Is My Child Being Disobedient or is it a Lack of Executive Functioning?

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What is executive functioning? It is the part of our brain that controls how we think, plan, do and stop. How we think through something; how we plan to get something done; how we execute the task, and how we stop ourselves. For most of us this task is unnoticeable and our brain just does it without us thinking twice about it.  For others, our brain has difficulty with executive functioning, so, for example, our morning routine doesn’t just happen and we need many reminders every day to brush our teeth, make our bed and eat breakfast. Sometimes this disability can also present a lot like ADHD or ADD, but its not.  ADHD/ADD and executive functioning go hand in hand because many of the symptoms of  ADHD are problems with executive function. However, there is one big difference between the two. While ADHD/ADD is an official diagnosis, a lack of executive functioning refers to a weakness in the brains self-management system. In fact, many kids with learning issues, not just ADHD, struggle with some of the same skill deficits.

Executive functioning takes place in the frontal lobes of the brain. The frontal lobes are connected with many other brain areas and coordinate the activities of these other regions. This is also the part of our brain that handles our self-control and our working memory, or, our ability to take one concept and move it to another concept., i.e. the stove is hot at grandmas’ house and because I got burned on it, that means the toaster might be hot as well.  This part of the brain also controls the ability to begin and complete a task.

 

Child school student with yellow lightbulb and school supplies design elements. 

What can we do to help our child who is struggling with executive functioning issues?

We can start by creating basic routines and focus in on giving bite sized bits of information, often, and break it down to specific areas of the home. For example, when your child wakes up in the morning in her bedroom, she needs to get dressed, make her bed and put on her glasses. Then when she moves to the bathroom she needs to brush her hair, brush her teeth, and take her medicine. Each room has 3 basic tasks to complete while she is there.  Be consistent with the language you use.  “Get dressed = get dressed” every day, not “put your clothes on.”

Practice builds habit. It is said that it takes about 21 days to create a habit, but for those who have ADD or executive function issues it will take a lot longer and it could take years. We want to create that muscle memory. We want their bodies to remember to do things that their executive functioning does not. We want the habit to last over time. This is why consistent routine and language are so important and helpful for these kids.

Sometimes we may also have to be the external brain for our child until they mature enough to take it over; or, maybe they will always need an external brain to help keep them on task. The idea is if we are not able to do executive functioning tasks, then we need an outside brain to walk through those steps  for us. Things like a planner or checklist can help, but may also be challenging to remember to go back and check off.  There are other suggestions such as a watch that has timers and reminders about tasks, or even an app that can help our child through his day.

Is this enabling? Not at all.  Accommodating is NOT enabling.  Having a lack of executive functioning is NOT disobedience, it’s a disability. Giving our child the ability to function independently is not enabling.

Remember that we are raising adults and we want to be able to hand these resources off to our child as they grow and mature. None of these situations are hopeless.

Check out understood.org to help your child get organized.

Information and examples discussed in this post can be found online at Honestlyadoption.com and understood.org

Blog post written by Sonya Lundstrom, LSW, Post Adopt Coordinator in Grand Forks.

 

How to Prepare for Success on the First Day of School (and for the WHOLE School Year)

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Schoolboy stands in front of the school door. Back to school.

Along with the spiral notebooks, glue-sticks, colored pencils and boxes of tissues comes the well-known stress (and maybe even freedom) of starting a new school year. For those of us with families formed through adoption, this can be especially complicated. Making sure that our child’s needs are met and helping the teacher understand how to manage his/her emotions through the day can be frustrating.  Here are a few pieces of advice to help you help your child succeed in school this year.  (thecradle.org)

  1. Establish a line of communication with your child’s teacher. Make sure you take the time to talk with the teacher and share important facts about your child and what his needs are. You can include tips from other providers that may help in the classroom and also what helps at home.
  2. Provide resources/ storybooks about adoption for the teacher to share with the class. Donate some books to the classroom library. Tell the teacher why you like those particular books and why you think that they are important. This may help ensure that the topic of adoption is treated in a natural and appropriate way.
  3. Be aware of sensitive assignments. Some teachers like to have their students create a family tree or something to explore their ancestry. These assignments can be difficult for adopted children for many different reasons. Communicate with the teacher about any concerns with assignments like this and discuss alternatives that may be more inclusive for everyone in the class.
  4. Always prepare your child. We do not have control of others actions or words. Your child’s teacher may have an understanding about your family situation, but another student or peer may not. Talk with your child about things they might hear from other students and why they may have that particular attitude. Help your child with how to share their story on their terms in an age-appropriate way.
  5. Educate the educators. There is always need for more information and knowledge. If your child’s school would like to know more about how to address adoption-related topics there are many resources available to help.

