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Archive for the ‘ADHD’ Category

50. Time’s Up

Posted in ADHD, Family, Homeschooling, Special Education, tagged , , , on July 9, 2012 | Leave a Comment »

Come on. You know why. Remember where Kenny was when the day hit its halfway mark in fourth grade? Just a few months ago? That’s right. That was him—metaphorically swinging from the hypothetical chandeliers. To paraphrase Popeye, he’d had all he could stand, and he couldn’t stand no more. His sensory filter was overflowing. His neurons needed a nap.
He needed time to absorb the morning’s worth of experiences. No amount of threats or promises, checks or x’s, medication or meditation could make it possible for him to sit in any classroom through three more hours of school. Even here. Even now.
Ding! Time’s up! Great class or not, this was his limit.So where are we? Home. At last. With Kenny. After all, this is Kenny’s story.To simplify life for all the grownups involved, Kenny is staying with Henry and me at our house during the school week and going back to Annie’s on weekends. There’s a lot to keep track of: medication, transportation, communication, behavior modification, and education coordination with the “home and hospital” aide whom the school system has provided as Kenny’s official tutor.

I think I’d better start keeping notes.

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49. Happytown

Posted in ADHD, Education, Homeschooling, Special Education, tagged , , , , on July 7, 2012 | Leave a Comment »

It was the middle of one of those standardized testing weeks. When I arrived to pick Kenny up from school, Mrs. Hart had given the class a break, some free time between tests. Her plan had been to let them unwind a little before they watched a video.
But then she noticed that, instead of breaking up individually or into small groups doing unrelated things, all eleven of them were over in the same corner together, building with k’nex and constructing elaborate villages, with overlapping activities and story lines.
Five of the kids had formed a group that called itself Happytown, under the leadership of one of the girls. She was making announcements about how they would live in peace and never fight anyone. (Also announcements about eating hamburgers. But the main message was peace.) Kenny and four of his buddies, predictably, had named their group Military City. Bam! Pow! Shazam! Another one of the girls had claimed a sector that she was calling Doom City, and she was actively recruiting allies from the other two groups.
In spite of their difference, all the kids were conferring continuously, the scenarios in constant flux. I watched them order and re-order their k’nex communities, sometimes conflicting, sometimes compromising. I looked over at Mrs. Hart, who was standing and watching them, too. She smiled, raised her eyebrows, looked sideways at them, and shrugged her shoulders.
“They’re so happy,” she said, “I just had to let them keep their game going. As a teacher, I always feel a little guilty at times like these, like—what are they learning?” But it was obvious, and I’m sure she knew it, too. They were learning a lot: building, collaborating, connecting, negotiating—and, at the same time, having a great time with each other.And that last thing—the great time part? That was big. These were Kenny’s peers. Not that they all had ADHD. There was a pretty broad variety of learning disabilities represented there. But there was one thing you can be pretty certain that they all had in common. Up till then, school hadn’t been so great. For a lot of them, it had been pretty bad. They’d gotten into trouble. They’d fallen behind. They’d been the ones who were “different.” But not now. Not here. Not in Mrs. Hart’s room. Here, they were all part of a great group.

All right, then. You get it. Amazing class. Plus, you already know that the heart and soul of our fifth grade plan for Kenny was for us to pick him up halfway through the day and bring him home.

Okay, but if things were so fantastic in his classroom, why not just forget the plan and let him stay?

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47. Just Say No

Posted in ADHD, Education, I.E.P., Special Education, tagged , , , on July 3, 2012 | Leave a Comment »

A kid has ADHD. He loses his book or forgets his homework or draws faces on his hands with magic marker and has them make funny noises to each other while someone else is trying to speak. Is this the first time any of that has happened? (Just say no.)
The teacher and the kid’s parents and probably the principal have already reminded and scolded the kid about just these things countless times already. So the teacher loses patience. The other kids think this kid must be a weirdo or a dummy—after all, they can do all that stuff. Why can’t he?
Remember that ADHD isn’t an official learning disability? That, while it does make it much harder to learn, it doesn’t get you an IEP? That, unless you also have a learning disability that’s on the official list, ADHD doesn’t get you into “the good kind of special ed?”
Here’s what ADHD gets you: punished, teased, excluded. Maybe bullied. Put out in the hall. Sent to the principal. There’s detention. Maybe suspension. One thing is guaranteed. He gets labeled. He is officially a problem. And once you get that label, it’s almost impossible not to feel that that’s who you really are.

