Taking Care of The Carers

Being a special needs parent isn’t easy. No one prepares you for it. While your friends are off living their typical lives with their typical children, it can feel quite isolated and lonely. But you are not alone. There is a whole army of special needs parents and carers out there. We’re all in this together! Recently, we held a webinar about how to take care of ourselves as the carer and below are some of the best strategies and links we discussed.

Mind. uk has some great advice for carers:

“When you spend a lot of your time focusing on someone else, you may feel as if you have
no time for yourself. But looking after your own wellbeing is important for you and for
them.
We have listed some self-care ideas that others have said they find helpful. Even trying
one small thing might help you feel more able to cope.

Share how you feel


It’s important to have someone to talk to, especially if you’re struggling to cope. You
could:
• share your feelings with someone you trust, such as a family member, friend or
neighbour
• join a support group for carers
• contact the Carers UK helpline
• talk to others on the Carers UK forum
• talk to someone through online mental health tools.
Not all of these options may feel right for you. Or you might feel like you have nobody to
share your feelings with. If you are feeling isolated or alone, our pages on coping with
loneliness offer more information.


“Try to find someone you can be honest with about your feelings, without
judgement.”

Try to be realistic


If you take too much on, you may feel as if you never achieve anything. Try to get a clear
idea about what you can do. By accepting the things that you can’t change or do alone,
you may feel more able to cope. You could try identifying and writing down:
• a list of all the support needs of the person you are caring for
• what you can do and what you’ll need help with
• how you’ll know when you need a break.


“Respite is possible – and necessary. You can’t give your all as a carer – you
just can’t. You have to save a bit of yourself just for you.”

Take a break and make time for yourself


Try and take a break, especially if you’re worried about your own mental health. You may
not be able to take a break whenever you need one, but it’s important to have some
time that’s yours.
You may need an hour or two to clear your head, or a day to help you feel more rested.
You could go out, have a nap or turn your phone off for an agreed period of time. Try to
make time for things you enjoy.


“I love running and being able to get out for half an hour each evening
allowed me to clear my head and relax.”

Look after your physical health


It’s important to try and make time to look after your physical health as best you can.
• Try and eat as healthily as you can and do some kind of regular physical activity.
See our pages on food and mood and physical activity for ideas you can fit into a
busy daily routine.
• Try to get enough sleep, as a lack of sleep can make it harder to cope with
everyday challenges. It can also make stress and depression worse. For more
information, see our pages on sleep and mental health.
• Use relaxation techniques, as these can help your mind and body feel more
rested. You need just a few minutes a day to do most of these exercises. For
more information, see our pages on relaxation.


“I have come up with my own saying, which is ‘you have to make your own
normal’. Your life changes so much as a carer and you have to make a new

life for yourself. You do not want to feel excluded from life, so you make
your own normal.”

Parents with chronic illness

A lot of parents of children with special needs are also coping with health problems of their own. Many of the parents we speak to each week are struggling with fatigue, anxiety, fibromyalgia, migraines or CFS. One thing that can help is to make sure we are taking care of ourselves physically. Here is a list of supplements that can help support carers physically and mentally.

Sleep

Restorative sleep is so important, both as a carer and as someone with a chronic illness. Have a look at our blog post about sleep solutions and get started on the passionfruit tea!

Migraines, Fatigue and Chronic Pain

Supplements to help with migraines, fatigue and chronic pain include a combination of Riboflavin (Vitamin B2), Co Enzyme Q10, and magnesium. My neurologist (who specialises in migraines), recommends 200mg riboflavin, 300mg Co Enzyme Q10 and 300mg magnesium each day. Please be sure to check with your GP or primary care physician first though!

Hormonal Imbalances

Hormonal imbalances are really tricky to deal with. It can be hard to get a referral to endocrinology and access the help we need. This tool by Dr Tassone (an OB/GYN and specialist in women’s endocrine issues) helps to pinpoint the areas of the endocrine system which need support. He then recommends a variety of diet, lifestyle and supplements for each Hormone Archetype.

You’re not in this alone. If you are struggling with being a carer and taking care of your own health, please get in touch with Carers Trust or visit Mind UK

They can put you in touch with local support groups, online carer forums, and grant providers; as well as providing lots of resources and strategies to help you manage.

How can we reduce problems with sleep?

Many children (and parents) struggle with establishing a regular, healthy sleep routine. This is especially true when our children have additional needs because they often have dysregulations in their neurotransmitter levels or are particularly sensitive to external stimuli. They may also be affected by circadian rhythm disorders or be genetically predisposed to certain sleep issues.

We’re going to consider the main ways we can help our children get in to a regular sleeping pattern and to make sure they are getting good quality, restorative sleep.

Environmental Factors

Behavioural Solutions

Natural & Herbal Sleep Solutions

Melatonin

Melatonin is one of the things I’m most asked about by sleep-deprived parents. Some consultants will prescribe liquid or tablet melatonin supplements. Some parents choose to order if over the internet from place such as Biovea, but others prefer to try to increase the melatonin levels naturally. Here are some of the best way to do so, according to Our Paleo Life:

There are many things one can do to naturally increase melatonin levels without supplements. The biggest one has to do with lights.

1. Take A Break From Technology

The best way to repair your circadian rhythm, experts say, is to stop using technology for a prolonged period of time. One week was found to be the perfect amount of time to normalize sleeping patterns for a group of participants who were asked to go camping for a week.

You can try to not touch any technology at home for a week but let’s face it, in today’s world it is nearly impossible to avoid technology at home. Even if you don’t want to watch TV, your spouse or your children might and that’ll tempt you to watch too.

The best solution is to plan a getaway for the whole family and turn off all the technology. If you must use it, designate only one or two hours in the middle of the day for it. Plus, leaving technology behind is a great way for the family to bond face to face.

2. Start Dimming Lights Early

Most people make the mistake of thinking melatonin starts when they turn off the lights to go to sleep, but this is not true. Melatonin levels increase when your body starts to sense there is less light.

What you can do to aid this process is by dimming the lights in your house and bedroom earlier. At least one hour before bedtime, start to turn off the lights in the house that you do not need and only leave on the ones that are crucial.