This blog post was written by post adopt coordinator, Sonya Lundstrom, LSW. 

Themes of Conflict in the Home

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As a professional working with youth and families, I’ve noticed some common themes resulting in conflict within the home, specifically when youth reach the adolescent stage of life.  Some of these themes include the youth exhibiting anger and aggression, a constant roller coaster of emotion, lack of communication, and pure defiance.  Maneuvering through these mood swings and behaviors can leave a parent exhausted and with a feeling they’re constantly walking on eggshells around their child.  Sometimes we find ourselves struggling as parents and when we finally ask for help, we have a “fix-my-kid” mentality.  We know this is not a healthy approach, however, hold this mentality because we have exhausted every tool in our toolbox.  As much as I wish I possessed a magic wand I could wave that would make all family units cohesive and eliminate conflict, I don’t.  Unfortunately, change in behavior (parents and children) takes a lot of work and time and will only be successful if all parties are willing to do the work.

One of the most important things a parent can do is to understand the adolescent brain and how it processes the world around them.  Frankly, I could completely geek out on brain development, cognition, neural connections, the procedural memory, etc…. but I may lose many of you.  If you can remember anything about brain development, remember this:  The prefrontal cortex of an adolescent brain, which controls decision-making, is not fully developed.  In addition to adolescent hormonal release, your adolescent’s decision-making and processing ability can be comparable to that of a toddler.  I know, I know, this statement seems a bit ridiculous and frankly insulting to adolescents, but let’s think about this… When was the last time you interacted with a 3-year-old and what do you recall?  I’m guessing you learned fairly quickly to have eyes on them at all times or the next thing you know they’re eating sand or wandering in to a busy parking lot as you’re loading your groceries in the car.

Check out this video to learn more about a child’s brain:

https://www.youtube.com/watch?v=gm9CIJ74Oxw

A key quality of a toddler is constantly seeking stimulation and exploration of the world around them, while still relying on the comfort of their caregiver when faced with new, overstimulating environments.  This is typical for children with healthy attachments.  There are similarities in adolescent behavior.  Adolescents are now seeking to understand the world for themselves and ways to seek stimuli gratification and reward.  Rather than learning to walk and eating sand, adolescents are equipped with vehicles and engaging is risky behaviors.  If the parent-child relationship is well maintained, adolescents will often seek comfort from their parents, which is often a bit of a love-hate script.

Advice to parents with adolescents who desire to regain sanity:

  1. Accept the fact that they’re not delicate babies.  They are young, capable adults-in-training.  It may be hard, but try your best to encourage and support their exploration of themselves and the world around them.  Often time behaviors occur when youth feel powerless and they have little or no control over their lives.
  2. Set clear and detailed expectations and consequences with the youth. Sit down with your child to talk about both of your expectations (realistic or unrealistic, all thoughts should be heard) and brainstorm appropriate “if, then” scenarios if these expectations are disrupted.  If youth is not home by her curfew at 10:00pm, then she will lose her phone for 2 days.  An even more detailed example would be: If youth is not home by her curfew Monday through Friday at 10:00pm, and then she will lose her phone for 2 days for every hour she is late.  The purpose is to ensure everyone is aware of the expectations and consequences, leaving no room for misunderstanding or misinterpretation, while holding them accountable.  Up the “corniness” of the whole idea and print a contact up, both sign it, and hang it on the fridge.  For warning, you will mostly likely get some push back from your youth about how “lame” it is or how “extra” you’re being, but trust me, it’ll help in the long run.
  3. They will make mistakes. Don’t “should” on your child.  Avoid using statements like “you should know better” or “you shouldn’t have done that.”  This will shut the conversation down fast.  When you use “should” when interacting with others, you’re sending the message of judgement and superiority.  Holding youth accountable in an assertive way will create an assertive adult.  When conflict arises, using simple “I” statements can remove blaming and allow them to understand how you feel.  An example would be, “I feel scared and worried about you when you punch the wall because you might hurt yourself or someone by accident” vs. “What is wrong with you?  Don’t you know you could hurt yourself by doing that?”
  4. Youth have this amazing ability to know how to get a rise out of you.  When things get heated, they know what to say to get you worked up.  Consistently across the board, respect is a major trigger for parents.  When we’re triggered, we begin to lose rationality.  I can’t be the only one who has had an argument with my child and after felt immense guilt for some of the words that came out of my mouth in the heat of the moment.  We’re human.  Don’t beat yourself up.  Take time to calm down, recognize your mistakes, own them, and don’t be afraid to apologize.  They’ll respect you for it.
  5. Continue to explore and learn about yourself. Understand your parenting style and why you are the way you are.  We all have a past that directly dictates how we perceive the world around us and interact with others.  The good news is, no matter how old were are, we can still make changes and grow.  Don’t be afraid to seek help for yourself.
  6. Get comfortable having tough conversations. In a world of social media and advertisement, our children have access to images, videos, and music glorifying risky behaviors.  It’s important to be comfortable and confident enough to have tough conversations.  As much as your adolescent will deny it, you are still one of the most influential people in their life.  If we don’t have those tough conversations with our kids, where will they get their information?