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46. What If

Posted in ADHD, Education, Homeschooling, Special Education, tagged , , , , , on July 1, 2012 | Leave a Comment »

While Kenny is absolutely unique to those of us who love him, we know that his situation is nothing like unique. There are countless kids out there who are just as overdue for a good school year as he was. Innumerable kids who desperately need to be one of eleven students with four teachers, in a classroom that’s been designed especially for them.
Most of those kids are still in regular classrooms, required to sit at their desks for six hours straight. Every Day. Except. Like Kenny, they can’t sit still for six hours straight. Literally. Physically. Neurologically. Cannot do it. So. They don’t. Granted, Kenny’s ADHD was (and is) extreme. But still, if a kid’s even half as impulsive as Kenny, if their sensory filter worked twice as well as Kenny’s, if their neurons fired twice as fast—that kid’s mind would still be wandering. He’d still be out of his seat, or at least out of the discussion, a few times (or more) every day, checking out or thinking about something not on the school’s agenda.
And a lot of those kids aren’t even in regular classrooms. They’ve already been assigned to special ed. And not, as Kenny says, to “the good kind of special ed.” They’re in the kind of special ed where, for instance, they get sent to time-out if they touch another kid.Where the time-out rooms have tiled walls, locked doors, and no windows. I’m not exaggerating. I’ve seen it. That’s where they were thinking of sending Kenny.
Some of those kids have teachers, even some special ed teachers, who are still convinced that managing ADHD is just a matter of will power. That ADHD is all in your head. Which, as far as it goes, is undeniably true. After all, where else would it be? In your foot? Haha. Very funny. But not really.
Because, like a whole lot of other things that human people do, ADHD doesn’t just go away if you take the abstinence pledge: I will abstain from impulsive behavior. ADHD doesn’t care when you just say no. ADHD isn’t even listening.

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45. Work and Luck

Posted in ADHD, Family, I.E.P., Special Education, tagged , , , , on June 29, 2012 | Leave a Comment »

So Kenny’s finally caught a real, official break. He’s one of the lucky eleven. And, as for us, his grownups, we’re pinching ourselves. We can’t quite believe our luck.Really? You call this luck? Because it sounds like a whole lot of people put an awful lot of thought and hard work and effort into making this happen.
Absolutely true. But. We’re lucky that dedicated advocates came before us and paved the way for this program to exist. We’re lucky we live in a place where they school system had the funding to pay for it. We’re lucky that Kenny’s case was assigned to a caring and experienced I.E.P. manager, who was willing and able to negotiate exactly the individualized education plan that this individual child needed.
And more luck: very few people have jobs as flexible as mine—freelancing, working from home, making my own hours. Our daughter, Annie, Kenny’s mom, was a widow, a single mother with a full-time job, plus two other, littler kids, besides Kenny. There was no way in the world that she could have picked him up in the middle of the day and brought him home for afternoon lessons. But I could take time off in the middle of the day. That was lucky.
When you’ve got a kid like Kenny, you can’t help thinking about how easily things could have tipped the other way. And what happens to other kids like him when that happens.

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44. Fifth Grade

Posted in ADHD, Education, Special Education, tagged , , , , on June 27, 2012 | Leave a Comment »

Well, here we are. Fifth grade. If ever a boy was overdue for a good year in school, that boy is Kenny, and this is the year. Think back. Kindergarten: what, me worry? First grade: teased by other kids AND the teacher. Second grade: caring teachers, but no friends. Third grade: still no friends; held back. Fourth grade: real friends, but nearly expelled. And now, fifth grade.
This is what he says about it, six years later, “That was the best year I ever had in school. Everyone got along. Not just the kids. The students AND the teachers.” He’s absolutely right.To begin with, the class was small—eleven kids. Seven boys, four girls. In addition to the teacher, there were three instructional aides. Amazing ratio. A great place to start.
But wait. That isn’t really where it started. Let’s walk this back a few steps. Because this classroom wouldn’t even have existed unless someone, somewhere along the way, hadn’t had the inspiration and the conviction to invest the dedication and the determination required to achieve the creation of a classroom intended specifically for this nearly invisible, distinctly special, hybrid breed of students—gifted and talented. And learning disabled.
Grateful applause. Heartfelt thanks to them for being here. Where we needed them.

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43. So what happened?

