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Expert Q&A

	By Dr. Bunni Tobias Kid Detective Psychologist

I have a 6-year-old boy diagnosed with ADD. He is very impulsive and has no frustration tolerance. I'm a special education teacher and know a lot of "tricks" but to no avail. Can you suggest any good resources for behavioral modification techniques? I'm really trying to avoid medications."

When the readers read your description of your student, faces in their own classroom will flash in their minds. The same will be true of parents, I have no doubt.

First let's talk about special education. In so many districts across the country, children are placed in special education on what is termed the discrepancy model which means there is a significant discrepancy between ability and achievement. The question that is NOT answered is "why" does that child require the services? Teachers try to teach, but the children may not have the developmental foundations to benefit from the specialized instruction being made available to them. This is because the REASON for the discrepancy may not have been defined and remediated so the instruction is effective.

I'm mentioning this because I and many other professionals believe that the label ADD does not address the question, "Why can't this child pay attention?" This is a big question. Attention difficulties are symptoms. So is impulsivity. If we don't know WHY, then the solution is trial and error as you are finding. Medication may suppress the symptoms but it still doesn't answer that "why" question.

They call me The Kid's Detective, and I'll help you be one, too. Take a close look at what the child can and cannot do. If there are behaviors that concern you, when do they occur (before or after what subject, how long has it been since the child ate, what did that child eat, what was the weather like, did the child get enough sleep, as examples). One teacher calendared (day and time et. al.) and told me her student displayed the symptoms that you described on Wednesdays and every other Monday. It turns out he stays with his dad every other weekend and Tuesday nights where he eats pizza (he's allergic to milk products), watches TV and goes to bed late and has a cookie on the way to school as his breakfast! The problem is now being resolved.

The message here is look at all factors. Is this child frustrated because of lack of achievement? Is he sugared out and/or does not have an adequate diet? Does he have allergies, a processing problem, or was their some birth trauma that caused him to be OHI (other health impaired) where further medical assistance is required?

When children do not respond well to behavior management, a quick tip is to use cause and effect in quick succession so the child gets the connection. Immediate reinforcement comes first. Check all of this out. I'd like to hear about what you discover."

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