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People Tell Their
Stories: To Empower! - Not Control! A
Holistic Approach to ADHD Thomas Armstrong, Ph.D. (first published in Educational Leadership, September, 1996,
modified and republished in present form in Reaching
Today’s Youth, Winter, 1998) Thousands of studies tell us what children with ADHD can't do, but
few tell us what they can do. This article presents holistic strategies
for helping children with ADHD succeed at home and in school by building on
their interests, learning styles, and many talents. Eight-year-old Billy, in the front row, will have nothing to do
with my demonstration on new techniques for teaching spelling. During my
visit to his elementary school classroom in upstate Later on, I realize that something more important than a spelling
lesson went on that afternoon: Billy was able to transform his external
physical hyperactivity into internal mental motion and, by internalizing his
outer activity level, was able to gain control over it. This incident occurred
some time ago but remains memorable to me. Why? Because it suggests
that internal empowerment, rather than external control, is often the best way
to help kids diagnosed as having AD/HD. A Decidedly Unholistic
Approach Much of the work currently being undertaken in the field of
AD/HD looks at the issue from an external control perspective. The two interventions touted in almost all books and
programs about AD/HD (and in several of the articles in this journal issue) are
medication and behavior modification. While these approaches are often
dramatically effective with young people with AD/HD, both have troubling
features that often receive scant attention. Some researchers suggest that
when children receive medication, they may attribute their improved behaviors
to the pills rather than to their own inner resources (Whalen & Henker, 1990). Others may expect the medication to do
all the work and thus neglect underlying issues that may be the true causes of
a child's attention and/or behavior difficulties. Behavior modification programs, which abound, seek to control
children's behaviors through some combination of rewards, punishments, or
response costs (the taking away of rewards). Some programs rely on token
economy systems, while others use behavior charts, stickers, and even machines.
For example, the Attention Training System sits on a child's desk and
automatically awards a point every 60 seconds for on-task behavior. The
teacher can also deduct points for bad behavior using a remote control.
Students trade points for prizes and privileges. Although behavior
modification programs may influence children to change their behavior, they do
it for the wrong reason-to get rewards. Such programs can discourage
risk-taking, blunt creativity, decrease levels of intrinsic motivation, and
even impair academic performance (Kohn, 1993). Looking at the Whole
Child Most AD/HD researchers and practitioners see children labeled with
AD/HD in terms of their deficits. Thousands of studies tell us what these
kids can't do, but few tell us what they can do and
who they really are. (Two exceptions are Crammond,
1994 and Hartmann, 1993.) Where are the studies that tell us what these
kids are interested in, what kinds of positive teaming styles or combinations
of intelligences they use successfully in the classroom, and what sorts of
artistic, mechanical, scientific, dramatic, or personal contributions they can
make to their schools and communities? A new vision of educational interventions is needed to reflect a
deeper appreciation for the whole child based upon a wellness paradigm, rather
than a deficit perspective rooted in a medical or disease-based model. We
need to initiate a new field of study to help children with behavior and
attention difficulties-one based upon discovering their strengths rather than
fixing their faults. Parents and teachers tell me about cases of
AD/HD-labeled kids who are talented dancers, musicians, sculptors, and dramatists.
The AD/HD community needs to conduct research on the positive qualities of
these children and what their abilities could mean in contributing to their
success in the classroom and in life. Such research would develop assessment strategies geared toward
identifying their inner capabilities. Gardner's theory of multiple
intelligences (Gardner, 1983) is one possible framework for developing
appropriate assessment instruments to help identify such abilities (a
refreshing change from the behavior rating scales and artificial performance
tests currently used to assess AD/HD in children). We must develop
individualized educational plans (IEPS) that give more than lip service to a
child's strengths and that solidly reflect, in their goals and objectives, a desire
to help children achieve success (rather than to "overcome their
problems"). While the AD/HD worldview tacitly approves of a teacher centered,
worksheet- and textbook-driven model of education (almost all of its
educational suggestions are based on this kind of classroom), current research
suggests that all students benefit from project-based environments in which
they actively construct new meanings based upon their existing knowledge of a
subject. Some research suggests that students with AD/HD do better in
environments that are active, self-paced, and hands-on (McGuinness,
1985). Video games and computers are powerful teaming tools for many of
these children. In fact, their high-speed behavior and thinking lend
themselves quite well to such cutting-edge technologies as hypertext and
multimedia (Armstrong, 1995). Finally, interventions need to go beyond strategies such as smiley
faces, points, and medications, and reflect a full sense of the child's true
nature. Here are a few approaches for use at home and school that might help
children identified as having AD/HD: Cognitive Use focusing and attention-training techniques. For example,
see how long a child can sit still in a chair using a stopwatch (make it into a
competitive game) or help kids visualize their favorite place when they need to
calmdown. Teach self-talk skills. For example, teach kids to say to
themselves: "If at first you don't succeed, try, try again," or show
them ways of talking through the steps to solving a math problem. Help with organizational skills. Help each student develop a
folder that contains sections for each subject, a calendar for due dates, a
place to hold accessories, etc. Ecological Use music to calm or focus. Sometimes rock or rap music may
paradoxically calm some kids down just as Ritalin (a stimulant) does. Limit television and video games to one hour per day and eliminate