Posted in ADHD, Behavior Modification, Family, Homeschooling, tagged , , , , on June 25, 2012 | Leave a Comment »

How long did it take? Did it cure Kenny’s ADHD?Well. We kept it up for a little more than a year. And, no. It wasn’t a cure. He still gets overstimulated and “loopy,” as he calls it, sometimes. Let’s be real. This is behavior modification, not magic. And he’s still Kenny.
But, on the other hand, there’s this. He met the most important goal. Now, because of behavior mod, he knows something that he never knew before. He knows that he can control his impulses, at least some of the time. Most of the time, in fact, when things are quiet and his medication is working right.Kenny knows his whole family learned this together. And, here’s something you can tell just by looking at him, by being with him: now he feels, deep inside, no matter what, that he’s good.

“Hey, buddy, you dropped your jacket the floor.”

“Okay. I got it.”

“Good job, man!”

“Check!”

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42. Lucky Numbers

Posted in ADHD, Behavior Modification, Family, Homeschooling, tagged , , , on June 23, 2012 | Leave a Comment »

I have to say that in some ways, we were very lucky. Kenny loves numbers. What does that mean? I think I can best explain it with a little story. One day, when he was in first grade, Kenny didn’t want to go to school. He ran into his bedroom, slid under his bed, and refused to leave. Here’s how I got him out: I told him he could hold our yardstick on the ride to school. I held out the yardstick, and he crawled out from under the bed. Really.
All the way there, he read me the numbers that were printed on the yardstick, and by the time we arrived, he’d calmed down enough to walk into school by himself. Reading the numbers soothed him. I know. I don’t get it, either. I was an English major. But it worked for him. And since this, on one level, at least, is a system whose performance is tracked numerically, statistically, that made it easy to get our behavior mod routine off the ground right away.
That’s why he loved it when we sat together on his bed in the evenings, grooving on his totals, calculating his percentages to the decimal point. That’s one reason he bought into the whole system so quickly. He was a natural number cruncher. Other kids with different interests would undoubtedly need different incentives. But with Kenny, lucky us, we had him at the word “count.”Even with Kenny’s enthusiastic participation, though, it wasn’t always easy to keep up with the system, believe me. Sometimes, when I was distracted or overloaded or rushing to get somewhere, I’d forget to mark down a check or an x, or several, and I’d have to try to recap the lost time later. Sometimes when other family members gave me their cards, I mislaid them or forgot to add them in. My records were not perfect. But all in all, they were pretty accurate. Or at least accurate enough.

We made up some modifications as we went along. There were some transgressions, like hitting, that would earn him an automatic x. On the other hand, if he did helpful things on his own, without being asked or reminded, he’d get a double check.

Sometimes he’d take a look at his card to see how he was doing mid-day. Or to make sure he’d gotten credit for all his prompt responses. Or to find out if he’d really gotten an x for something he’d hoped I’d overlooked.

Eventually we came up with a list of rewards, too. Kenny could use five earned checks to “buy” lunch desserts, for instance. Or, for twenty, he could “buy” an extra hour of computer time. If he really saved up a lot, we might take him out for ice cream or buy him a new lego set.

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41. Checks, X’s, and the Other Label

Posted in ADHD, Behavior Modification, Education, Family, Homeschooling, tagged , , , , on June 21, 2012 | Leave a Comment »

The problem is, if you’re a kid like Kenny, whose neurons make it impossible for you to override your first impulses and do what your grownups expect of you, and instead, just act loony a lot of the time and get yelled at and punished, while your sister and brother are going with the program—if you’re a kid like that, you get a different label: bad.
Obviously, Kenny never woke up in the morning and said to himself, “My plan for today is to be bad.” That would be ridiculous. No one had to tell us that he wasn’t being “bad” on purpose. No one  had to tell his teachers that. But that didn’t keep him from getting into trouble. That didn’t keep us or his teachers from getting exasperated with him.That didn’t keep him from starting to feel, deep down, that he was. Bad.You can see why it felt so powerful—earth-shaking, tear-jerking, really—when Kenny proclaimed, “I’m turning my day around!” When, all of a sudden—after all those years of things going wrong for him—he’d figured out how to make things go right! Ta-da!

And how’d that happen? Behavior mod, man. And not just any behavior mod. Behavior mod that—sing it—accentuates the positive.

The checks tell Kenny, “you did that right.” They “catch him being good,” to use the phrase of the moment. That’s the big thing about this form of behavior mod (and I’ve got to believe there are many others out there): it’s positive. Yes, the kid gets x’s when his responses don’t hit the mark. But the checks are the main event. The checks are the currency that earns him privileges and treats. The x’s? Really, they’re just not-checks. The basic function of the x is to give the kid incentive to get checks next time around, instead.