This blog post was written by Brittney Engelhard, Post Adopt Coordinator in Bismarck, ND.

What to Expect When Bringing Your Child to a Therapist

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Your child is struggling with their emotions and behaviors and you would like them to see a therapist. What should you expect?

Shawna Croaker, the Director of Community Based Services and licensed therapist at PATH, gives pointers on what to expect when starting the process.

Legal Paperwork: When starting therapy, you will need to sign paperwork indicating you understand your privacy, responsibility, and confidentiality rights; complete consents for treatment; and provide insurance information. Releases of information need to be signed for anyone you want your therapist to get information from or collaborate with, such as teachers or medical providers. Make sure to ask questions and request copies of these releases if you would like them.

Thorough Assessment: Expect your therapist to ask many questions. They will need history, family, medical, social, educational, behavioral, and functioning information to determine how to best help your child and family. Depending on your child’s age and concerns, your therapist may have you or your child’s teacher complete some additional assessment forms or questionnaires to gather more information.

Diagnosis: Your therapist is gathering information to identify needs and goals, but also to determine a diagnosis. A diagnosis helps guide treatment and is required by insurance companies for reimbursement. A diagnosis may be long-term, as with physical diagnosis, but also may be short-term and discontinued as functioning improves and symptoms decrease.

Explanation and Overview of the Treatment Model and Expected Length of Time for Therapy: The assessment process determines the treatment model used. Some models typically used for children are: Cognitive Behavioral Therapy, Parent-Child Interaction Therapy, Solution Focused Therapy, Trauma-Focused Cognitive Behavioral Therapy, among others.

Therapeutic Activities that are Appropriate for your Child’s Age and Development: Most children do not benefit from “talk therapy” alone. We know play and interesting activities help children learn, adopt skills, and process trauma and stress. Sometimes things discussed in therapy can be upsetting for a child, so therapists often try to end the session with a brief, fun activity, such as a game, to help ease the transition back to their other environments.

Caregiver Involvement: For therapy to be most effective, research indicates it is important that caregivers are involved to help support the child and guide them through skills learned in session. This helps to translate skills to other environments, as well as improve the relationship with the main caregiver. Caregivers should be involved in all aspects of therapy, from assessment, treatment, and discharge planning.

It is important to remember that therapy is not a magic fix and it can take some time to see progress. In addition to supporting the child individually, it is also helpful for adults to learn new ways to respond to their children’s big emotions and behaviors, and ways to enhance the relationship. Building this relationship is also part of the role of the therapist and will create lasting positive impact.

Nexus has two locations, Gerard Academy in Austin, MN and PATH in Fargo, ND, that offer Outpatient Services. The locations offer services from trained professionals that can assist with the stress of life that can lead to problems at home, work, school, or in the community.

This blog post was originally written for the Nexus blog and used with permission. Photo by frank mckenna on Unsplash


Having trouble finding a therapist in our rural state?  Contact post adopt staff at postadopt@pathinc.org for referrals and recommendations!

 

 

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