If you only have one light in your bedroom, consider getting a desk lamp or installing a light

dimmer so you can control the amount of light you can have in your room. By reducing the intensity of the light in your house way before bedtime, you’ll be signaling to your body to get ready for bed and this should help the chemicals going.

3. Reduce Exposure to Blue Lights Before Bed Time

We’re all guilty of this. Scrolling through our phones before bedtime but this is probably one of the worst sleeping habits anyone can have. The blue light emitted from your phone screen is distinctly harmful to melatonin production.

It’s not easy to put away the phone though, we know. What we suggest is for you keep the phone outside of your bedroom. Leave it charging in the kitchen or in the living room and let your friends and family know that you are trying to reduce phone usage before bedtime so they don’t call unless it’s an emergency.

Also: pro tip – blue blocking glasses at night. Check out Amazon for a bunch of options.

4. Cut Back on Social Media

Similar to point number three, social media is one of the reasons why many people are addictedto their cell phones and computers. If you find yourself scrolling through social media for hours before bedtime, stop.

5. Eat A Healthy Diet

While this seems like a generic piece of advice, a healthy diet is crucial to better sleep. In fact, did you know all plants have a certain amount of melatonin in them? That’s because plants, like us, also rely on light to grow.

Foods that have a high amount of naturally occurring melatonin are:

  • Tart cherries
  • Asparagus
  • Tomatoes
  • Sweet potato
  • Pomegranate
  • Olives
  • Nuts and seeds

Foods that are rich in tryptophan, magnesium, calcium, and B6 are also known to promote sleepiness.

6. Increase Relaxation

Another way to induce sleepiness at night is to increase relaxation and this could mean different things for different people. For example, music might relax one person but might stimulate another.

Here’s some ideas:

  • Take a bath
  • Essential oil diffuser
  • Play soothing music
  • Use a sound machine that plays white noise
  • Drink non-caffeinated herbal tea
  • Stretch
  • Search, Ponder and Pray

Anxiety & sleep

The last point on that list is very important for our children. Many of them struggle with anxiety and/or depression. Being able to process their emotions and anxieties can have a dramatic affect on the quality of their sleep.

The Therapist’s Aid website has some great worksheets, so does Twinkl.

Have a look at our previous post about anxiety workbooks and worry eaters if you feel anxiety is an issue for your child or young person.

Do you have any sleep management tips you’d like to share with other parents? Let us know in the comments!

P x

Creating a sensory diet for your child

It is strongly recommended that you seek the advice of an occupational therapist or other SEN advisor before implementing a sensory diet, but below are some tools to help establish your child’s needs and a variety of safe strategies and materials you can use at home while you are awaiting further assessment.

So first off, we need to establish the area our child is struggling with and which areas they are particularly hyper- or hypo- sensitive to.

Below are two tools, with links, which you can use to establish your child’s preferences.

The first was published in Raising a Sensory Smart Child by Biel & Peske

To download and print a copy please use this link: Sensory Checklist Biel & Peske

Our second resource was published by Robert Cox for Life Recovery Consulting

To view & print please use the following link: Life Recovery Consulting

Once you have established your child’s needs, you can start to implement strategies and establish a sensory diet that works for them.

Understood.org helps to explain how a sensory diet could look throughout the day and what it may involve:

“What might an example sensory diet look like?

A sensory diet is made up of a group of activities specific to your child’s needs. These depend on your child’s sensory issues. Let’s say your child is what OT’s call low arousal (meaning sluggish). Her routine might include:

  • 20 jumping jacks
  • Bouncing on a therapy ball 20 times
  • Holding a Zen bug yoga pose for 10 seconds

Your child will repeat this circuit of activities a set number of times. Each session should last 10 to 15 minutes (the effects can last for hours). Once your child’s routine is set, she’ll do it two or three times throughout the day.

What activities might be included in a sensory diet routine?

Your child’s OT will observe her to see what sensory input she seeks or avoids. The OT takes those preferences into account when coming up with a routine. Here are some standard activities they draw on to create a sensory diet:

  • Jumping jacks or lying on the ground and doing snow angels
  • Somersaults
  • Log rolling (rolling back and forth)
  • Swinging on swings
  • Climbing ladders and sliding down slides at the playground
  • Hopping up and down
  • Push-ups (which can be modified to pushing off the wall or on their knees)
  • Bouncing on a therapy ball with feet on the ground while clapping
  • Rolling on a therapy ball on their belly, forward and backward
  • Rolling a therapy ball on their back while they lie on the ground to “make a sandwich”
  • Yoga poses like downward dog or happy baby (also known as Zen bug), holding a position for at least 10 seconds
  • Facing a wall and pushing as hard as possible (variations include standing sideways and pushing against the wall with a shoulder, or pushing while sitting with the back against the wall, holding positions for at least 10 seconds)
  • Heavy work activities at home with supervision, like sweeping/dry mopping, dusting, vacuuming, lifting and carrying grocery bags from the car into the home
  • Animal walks such as crab walk (on all fours facing sky) or bear walk (on all fours facing ground)

A sensory diet may also include other activities that target specific sensory issues. One technique, the Therapressure Protocol (you may hear it referred to as brushing), can be very helpful to some kids. But it requires specific training from an OT and is not something parents can do without professional guidance.

In addition to physical activities, a sensory diet may incorporate other sensory experiences that help your child feel “just right.” These could include using fidget toys or weighted blankets, or chewing crunchy foods throughout her day.”

Here are two more examples provided by Healthline

For a child who seeks out rough play, has trouble calming themselves, and chews on objects

  • 8 a.m.: Have a chewy breakfast or snack, like a bagel or granola bar.
  • 9 a.m.: Carry a crate of books to the school library.
  • 10 a.m.: Hold the heavy library door open for the class.
  • 11 a.m: Squish with a beanbag chair.
  • 12 p.m.: Lunchtime with chewy options and water bottle with bite valve.
  • 1 p.m.: Do wall pushes.
  • 2 p.m.: Play with crash pad.
  • 3 p.m.: Walk with weighted backpack.