And then there’s the goal. Okay, let’s think about that. What exactly is the goal here? It’s certainly not punishment, though it is discipline in the broad sense. As in self-discipline. And it’s not just one goal. It’s a progressive set of goals. On the most fundamental, mechanical level, the goal is for Kenny to comply with a request, an order, a command, within five seconds.

The next goal is for him to accomplish that most of the time.

From there, it’s just another step to the first big change: his own awareness that he’s gained the ability to direct his own behavior. When the kid can say, “I’m turning the day around!”

That’s how you know the kid is feeling good. He’s having a good day. And here’s the brass ring: he knows that he’s the one who made that happen.

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39. Turning the Day Around

Posted in ADHD, Behavior Modification, Family, Homeschooling, Special Education, tagged , , on June 17, 2012 | Leave a Comment »

I made an appointment to meet with Kenny’s teacher, Mrs. Hart. Dr. Block had told us that we all had to be consistent for this to work. “All” would definitely have to include her. As nice as she was—and she really was an exceptionally kind, understanding and flexible teacher—I wasn’t optimistic that she’d be able to work the checks and x’s into her already very complicated school day. But I described the method to her, and she seemed willing to give it a try.
When I picked Kenny up from school a couple of days later, the first thing I noticed was that he’d gotten another time-out that morning. Sigh. But then I saw that Mrs. Hart was actually keeping track of his behavior moment-by-moment, index card in hand. Bless your heart, Mrs. Hart! All hands are on the deck! Check!
Check for us, anyway. After we got home, Kenny himself was very antsy and uncooperative. X. X. X. His behavior didn’t seem to be modifying very effectively. He didn’t seem to be listening at all. I got angry. “I am very angry at you!” I said to him. I told him to go into the other room and give me a few minutes by myself. He did. Check.He had a dentist’s appointment that afternoon, and in a few minutes, it was time for us to leave. “What was that all about?” I asked him, when we got into the car.“I was nervous about going to the dentist,” he said.

“Well, next time it would be a lot better if you’d just say you were nervous about the dentist,” I told him. “I can’t promise I can help you to stop feeling nervous, but at least you won’t be getting into trouble.”

So why am I going into all this detail about one afternoon? Because, starting at that moment, he transformed into Mr. 5-Second Compliance Man, racking up check after check for the rest of the afternoon.

Around supper time, I told him to do something, and—as he was doing it—he proclaimed, “That’s a check mark! I’m turning the day around!”

Forgive me if I don’t say anything for a minute and just take that in.

Kenny. Is turning. The day. Around. He’s turning a hard day into a good day. This is something he’s never been able to do before. We thought he didn’t have a clue about how to do it. It turns out, though, that the problem was really that he didn’t have the tools. But now he has checks. He has x’s. He has a grownup standing nearby with an index card and a pencil. And with those tools, he can do what he’s been told to do in just five seconds! He can do it over and over! He can do it enough times to be able to turn this big old battleship of a day around and set its course for a completely new direction!

How do you think that makes him feel? All you have to do is look at him. That’s right. He feels good.

And, really, that’s the whole point, you know?

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38. The Behavior Mod Squad

Posted in ADHD, Behavior Modification, Family, Homeschooling, tagged , , , , , , on June 15, 2012 | Leave a Comment »

I could see what Dr. Block was getting at. Even if the teachers gave the kids hourly assessments, he said, it wouldn’t be often enough to make any impact on their behavior at all. The link between cause and effect had to be established immediately—within five seconds—to have any value, to make any difference, to keep the signal moving from one neuron to the next.
“There’s only one way behavior mod won’t work,” he said. We all nodded expectantly. “And that’s if you’re not consistent. Whatever Kenny’s doing, whoever he’s doing it with, he has to be getting the same feedback from everybody, in exactly the same way.”We understood. We had pencils. We bought a 100-pack of index cards. We put them into our pockets. The Behavior Mod Squad was ready for action.
The first step, of course, was to tell Kenny about what was coming down the pike. And, as everybody knows, if you have something important to discuss with a kid, the best place to do it is in the car. So I brought it up with him on the way home from school.“Remember when we used to do 1-2-3 Magic when you guys were misbehaving?” I asked.“Yeah,” he said.

“Remember when we used to give you points and gold stars for good behavior?” I asked.

“Uh huh,” he said.

