Teaching Children with ADD to Get What They Need
Psychologists have found that children and teens who have chronic behavioral problems consistently lack the ability to identify legitimate ways to get the same payoffs that they derive from destructive activities. There is a simple test for measuring a person's tendency toward destructive thinking patterns. You begin a story but stop before the ending with the request that the person complete the story. The story might begin, "There was this boy named Johnny, and he always felt that he was different from everyone else because he was born with yellow eyes. He could have considered himself special because most people told him that his eyes were very mysterious and had a special intensity. But Johnny hated this feature about himself...
"Now complete the story."
The way the individual completes the story is rather predictive of how that person responds to challenges. The next step in the assessment is to ask the test subject to add a second ending; when that is concluded, another ending is requested; then another. A person with a healthy approach to life generally can come up with at least three different endings. This implies that the individual has the ability to find alternative behaviors to deal with challenges and stressful situations. Psychologists call this cognitive flexibility.
Children and adults who have trouble following the rules, whether at home, in school, or in society, have difficulty coming up with more than one ending. These individuals have difficulty finding socially acceptable ways to get the payoffs they want. Your job as the parent of an ADD child--or any child, for that matter--is to help the youngster learn to identify multiple acceptable options that meet his needs.
The I-OPT Approach
In my clinical practice and teaching, I have found that children can quickly learn to choose alternative behaviors with a method I call the I-OPT approach. The four steps that give this method its name are
- Illusionary behavior
- Objective feeling, or payoff, sought
- Possible alternatives
The first step in the I-OPT method of treatment for this negative behavior is to describe the illusionary behavior: "Johnny, you seem to be very angry with your teacher. Can you help me understand why you feel that way?" Johnny might answer, "Ms. Smith makes me so angry because she expects me to do all those math problems, and it takes me forever. She is so unfair."
If children have few coping skills (not many do), they usually react to stress and threat in one of two proactive ways: fight or flight. In the first way, they try to escape these situations by avoiding, denying, or running away--hence the word flight. In the second type, they become angry, stubborn, and hostile--hence the term fight.
The next step is to inquire about the objective feeling--the payoff--the child really seeks. "OK, Johnny, let's just pretend for a minute that you've just gotten really angry at the teacher. When you get to this point, how does it make you feel?"
Johnny might say, "I would feel good because I would get rid of my frustration and she would understand how I feel."
The next step is to have the child consider possible alternatives that would give him the desired objective feeling. For example, "OK, Johnny, so you want to feel two ways. You want to feel less frustrated and you want to feel that Ms. Smith understands you better. Besides blowing up, can you think of any other ways you could behave, and feel those things?"
Johnny gives some thought to the question. "Well, I could write her a letter and tell her, or I could just tell her how I feel."
From The ADD Answer: How to Help Your Child Now by Frank Lawlis, M.D. Copyright © 2005. Used by arrangement with Penguin Group (USA) Inc.
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