For a child who can’t sit still and constantly touches and fidgets with objects

  • 8 a.m.: Use fidget toy on the bus.
  • 9 a.m.: Jump on trampoline.
  • 10 a.m.: Play with tactile sensory bin.
  • 11 a.m.: Sit in rocking chair for reading time.
  • 12 p.m.: Bounce on a yoga ball.
  • 1 p.m.: Swing at recess.
  • 2 p.m.: Play-Doh time.
  • 3 p.m.: Sit on a yoga ball while doing homework.

*Have you had success in implementing a sensory diet for your child? Which strategies did you find particularly effective?

More resources:

Basic sensory diet ideas NHS

Sensory diet treatment, what you need to know

Beginners guide to a sensory diet

OT Sensory Processing Assessment for Caregivers

How to help our children with anxiety: using workbooks

Many of our children struggle with anxiety; especially if they have SEN or disabilities. The anxiety has only been heightened by the Covid-19 pandemic and the many disruptions to their lives. I’m often asked for recommendations of emotional literacy resources and workbooks to help with anxiety. Here are a few of the favourites- let me know if you’ve used them or there’s any others you have found particularly helpful.

P x

No Worries! Mindful Kids: An activity book for children who sometimes feel anxious or stressed

No Worries! is an interactive self-care activity book for children aged 7+ to colour and doodle their way to happiness, calm and confidence.

The encouraging and simple activities and exercises tackle anxiety, sadness and stress; children will enjoy using their creativity to combat negative feelings, work out why they feel worried and how to put stress back in its place through writing, colouring, doodling and drawing.

Featuring the charming and quirky illustrations of Katie Abey, a UK-based illustrator. Her quirky pictures will keep the reader entertained and focused as they work through the book, or simply dip into the pages for ten minutes of calm colouring.

CBT strategies to help kids ages 6 to 10 stand up to anxiety and feel calm

Worrying all the time can stop kids from having fun with friends, hobbies, sports, or school. The CBT Workbook for Kids helps them get back to doing the things they love. The ideas and activities inside use proven, up-to-date cognitive behavioral therapy (CBT) strategies to help manage―or even change―worried thoughts and feelings.

This CBT workbook is an emotional toolbox for any anxious child, full of methods to help lower anxiety. First it helps them figure out what’s going on in their heads, and then it gives them tools to change it. Fun quizzes, drawing challenges, and fill-in-the-blank exercises show them new ways to look at each worry.

The CBT Workbook for Kids includes:

  • Helpful skills―Learn techniques for expressing feelings, dealing with anger, staying focused, and making smart decisions.
  • Relaxation strategies―Discover everyday calming methods, like creating a morning routine, asking for help, and facing fears a tiny bit at a time.
  • Experiences from other kids―Each chapter in this CBT workbook has stories about how other kids might experience anxiety, too.

Helps kids take a deep breath, face their fears, and win with this CBT workbook!

Conquer anxiety and calm your body and mind–a workbook for teens ages 13 and up

Anxiety is a difficult emotion to manage, and the added stressors of teenage life can make it feel impossible to overcome. But you have the power to handle it–you just need the right tools. Unlock your ability to conquer anxiety with this therapeutic workbook. The exercises teach you practical, effective techniques to tackle worrying in the moment―so it doesn’t ruin your day and run your life.

You’ll find out how to identify the types of anxiety you’re experiencing–general anxiety, social anxiety, panic attacks, or phobias. Using strategies from cognitive behavioral therapy and mindfulness practices, you’ll learn how to manage your thoughts, emotions, and behaviors. With helpful examples of real scenarios teenagers face at school, home, or with friends, this book is your secret weapon against anxiety in any situation.

The Conquer Anxiety Workbook for Teens lets you:

  • Soothe your mind―Learn how anxiety plays tricks on your mind, and find out how to be more realistic and confident while correcting “thinking errors” and old beliefs.
  • Understand your body―Discover immediate calming strategies like body scanning, taking charge of your anxious alter-ego, creating a self-care routine, and more.
  • Write in the book―This workbook has lined space to invite you to answer questions, try thoughtful exercises, and take quizzes right on the page.

Release stress and worry while you nurture your mental health with the Conquer Anxiety Workbook for Teens.

Big Life Journal (ages 7-10)

Big Life Journal helps children develop strong Social-Emotional Learning (SEL) and growth mindset skills through inspiring stories, colourful illustrations, and engaging guided activities.

In this illustrated journal, children discover:

  • how to believe in themselves
  • how to face challenges with confidence 
  • mistakes are opportunities to grow 
  • they can achieve anything when they’re persistent

Are there any others that are your particular favourites? Let me know in the comments 🙂

P x

The impact of sensory processing issues and how to help

Sensory processing issues are a common comorbidity of neurodevelopmental disorders such as autism and ADHD. But what does the term ‘sensory processing’ actually mean and how does it manifest? How can we help our children when they are suffering from sensory overload or sensory-craving to the point of injuring themselves?

Some children receive a diagnosis of Sensory Processing Disorder (SPD). In the UK, this is usually diagnosed after an assessment with Occupational Therapy or Peadiatrics. However, in this article, we will use the more generic term of ‘sensory processing issues’ or ‘sensory processing difficulties’ because many children are affected by sensory dysregulation but don’t have a specific diagnosis of SPD.

What do these terms mean?

Hypersensitive

being overly responsive to sensory input, can lead to sensory-avoiding behaviour (see below).

Hyposensitive

being under responsive to sensory input, can lead to sensory-seeking behaviour (see below).

Sensory craving

is described as when one is “driven to obtain sensory stimulation, but getting the stimulation results in disorganization and does not satisfy the drive for more”. It can become excessive and even dangerous; such as in cases of repeated head-banging.

Hyperarousal

involves heightened baseline levels of autonomic arousal. The child is already in a heightened state of arousal so it doesn’t take much for them to become seriously overwhelmed.

Hypervigilant

involves scanning the environment for threat-relevant stimuli, and preparation for potential threat. In the case of children with sensory processing issues, they may seem to always be on the alert and extremely anxious about the possibility of sudden loud noises.

