Wednesday, June 2, 2010

More Fixes For Attentional Issues

More thoughts about why your child is having attentional difficulties, and some possible solutions.

1.  If your child does not have a set bedtime, it's time to enforce one.  Small children need an average of ten or eleven hours of sleep every night.  If your child has trouble transitioning into sleep, limit computer time and video gaming during the school week.   Turn off any computer activities, which stimulate the brain, a minimum of two to three hours before bedtime.  Try a warm bath in Epsom salts.

2.  Is your child overscheduled?  I evaluated a four year old a few years ago whose parents couldn't  figure out how to squeeze his OT in around all of his after school activities.  He was enrolled in soccer, cooking class, acting class,  woodworking, and ice skating.  I tried and tried to tell his parents, who were both highly ambitious and driven,  routinely worked fourteen hour days, traveled to Europe and Asia on business at least once a month, and socialized with their work colleagues every weekend, that just one of those activities would be enough for a child his age.  Many of his issues were stemming directly from having to be "on" all of that time for strangers, and from being passed from day nanny to night nanny to weekend nanny and back again,  rarely spending any down time with his parents.  They didn't listen, and although his sensory issues cleared up, according to his teacher's report of how he functioned in the classroom, his behavioral issues did not.

3.  For a child who gives up easily, find something he enjoys and can succeed at, and build from there.  What makes your child stand out and feel special? Nothing motivates like success, and nothing impairs the ability to succeed like poor tolerance for frustration.

4.  If your child has attentional issues,  activities that encourage him to hyperfocus to the exclusion of everything else, like video games, should be kept to a minimum.  The best kind of attention for succeeding at school, and for most of modern life, is one that is flexible.  It takes in  and  processes  sensory information while filtering it as needed.  This make it possible to attend to what is most relevant, while registering, without necessarily responding to, ambient sounds, smells, and movement in the environment.  In other words, a child's ability to focus should include an easy awareness of  everything around him, without being distracted by it.  He ideally should have no problems with temporary interruptions and be able to easily switch gears back and forth between activities.

5.  Children who have a hard time attending to fine motor tasks or to close work like drawing, reading, or writing often have undetected visual problems and might benefit from a course of vision therapy.

6.  Does your child have a hard time sitting down to homework? Make sure he gets some time outside, has eaten a nutritious snack with some protein, and has had a good drink of water before demanding that he sit back down.  He's been doing it all day, and he needs to move to activate his brain.  Build movement breaks into his homework time as needed, and incorporate movement into anything that requires problem solving, rote learning, and memorization.  A piece of hard candy to suck on helps the child concentrate and pulls the eyes in together.

7.  Walkers for babies are not a good idea.  They interfere with normal development by keeping the child upright when he should be crawling.  Crawling, among many other things, integrates communication between the two sides of the brain and body, sets up the trunk and pelvis for walking, strengthens the shoulders and hands for fine motor coordination, and develops visual skills like figure ground and depth perception.  Crawling is a critical part of development, and if it is interfered with, or if the crawling phase is too short, the child's physical and neurological maturation can experience delays.  This will in turn affect his ability to sit and attend.  Encouraging low tone children to do activities on hands and knees, like putting together puzzles on the floor and crawling through tunnels, will help recover some of those missing skills, even when the crawling stage is long past.

8. If your child is older than the age of, say about three, it's time to ditch the stroller. I see five and six year olds stuffed into strollers in New York, and it makes me nuts. Children can't develop balance, strength, depth perception, or endurance {things they need to help them sit still for long periods} if they're being strolled everywhere they go.

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