all violent programming, because research is clear that this provokes
aggressive behavior in kids. Find the time when the child is most alert. Mornings are
usually best for focused work (e.g., seat-work, lectures, etc.); afternoons are
best for open-ended activities (e.g., projects, arts, cooperative groups,
etc.). Provide a balanced breakfast. Research suggests that
balancing protein with carbohydrates (e.g., eggs and toast) is better for
helping foster focused activity than simply a carbohydrate breakfast (e.g.,
pastries and orange juice). Physical Emphasize a strong physical education program in the
schools. Include aerobic activity, individual sports (e.g., swimming,
gymnastics), walking, and martial arts. Allow appropriate movement in the classroom. Give kids
chores to do, allow them to use a squeeze ball to keep their hands busy while
listening to the teacher talk, give them active projects that involve frequent
changes of seating, teach skills using physical movement (e.g., in group choral spelling,
standing up on the vowels and sitting down on the consonants). Use hands-on teaming. Give students frequent opportunities
to build things with their hands (e.g., dioramas i
history, models of science concepts, props for plays in literature) and to use manipulatives (e.g., in math) whe
teaming about new concepts. Emotional Provide positive role models. Study the lives of great
people who had difficulty with behavior in school (e.g., Winston Churchill,
Florence Nightingale, Louis Armstrong). Identify talents, strengths, and abilities. Find out which
combination of Howard Gardner's eight intelligences (linguistic, logical-mathematical,
spatial, bodily-kinesthetic, musical, naturalist, interpersonal, or
intrapersonal) each student has most highly developed and use that information
to provide appropriate instruction. Envision positive futures. Help students see roles and careers
for themselves in the world that make use of their special talents and
abilities. Behavioral Use behavior contracting. Let the student have an important
say in writing up a contract that includes the problem behavior(s), and what
will happen (e.g., rewards, etc.) if the difficulties are removed. Provide immediate feedback. Videotape a child acting out and
show it to him or her right away. Give answers on tests right away.
Count the number of times a problem behavior occurs and give the child the
figure in a nonjudgmental way each day. Help them keep track of their own
behaviors (self-monitoring). Have consistent routines in the classroom and involve the student
in them (e.g., the student is selected to collect papers, to signal others to
get ready for lunch, etc.). Social Hold class meetings. Use these meetings as opportunities to
air grievances, work out interpersonal problems between class members, plan for
parties, and share other feelings and thoughts about how the class is going. Use effective communication strategies. For example,
practice using "I" language ("I am disturbed by your
language") rather than "you" communication ("You have a
filthy mouth"), and help the student practice them as well. Have the student be a "buddy" to a younger student, so
that he needs to become the responsible member of the duo. Ask him to
teach another student something he knows how to do (this helps teach
organizational skills). Educational Create a highly stimulating educational environment. Research
suggests that kids labeled AD/HD do better under high-stimulation than
low-stimulation conditions (e.g., use role playing, field trips, project
building, music, humor, expressive arts, etc.). Use attention-grabbing strategies, such as a hand signal or
musical cue to alert students to the need to begin cleaning up for lunch. Employ computer software that is interactive, colorful, provides
immediate feedback, and is instructionally sound. This list provides a far richer storehouse of interventions than the
instructional strategies given in the mainstream AD/HD literature-for example,
seating the child next to the teacher, posting assignments on a The Creative Roots of
AD/HD Because research (Zentall, 1975) has
long suggested that many children labeled AD/HD are actually underaroused (Ritalin provides enough medical stimulation
to bring their nervous systems to an optimal level of arousal), a strength
based approach makes more sense than a deficit-based one,.
By providing these students with high-stimulation learning environments
grounded in what they enjoy and can succeed in, we are essentially providing
them with a kind of educational psychostimulant that
can work as well as Ritalin but is internally empowering rather than externally
controlling. Remember that a hyperactive child is an active child. These
young people often possess great vitality-a valuable resource that society
needs for its own renewal. Look at the great figures who transformed
society, and you will find that many of them were behavior problems or
hyperactive as children: Thomas Edison, Winston Churchill, Pablo Picasso,
Charles Darwin, Florence Nightingale, Friedrich Nietzsche (see Goertzel & Goertzel,
1962). As educators, we can make a big difference in the lives of these
students if we stop getting bogged down in their deficits and start
highlighting their strengths! © Thomas Armstrong, 1998. All rights reserved. Reprinted
by permission of the Thomas Armstrong. Thomas Armstrong, Ph.D., is the author
of eight books including The Myth of the
ADD Child: 50 Ways to Improve Your Child's Behavior and Attention Span without
Drugs, Labels, or Coercion. For more information on the book, call:
1-800-247-6553. Visit his website at: www.thomasarmstrong.com or e-mail him
for general information: thomas@thomasarmstrong.com
REFERENCES Armstrong, T (1995). The Myth of the ADD
Child. Cramond, B. (1994).
Attention-deficit hyperactivity disorder and creativity: What is the
connection? Journal of Creative Behavior, 28(3), 193-210. Gardner, H. (I 983). Frames of mind.
Goertzel, V., & Goertzel, M. G.
(1962). Cradles of
eminence. Hartmann, T. (1993).
Attention Deficit Disorder: A different perception. Kohn, A. (I 993). Punished by rewards.
McGuinness, D. (1985). When children don't learn. Whalen, C., & Henker, B. (I
980). Hyperactive children.- The social ecology of identification and treatment.
Zentall, S. (1975). Optimal stimulation as a theoretical basis of hyperactivity.
American Journal of Orthopsychiatry, 45(4), 549-563. | Family and Relationship Issues | People Tell Their Stories | Copyright
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