Sensory overload

this happens when you’re getting more input from your senses than your brain can sort through and process. Multiple conversations going on in one room, flashing overhead lights, or a loud party can all produce the symptoms of sensory overload. But when there’s competing sensory information, your brain can’t interpret it all at the same time. For some people, this feels like getting “stuck”; your brain can’t prioritize what sensory information it needs to focus on. Your brain then sends your body the message that you need to get away from some of the sensory input you’re experiencing. Your brain feels trapped by all the input it’s getting, and your body starts to panic in a chain reaction.

Have a look at these videos by The National Autistic Society to see how sensory overload can feel:

‘Make It Stop’

‘Can You Make It To The End?’

This causes the ‘flight or fight’ response of the sympathetic nervous system to be triggered. Have a look below at the difference between the sympathetic nervous system and the parasympathetic nervous system & the vast array of systems they can affect.

When we experience sensory overload, our sympathetic nervous system is activated. To help calm a child down during sensory overload, we want to reduce the input they are receiving and try to activate the parasympathetic nervous system instead.

These activities stimulate the vagus nerve and encourage the body to calm down. It can be really effective to implement some of these strategies when our children are struggling. Try a few and see which work best for you.

How many senses do we have?

Most people with automatically respond with “Five”, but we actually have at least eight.

Let’s look at each sense in turn. We will see how to spot whether our children are under or overly responsive to various types of stimuli, and also what adjustments we can make to help them.

The Auditory System

A healthy functioning auditory system allows children to respond appropriately to what they hear. For example, they may turn their head when their name is called, or follow verbal directions given by a teacher. They would also be able to filter out irrelevant noises (such as another child tapping their pen, or the buzz of an electric light). Some children however, may be hyper or hyposensitive to the sounds that they hear and this can affect their behaviour.

The Visual System

A healthy visual system allows the child to filter out inconsequential things they can see, and also to pay attention to information that is important. Some children are overly sensitive to visual stimuli; this is particularly true of children on the autism spectrum.

They may benefit from a reduction in visual stimuli, as demonstrated below.

As seen here, the TEACHH workstation method is very effective for children who are hypersensitive to visual stimuli.

Some children are under sensitive to visual stimuli and may need bright colours and visual stimulation to keep them engaged.

The Tactile System

The tactile system is the sense of touch. A healthy tactile system allows us to process temperature, feel pain, differentiate pressure and texture. When the tactile system is well regulated, a child is able to filter out unnecessary tactile input; such as a breeze blowing in their face. They are also able to tolerate a variety of textures, such as different fabrics of clothing.

A child who is overly sensitive to tactile input may present with the following behaviours:

Children who are under responsive to tactile input may benefit from the following strategies:

The Gustatory (Oral) System

The sensory receptors in our mouths allow us to perceive temperature, texture (e.g. smooth like yogurt, hard like a crisp, or a mixture of textures like cereal with milk), and taste (e.g. sweet, salty, bitter, sour).

Our brains also receive lots of proprioceptive information from the joint of the jaw as we bite and chew different foods that provide different types of resistance (e.g. a crunchy carrot, chewing gum)

Children with a healthy oral system are able to eat a variety of foods, including a range of tastes and textures. They would also not need to seek out extra oral sensory input such as chewing on clothes, in order to regulate their behaviour.

A child with dysregulation in the gustatory system may demonstrate some of the symptoms below:

Alerting and calming activities can help to regulate the gustatory sensory system.

The Olfactory System

A child with a healthy olfactory system is able to tolerate smelling foods and other odors in his environment.  He can even tolerate unpleasant odors (within reason) without extreme reactions.  A functioning olfactory system helps a child know the difference between “good” smells – those that are safe, pleasant, or associated with positive emotions – and “bad” smells – those that are dangerous, displeasing, or reminders of negative experiences.

Children who are hypersensitive to smells may demonstrate the behaviours below:

Some children may crave olfactory input and would benefit from trying some of these activities:

The Proprioceptive system

What is the proprioceptive system?

When children move and play, their muscles stretch and contract.  Proprioception refers to the way joints and muscles send messages to the brain to help coordinate movement.

This sense also allows us to grade the force and direction of our movements – our bodies instinctively know to apply more effort when lifting a heavy box and less effort when lifting a piece of paper.  While the vestibular system tells the brain about balance and moving against gravity, the proprioceptive system helps us coordinate the movement of our arms and legs in an efficient manner to play and move without even having to look.

A functioning proprioceptive system allows a child to write with a pencil without pushing so hard that he breaks the tip or take a drink from a paper cup without crushing it in his hand. A functioning proprioceptive system allows children to move, play, and explore in a smoothly coordinated and efficient way – not too gently, not too rough.

To help regulate the proprioceptive system, sensory circuits; a sensory diet and heavy work can be very beneficial.

The Vestibular system

The vestibular system has to do with balance and movement and is centered in the inner ear.  Each of us has vestibular organs located deep inside our ears. When we move our heads, the fluid in these organs moves and shifts, constantly providing us with information about the position of our heads and bodies in space (spatial awareness).

When our vestibular sense is fully functioning, we are secure and organized enough in our bodies to be able to attend and respond to all of the other senses we encounter daily.  A child with a well-developed vestibular sense feels confident and safe during movement activities, even if his feet are off the ground.  He is able to start and stop movement activities calmly and with control.  He is comfortable with climbing, swinging, somersaulting, and jumping – knowing that his body will adapt and that he will be able to maintain his balance and keep himself from falling or getting hurt.

The Interoceptive system

So how can we help our children with sensory processing issues?

Apart from using the sense-specific strategies above, children with sensory processing disorders can be really helped by the use of sensory circuits and a specifically-tailored sensory diet.

Both programs take time to organize and implement so we will have a blog post dedicated to each one individually. Subscribe to have them delivered straight to your inbox!

P x

Helpful links:

Subtypes of SPD

Hypervigilence: symptoms, causes and strategies

Anxiety disorders & sensory over-responsivity in children

OT & self-regulation

Heavy work activities & sensory processing disorder

What causes ADHD and how to help a child with ADHD

In this series of articles, we will discuss some of the most common questions parents ask about various additional needs. We’re going to start with ADHD.

ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.

There are three main types of ADHD…

Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.

Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.

