Working with Scouts with ADHD University of Scouting 2013

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Working with Scouts with ADHD University of Scouting 2013. Dr. Charles Pemberton, LPCC Past President KCA ACA Chair - Taskforce on DSM 5 Ed.D . in Educational Counseling 20+ years in Counseling and Mental Health SR-989, Cubmaster, Member of Review Board PARENT Adjunct Professor - PowerPoint PPT Presentation

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Working with Scouts with ADHD

University of Scouting 2013DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comIntroductionDr. Charles Pemberton, LPCC Past President KCA ACA Chair - Taskforce on DSM 5 Ed.D. in Educational Counseling20+ years in Counseling and Mental HealthSR-989, Cubmaster, Member of Review BoardPARENTAdjunct Professor Graduate University of LouisvilleUndergraduate KCTCSPrivate Practice 80% children and familiesDimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comTodays ScheduleDiagnosis and IdentificationMeeting interventionsBehavioral StrategiesTools and ResourcesQuestionsWont get a plan that works Everywhere with EveryoneDimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comCauses of ADHDBiological DisorderNeurological dopamine/norepinephrineGeneticToxinsHead injuriesImmunizationsNo evidence:SugarFood additivesAllergies

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com

HyperactivityImpulsivityInattentionCharacteristics of ADD/ADHD

The Tip of the Iceberg Hidden below the surfaceDimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comCharacteristics of ADD/ADHDHyperactivityImpulsivityInattentionPhysiologicalFactorsWeak Executive Functioning

Sleep DisturbanceImpaired Sense of TimeDelayed SocialMaturityNot Learning EasilyFrom Rewards andPunishmentCoexistingConditionsLearningDifficultiesLow FrustrationToleranceHidden below the surfaceDimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comMajor FeaturesOften will not complete tasksEasily distracted by minor stimuliWork often messy and completed w/o thoughtForgetful in day-to-day activitiesImpulsive (interrupting others, cannot wait turn, etc.)FidgetinessExcessive talkingDimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comADHD SCOUTS HAVE GREAT ATTRIBUTES TOO!EngagingBrightExcitedCreativeHappy-go-luckyEnthusiasticExceptionalInquisitive

SpontaneousCleverUniqueEagerEnergeticCarefree

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comMedication parents infoIf your Scout takes medication to help him focus at school, it may help him focus better during Scout activities as well. You may want to discuss this issue with your Scouts physician.Make sure your Scout knows that medication is to help him focus, not make him be good.DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com9MedicationPrescription medication is the responsibility of the Scout taking the medication and/or his parent or guardian. A Scout leader, after obtaining all necessary information, can agree to accept the responsibility of making sure a Scout takes the necessary medication at the appropriate time, but BSA policy does not mandate nor necessarily encourage the Scout leader to do so. Also, if state laws are more limiting, they must be followed.DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com10How to helpGet trainedComplementThey are all individualsClear expectationsTalk to Parents about what worksMeetingsDay tripsWeekendsWeek long

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com11How to helpSet a schedule (mental/physical)Know what is expectedUse daily/weekly forms for planningUse color codesLimit timeGive BreaksProvide reviewProvide Transition timeMinimize spaces/distractionsOrganizeDimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com12How to HelpPut it in writingSet smaller/reachable goalsDivide into smaller segments Reward all completionsReview for hasty errorsWork on discovering what is really happening (i.e. Forgetting)DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com13Forgetting1- Need to notice2- Need to write/record3- Need to bring home4- Need to look5- Need to understand6- Need to start/finish7- Need to store8- Need to turn-inDimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com14MovementOffer opportunities for purposeful movement, such as Leading cheersPerforming in skitsAssisting with demonstrations

This mayImprove focus, Increase self-confidence, andBenefit the troop as a whole

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com15Warning SignsBe aware of early warning signs, such as fidgety behavior, that may indicate the Scout is losing impulse control. When this happens, try a

Private, nonverbal signal or

Proximity control (move close to the Scout)

to alert him that he needs to focus.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com16Warning SignsDuring activities, games and transition times, be aware when a Scout is starting to become more impulsive or aggressive.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com17Helping a child control his behaviorMinimize distractionsGive choicesLimit ChoicesTeach problem solvingUse calm discipline - distractionDimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com18RedirectingWhen you must redirect a Scout,

Do so in private, in a calm voice, unless safety is at risk.Avoid yelling. Never publicly humiliate a Scout. Dont sandwich a correction between two positive comments.Good, bad, good

