especially important, researchers feel, for children with a history of rages to learn to take a Time Out.

By sitting  quietly in a chair for 10 minutes and then talking with a therapist or staff member, the child learns to identify the triggers that lead to a rage outburst and alternative behaviors for mitigating an episode of rage.

Many children, they say, respond favorably to the unit structure and the Time Outs from the time of admission.  Staff members who observe children starting to lose control will also teach them to “chill out” before a full-blown raging episode occurs.  This technique places self control in the child’s hands.

Children who are unable to take a Time Out are escorted to the quiet room where the door remains open (as long as they stay in the room and don’t try to hurt themselves).  A nurse unobtrusively observes until the child has remained quiet for 10 minutes and can subsequently talk about alternatives.  This option has cut the use of closed seclusion and physical restraint dramatically.

It is true that some children simply can’t calm themselves and require medication; a few children become so unreachable when they are angry or distressed that no corrective intervention has been successful.  Researchers say alternative strategies such as collaborative problem solving may be an option, but these have not been studied sufficiently.  These children require the longest duration of hospitalization.

Parental Involvement

To maintain gains made by the children, the staff begins to work with parents immediately on admission.  To ensure cooperation and reduce defensiveness, the therapist helps parents understand that while they didn’t create the child’s problems, these problems nevertheless require a particular approach.

Parents who feel sorry for the child may think any form of consequence is unfair, so the social learning paradigm (behavior modification) is reframed to state that behavior that causes failure has a negative consequence.  Behavior that ensures success earns a positive consequence.  Most parents want their children to succeed.

Parents are taught to use the Time Out procedure when the child is not following directions, or when he or she exhibits verbal or physical aggression.

In optimum circumstances, parents learn the procedure and are able to get their child to take a successful Time Out before the child has a pass for a home visit, and certainly before discharge.  Like the children themselves, parents have different learning curves in understanding and responding consistently and appropriately to their children.

Time  on therapeutic passes provides plenty of opportunity for parents to practice skills with the option of bringing the child back from home pass if the child is unable to take successful Time Outs.  This step is vital to support the parents’ effort to gain the child’s cooperation.  A confident, reasonable, and well-trained parent helps the child after discharge.  Some children need a readmission before they understand that coercing caregivers into capitulating is not an option.

Discharge planning included smaller, special education class placements.  Ninety percent of children with rages received an ADHD medication and/or an atypical antipsychotic/mood stabilizer.   They were 4 times more likely to receive both than children without rages.

Multidisciplinary treatment was partially successful for most children, but children continued to  need many services and polypharmacy.  Successful parenting was necessary but rarely sufficient in and of itself to manage children with rage behaviors.

Researchers feel that much additional research is needed in order to develop a more consistently successful series of options.  Rage behaviors are a condition that is not only common but disabling – this is a situation that needs solutions.

source: for  the complete article, visit www.psychiatrictimes.com.  Article was in the Psychiatric Times, Vol 26, No7.  Authors are Gabrielle A Carlson MD, Michael Potegal, PhD, and Paul J Grover, RN.

tutoring in Columbus OH:   Adrienne Edwards   614-579-6021   or email  aedwardstutor@columbus.rr.com

+ Summertime Tips from an ADD Coach

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Here is a great site for information about living with ADD or ADD kids: http://www.addstudent.com.

Brenda Nicholson is an “ADD mom,” and an ADD coach of many years.

Summertime, with its endless free time, no “getting up” or “going to bed” time, can be distressing for kids with ADD.

Brenda says most ADHD kids thrive on structured, organized environments.  But every kid, and every family, is different.  Build in the structure that’s right for your household.

You might establish a set reading time — perhaps the hour after lunch, or mid-afternoon when it’s hottest.  Read to each other; almost everyone loves being read to.  Or read silently.  Turn off the electronics. 

Brenda sometimes creates a theme for the summer months.  International summer: each week they picked a country and learned about it.  They’d cook a meal that was typical for the country; make crafts tied to the culture of the country.

And she feels summer is a great time for experimenting with crafts.  Kids can use paints and glitter and glue with abandon at a table out on the grass.  Boy Scout (Girl Scout) handbooks are terrific sources for activities.

And don’t forget the library for books and local events.

She offers 5 tips:

1. Encourage reading for pleasure.  Kids lose a portion of their reading skills during summer break.  This means teachers have to backtrack for a few weeks to bring them back up to speed.  And those reading skills directly impact math and science learning.
2. Improve your children’s diets.  Take advantage of fresh fruits and vegetables.  Rely less on packaged or processed foods.  Brenda: “Take the words drive-through out of your vocabulary.”
3. Give kids a chance to live by their own rhythms a bit, though.  Let them stay up later and sleep in (reasonably, of course.)
4. Encourage time spent  outdoors.  Being outdoors seems to soothe the ADHD soul.    Let kids get dirty, watch insects, notice what sounds they hear and how it makes them feel.  Let them check how   water and rain affect sand or earth.  Put up a basketball hoop or a pool.  Join a pool.  Ride bikes; roller blade.  Go camping; put up a tent outside.  Plan your vacation in an outdoor setting or at a national park.
5. Use activities they love to teach skills.  If  focusing is a problem, look for times or situations when he focuses well.  For example, if he can concentrate when he plays baseball, talk about how that works and feels; question him about what happens when he concentrates.  Discuss how to tranfer that to other activities.   

If you’re traveling with kids in a car, suggests Brenda, pack lunches and snacks and stop frequently at a rest area; they can get out of the car and really move.  The peace of mind will be well worth the extra time you spend.  

 Whether driving or flying, bring along DVDs or handheld games.  Have certain games and activities that are “just for the car” or “just for the trip.”  

Also, she says, Mother Nature can help you out: if you start the trip at 4am, some of the time can be spent sleeping.

Check out Brenda’s site.  It looks very helpful.  You can contact her directly for advice (she gives her email address), and subscribe to her RSS feed.

tutoring in Columbus OH:   Adrienne Edwards   614-579-6021   or email  aedwardstutor@columbus.rr.com