Combined Presentation: Symptoms of the above two types are equally present in the person.

Usually a child will be diagnosed with one of these three types, according to the diagnostic criteria in the ICD-10 or DSM-5. However, the latest research shows that there are actually seven different types of ADHD and they all manifest in slightly different ways. To learn more about this, have a look at Dr Amen’s work with SPECT scans: a special kind of scan to see areas of brain activity.

what causes ADHD?

ADHD is caused by a variety of factors including genetics, neurotransmitter levels in the brain and the ‘wiring’ of the brain itself. It is not caused by bad parenting!

Usually a parent or close (male) relative has ADHD. Identical twins 90% chance of both having ADHD; this shows us that there is definitely a strong hereditary cause.

What about the neurotransmitters? What are they?

Neurotransmitters are the body’s ‘chemical messengers’; they pass information from one neuron to another. Two neurotransmitters are either imbalanced or reduced in children who have ADHD. These are noradrenaline and dopamine.

Noradrenaline affects behaviors including our levels of vigilance, arousal, attention, motivation, reward, and also learning and memory.

Dopamine is  involved in reward, motivation, memory, attention and even regulating body movements.

When these two brain chemicals are unbalanced, or not being produced in the right amounts, it causes a lack of concentration, hyperactive behaviour and difficulties controlling impulses.

This is compacted by the way the ‘wiring’ is in the brain of a child with ADHD. On PET and SPECT scans, scientists can see that there is dysfunction in the frontal lobes-the part of the brain that says “hmm, is this a good idea?”- so the children can’t put the brakes on their behaviour

In addition, other areas such as the limbic area are under functioning which means the children are taking in lots more unnecessary information through their eyes and ears but they can’t filter the information. 70% of children with ADHD show ‘markers’ on brain MRIs which show their internal system is dysregulated: they are underactive when they should be busy, but hyper when they should be quiet. They also really struggle to monitor and regulate their behaviour.

All of these things added together obviously make a huge impact on their behaviour and emotions. Imagine how you would feel if you were in your car and had a near-miss. You’d likely have an adrenaline rush- the ‘flight-or-fight’ response- and would feel shaken up. Now imagine feeling like that for most of the day and being asked to sit down and write an essay or do some maths: it’s practically impossible.

Behaviours that parents find most difficult to deal with

What about girls with ADHD?

Girls with ADHD do tend to demonstrate slightly different behaviours and there is still a long way to go in researching why this is the case. However, some of the most commons signs of ADHD in girls are shown in the diagram below:

So how can I help my child?

As in the infographic above, the most effective behavioural treatments for ADHD involve living by routine, rewarding the good and taking a step back from confrontation.

Approximatly 50% of children with ADHD also have a Specific Learning Difficulty such as dyslexia, dyspraxia, slow processing speed or poor working memory. They need routine and structure in order to thrive. Children with ADHD often have mood swings and emotional variability so they need help regulating and expressing their emotions. Additionally, they can be very sensitive and suffer from cripplingly low self-esteem: they are ‘out of kilter’ with their peers, misread social cues and tend be treated as the annoying outcast who won’t calm down and keep up with the group. They put a lot of effort into their school work but achieve little because they are unable to focus and channel their attention. To help them we need to tackle the issues of emotional regulation, sensory processing problems and brain chemistry.

But how do i do that?

We need to make sure they eat and sleep well. Sugar crashes are far more severe in our children and they get ‘hangry’ quickly. They need a diet that helps to balance their noradrenaline and dopamine levels. This includes a protein heavy breakfast- turkey burgers are particularly good, but baked beans, boiled eggs and other sources of protein are excellent choices. Choose brown carbs over white carbs- they have a grounding affect and take longer to break down which means our children don’t suffer such extreme energy crashes. Iron, zinc and magnesium are essential in the production of neurotransmitters so a multivitamin is essential, along with green leafy veg (maybe in a smoothie with some orange juice to aid the iron absorption). Fortified bread and cereal are excellent choices too, along with bananas (which are an excellent source of B6- a vitamin that helps in neurotransmitter function). Zinc can be found in meat products, beans, chickpeas and nuts. A breakfast of baked beans or peanut butter on whole-wheat toast is an ideal way to get the day off to a good start!

Make sure the children are surrounded by positive social support. They may be left out at school, with friends pushing them to the side when they’ve had enough of the mood swings or inattentiveness. This really impacts our children’s mental health so we need to give them plenty of positive social interaction and specific praise from family and friends. They may find it easier to be friends with younger children who are at a similar developmental age.

Children with ADHD are very sensitive to stress and become overwhelmed very quickly. We need to find out what their triggers are, think ahead and plan ahead. Choose which aspect of their behaviour you’d like to work on and stick with just that to begin with. Don’t overwhelm them with lots of changes and punishments. Use a behaviour system such as ‘1,2,3…Magic’. It’s one of the most popular programs and really works well for children with ADHD because it gives them the chance to stop, think and make the right choice. We need to make sure we don’t ask too much of them; don’t expect the impossible. Keep distraction to a minimum as far as possible and have structures in place to help the child. This could be things such as having a place for everything in the home, getting them to count what they need in their school bag, repeating requests back to you. As they get older, organization and note apps are really helpful for them to keep track of their thoughts and their day.

Their body, mind and brain are all sending and receiving mixed signals due to their systemic dysregulation and sensory issues. We need to help their body and mind ‘tune in’ to each other and balance their neurophysiology as far as we are able to. This can be done by using grounding activities, mindfulness, and helping them to recognize what they are feeling. For a younger child, we might ask them to colour in on a picture of a body and point to “where they feel cross” or “where they feel sad”. We could then do some mindful breathing exercises and grounding techniques. Even just 15 minutes of mindfulness per day has been shown phenomenal improvements in attention, working memory, compassion and anxiety reduction. Apps such as Positive Penguins and Molehill Mountain are very effective. Another useful habit to start is journaling and using a diary to monitor their emotions. The one I recommend is the Happy Self Journal; it asks different questions every day and helps the children to process their feelings and events of the day. This is also so useful to us as parents because sometimes our children struggle to express themselves verbally and using the journal allows them the opportunity to share their feelings through writing or drawing.