“Well, today we had a meeting with a new doctor. And he gave us some new ideas,” I said.

“Mm hm,” he said.

I described the checks and the x’s and the index cards. I told him that Mommy, Pop, I, Baba, Grandpa—all of his grownups—were going to keep track in exactly the same way, so that he’d get credit for his all checks, no matter who he’d spent the day with. I told him that every night, we’d count up his checks and x’s for the day and write them all down on a chart.

And then, at the end of each week, we’d total up the numbers for all seven days and figure out which percent were checks and which were x’s. Dr. Block had told us that most of his clients got their kids to buy into this plan by making up a scale of rewards they could earn with the checks they’d accumulated.

I was about to start in on that part of my pitch when I realized that Kenny was on board already. He was already grooving on the statistical record-keeping aspect of the process. The personal-best aspect. So I didn’t even mention the redeeming-your-checks aspect. I decided to keep that in reserve.

Something told me that a time would come when I’d need that later.

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37. School for Neurons

Posted in ADHD, Behavior Modification, Education, Homeschooling, Special Education, tagged , , , , on June 13, 2012 | Leave a Comment »

At school, Kenny was in fifth grade, in a GTLD class. That’s gifted and talented and learning disabled. One teacher, three aides, eleven kids. About as good a ratio as you can find, especially in the public schools. But, still, that’s eleven different constellations of gifts and LDs revolving around the room. Needless to say, rewards and punishments were deployed liberally there, in an attempt to provide incentive for cooperation and orderly behavior.
All eleven names were listed in a row on the far corner of the chalkboard. At the end of every morning and every afternoon, one of the teachers would chalk a star, or not, next to each name, depending on how well-behaved, or not, each one of the kids had been for the past few hours.
As Dr. Block explained it to us at that first appointment, the morning/afternoon method of behavior assessment was a non-starter—as far as behavior modification was concerned—at least for kids with ADHD.That made sense.

Remember the neurons? The billions of nerve cells in everybody’s brain? Remember what happens when the neurons fire? You know what I mean, not like starting a fire or firing a gun. But that incredible thing that only neurons can do—sending an signal across a synapse, the space between one neuron and its next-door neighbor, and on and on down the line.

Remember what happens if your neurons fire slowly?  If they’re, like, “Oh, yeah, man. Ha ha. Almost forgot. Okay. Whatever. Fire.” The way they are in your brain when you have ADHD?

When you think about it that way, it’s easy to understand why it’s hard to remember things from moment to moment—to maintain awareness of other people’s expectations, for instance—if you have ADHD. To keep those kind of things in mind, the neurons in your brain need to keep firing at a steady, rapid pace. Or—poof! What’s that shiny object over there?

“What are you doing, young man?”

Huh?

“Oh, sorry. I forgot. I saw that thing shining over there, and I just wanted to find out what it was.”

“If I catch you out of your seat one more time, Mister, you’ll have to go see the principal again!”

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36. And then what?

Posted in ADHD, Behavior Modification, Family, Homeschooling, tagged , , , , on June 11, 2012 | Leave a Comment »

Wait! What about the lesson he was supposed to learn? Don’t I at least have to explain what was so bad about what he did, to try to keep it from happening again?
Excuse me. Has lecturing ever worked for you before? Not for me, either. Think about what just happened. He misbehaved. He immediately got a time out. No muss. No fuss. No distractions. Just cause. And effect. He got the point. That’s behavior modification at work.
So, no. There aren’t any follow-up lectures, no post-magic ranting. There’s a beginning, a middle, and an end. A script: 1, 2, 3. It was so simple that Jamie, the littlest, understood it, and he was only two.
Sometimes the kids would even joke with us. “We’re gonna count you!” And we’d laugh and say, “Good! I want to go to my room for 45 minutes!” Ha ha.
It was so remarkably effective that we shared it with friends. Unfortunately, it didn’t always work as well for them as it had for us. “I counted to three,” one dad told us, “and then she still didn’t do what I said. So I kept on counting till I got to ten, and then I had to spank her.” So much for improvisation.
It only works if you stick to the script. If you can do that, it really does help to lower the chaos level in the house. Not to mention the wear and tear on your vocal cords.
It’s great. As far as it goes. Which is solving the problem of what to do when your kids are small  and doing things you don’t want them to—or not doing the things you do want them to. The title of the book sets the limit of 1-2-3’s effectiveness at twelve. Kids age out of it.
Beyond that, the way Annie and I used 1-2-3, it only addressed half the issue: the problem half. Sure, we all naturally give our kids pats on the back, hugs, praise, and the occasional reward. But mostly we do it on an ad hoc basis, when a job is especially well done, when grades have gone up, when we’re in a good mood, when something catches our eye as we’re hurrying by. As parents, our default seems to tilt more toward eliminating the negative than accentuating the positive.
Add to that the fact that you can’t do “magic” in school. You can’t keep sending kids to time-out for eight, nine, ten minutes at a stretch when you’re trying to teach in a classroom. You’d never get anything done.