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com19Time outIf it has not been possible to intervene proactively and you must impose consequences for out-of-control behavior, use time-out or cooling off.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com20Keep CoolDont take challenges personally. ADHD Scouts (should be Scouts with ADHD)want to be successful, but they need support,positive feedback,and clear limits.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com21EDGEThrough systematic Explanation, interactive Demonstration, and Guided practice, Scouting Enables Scouts with Scouts to discover and develop their unique strengths and interests.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com22Excuses Expect the Scout with ADHDto follow the same rules as other Scouts. ADHD is NOT an excuse for uncontrolled behavior.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com23Some bad ExamplesWeA fair trial often includes assessing the scout's behavior on camping trips or other activities both on and off his medication. If you choose to have your son take no medication for 1-2 events and he is unable to focus and benefit from the experience, it is reasonable to then medicate him for 1-2 events to determine if the medication actually yields any benefit. If the scout clearly does better on medication than off, it is expected that he will remain on medication for all activities longer than 2-3 hours.DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comSuggested StrategiesWeTell the Scouts in advance what they will learn Provide a combination of visual, written and oral instructions since these help the Scout to focus and remember the key parts of a learning activity. Repeat instructions often Break large tasks into a set of smaller tasks or steps and monitor for completion of each step Make a written list of these steps and allow the Scout to cross off each step as it is completed. This method may also be used for any number of tasks.Work on one step at a time.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comSuggested StrategiesWeAllow for extra time for some Scouts to compete certain stepsHave different (and adjustable) activities for faster and slower learnersTry to provide a quiet area with limited distractions. Create a routine and expectations for each meeting.Plan short breaks Provide an area or time where the Scouts can move around and release excess energy. Establish a clearly defined and posted system of rules and consequences for behavior.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comSuggested StrategiesWeA card or a picture may serve as a visual reminder to use the right behavior, like raising a hand instead of shouting out, or staying in a seat instead of wandering around the room.Accept and praise each boys best effort in keeping with the Scout Oath. Never make comparisons. Help everyone to understand that while fair means giving everyone what he need, it is not necessarily equal. (Weinstein, 1994)

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comSumming it upDont Spoil Me. I know I should not get all I ask for. I am only testing youDont be afraid to be firm with me. I prefer to know where I standDont use force with me. It teaches me that power is all that counts. I respond better to examples of what I should doDimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com28Summing it upDont be inconsistent. Youll just confuse me and make me try harder to get away with anything I canDont make promises you cant keep. I will learn not to trust youDont let me provoke you. If I say or do things to upset you, dont blow up or I may do it again. I dont mean it. I just want you to feel sorry for me.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com29Summing it upDont me feel smaller than I am. Ill just make up for it by acting like a big shot.Dont do things for me that I can do myself. This only makes me more dependent.Dont give my bad habits a lot of attention. This only encourages me to keep showing these to you

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com30Summing it upDont correct me in front of others. It is better to correct me quietly and in private.Don't discuss my behavior in the heat of conflict. I don't hear or cooperate well at this time. Do what needs to be done, but save the words for later.Don't preach to me. You'd be surprised how well I already know what's right and wrong

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com31Final WordScouts with ADHD are generally energetic, enthusiastic, and bright. Many have unique talents as well. Help them use their strengths to become leaders in your troop.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com32Tools/ResourcesWorking with Scouts with Disabilities http://www.wwswd.org/Teenagers with ADD: A Parents Guidewww.myadhd.comwww.adhdhelp.comwww.dimensionsfamilytherapy.com

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comReferenceshttp://www.additudemag.com/adhdforums/thread/6480.html

http://scoutingmagazine.org/2000/10/unit-leaders-and-add/

http://www.bsa-gwrc.org/district/wp/guide-ADD_Handout.html

The ADD/ADHD Iceberg adapted by permission of Chris Dendy, Teaching Teens With ADD and ADHD: A Quick Reference Guide.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.comReferencesAmerican Academy of Pediatrics. Diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics. 2000;105:1158-1170. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. DSM-IV-TR. In: Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence: Diagnostic Criteria for Attention-Deficit/Hyperactivity Disorder. Washington, DC: American Psychiatric Association; 1994:92-93. National Institute of Mental Health. National Institutes of Health. Attention deficit hyperactivity disorder. Available at: http://www.nimh.nih.gov/publicat/helpchild.cfm. Accessed April 19, 2002. U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Available at: http://www.surgeongeneral.gov/library/mentalhealth/chapter3/sec4.html. Accessed April 19, 2002. Dulcan M. Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 1997;369(suppl):855-1215. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. DSM-IV-TR. In: Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence: Diagnostic Criteria for Attention-Deficit/Hyperactivity Disorder. Washington, DC: American Psychiatric Association; 1994:92-93. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. DSM-IV-TR. In: Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence: Diagnostic Criteria for Attention-Deficit/Hyperactivity Disorder. Washington, DC: American Psychiatric Association; 1994:92-93. National Institute of Mental Health. National Institutes of Health. Attention deficit hyperactivity disorderquestions and answers. Available at: http://www.nimh.nih.gov/publicat/adhdqa.cfm. Accessed April 19, 2002. National Institute of Mental Health. National Institutes of Health. Attention deficit hyperactivity disorderquestions and answers. Available at: http://www.nimh.nih.gov/publicat/adhdqa.cfm. Accessed April 19, 2002. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.Fauman, M. A. (2002). Study Guide to DSM-IV-TR. Washington, DC: American Psychiatric Publishing, Inc.

DimensionsFamilyTherapy2302 Hurstbourne Village Dr.Suite 300Louisville, KY 40299Phone: 502-491-9720Fax: 502-491-9721www.LouisvilleDFT.com

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