Monday, July 6, 2009

Sue Scheff: Summer Survival Tips for Families Managing ADHD


Striking a Balance: Summer Survival Tips for Families Managing ADHD

One major issue with ADHD and summer vacations is the bored factor. Once the novelty of having all that free-time-to-do-anything wears away, what to do with all that free time becomes a problem. On the other hand, over-scheduling and over-planning the summer can lead to burn-out and irritability for both parents and children. The art of managing ADHD during the summer is really about the art of finding balance. Several strategies can help strike this balance.

Keep a calendar: Use a monthly or weekly calendar and write down vacation, camp and community trip dates. Kids need routine to feel secure, but be sure to leave some dates empty to allow for free time to simple create and imagine in the back yard.

Prescript your day: Early in the day, sit with your child and review what they want to accomplish and what you need to accomplish. Negotiate how each of you will spend your time so as not to conflict. Explicitly state how you expect your child to behave for any important activities (like that very important conference call at 1PM) and be sure to reward them for following the “script.”

Make a summer contract: Use the summer as an opportunity to help your child explore their interests, reinforce their academic skills, and find their passions. Write out a contract with your child, in which they list their goals for the summer. Goals could include places they would like to visit, books they would like to read, cub scout activities they would like to complete, models they would like to build- the list of possibilities is endless. Include goals you and the teacher identify as well. If you have a therapist, consult them regarding activities to persue over the summer break. Activities can be focused on building a friendship with a particular friend, trying new foods with dinner, volunteering at a local soup kitchen, or learning the steps to complimenting a sibling. Set a due date and reward for completing each goal. Consider rewarding the child with a bonus for completing all their goals for the summer.

Loosen up but keep a routine: Part of the brillance of summer is the long days and lazy nights without a tight schedule to keep. The occasional later bedtime and relaxation of the rules are part of the inherent beauty of summer vacation. That being said, basic family rules, chores, and routines still need to be followed. Be mindful that a little sleep deprivation can lead to meltdowns for both parent and child any time of year. Rules about not playing on the computer all day, still need to be followed, even during the summer. Too much screen time robs kids of opportunities to build social skills and develop interests as well as leads to irritability.

Manage medicine: Some parents take a medication vacation over the summer, in an effort to allow their children to gain some weight and height. There is little evidence however, that ADHD medications permanently impact a child’s height. Kids often grow slower than their non-medicated peers, but do eventually catch-up.
Before taking a medication vacation, consider all the aspects of your child’s summer. Will you be taking a long trip, during which time your child will need to sit still? How will you all survive the trip? Will your child be in camp, where she will need to follow directions? Will ADHD behavior make it hard for her to participate in group activities or attend to social cues from new friends? Will your child have lots of unscheduled time with neighborhood kids, in which impulsive behavior could result in unsafe decisions or poor peer interactions? Before taking a medication vacation, consider all these potential situations.

ADHD is a chronic lifelong condition that needs to managed- will your child’s self-esteem, self-image, and social skill acquisition benefit from a medication vacation? Consider your goals for your child’s summer and how a medication vacation could affect your child’s success in their summer activities.

In lieu of a complete ADHD medication vacation, consider the use of shorter acting medications for the most challenging activities of your child’s summer- like a long car ride or plane trip. Shorter acting medications can cause fewer appetite- suppressing effects. Speak with your child’s physician, and collaborate with your child, as you make these decisions. Remember that as you are modeling healthy management of a condition that will likely be a lifelong journey for your child. Fuel their passions, provide opportunities to build skills, and model a healthy approach to symptom management.

Relax: Use the summer to reconnect and play. Just as your kids schedule time to do homework during the school year, schedule regular time to play with your kids every day after work. Play catch, go for a swim, bike down to the ice cream shop- do activities together to build your relationship and create a healthy self- image. Enjoy your summer together!

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