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What's the Difference Between Hyperactivity and Impulsivity?
People tend to lump together hyperactivity and impulsivity in ADHD. Are they really that different? Think of hyperactivity as the endless urges to move and talk, and the impulsivity is the affected child's inability to make good decisions.
How can you make a difference in your child's life? It's frustrating dealing with their hyperdrive on a daily basis, but even worse are the pointed comments from relatives, friends and even teachers about "how brave you are" to put up with "all Johnny's shenanigans." This is the time when you need to remind them that attention deficit hyperactivity disorder is a neurobiological condition. Your child has biochemical differences in the brain and is not purposely acting out or misbehaving.
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Your Child's Bill of Rights
What you can do to mitigate the symptoms of hyperactivity and impulsivity in ADHD is to set out a plan that you, your family members, your child's teacher, and even his or hers friends' parents can follow. About 20 years ago, Ruth E. Harris of the Northwest Reading Clinic (with locations in Tigard, Oregon, and Vancouver, Washington) wrote An ADHD Child's Bill of Rights.
Help your child to focus. With all the activity and thought flow taking place, a touch on the arm does the trick to bring their attention back into focus. Ms. Harris states in her original bill that ADHD children respond well to tactile instructions.
Give advanced warning of changes. ADHD children process their daily routines better if they know what's coming. When the regular schedule is disrupted, kids with ADHD have more difficulty adjusting. If you plan on changing the usual stream of events, let them know ahead of time.
Don't rush the ADHD child. Yes, they seem as if they are always rushing---so resist the urge to initiate rushes of your own. When you ask questions, give your ADHD child more time to think through and formulate a response. Ask them to "take a minute to think about it", and then you can add, "Anything else?" If you don't give them this pause, you can expect confusion and dismay.
Offer alternative solutions. When your ADHD child is stuck on solving a problem, suggest a few ideas. Don't feel that your child isn't creative; just realize that they sometimes reach a mental impasse and need a little nudge.
Give feedback. All children need feedback--children stymied by the hyperactivity and impulsivity of ADHD need it more often. Be honest but kind; these children don't want a free pass, they truly want to do well. It's also helpful to decide on a signal between the two of you--a hand wave or a variation of the thumb's up--that will silently express your praise.
Repeat instructions when necessary. Sometimes people think that their ADHD kids are ignoring orders. The truth is that possibly they didn't hear what you said in the first place. If you don't see your child responding, touch their arm and repeat what you said. And smile!
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Help them make good decisions. When your child takes their sibling's toys or sits where they're not supposed to, just tell them to "take a minute and think" (yes, that same phrase again) whether they're doing the right thing. This is another time when a hand signal can help--a tub on the earlobe lets them know that your patience is wearing thin.
Accept the lack of focus. Because of the neurochemical disruptions in the brain, these kids often begin a task enthusiastically but quickly feel ready to move on to something else. If you're dividing up household chores, for example, give your child the one that will let him or her move from room to room.
Repeat your directions--but differently. Often your child will ask you what you've just said. It's not that they don't want to hear your words and follow instructions. It's just that they were thinking of something else; possibly they need you to rephrase your instructions. See if you can use different words, hand gestures, or even draw a picture to illustrate what you want.
Reassure your child of partial successes. Kids affected by hyperactivity and impulsivity in ADHD usually fail to complete a project or chore to 100% perfection. Accept this fact about them and give praise for the parts that they do get right. If you wait for total success before you issue praise, you'll discourage your child.
Stop and smell the flowers. If you realize you've been correcting and redirecting your child all day long, your communication could use a retuning; take a minute to appreciate something they've done well. ADHD kids hear too much criticism, and everybody needs to feel the glow of achievement.
Give rewards. If you've fallen into the habit of rewarding only the child that brings assignments in on schedule without nagging, it's time to spread out the cheer. Tell your child that you know they're trying and how much you appreciate it.
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Summary and Resources
Once you've read Ruth E. Harris's exact "Bill of Rights", you can adapt a version that works in your household. You'll find that it's a little easier to get a grip on your ADHD child's hyperactivity and impulsivity. The Bill of Rights is available in either of the following sources:
Cooley, Myles L. Teaching Kids with Mental Health & Learning Disorders in the Regular Classroom. Chapter on Attention Deficit Hyperactivity Disorder, pp. 135-146. Free Spirit Publishing, 2007.
Cunliffe, A. of St. Augustine's High School, Billington, Lancashire. Adaptation done in 2003. Retrieved at http://www.adhdcumbria.org.uk/An%20ADHD%20child%27s%20bill%20of%20rights.pdf