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35. Gold Stars, Freestyle Yelling, and Magic

Posted in ADHD, Behavior Modification, Family, Homeschooling, tagged , , , , , on June 9, 2012 | Leave a Comment »

Needless to say, Annie and I had tried reward schemes before. Gold stars, points, special treats. Also punishment. The ever-popular, “If you don’t cut that out right now, I’ll (fill in the blank).” And, “Go to your room, and don’t come out till I tell you to!” Also freestyle yelling. Always so productive. And guaranteed to make you feel effective as a parent.
Then, when the three kids were still really little, Annie and I discovered 1-2-3-Magic, a very basic behavior modification system, described in the book “1-2-3 Magic: Effective Discipline for Children 2-12,” by Thomas W. Phelan.
Is there a parent out there who’s never given their kids the count? “I’m going to give you till the count of five, and then I’ll (fill in the blank)!” Parents have probably been giving their kids the count since they had to do it in Roman numerals. What makes this count “magic?”
Funny you should ask. I’ll tell you what. Here it is: You tell your kid to do something. If he says no, or if, after maybe ten seconds or so, he keeps on doing what you’ve told him to stop doing, or if he just ignores you, you say, “One.” If he continues, you say, “Two.” If he keeps it up after that, you say, “Three.” That’s when he gets sent to his room for the number of minutes that’s equivalent to his age in years. For instance, six years old equals six minutes. The math is simple.
And here’s the key, the “magic,” if you will: Unlike the usual, extemporaneous count, brought on by the chaos of the moment, during which you’re frantically running through a mental inventory of potential consequences—while simultaneously yelling at your misbehaving children—unlike that, this method is predictable. After you’ve gone through it once, everyone knows the score.
Your kid knows exactly why he’s getting a time-out. He knows exactly how long his time-out is going to last. And when he’s in his room, he doesn’t have to do, or not do, anything in particular. He can, for instance, play with his toys. In other words, he can calm down. When his six minutes are up, you open the door. He can come out or stay in his room, his choice.
That sounds pretty good, right? And get this: At that point, the event is over.

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34. Tick Tock

Posted in ADHD, Behavior Modification, Family, Homeschooling, tagged , , , , , , , on June 7, 2012 | Leave a Comment »

Hey, buddy, you dropped your jacket the floor.
One Mississippi. Two Mississippi. Three Mississippi. Four Mississippi.
Five Mississippi.
Still waiting?
How many seconds does it take before your kid turns around, finds his way back over to the place where his jacket detached itself from his fingers, and then hangs it on its hook by the door?That’s essentially what Dr. Block asked us at our first appointment.
By us, I mean Kenny’s full posse of grownups, the gang of five—Annie, my mother, my father, my husband, and me. And by Dr. Block, I mean the behavioral psychologist whom the neuropsychiatrist, who evaluated Kenny last summer, recommended that we consult about behavior modification therapy for our boy.
That’s right. Only us. Just the grownups. We’d assumed that, since it was Kenny’s behavior we were there to discuss, that Dr. Block would be eager to meet him. Not so. It was the grownups’ behavior, Dr. Block assured us, that needed to be modified. A little surprising. But okay. Here we are.
After introductions all around, Dr. Block asked us each to take a guess. How many seconds does it usually take for Kenny to respond when he’s told to do something? We went around the room. Everyone gave a number. I was last to answer. “20 seconds, maybe? If at all?” Dr. Block made some notes on his pad. Then he described the plan.Here’s what he told us to do:

1. Tell Kenny to do something. Not a pair of things. Not a sequence. One thing: pick up your jacket.

2. Start the clock. One Mississippi.

3. If he complies before you get to Five Mississippi, you make a checkmark on the index card or pint-size notebook  that you’re conveniently carrying in your pocket for just this purpose.

4. If you get to Five Mississippi before he complies, you make an x.

There are some additional details, but that’s the nuts and bolts. A check or an x. Five seconds.

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