What about medication?

There are quite a few options for medication in treating ADHD, and all are working towards the same end goal: adjusting the levels of brain chemistry and compensating for the brain wiring problems so that the child can focus. According to Childmind.org, “Stimulants are the best and most common type of medication used to treat ADHD. There are only two stimulant medications, methylphenidate (the active ingredient in Ritalin, Concerta and other formulations) and amphetamine (the active ingredient in Adderall, Vyvanse and other formulations). Both medications are available as short-acting medications and in longer acting preparations.

The two types of medications (methylphenidate and amphetamine) are equally effective and have the same benefits and the same risks. While most people will respond equally well to either medication, there are a few people who respond better to one versus the other. Typically, if you start treatment with one of these medications and it doesn’t work well or is not tolerated, you should probably try the other medication.”

Which books do you recommend?

Always a favourite point to end on, here are some of my favourite books for children with ADHD & their parents.

The Survival Guide for Kids with ADHD

All dogs have ADHD

Thriving with ADHD: Workbook for Kids

Self-Regulation Interventions and Strategies

CBT Toolbox for Children & Adolescents

Understanding ADHD

Understanding Girls with ADHD

The Explosive Child

What do you find most challenging about being a parent of a child with ADHD? Have you noticed if you have ADHD traits yourself, or a diagnosis even? How do you manage your child’s behaviour? I’d love to hear your feedback.

P x

Questions parents ask…about ADHD

In this series of articles, we will discuss some of the most common questions parents ask about various additional needs. We’re going to start with ADHD.

ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active.

There are three main types of ADHD…

Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines.

Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others.

Combined Presentation: Symptoms of the above two types are equally present in the person.

Usually a child will be diagnosed with one of these three types, according to the diagnostic criteria in the ICD-10 or DSM-5. However, the latest research shows that there are actually seven different types of ADHD and they all manifest in slightly different ways. To learn more about this, have a look at Dr Amen’s work with SPECT scans: a special kind of scan to see areas of brain activity.

what causes ADHD?

ADHD is caused by a variety of factors including genetics, neurotransmitter levels in the brain and the ‘wiring’ of the brain itself. It is not caused by bad parenting!

Usually a parent or close (male) relative has ADHD. Identical twins 90% chance of both having ADHD; this shows us that there is definitely a strong hereditary cause.

What about the neurotransmitters? What are they?

Neurotransmitters are the body’s ‘chemical messengers’; they pass information from one neuron to another. Two neurotransmitters are either imbalanced or reduced in children who have ADHD. These are noradrenaline and dopamine.

Noradrenaline affects behaviors including our levels of vigilance, arousal, attention, motivation, reward, and also learning and memory.

Dopamine is  involved in reward, motivation, memory, attention and even regulating body movements.

When these two brain chemicals are unbalanced, or not being produced in the right amounts, it causes a lack of concentration, hyperactive behaviour and difficulties controlling impulses.

This is compacted by the way the ‘wiring’ is in the brain of a child with ADHD. On PET and SPECT scans, scientists can see that there is dysfunction in the frontal lobes-the part of the brain that says “hmm, is this a good idea?”- so the children can’t put the brakes on their behaviour

In addition, other areas such as the limbic area are under functioning which means the children are taking in lots more unnecessary information through their eyes and ears but they can’t filter the information. 70% of children with ADHD show ‘markers’ on brain MRIs which show their internal system is dysregulated: they are underactive when they should be busy, but hyper when they should be quiet. They also really struggle to monitor and regulate their behaviour.

All of these things added together obviously make a huge impact on their behaviour and emotions. Imagine how you would feel if you were in your car and had a near-miss. You’d likely have an adrenaline rush- the ‘flight-or-fight’ response- and would feel shaken up. Now imagine feeling like that for most of the day and being asked to sit down and write an essay or do some maths: it’s practically impossible.

Behaviours that parents find most difficult to deal with

What about girls with ADHD?

Girls with ADHD do tend to demonstrate slightly different behaviours and there is still a long way to go in researching why this is the case. However, some of the most commons signs of ADHD in girls are shown in the diagram below:

So how can I help my child?

As in the infographic above, the most effective behavioural treatments for ADHD involve living by routine, rewarding the good and taking a step back from confrontation.

Approximatly 50% of children with ADHD also have a Specific Learning Difficulty such as dyslexia, dyspraxia, slow processing speed or poor working memory. They need routine and structure in order to thrive. Children with ADHD often have mood swings and emotional variability so they need help regulating and expressing their emotions. Additionally, they can be very sensitive and suffer from cripplingly low self-esteem: they are ‘out of kilter’ with their peers, misread social cues and tend be treated as the annoying outcast who won’t calm down and keep up with the group. They put a lot of effort into their school work but achieve little because they are unable to focus and channel their attention. To help them we need to tackle the issues of emotional regulation, sensory processing problems and brain chemistry.

But how do i do that?

We need to make sure they eat and sleep well. Sugar crashes are far more severe in our children and they get ‘hangry’ quickly. They need a diet that helps to balance their noradrenaline and dopamine levels. This includes a protein heavy breakfast- turkey burgers are particularly good, but baked beans, boiled eggs and other sources of protein are excellent choices. Choose brown carbs over white carbs- they have a grounding affect and take longer to break down which means our children don’t suffer such extreme energy crashes. Iron, zinc and magnesium are essential in the production of neurotransmitters so a multivitamin is essential, along with green leafy veg (maybe in a smoothie with some orange juice to aid the iron absorption). Fortified bread and cereal are excellent choices too, along with bananas (which are an excellent source of B6- a vitamin that helps in neurotransmitter function). Zinc can be found in meat products, beans, chickpeas and nuts. A breakfast of baked beans or peanut butter on whole-wheat toast is an ideal way to get the day off to a good start!

Make sure the children are surrounded by positive social support. They may be left out at school, with friends pushing them to the side when they’ve had enough of the mood swings or inattentiveness. This really impacts our children’s mental health so we need to give them plenty of positive social interaction and specific praise from family and friends. They may find it easier to be friends with younger children who are at a similar developmental age.

