dimensions family therapy 2302 hurstbourne village dr. suite 300 louisville, ky 40299 phone:...
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DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Working with Scouts with ADHD
University of Scouting 2013
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Introduction• 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 –
• Graduate University of Louisville• Undergraduate –KCTCS
– Private Practice – 80% children and families
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Today’s Schedule• Diagnosis and Identification• Meeting interventions
– Behavioral Strategies• Tools and Resources• Questions• Won’t get a plan that works
Everywhere with Everyone
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Causes of ADHD• Biological Disorder
– Neurological – dopamine/norepinephrine– Genetic
• Toxins• Head injuries• Immunizations• No evidence:
– Sugar– Food additives– Allergies
Hyperactivity
ImpulsivityInattention
Characteristics of ADD/ADHD
The Tip of the Iceberg
Hidden below the surface
Characteristics of ADD/ADHD
Hyperactivity Impulsivity Inattention
PhysiologicalFactors
Weak “Executive Functioning”
Sleep Disturbance
Impaired Sense of Time
Delayed Social
Maturity
Not Learning EasilyFrom Rewards and
Punishment
CoexistingConditions
LearningDifficulties
Low Frustratio
nTolerance
Hidden below the surface
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Major Features• Often will not complete tasks• Easily distracted by minor stimuli• Work often messy and completed w/o
thought• Forgetful in day-to-day activities• Impulsive (interrupting others, cannot
wait turn, etc.)• Fidgetiness• Excessive talking
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
ADHD SCOUTS HAVE GREAT
ATTRIBUTES TOO!• Engaging• Bright• Excited• Creative• Happy-go-lucky• Enthusiastic• Exceptional• Inquisitive
• Spontaneous• Clever• Unique• Eager• Energetic• Carefree
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Medication – parents’ info• If 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 Scout’s physician.
• Make sure your Scout knows that medication is to help him focus, not make him “be good.”
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
MedicationPrescription 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.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
How to help• Get trained• Complement• They are all individuals• Clear expectations• Talk to Parents about what works
– Meetings– Day trips– Weekends– Week long
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
How to help• Set a schedule (mental/physical)
– Know what is expected– Use daily/weekly forms for planning– Use color codes– Limit time– Give Breaks– Provide review– Provide Transition time
• Minimize spaces/distractions• Organize
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
How to Help• Put it in writing• Set smaller/reachable goals• Divide into smaller segments • Reward all completions• Review for ‘hasty’ errors• Work on discovering what is really
happening – (i.e. Forgetting)
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Forgetting• 1- Need to notice• 2- Need to write/record• 3- Need to bring home• 4- Need to look• 5- Need to understand• 6- Need to start/finish• 7- Need to store• 8- Need to turn-in
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Movement• Offer opportunities for purposeful
movement, such as – Leading cheers– Performing in skits– Assisting with demonstrations
• This may– Improve focus, – Increase self-confidence, and– Benefit the troop as a whole
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Warning 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.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Warning Signs
During activities, games and transition times, be aware when a Scout is starting to become more impulsive or aggressive.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Helping a child control his behavior
• Minimize distractions• Give choices• Limit Choices• Teach problem solving• Use calm discipline - distraction
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
RedirectingWhen 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. • Don’t “sandwich” a correction
between two positive comments.– Good, bad, good
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Time 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.”
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Keep CoolDon’t take challenges personally.
ADHD Scouts (should be “Scouts with ADHD”)
want to be successful, but they need support,positive feedback,and clear limits.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
EDGEThrough systematic Explanation, interactive Demonstration, and Guided practice, Scouting Enables Scouts with
Scouts to discover and develop their unique strengths and interests.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Excuses Expect the Scout with ADHD
to follow the same rules as other Scouts.
ADHD is NOT an excuse for uncontrolled behavior.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Some bad Examples• We• A 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.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Suggested Strategies• We• Tell 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.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Suggested Strategies• We• Allow for extra time for some Scouts to compete
certain steps• Have different (and adjustable) activities for faster and
slower learners• Try 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.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Suggested Strategies• We• A 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 boy’s 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)
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Summing it up• Don’t Spoil Me. I know I should not
get all I ask for. I am only testing you• Don’t be afraid to be firm with me. I
prefer to know where I stand• Don’t use force with me. It teaches
me that power is all that counts. I respond better to examples of what I should do
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Summing it up• Don’t be inconsistent. You’ll just
confuse me and make me try harder to get away with anything I can
• Don’t make promises you can’t keep. I will learn not to trust you
• Don’t let me provoke you. If I say or do things to upset you, don’t blow up or I may do it again. I don’t mean it. I just want you to feel sorry for me.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Summing it up• Don’t me feel smaller than I am. I’ll
just make up for it by acting like a big shot.
• Don’t do things for me that I can do myself. This only makes me more dependent.
• Don’t give my bad habits a lot of attention. This only encourages me to keep showing these to you
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Summing it up• Don’t 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
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Final 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.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Tools/Resources• Working with Scouts with
Disabilities – http://www.wwswd.org/
• Teenagers with ADD: A Parents’ Guide
• www.myadhd.com• www.adhdhelp.com• www.dimensionsfamilytherapy.com
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
Referenceshttp://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.
DimensionsFamilyTherapy
2302 Hurstbourne Village Dr.Suite 300
Louisville, KY 40299Phone: 502-491-
9720Fax: 502-491-9721
www.LouisvilleDFT.com
References• American 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 disorder—questions 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 disorder—questions 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.