Working with Scouts with ADHD University of Scouting 2011

1. Working with Scouts with ADHD University of Scouting 2011

2. Dr. Charles Pemberton, LPCC Past President KCA ACA Chair - Taskforce on DSM 5 Ed.D. in Educational Counseling 20years in Counseling and Mental Health SR-989, Pack Trainer, Member of Review Board PARENT Adjunct Professor – Graduate University of Louisville Undergraduate –KCTCS Private Practice – 80% children and families Introduction

3. Diagnosis and Identification Meeting interventions Behavioral Strategies Tools and Resources Questions Won’t get a plan that works Everywhere with Everyone Today’s Schedule

4. Biological Disorder Neurological – dopamine/norepinephrine Genetic Toxins Head injuries Immunizations No evidence: Sugar Food additives Allergies Causes of ADHD

5. Characteristics of ADD/ADHD Impulsivity Hyperactivity Inattention The Tip of the Iceberg Hidden below the surface

6. Characteristics of ADD/ADHD Impulsivity Inattention Hyperactivity Physiological Factors Coexisting Conditions Delayed Social Maturity Weak “Executive Functioning” Learning Difficulties Sleep Disturbance Not Learning Easily From Rewards and Punishment Low Frustration Tolerance Impaired Sense of Time Hidden below the surface

7. 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 Major Features

8. What you see • Anxiety • Depression • Impulsivity • Inattention • Hyperactivity • emotional libility • mood swings • compulsions • Change in ability to deal with transitions • Change in sleep • Decreased socialization • Decreased creativity

9. Engaging Bright Excited Creative Happy-go-lucky Enthusiastic Exceptional Inquisitive Spontaneous Clever Unique Eager Energetic Carefree ADHD SCOUTS HAVE GREAT ATTRIBUTES TOO!

10. 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.” Medication

11. Prescription 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. Medication

12. Get trained Complement They are all individuals Clear expectations Talk to Parents about what works Meetings Day trips Weekends Week long How to help

13. 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 How to help

14. 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) How to Help

15. 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 Forgetting

16. Establish “study buddy” Good seat Work reductions Consult with advancement policies Allow Movement – purposeful Watch for fatigue How to Help

17. 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 Movement

18. Be 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. Warning Signs

19. During activities, games and transition times, be aware when a Scout is starting to become more impulsive or aggressive. Warning Signs

20. Minimize distractions Give choices Limit Choices Teach problem solving Use calm discipline - distraction Helping a child control his behavior

21. When 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. Whenever possible, “sandwich” correction between two positive comments. Redirecting

22. If it has not been possible to intervene proactively and you must impose consequences for out-of-control behavior, use time-out or “cooling off.” Time out

23. Don’t take challenges personally. ADHD Scouts want to be successful, but they need support, positive feedback, and clear limits. Keep Cool

24. Through systematic Explanation, interactive Demonstration, and Guided practice, Scouting Enables ADHD Scouts to discover and develop their unique strengths and interests. EDGE

25. Expect the ADHD Scout to follow the same rules as other Scouts. ADHD is NOT an excuse for uncontrolled behavior. Excuses

26. ADHD Scouts are generally energetic, enthusiastic, and bright. Many have unique talents as well. Help them use their strengths to become leaders in your troop. Final Word

27. Working with Scouts with Disabilities http://www.wwswd.org/ Teenagers with ADD: A Parents’ Guide www.myadhd.com www.adhdhelp.com www.dimensionsfamilytherapy.com Tools/Resources

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

29. 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. References