Children with ADHD are very sensitive to stress and become overwhelmed very quickly. We need to find out what their triggers are, think ahead and plan ahead. Choose which aspect of their behaviour you’d like to work on and stick with just that to begin with. Don’t overwhelm them with lots of changes and punishments. Use a behaviour system such as ‘1,2,3…Magic’. It’s one of the most popular programs and really works well for children with ADHD because it gives them the chance to stop, think and make the right choice. We need to make sure we don’t ask too much of them; don’t expect the impossible. Keep distraction to a minimum as far as possible and have structures in place to help the child. This could be things such as having a place for everything in the home, getting them to count what they need in their school bag, repeating requests back to you. As they get older, organization and note apps are really helpful for them to keep track of their thoughts and their day.

Their body, mind and brain are all sending and receiving mixed signals due to their systemic dysregulation and sensory issues. We need to help their body and mind ‘tune in’ to each other and balance their neurophysiology as far as we are able to. This can be done by using grounding activities, mindfulness, and helping them to recognize what they are feeling. For a younger child, we might ask them to colour in on a picture of a body and point to “where they feel cross” or “where they feel sad”. We could then do some mindful breathing exercises and grounding techniques. Even just 15 minutes of mindfulness per day has been shown phenomenal improvements in attention, working memory, compassion and anxiety reduction. Apps such as Positive Penguins and Molehill Mountain are very effective. Another useful habit to start is journaling and using a diary to monitor their emotions. The one I recommend is the Happy Self Journal; it asks different questions every day and helps the children to process their feelings and events of the day. This is also so useful to us as parents because sometimes our children struggle to express themselves verbally and using the journal allows them the opportunity to share their feelings through writing or drawing.

What about medication?

There are quite a few options for medication in treating ADHD, and all are working towards the same end goal: adjusting the levels of brain chemistry and compensating for the brain wiring problems so that the child can focus. According to Childmind.org, “Stimulants are the best and most common type of medication used to treat ADHD. There are only two stimulant medications, methylphenidate (the active ingredient in Ritalin, Concerta and other formulations) and amphetamine (the active ingredient in Adderall, Vyvanse and other formulations). Both medications are available as short-acting medications and in longer acting preparations.

The two types of medications (methylphenidate and amphetamine) are equally effective and have the same benefits and the same risks. While most people will respond equally well to either medication, there are a few people who respond better to one versus the other. Typically, if you start treatment with one of these medications and it doesn’t work well or is not tolerated, you should probably try the other medication.”

Which books do you recommend?

Always a favourite point to end on, here are some of my favourite books for children with ADHD & their parents.

The Survival Guide for Kids with ADHD

All dogs have ADHD

Thriving with ADHD: Workbook for Kids

Self-Regulation Interventions and Strategies

CBT Toolbox for Children & Adolescents

Understanding ADHD

Understanding Girls with ADHD

The Explosive Child

What do you find most challenging about being a parent of a child with ADHD? Have you noticed if you have ADHD traits yourself, or a diagnosis even? How do you manage your child’s behaviour? I’d love to hear your feedback.

P x

SEN Resources: Visual Aids

Visual aids are a marvelous way to help children with additional needs. Many children are visual learners, and children who struggle with sensory overload find verbal prompts or reminders difficult to understand when they already have so much information being processed. A visual aid helps them to focus, to understand what is happening next, which behaviours are required of them and also allows them the opportunity to express what they are feeling or to ask for something they need.

This blog post is going to discuss various forms of visual aids which can be used to support learning, to help with routines and to aid children in expressing themselves.

Now, Next & Then Boards

These are particularly useful in supporting children who have autism or learning difficulties. The boards explain clearly what is happening now and in the near future. This can help to settle anxiety and help the child to understand that they need to, for example, wash their hands before having their lunch.

Visual Timetable

Visual timetables are an effective way for children to see exactly what is happening that day, or to help them develop independence in their daily routines (such as getting dressed). These can be used in class and also at home. They are particularly useful for days out or when there is a change in routine. Some visual timetables have each activity attached with Velcro so once the activity is finished, it is removed from the timetable. This helps to keep things simple and gives the child a visual reminder of how many activities are left to be completed.

As a child gets older, they may prefer not to use pictures or symbols as part of their timetable. Checklists are a useful transition tool and way for them to become more independent with appropriate support tools.

Emotional regulation & expression

Some children (particularly those on the autistic spectrum) may find it hard to express or recognize the feelings they are having. Most children with autism also struggle to understand facial expressions so visual aids are an important way for them to learn what other people are feeling and also for them to demonstrate what emotions they are experiencing.

Behaviour reminders

These are useful to have when out and about or in the classroom. The reminders can be kept on a keychain or lanyard, or in a pocket; anywhere easily accessable. They can be used to remind the child of which behaviours are ‘expected’ (such as standing nicely in a queue at the supermarket) and also contain other communication cards for the child to use when they are too overwhelmed to use verbal communication.

PECS (Picture Exchange Communication System)

PECS is a widely used communication system.

“The Picture Exchange Communication System, or PECS, allows people with little or no communication abilities to communicate using pictures. People using PECS are taught to approach another person and give them a picture of a desired item in exchange for that item. By doing so, the person is able to initiate communication. A child or adult with autism can use PECS to communicate a request, a thought, or anything that can reasonably be displayed or symbolized on a picture card. PECS works well in the home or in the classroom.  PECS was developed in 1984 by Lori Frost, MS, CCC/SLP and Dr. Andrew Bondy. It was first used at the Delaware Autistic Program. The goal of (PECS) is to teach children with autism a fast, self-initiating, functional communication system. PECS begins with the exchange of simple icons but rapidly builds “sentence” structure.” The National Autism Resources.com website

How to help our special needs children: Using Visual Aids

Visual aids are a marvelous way to help children with additional needs. Many children are visual learners, and children who struggle with sensory overload find verbal prompts or reminders difficult to understand when they already have so much information being processed. A visual aid helps them to focus, to understand what is happening next, which behaviours are required of them and also allows them the opportunity to express what they are feeling or to ask for something they need.

This blog post is going to discuss various forms of visual aids which can be used to support learning, to help with routines and to aid children in expressing themselves.

Now, Next & Then Boards

These are particularly useful in supporting children who have autism or learning difficulties. The boards explain clearly what is happening now and in the near future. This can help to settle anxiety and help the child to understand that they need to, for example, wash their hands before having their lunch.

Visual Timetable

Visual timetables are an effective way for children to see exactly what is happening that day, or to help them develop independence in their daily routines (such as getting dressed). These can be used in class and also at home. They are particularly useful for days out or when there is a change in routine. Some visual timetables have each activity attached with Velcro so once the activity is finished, it is removed from the timetable. This helps to keep things simple and gives the child a visual reminder of how many activities are left to be completed.

As a child gets older, they may prefer not to use pictures or symbols as part of their timetable. Checklists are a useful transition tool and way for them to become more independent with appropriate support tools.

Emotional regulation & expression

Some children (particularly those on the autistic spectrum) may find it hard to express or recognize the feelings they are having. Most children with autism also struggle to understand facial expressions so visual aids are an important way for them to learn what other people are feeling and also for them to demonstrate what emotions they are experiencing.

Behaviour reminders

These are useful to have when out and about or in the classroom. The reminders can be kept on a keychain or lanyard, or in a pocket; anywhere easily accessable. They can be used to remind the child of which behaviours are ‘expected’ (such as standing nicely in a queue at the supermarket) and also contain other communication cards for the child to use when they are too overwhelmed to use verbal communication.

PECS (Picture Exchange Communication System)

PECS is a widely used communication system.

“The Picture Exchange Communication System, or PECS, allows people with little or no communication abilities to communicate using pictures. People using PECS are taught to approach another person and give them a picture of a desired item in exchange for that item. By doing so, the person is able to initiate communication. A child or adult with autism can use PECS to communicate a request, a thought, or anything that can reasonably be displayed or symbolized on a picture card. PECS works well in the home or in the classroom.  PECS was developed in 1984 by Lori Frost, MS, CCC/SLP and Dr. Andrew Bondy. It was first used at the Delaware Autistic Program. The goal of (PECS) is to teach children with autism a fast, self-initiating, functional communication system. PECS begins with the exchange of simple icons but rapidly builds “sentence” structure.” The National Autism Resources.com website

Introduction to Sensory Processing

Many children with autism struggle with sensory processing. As shown in a previous article, sensory issues are now part of the diagnostic criteria.

Our senses affect how we respond to the world around us. Many children are either over-sensitive (hyper) or under-sensitive (hypo) and it can be tricky for them to cope with their reactions to what is going on around them.

Below are some examples of different issues that our children may have and just a few tips on how to help them. This is an extensive subject with many research projects underway, so there will be more in depth articles to follow.

  • Taste

Some children may need to sniff their food before tasting it, or they may have a preference for very bland flavours. Similarly, they may prefer textures that are only crunchy, dry, or liquid or they might love spicy food. Trying new foods can be really challenging. My son declared that he hates kiwi fruit and it’s the worst thing in the world; he’s never tried it but he wanted to make sure he didn’t have to. When he did try it later, he decided that he loved it. I still can’t persuade him to try anything that looks too wet or ‘slimy’ (as he puts it).

How To Help: Offer the child a small amount, but don’t force it. If your child has a preference for certain textures or flavours, try to introduce similar items to their diet so it is balanced and healthy.

  • Sound

I’ve found that for most children and adults that I’ve worked with noise is a big trigger for negative behaviour. Many autistic people are sensitive to certain noises or pitches. Sudden noises, such as a police car or fire alarm, can be really distressing. In addition, areas with a lot of background noise- such as a busy cafe or supermarket can cause a build up in anxiety.

How To Help: Ear defenders are a good option and available in many colours and sizes. Alternatively, having an iPod or MP3 player handy when out and about can give the child something auditory to focus on and block out the rest of the noise.

  • Touch

This can be pressure on the body, the feel of clothes, physical contact with other people like hugging or holding hands, brushing teeth, getting their face wet, or experiencing pain. Some of our children may be hypo (under) sensitive to pain or temperature, whilst others may really struggle with something as (apparently) simple as a hug.

How To Help: For a child that is over-sensitive to touch, a verbal or visual warning may be needed. Don’t force the child to hug/cuddle/touch something if they find it too distressing as this could only exacerbate the issues.

For a child that is under-sensitive, then they may like a weighted jacket or blanket, or deep pressure massage.

  • Vision

Children with autism are predominantly visual learners. This means that they take in a lot of information through what they can see. Some colours or sights may be distressing or overstimulating. They may struggle with bright sunshine or the flickering of a strobe light.

How To Help: Sunglasses and window shades in the car- these have been a lifesaver for me and avoided many a meltdown due to the sun being “too shiny”. Try to keep bedroom walls clear of clutter and posters, this will help the child to be settled at bedtime rather than visually over-stimulated.

  • Smell

Smell can be a particularly emotive sense for many people and children with autism are no different. Some scents may be preferred and a source of comfort,  whereas a change in washing powder or air freshener can be very upsetting.

How To Help: Introduce new scents slowly. If a change in behaviour is noticed as a response to a certain smell, it may be best to avoid it.

  • Proprioception

This is basically our sense of position and movement. It’s something that many children with autism and ADHD struggle with as their sense of spatial awareness and connection with their own body can be a bit disjointed. This may manifest as clumsiness and issues with personal space.

  • Vestibular

This ties in very closely with proprioception in that it affects spatial awareness but also incorporates balance. Again, it can manifest as clumsiness or a child who spins or swings quite vigorously in order to get some sensory feedback from that sensation.

How To Help: Sensory circuits and physiotherapy exercises can really make a difference with these issues. There will be a guide to sensory circuits on the website in a few weeks, as it is such an effective way to help with behaviour due to sensory imbalances.

Occupational therapy and physiotherapy can help the child to master their fine motor control and strengthen their core. An occupational therapy assessment would be the first port of call to assess which difficulties the child has and how to help them individually. 

As I said before, this is just a brief introduction to sensory issues and there are more in depth articles on the way. In the meantime, please feel free to e-mail me for advice or further information.

© Peta Slaney, 2020, All Rights Reserved.